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 N
13162 1199 National Benefit Fund N C H N N N Y N 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.)
13162 1199 National Benefit Fund N C M 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 N
51028 21st Century Insurance and Financial Services N C MN M N N N N Y For Minnesota only
51028 21st Century Insurance and Financial Services N C MN H N N N N N For Minnesota only
20413 3P Admin N C H N N N N N
20413 3P Admin N C M N N N N Y
74234 8th District Elec N C UT M N N N N N
93044 A & I Benefit Plan Administrators N C M N N N N Y
75240 AAG - American Administrative Group N C M N N N N Y Formerly Icon Benefit Admin
75240 AAG - American Administrative Group N C H N N N N N Formerly Icon Benefit Admin
75240 AAG Benefit Plan Administrators, Inc. N C H N N N N N
75240 AAG Benefit Plan Administrators, Inc. N C M 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 N 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 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.
36273 AARP- Medicare Supplement- UnitedHealthcare Insurance Co N C M 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 N
AHS01 Access Administrators N C M N N N N Y
COACC Access Behavioral Care N C CO M N N N N Y
AMM06 Access Medical Group N C CA M N N N N N
AMM06 Access Santa Monica (Access Medical Group) N C CA M N N N N N
64071 Acclaim N C M N N N N Y
64071 Acclaim N C H N N N N N
MHIPA Acclaim IPA N C CA M N N N N N Accepting for Dates of Service in 2012 only.
MHIPA Acclaim IPA (MHCAC) N C CA M N N N N N Accepting for Dates of Service in 2012 only.
21356 Acclaim Repricing N C H N N N N N
21356 Acclaim Repricing N C M N N N N Y
ABHA1 Accountable Behavioral Health N C OR M N N N Y N 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 N
72467 ACS Benefit Services, Inc. N C M N N N N Y
72467 ACS Benefit Services, Inc. N C H N N N N N
36112 ACS Rewards Administration Center N C H N N N N N
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 N
Administration Concepts, Inc. N C M N N N N Y
38265 Administration Systems Research Corp N C M N N N N Y
38265 Administration Systems Research Corp N C H N N N N N
38265 Administration Systems Research Health Benefits N C H N N N N N
38265 Administration Systems Research Health Benefits N C M N N N N Y
22384 Administrative Concepts Inc N C M N N N N N
59141 Administrative Services Inc N C M 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 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 N
Advanstaff, Inc. N C M N N N N N
68056 Advantage by Bridgeway Health Solutions N C M N N N N Y
68056 Advantage by Bridgeway Health Solutions N C H N N N N N
68056 Advantage by Buckeye Community Health Plan N C H N N N N N
68056 Advantage by Buckeye Community Health Plan N C M N N N N Y
68056 Advantage by Managed Health Services N C M N N N N Y
68056 Advantage by Managed Health Services N C H N N N N N
68056 Advantage by Superior HealthPlan N C H N N N N N
68056 Advantage by Superior HealthPlan N C M N N N N Y
ACIPA Advantage Care IPA N C CA M/H N N N N Y
35209 Advantage Health Solutions N C H N N N N N
NMM01 Advantage Medical Group N C M N N N N Y
ADVTK Advantek Benefit Administrators N C M/H N N N N N
25133 Advantra - Health Assurance - Health America, Inc. N C M/H N N N N Y
25133 Advantra - Kansas City Medicare - Coventry N G KS M N N Y Y Y
25133 Advantra - Kansas City Medicare - Coventry N G KS H N N Y Y 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 H N N N N N Roseville, California
95340 Adventist Health System West N C CA M N N N N Y Roseville, California
65093 Advocate Health Centers N C IL M N N N N Y
65093 Advocate Health Centers N C IL H N N N N N
65093 Advocate Health Partners N C IL M N N N N Y
65093 Advocate Health Partners N C IL H N N N N N
33898 Aegis Security Insurance Company N C PA M/H N N N N N
60054 Aetna N C M N N Y Y Y Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna N C H N N N Y N Pre Enrollment is required for Electronic Remittance Advice.
57604 Aetna Affordable Health Choices (SM) - SRC N C H N N N N N
57604 Aetna Affordable Health Choices (SM) - SRC N C M N N N N Y
60054 Aetna Better Health N C H N N Y Y N Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna Better Health N C M N N Y Y Y Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna Better Health - CT Medicaid N C CT M N N N Y Y Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna Better Health - CT Medicaid N C CT H N N N N N Pre Enrollment is required for Electronic Remittance Advice.
23228 Aetna Better Health – PA Medicaid N C PA M/H N N N N N
60054 Aetna Student Health N C H N N N Y N Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna Student Health N C M N N Y Y Y Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna TX Medicaid N C TX M N N Y Y Y Pre Enrollment is required for Electronic Remittance Advice.
60054 Aetna TX Medicaid N C TX H N N N Y N 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 N
13334 Affinity Health Plan Y C M N 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
13334 Affinity Health Plan Y C H N N N N N 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 N N N N Y
95426 Affordable Benefit Administrators, Inc. N C H N N N N N
34444 AFL - CIO Food & Beverage Dealer�s Trust Fund N C OH M N N N N N
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