Payer List - Professional (CMS1500) & Institutional (UB04)
Payer ID Payer Name State   
Line of Business Type/Model Transactions   
             
  • ENR = Pre Enrollment Required
  • TYP = Type/Model
  • C = Commercial
  • G = Government
  • ST = State
  • LOB = Line Of Business
  • M = Medical / Professional
  • H = Hospital / Institutional
  • RTE1 = Real Time Eligibility for Service Center (270/271)
  • RTE2 = Real Time Eligibility for PM/EHR (270/271)
  • RTS = Real Time Claim Status (276/277)
  • ERA = Electronic Remittance Advice (835)
  • SEC = Secondary (COB)
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Payer IDPayer NameENRTYPSTLOB RTE1 RTE2 RTSERASECNote
27094 Simply Health Care Plan N C M N N N N Y
13162 1199 National Benefit Fund N C M/H N N N Y Y Provider should submit claims with assigned Plan Provider ID as 2 digit suffix is no longer required. Call Renaud Dufresneat (646) 473-6960 for a list of Network ID's.)
13165 1199 SEIU National Benefit & Pension Fund N C M N N N Y N
59069 21st Century Health and Benefits N C M/H N N N N Y
51028 21st Century Insurance and Financial Services N C MN M/H N N N N Y For Minnesota only
20413 3P Admin N C M/H N N N N Y
74234 8th District Elec N C UT M N N N N Y
93044 A & I Benefit Plan Administrators N C M/H N N N N Y
75240 AAG - American Administrative Group N C M/H N N N N Y Formerly Icon Benefit Admin
75240 AAG Benefit Plan Administrators, Inc. N C M/H N N N N Y
87726 AARP - Medicare Complete-Secure Horizons N C M N N N Y Y Pre Enrollment is required for Electronic Remittance Advice. Payer ID valid only for claims with a billing submission address of PO Box 30968 Salt Lake City, UT 84130; PO Box 31361 Salt Lake City, UT 84161; PO Box 31362 Salt Lake City, UT 84161
87726 AARP - Medicare Complete-Secure Horizons N C H N N N Y Y Pre Enrollment is required for Electronic Remittance Advice. Payer ID valid only for claims with a billing submission address of PO Box 30968 Salt Lake City, UT 84130; PO Box 31361 Salt Lake City, UT 84161; PO Box 31362 Salt Lake City, UT 84161
36273 AARP- Medicare Supplement- UnitedHealthcare Insurance Co N C M/H N N N Y Y Payer id valid only if members card matches this payer id. Pre Enrollment is required for Electronic Remittance Advice.
03443 ABRAZO Advantage Health Plan N C M N N N N Y
68055 Absolute Total Care N C SC M N N N N Y
AHS01 Access Administrators N C M/H N N N N Y
COACC Access Behavioral Care N C CO M N N N N Y
AMM06 Access Santa Monica (Access Medical Group) N C CA M N N N N Y
64071 Acclaim N C M N N N N Y
MHIPA Acclaim IPA N C CA M/H N N N Y Y For Claims with DOS starting 1/1/12.
MHIPA Acclaim IPA (MHCAC) N C CA M/H N N N Y Y For Claims with DOS starting 1/1/12.
ABHA1 Accountable Behavioral Health N C OR M N N N Y Y Administered by PH Tech
AHIPA Accountable IPA Y C CA M N N N N N
59140 ACEC N C NV M N N N N Y
72467 ACS Benefit Services, Inc. N C M N N N N Y
36112 ACS Rewards Administration Center N C M N N N N Y
AHC01 ActivHealthCare N C M N N N N N
91173 Adaptis N C H N N N N Y
Administration Concepts, Inc. N C M N N N N Y
38265 Administration Systems Research Corp N C M/H N N N N Y
38265 Administration Systems Research Health Benefits N C M/H N N N N Y
22384 Administrative Concepts Inc N C M N N N N Y
59141 Administrative Services Inc N C M/H N N N N Y
Administrative Services, Inc. N C M N N N N Y
Administrative Services, Inc. N C H N N N N N
Administrative Systems Research Corporation N C H N N N N N
37278 AdminOne N C M/H N N N N Y
TMG01 Advanced Medical Associates N C M N N N N N Testing of each provider is required by payer and done automatically by Office Ally once you start submitting claims for this payer
AMM02 Advanced Medical Management MSI N C CA M/H N N N N Y
Advanstaff, Inc. N C M N N N N N
68056 Advantage by Bridgeway Health Solutions N C M/H N N N N Y
68056 Advantage by Buckeye Community Health Plan N C M/H N N N N Y
68056 Advantage by Managed Health Services N C M/H N N N N Y
68056 Advantage by Superior HealthPlan N C M/H N N N N Y
ACIPA Advantage Care IPA N C CA M/H N N N N Y
NMM01 Advantage Medical Group N C M/H N N N N Y
ADVTK Advantek Benefit Administrators N C M/H N N N N Y
25133 Advantra - Health Assurance - Health America, Inc. N C M/H Y Y N N N
25133 Advantra - Kansas City Medicare - Coventry N G KS M N N Y N N
25133 Advantra - Kansas City Medicare - Coventry N G KS H N N Y N N
Advantra Freedom N C M N N Y Y Y ERA - Requires Pre Enrollment
Advantra Freedom N C H N N Y Y N ERA - Requires Pre Enrollment
95340 Adventist Health System West N C CA M/H N N N N Y Roseville, California
36320 Advocate Health Centers N C M/H N N N N Y
65093 Advocate Health Partners N C IL M/H N N N N Y
33898 Aegis Security Insurance Company N C PA M/H N N N N Y
60054 Aetna N C M Y Y Y Y Y Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna N C H Y Y N Y Y Pre Enrollment is required for Electronic Remittance Advice.
57604 Aetna Affordable Health Choices (SM) - SRC N C M/H N N N N Y
58730 Aetna ASA PPO/Assurant Health (Signature Admin) N C M N N N N N
60054 Aetna Better Health N C M/H Y Y Y Y Y Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna Better Health - CT Medicaid N C CT M/H Y Y N Y Y Pre Enrollment is required for Electronic Remittance Advice.
23228 Aetna Better Health – PA Medicaid N C PA M/H N N N N Y
60054 Aetna Student Health N C H Y Y N Y Y Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna Student Health N C M Y Y Y Y Y Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna TX Medicaid N C TX M Y Y Y Y Y Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna TX Medicaid N C TX H Y Y N Y Y Pre Enrollment is required for Electronic Remittance Advice.
ADOCS Affiliated Doctor's of Orange County (ADOC) N C CA M/H N N N N N
APG01 Affiliated Physicians Group (APG) N C IL M N N N N Y
13334 Affinity Health Plan Y C M/H Y N N N Y For Medicare claims with DOS prior to 1/1/2010 and for Medicaid, Child Health Plus and Family Health Plus claims regardless of DOS. Please contact before sending claims edi@affinityplan.org or 718-794-7592
46594 Affinity Medical Group N C CA M N N N N Y Claim Status reports available at https://affinity-portals.ikaenterprise.com/Default.aspx
13333 Affinity Medicare Advantage N C M N N N N Y For Medicare claims with DOS on or after 1/1/10.
95426 Affordable Benefit Administrators, Inc. N C M/H N N N N Y
13346 AFTRA Health Fund N C NY M/H Y Y Y N Y
37280 AGA N C H N N N N Y
64158 Agency Services Inc. N C M/H N N N N Y Now known as Meritain Health
CAPMN AKM Medical Group (Cap Managements Systems) N C CA M/H N N N N N
06311 Alabama Medical Surgical Associates N C M N N N N N
95327 Alameda Alliance for Health N CA M N N N N Y Please contact Anet Quiambao at 510-747-6153 or aquiambao@alamedaalliance.org to join Alameda Alliance`s EDI network BEFORE submitting claims.
91136 Alaska Children''s Services, Inc. Group #P68 N C M/H N N N N N
92600 Alaska Electrical Health & Welfare Fund N C AK M Y Y N N Y
91136 Alaska Laborers Construction Industry Trust Group # F23 N C AK M/H N N N N Y
91136 Alaska Pipe Trades Local 375 Group # F24 N C AK M/H N N N N Y
91136 Alaska UFCW Health & Welfare Trust Group # F45 N C AK M/H N N N N Y
13550 ALICARE N C M/H N N N N Y
58213 Alignis N C M N N N N Y
37602 All Savers Insurance Company N C M/H N N N N Y
81040 Allegiance Benefit Plan Management Inc. N C M/H N N N N Y
23071 Alliance Behavioral Health Y G NC M N N N Y Y Enrollment required, call 919-651-8500 ext. #2 or email AlphaSupport@AllianceBHC.org. When approved you will be given a 4 digit Provider ID. Send email with your name, Provider ID, Office Ally username and NPI to support@officeally.com . In Subject line put “Alliance BH EDI Approval”
13079 Alliance Healthcare - Stones River Regional IPA N C M/H N N N N Y
HCP01 Alliance IPA N C CA M/H N N N Y Y
20257 Alliance Physicians (High Desert Primary Care Alliance) N C CA M N N N N Y Hesperia, CA
APP01 Alliance Physicians Medical Group N C CA M N N N N Y Now known as Applecare Medical Management. Only for claims with DOS 12-1-10 and forward.
22417 Alliance Physicians of the High Desert N C CA M N N N N Y
52149 Alliance PPO N C MD M/H N N N N Y Now known as OneNet PPO
Alliance, The N C M N N N N N A Wisconsin provider network. Call Dave Sell at 608-210-6656 to pre-enroll
Alliant Health Plan (FCHN) N C WA M N N N N N
58234 Alliant Health Plans of Georgia N C GA M/H N N N N Y
94177 Allied Administrators N C CA M/H N N N N Y San Francisco, California
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