January 28, 2008 Damar Software/Claims Midwest

*** DENTAL PAYER LIST ***
12:14:23 PM
592 Payers On-Line

Payer Name Payer
Id
Card
Type
Additional
Enrollment
(NLH) Netcare Life and Health Insurance
PAR/CLAIMS/COMMERCIAL
66055 Y No
3P ADMIN
PAR/CLAIMS/COMMERCIAL
20413 Y No
A & I BENEFIT PLAN ADMINISTRATORS
PAR/CLAIMS/COMMERCIAL
93044 Y No
A & I Benefit Plan Administrators
PAR/CLAIMS/COMMERCIAL
CX044 Y No
AAG Benefit Plan Administrators, Inc.
PAR/CLAIMS/COMMERCIAL
75240 Y No
AAG-American Administrative Group (Formerly Gallagher Benefit Admin)
PAR/CLAIMS/COMMERCIAL
37283 Y No
AARP
PAR/CLAIMS/COMMERCIAL
AARP claims with a mailing address of PO Box 2059, Mechanicsburg, PA
AARP1 Y No
AARP (administrated by Delta Dental of Washington DC)
PAR/CLAIMS/DELTA DENT
Used for claims with a mailing address of 1 Delta Drive, Mechanicsburg, PA.
52147 Y No
ACS Benefit Services Inc.
PAR/CLAIMS/COMMERCIAL
72468 Y No
ACS Benefit Services a.k.a NC BCBSNC - DBS
PAR/CLAIMS/COMMERCIAL
61474 N No
ACS Benefit Solutions
PAR/CLAIMS/BCBS
61473 Y No
AFLAC
PAR/CLAIMS/COMMERCIAL
58066 Y No
APA Partners, Inc.
PAR/CLAIMS/COMMERCIAL
16140 Y No
ASR Corporation
PAR/CLAIMS/COMMERCIAL
38265 Y No
Acceptius (Benefit Management Inc of MO (BMI)
PAR/CLAIMS/COMMERCIAL
43178 Y No
Acclaim
PAR/CLAIMS/COMMERCIAL
64071 Y No
Activa Benefit Services, LLC/Dental
PAR/CLAIMS/COMMERCIAL
(Formerly Amway Corporation/Dental)
38255 Y No
Adminstrative Services Only
NON/CLAIMS/COMMERCIAL
Addt'l enrollment is not required by the payer. Providers wishing to submit claims electronically must be credentialed with the payer. Please ensure you have successfully processed one paper claim prior to submitting your first electronic claim.
CX076 N No
Advantage Dental Plan, Inc.
PAR/CLAIMS/COMMERCIAL
93524 N No
Adventist Health System West - Roseville, CA
PAR/CLAIMS/COMMERCIAL
95340 Y No
Aetna
PAR/CLAIMS/COMMERCIAL
60054 Y No
Aetna
PAR/ENCOUNTERS/COMMERCIAL
Use this Payer ID for submitting DMO services only.
68246 Y No
Aetna Affordable Health Choices (SM) - SRC
PAR/CLAIMS/COMMERCIAL
57604 Y No
Alaska Children's Services, Inc.
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
Alaska Electrical Health & Welfare Fund
PAR/CLAIMS/COMMERCIAL
92600 Y No
Alaska Laborers Construction Industry Trust
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
Alaska Medicaid
NON/CLAIMS/MEDICAID
CKAK1 Y Yes
Alaska Pipe Trades Local 375
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
Alaska United Food & Commercial Workers Health & Welfare Trust
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
Allen Medical Claims Administrator
NON/CLAIMS/COMMERCIAL
CX016 Y No
Allied Administrators (San Francisco, CA)
PAR/CLAIMS/COMMERCIAL
94177 Y No
Allied Benefit Systems
PAR/CLAIMS/COMMERCIAL
37308 Y No
Altus
PAR/CLAIMS/DELTA DENT
50503 Y No
Amalgamated Life - PA / Alicare
PAR/CLAIMS/COMMERCIAL
13343 Y No
American Administrative Group, Inc (AAG)
PAR/CLAIMS/COMMERCIAL
74223 Y No
American Benefits Management (North Canton, OH)
PAR/CLAIMS/COMMERCIAL
34187 N No
American Medical Security
PAR/CLAIMS/COMMERCIAL
CX001 Y No
American Postal Workers Union Health Plan
PAR/CLAIMS/COMMERCIAL
44444 Y No
Ameritas Life Insurance Corp.
PAR/CLAIMS/COMMERCIAL
47009 Y No
Amway Corporation
PAR/CLAIMS/COMMERCIAL
(Formerly Amway Corporation/Dental)
38255 Y No
Anchor Benefit Consulting, Inc.
PAR/CLAIMS/COMMERCIAL
53085 Y No
Antares Management Solutions
PAR/CLAIMS/COMMERCIAL
34192 N No
Anthem Blue Cross Blue Shield Connecticut
PAR/CLAIMS/BCBS
No FEP Claims. Please send FEP on paper or use Payer ID 06126.
84105 Y No
Arkansas Best Corporation - Choice Benefits
PAR/CLAIMS/COMMERCIAL
75278 Y No
Ascent Benefits
PAR/CLAIMS/COMMERCIAL
CX072 Y No
Assurant Employee Benefits
PAR/CLAIMS/COMMERCIAL
70408 Y No
Assurant Health
PAR/CLAIMS/COMMERCIAL
f.k.a Protective Health
39065 Y No
Assurant, Inc
PAR/CLAIMS/COMMERCIAL
f.k.a. First Fortis Life Insurance
70408 Y No
Athens Area Health Plan Select
PAR/CLAIMS/COMMERCIAL
95691 Y No
Atlantic Dental Inc.
PAR/CLAIMS/COMMERCIAL
CX052 Y Yes
Avesis
PAR/CLAIMS/COMMERCIAL
86098 Y No
BCBS of Rochester New York
NON/CLAIMS/BCBS
CBNYR N No
BCI Administrators, Inc.
PAR/CLAIMS/COMMERCIAL
49153 Y No
Bell Atlantic
PAR/CLAIMS/COMMERCIAL
68241 Y No
Bencomp National Corporation
PAR/CLAIMS/COMMERCIAL
33192 Y No
BeneCare Dental Plans
PAR/CLAIMS/COMMERCIAL
23210 Y No
Benefit Administrative Systems
PAR/CLAIMS/COMMERCIAL
36149 Y No
Benefit Coordinators Corporation (Pittsburgh, PA)
PAR/CLAIMS/COMMERCIAL
Payer ID valid only for claims with a submission address of 111 Ryan Court, Suite 300, Pittsburgh, PA 15205.
25145 Y No
Benefit Management Services, Inc
PAR/CLAIMS/COMMERCIAL
56139 N No
Benefit Plan Administrators Co. (Eau Claire, WI)
PAR/CLAIMS/COMMERCIAL
Payer ID valid only for claims with a billing submission address of P.O. Box 1128, Eau Claire, WI 54702-1128.
39081 Y No
Benefit Planners, Inc.
PAR/CLAIMS/COMMERCIAL
74223 Y No
Benefit Systems & Services, Inc. (BSSI)
PAR/CLAIMS/COMMERCIAL
36342 Y No
Benesys, Inc.
PAR/CLAIMS/COMMERCIAL
58102 Y No
Best Life & Health Insurance Co.
PAR/CLAIMS/COMMERCIAL
95604 Y No
Better Health Plans of South Carolina
PAR/CLAIMS/COMMERCIAL
32006 Y No
Big Lots Associate Benefit Plan (EBMC)
PAR/CLAIMS/COMMERCIAL
CX025 Y No
Blue Care Family Plan
PAR/CLAIMS/COMMERCIAL
Administered by Golden West (Well point)
GWD01 N No
Blue Care Family Plan (BCBS of CT)
PAR/CLAIMS/BCBS
Administered by Anthem of CT
700 Y No
Blue Cross of North Dakota (ND Dental Services)
NON/CLAIMS/BCBS
CX004 Y Yes
Blue Cross Blue Shield of Michigan
NON/CLAIMS/BCBS
CBMI1 Y No
Blue Cross Blue Shield of Montana
PAR/CLAIMS/COMMERCIAL
CBMT1 Y No
Blue Cross Blue Shield of North Carolina
PAR/CLAIMS/BCBS
61473 Y No
Blue Cross Blue of Louisiana
PAR/CLAIMS/BCBS
23739 Y Yes
Blue Cross of Alabama
NON/CLAIMS/BCBS
CBAL1 Y Yes
Blue Cross of Alaska and Washington
PAR/CLAIMS/BCBS
47570 Y No
Blue Cross of Arkansas
NON/CLAIMS/BCBS
CBAR1 Y Yes
Blue Cross of California
PAR/CLAIMS/BCBS
47198 Y No
Blue Cross of Colorado
PAR/CLAIMS/BCBS
No FEP Claims. Please send FEP claims on paper or use Payer ID 06126.
84099 Y No
Blue Cross of Delaware
PAR/CLAIMS/BCBS
53287 Y No
Blue Cross of Georgia
PAR/CLAIMS/BCBS
CBGA1 Y Yes
Blue Cross of Idaho
NON/CLAIMS/BCBS
CBID1 Y Yes
Blue Cross of Illinois
NON/CLAIMS/BCBS
CB621 Y No
Blue Cross of Indiana Anthem
PAR/CLAIMS/BCBS
No FEP Claims. Please send FEP on paper or use Payer ID 06126.
84105 Y No
Blue Cross of Iowa
NON/CLAIMS/BCBS
CBIA2 Y Yes
Blue Cross of Iowa (FEP Claims Only)
NON/CLAIMS/BCBS
CBIA1 Y Yes
Blue Cross of Kansas
NON/CLAIMS/BCBS
CBKS1 Y Yes
Blue Cross of Kentucky Anthem
PAR/CLAIMS/BCBS
No FEP Claims. Please send FEP on paper or use Payer ID 06126.
84105 Y No
Blue Cross of Massachusetts
PAR/CLAIMS/BCBS
CBMA1 Y Yes
Blue Cross of Nebraska
NON/CLAIMS/BCBS
CBNE1 N No
Blue Cross of Nevada
PAR/CLAIMS/BCBS
No FEP claims. Please send FEP claims on paper or use Payer ID 06126.
84101 Y No
Blue Cross of New Jersey
PAR/CLAIMS/BCBS
22099 Y Yes
Blue Cross of New Mexico
NON/CLAIMS/BCBS
CBNM1 N No
Blue Cross of North Carolina Federal Employee Claims
PAR/CLAIMS/BCBS
61472 Y No
Blue Cross of Ohio Anthem
PAR/CLAIMS/BCBS
No FEP Claims. Please send FEP on paper or use Payer ID 06126.
84105 Y No
Blue Cross of Oregon
NON/CLAIMS/BCBS
CB850 Y Yes
Blue Cross of Rhode Island
NON/CLAIMS/BCBS
CB870 Y Yes
Blue Cross of Tennessee
NON/CLAIMS/BCBS
CBTN1 Y Yes
Blue Cross of Texas
NON/CLAIMS/BCBS
CB900 Y Yes
Blue Cross of Wisconsin
PAR/CLAIMS/BCBS
CB950 Y Yes
Blue Shield of Idaho
NON/CLAIMS/BCBS
CBID2 Y Yes
Blue Shield of Pennsylvania Dental Plus
NON/CLAIMS/BCBS
Please contact Dental Electronic Services at (800) 633-5430 to register to send electronic claims.
CBPA2 Y Yes
Boilermakers National Health & Welfare Fund
PAR/CLAIMS/COMMERCIAL
36609 Y No
Boon-Chapman Benefit Administrators, Inc.
PAR/CLAIMS/COMMERCIAL
74237 Y No
Boston University Dental Health Plan (Boston, MA)
PAR/CLAIMS/COMMERCIAL
4210 Y No
Bridgeport LLC
PAR/CLAIMS/COMMERCIAL
Provider ID numbers must be 9 digits and is generally the Providers SSN or TIN. The recipient's ID number is 8 digits in length. Maximum of 13 procedure lines per claim. Pre-determination claims cannot be sent electronically. Claims where Bridgeport LLC
CX028 Y No
Brokers National
PAR/CLAIMS/COMMERCIAL
CX032 Y No
Businessmen's Assurance (BMA)
PAR/CLAIMS/COMMERCIAL
47009 Y No
Butler Benefit
PAR/CLAIMS/COMMERCIAL
42150 Y Yes
C. L. Frates and Company - OSMA Health
PAR/CLAIMS/COMMERCIAL
CX075 Y No
CBCA Administrators
PAR/CLAIMS/COMMERCIAL
55438 Y No
CBCA Administrators (HRM)
PAR/CLAIMS/COMMERCIAL
[Formerly Health Risk Management (HRM)
41170 Y No
CBSA
PAR/CLAIMS/COMMERCIAL
41124 Y No
CDH (Cigna Dental Health)
PAR/ENCOUNTERS/COMMERCIAL
10050 Y Yes
CDO Technologies
PAR/CLAIMS/COMMERCIAL
87065 Y No
CDS Group Health
PAR/CLAIMS/COMMERCIAL
88022 Y No
CHAMPVA - HAC
PAR/CLAIMS/COMMERCIAL
CHAMPVA - HAC is not associated with and does not process claims for TRICARE (formerly CHAMPUS)
84147 Y No
CIGNA
PAR/CLAIMS/COMMERCIAL
62308 Y No
Cadent Administrators
PAR/CLAIMS/COMMERCIAL
33192 Y No
Cadent Underwriters
PAR/CLAIMS/COMMERCIAL
33192 Y No
Cannon Cochran Management Services, Inc. Danville, IL
PAR/CLAIMS/COMMERCIAL
Payer ID for claims with a mailing address of PO Box 1430, Danville, IL 61834
37105 Y No
Cannon Cochran Management Services, Inc. Metairie, LA
PAR/CLAIMS/COMMERCIAL
Payer ID for claims with a mailing address of PO Box 6794, Metairie, LA 70009
71057 Y No
Capital Dental
PAR/CLAIMS/COMMERCIAL
CX037 Y No
CareSource
NON/CLAIMS/MEDICAID
CKOH2 Y No
Carpenter's Health and Welfare Trust Fund of St. Louis
PAR/CLAIMS/COMMERCIAL
25125 Y No
Caterpillar Inc.
PAR/CLAIMS/COMMERCIAL
37060 Y No
Cement Masons & Plasterers Health & Welfare Trust
PAR/CLAIMS/COMMERCIAL
91136 Y No
Central States Health & Welfare Funds
PAR/CLAIMS/COMMERCIAL
36215 Y No
Choice Plus (TRW)
PAR/CLAIMS/COMMERCIAL
68241 Y No
Christian Brothers Services
PAR/CLAIMS/COMMERCIAL
61271 Y No
Citizens Security Life Insurance
PAR/CLAIMS/COMMERCIAL
CX071 Y No
Civil Service Employees Association (CSEA)
PAR/CLAIMS/COMMERCIAL
Provider ID number required. Max of 50 procedure lines per claim. ID number must be 5 characters in lenght, numbers 6 in lenght & ending with a '1' are accepted when '1' is removed. Numbers with leading zeros will have leading zeros omitted. ID numbers c
CX054 Y No
Clarendon's Healthy Kids
PAR/CLAIMS/COMMERCIAL
33192 Y No
CommonWealth Administrative Group
PAR/CLAIMS/COMMERCIAL
37237 Y No
Community Choice Health Plan of Westchester
PAR/CLAIMS/COMMERCIAL
61948 Y No
Community Health Electronic Claims/CHEC/webTPA
PAR/CLAIMS/COMMERCIAL
75261 Y No
Comp - Ohio (Austintown, OH)
PAR/CLAIMS/COMMERCIAL
34177 Y No
CompBenefits
PAR/CLAIMS/COMMERCIAL
CX021 Y No
Companion Life
NON/CLAIMS/COMMERCIAL
77828 Y Yes
Comprehensive Benefits Administrator, Inc.
PAR/CLAIMS/COMMERCIAL
3036 Y No
Connecticut Carpenters Health Fund
PAR/CLAIMS/COMMERCIAL
37307 Y No
Connecticut General (CIGNA)
PAR/CLAIMS/COMMERCIAL
62308 Y No
Consolidated Group Dental
PAR/CLAIMS/COMMERCIAL
61305 Y No
Cook Children's Health Plan
PAR/CLAIMS/COMMERCIAL
CPPCH Y Yes
Cooperative Benefit Administrators (CBA)
PAR/CLAIMS/COMMERCIAL
52132 Y No
CoreSource AZ MN
PAR/CLAIMS/COMMERCIAL
Only for claims where the ""submit claims to address"" on the medical ID card is a CoreSource address in the states of Arizona or Minnesota. For assistance call 800-698-0106.
41045 Y No
CoreSource Little Rock
PAR/CLAIMS/COMMERCIAL
75136 Y No
CoreSource MD PA IL
PAR/CLAIMS/COMMERCIAL
Only for claims where the ""submit claims to address"" on the medical ID card is a CoreSource address in the states of Maryland, Pennsylvania or Illinois. For assistance call 800-689-0106.
35182 Y No
CoreSource NC IN
PAR/CLAIMS/COMMERCIAL
Only for claims where the ""submit claims to address"" on the medical ID card is a CoreSource address in the states of North Carolina or Indiana. For assistance call 800-689-0106.
35180 Y No
CoreSource OH
PAR/CLAIMS/COMMERCIAL
35183 Y No
CoreStar
PAR/CLAIMS/COMMERCIAL
Only for claims where the ""submit claims to address"" on the medical ID card is a CoreSource address in the states of Arizona or Minnesota. For assistance call 800-698-0106.
41045 Y No
Corporate Benefit Services of America
PAR/CLAIMS/COMMERCIAL
Payer ID valid only for claims with a billing submission address of P.O. Box 27267, Minneapolis, MN 55427-0267.
41124 Y No
Corporate Benefits Service, Inc. (NC)
PAR/CLAIMS/COMMERCIAL
56116 Y No
Covenant Administrators, Inc. (Atlanta, GA)
PAR/CLAIMS/COMMERCIAL
58102 Y No
Coventry Health Care National Network (f.k.a. First Health)
PAR/CLAIMS/COMMERCIAL
87043 Y No
Coventry Health Care of Georgia
PAR/CLAIMS/COMMERCIAL
25148 Y No
Creative Plan Administrators
PAR/CLAIMS/COMMERCIAL
37320 N No
Crescent Dental - Meritain Health
PAR/CLAIMS/COMMERCIAL
CX074 Y No
Custom Benefit Administrators
PAR/CLAIMS/COMMERCIAL
39170 Y No
CustomCare
PAR/CLAIMS/COMMERCIAL
68241 Y No
DART MANAGEMENT CORPORATION
PAR/CLAIMS/COMMERCIAL
6172 Y No
DH Evans
PAR/CLAIMS/COMMERCIAL
CX065 Y No
Delaware Medicaid
NON/CLAIMS/MEDICAID
CKDE1 Y Yes
Delta Dental Insurance Co. (DDIC)
PAR/CLAIMS/DELTA DENT
94276 N No
Delta Dental of Alabama (DDIC)
PAR/CLAIMS/DELTA DENT
94276 N No
Delta Dental of Alabama (DDIC)
NON/CLAIMS/DELTA DENT
DDAL1 N No
Delta Dental of Alaska (DDIC)
PAR/CLAIMS/DELTA DENT
94276 N No
Delta Dental of Alaska (DDIC)
PAR/CLAIMS/DELTA DENT
DDAK1 N No
Delta Dental of Arizona
PAR/CLAIMS/DELTA DENT
86027 Y No
Delta Dental of Arkansas
NON/CLAIMS/DELTA DENT
CDAR1 Y No
Delta Dental of California - CA00 Claim Office
PAR/CLAIMS/DELTA DENT
77777 Y No
Delta Dental of California/Tricare Retiree Dental
PAR/CLAIMS/DELTA DENT
CDCA1 Y No
Delta Dental of Colorado
PAR/CLAIMS/DELTA DENT
84056 Y No
Delta Dental of Delaware
PAR/CLAIMS/DELTA DENT
51022 Y No
Delta Dental of Florida (DDIC)
PAR/CLAIMS/DELTA DENT
94276 N No
Delta Dental of Florida (DDIC)
PAR/CLAIMS/DELTA DENT
DDFL1 N No
Delta Dental of Georgia (DDIC)
PAR/CLAIMS/DELTA DENT
94276 N No
Delta Dental of Georgia (DDIC)
PAR/CLAIMS/DELTA DENT
DDGA1 N No
Delta Dental of Idaho
PAR/CLAIMS/DELTA DENT
82029 Y No
Delta Dental of Illinois
PAR/CLAIMS/DELTA DENT
5030 Y No
Delta Dental of Indiana
NON/CLAIMS/DELTA DENT
CDIN1 Y No
Delta Dental of Iowa
NON/CLAIMS/DELTA DENT
CDIA1 Y No
Delta Dental of Kansas
PAR/CLAIMS/DELTA DENT
CDKS1 Y No
Delta Dental of Kentucky
PAR/CLAIMS/DELTA DENT
CDKY1 Y No
Delta Dental of Louisiana (DDIC)
PAR/CLAIMS/DELTA DENT
94276 N No
Delta Dental of Louisiana (DDIC)
PAR/CLAIMS/DELTA DENT
DDLA1 N No
Delta Dental of Maryland (Pennsylvania)
PAR/CLAIMS/DELTA DENT
23166 Y No
Delta Dental of Massachusetts
PAR/CLAIMS/DELTA DENT
4614 Y No
Delta Dental of Michigan
NON/CLAIMS/DELTA DENT
CDMI0 Y No
Delta Dental of Minnesota
NON/CLAIMS/DELTA DENT
CDMN1 Y No
Delta Dental of Mississippi (DDIC)
PAR/CLAIMS/DELTA DENT
94276 N No
Delta Dental of Mississippi (DDIC)
PAR/CLAIMS/DELTA DENT
DDMS1 N No
Delta Dental of Missouri
PAR/CLAIMS/DELTA DENT
43090 Y No
Delta Dental of Montana (DDIC)
PAR/CLAIMS/DELTA DENT
94276 N No
Delta Dental of Montana (DDIC)
PAR/CLAIMS/DELTA DENT
DDMT1 N No
Delta Dental of Nebraska
NON/CLAIMS/DELTA DENT
CDNE1 Y No
Delta Dental of Nevada (DDIC)
PAR/CLAIMS/DELTA DENT
94276 N No
Delta Dental of Nevada (DDIC)
PAR/CLAIMS/DELTA DENT
DDNV1 N No
Delta Dental of New Jersey
PAR/CLAIMS/DELTA DENT
22189 Y No
Delta Dental of New Mexico
PAR/CLAIMS/DELTA DENT
85022 Y No
Delta Dental of New York
PAR/CLAIMS/DELTA DENT
11198 Y No
Delta Dental of North Carolina
PAR/CLAIMS/DELTA DENT
56101 Y No
Delta Dental of North Dakota
NON/CLAIMS/DELTA DENT
CDND1 Y No
Delta Dental of Ohio
NON/CLAIMS/DELTA DENT
CDOH1 Y No
Delta Dental of Oklahoma
NON/CLAIMS/DELTA DENT
CDOK1 Y No
Delta Dental of Oregon (Oregon Dental Service)
NON/CLAIMS/DELTA DENT
CDOR1 Y No
Delta Dental of Pennsylvania
PAR/CLAIMS/DELTA DENT
Incl. Maryland
23166 Y No
Delta Dental of Rhode Island
PAR/CLAIMS/DELTA DENT
5029 Y No
Delta Dental of South Carolina
PAR/CLAIMS/DELTA DENT
43091 Y No
Delta Dental of South Dakota
PAR/CLAIMS/DELTA DENT
54097 Y No
Delta Dental of Tennessee
PAR/CLAIMS/DELTA DENT
CDTN1 Y No
Delta Dental of Texas (DDIC)
PAR/CLAIMS/DELTA DENT
94276 N No
Delta Dental of Texas (DDIC)
PAR/CLAIMS/DELTA DENT
DDTX1 N No
Delta Dental of Utah (DDIC)
PAR/CLAIMS/DELTA DENT
94276 N No
Delta Dental of Virginia
NON/CLAIMS/DELTA DENT
Effective 1-16-07: electronic payer ID for claims printed and mailed to Delta Dental Virginia
CDVA1 N No
Delta Dental of Washington DC
PAR/CLAIMS/DELTA DENT
52147 Y No
Delta Dental of West Virginia
PAR/CLAIMS/DELTA DENT
31096 Y No
Delta Dental of Wisconsin
PAR/CLAIMS/DELTA DENT
39069 Y No
Delta Dental of Wyoming
NON/CLAIMS/DELTA DENT
CDWY1 Y No
Delta Dentoal of Utah (DDIC)
PAR/CLAIMS/DELTA DENT
DDUT1 N No
Delta Health Systems
PAR/CLAIMS/DELTA DENT
94235 Y No
DeltaCare USA
PAR/CLAIMS/COMMERCIAL
f.k.a. PMI
CDCAP Y Yes
DentaQuest
PAR/CLAIMS/DELTA DENT
4356 Y No
Dental Benefit Providers
PAR/CLAIMS/COMMERCIAL
52133 Y No
Dental Care Plus
PAR/CLAIMS/COMMERCIAL
CX035 Y No
Dental Network
NON/CLAIMS/COMMERCIAL
CX034 Y No
DentalComp
NON/CLAIMS/COMMERCIAL
CX017 Y No
Denti-Cal
NON/CLAIMS/MEDICAID
Denti-Cal requires provider enrollment and has special data requirements. Contact Denti-Cal EDI Support at (916) 853-7373.
94146 Y Yes
Diversified Administration Corporation
PAR/CLAIMS/COMMERCIAL
CX040 Y No
Doral Dental Plan of Wisconsin
PAR/CLAIMS/MEDICAID
ADMINISTERED BY DORAL DENTAL. PLEASE SEE DORAL ON THE PAYER ENROLLMENT FORMS LIST.
CX014 Y Yes
Dunn and Associates Benefits Administrators, Inc.
PAR/CLAIMS/COMMERCIAL
35186 Y No
E-V Benefits Management, Inc (Columbus, OH)
PAR/CLAIMS/COMMERCIAL
Now known as Meritain Health.
34159 Y No
EBC, Inc.
PAR/CLAIMS/COMMERCIAL
Payer Id valid only for claims with a billing submission address of Employee Benefit Consultants, located in Broadview Hts, OH, Appleton, WI, Albuquergue, NM, Findlay, OH, Louisville, KY and Milwaukee, WI
37257 N No
EBMS (Employee Benefit Management Services, Inc.)
PAR/CLAIMS/COMMERCIAL
81039 Y No
EBS Benefit Solutions
NON/CLAIMS/COMMERCIAL
CX043 N No
EHI
PAR/CLAIMS/COMMERCIAL
73288 Y No
EMPHESYS
PAR/CLAIMS/COMMERCIAL
73288 Y No
ENH Medical Group IPA
PAR/CLAIMS/COMMERCIAL
36364 Y No
EQUICOR
PAR/CLAIMS/COMMERCIAL
62308 Y No
ES Beveridge and Associates
PAR/CLAIMS/COMMERCIAL
34108 Y No
Empire Blue Cross Blue Shield
NON/CLAIMS/BCBS
CBNY1 N No
Employee Benefit Administrators
NON/CLAIMS/COMMERCIAL
CX012 Y No
Employee Benefit Concepts (Farmington Hills, MI)
PAR/CLAIMS/COMMERCIAL
38241 Y No
Employee Benefit Consultants
PAR/CLAIMS/COMMERCIAL
Payer Id valid only for claims with a billing submission address of Employee Benefit Consultants, located in Broadview Hts, OH, Appleton, WI, Albuquergue, NM, Findlay, OH, Louisville, KY and Milwaukee, WI
37257 N No
Employee Benefit Management Corporation of Ohio
PAR/CLAIMS/COMMERCIAL
CX025 Y No
Employee Benefit Services of Louisiana, Inc (EBS)
PAR/CLAIMS/COMMERCIAL
41198 Y No
Employee Benefits Plan Administration, Inc. (E.B.P.A.)
PAR/CLAIMS/COMMERCIAL
3036 Y No
Employee Group Services
NON/CLAIMS/COMMERCIAL
CX022 Y No
Employee Plans, LLC
PAR/CLAIMS/COMMERCIAL
35112 Y No
Employer Plan Services, Inc.
PAR/CLAIMS/COMMERCIAL
CX031 Y No
Employers Direct Health
PAR/CLAIMS/COMMERCIAL
75232 Y No
Employers Health
PAR/CLAIMS/COMMERCIAL
73288 Y No
Employers Health Insurance
PAR/CLAIMS/COMMERCIAL
73288 Y No
Employers Mutual, Inc.
PAR/CLAIMS/COMMERCIAL
59297 Y No
Enstar Natural Gas
PAR/CLAIMS/COMMERCIAL
91136 Y No
Equitable Plan Services (Oklahoma City, OK)
PAR/CLAIMS/COMMERCIAL
Payer ID valid only for claims with a billing submission address of P.O. Box 720460, Oklahoma City, OK 73172.
73126 Y No
Erin Group Administrators
PAR/CLAIMS/COMMERCIAL
CX046 Y No
Essex Dental Benefits
PAR/CLAIMS/COMMERCIAL
43168 Y No
ExclusiCare
PAR/CLAIMS/COMMERCIAL
71412 Y No
FMH Benefit Services, Inc.
PAR/CLAIMS/COMMERCIAL
48117 Y No
Fed Ex Freight East, Inc.
PAR/CLAIMS/COMMERCIAL
71056 Y No
Federated Mutual Insurance
PAR/CLAIMS/COMMERCIAL
41041 Y No
First Ameritas Life Insurance Corporation of New York
PAR/CLAIMS/COMMERCIAL
72630 Y No
First Care/Southwest Life & Health
PAR/CLAIMS/COMMERCIAL
CX050 Y Yes
First Health
PAR/CLAIMS/COMMERCIAL
87043 Y No
First Reliance Standard (NY Business)
PAR/CLAIMS/COMMERCIAL
13317 Y No
Fiserv Health - Wausau Benefits/Benesight
PAR/CLAIMS/COMMERCIAL
39026 Y No
Fitzharris & Company, Inc.
PAR/CLAIMS/COMMERCIAL
11244 Y No
FlexCare
PAR/CLAIMS/COMMERCIAL
68241 Y No
Florida Power & Light
PAR/CLAIMS/COMMERCIAL
68241 Y No
Foundation Benefit Admin (FBA) - Boon Group
PAR/CLAIMS/COMMERCIAL
BOONG Y No
Fraternal Order of Police - Dental Division (Philadelphia, PA)
PAR/CLAIMS/COMMERCIAL
CX041 N No
Fringe Benefit Management
PAR/CLAIMS/COMMERCIAL
59069 Y No
GHI - New York (Group Health Inc.)
PAR/CLAIMS/COMMERCIAL
13551 Y No
GIC Indemnity Plan
PAR/CLAIMS/COMMERCIAL
80314 Y No
Genworth Life and Health Insurance Company (GLHIC) (Formerly GEGLAC)
PAR/CLAIMS/COMMERCIAL
67814 Y No
Gettysburg
PAR/CLAIMS/COMMERCIAL
CX064 Y No
Gilsbar, Inc.
PAR/CLAIMS/COMMERCIAL
7205 Y No
Golden West Dental
PAR/CLAIMS/COMMERCIAL
GWD01 N No
Government Employees Hospital Association (GEHA)
PAR/CLAIMS/COMMERCIAL
44054 Y No
Great-West Healthcare
PAR/CLAIMS/COMMERCIAL
80705 Y No
Great-West Healthcare (formerly American General)
PAR/CLAIMS/COMMERCIAL
63665 Y No
Group Administrators Ltd.
PAR/CLAIMS/COMMERCIAL
36338 Y No
Group Benefit Administrators (Hendersonville, TN)
PAR/CLAIMS/COMMERCIAL
72153 Y No
Group Benefit Services
NON/CLAIMS/COMMERCIAL
CX011 Y No
Group Dental Services
PAR/CLAIMS/COMMERCIAL
CX036 Y No
Group Health Managers
PAR/CLAIMS/COMMERCIAL
38194 Y No
Group Insurance Service Center, Inc.
PAR/CLAIMS/COMMERCIAL
37276 Y No
Group Link of Indiana
NON/CLAIMS/COMMERCIAL
CX015 Y No
Guardian Life Insurance Company of America
PAR/CLAIMS/COMMERCIAL
64246 Y No
HCS - Health Claims Service (Boise, ID)
PAR/CLAIMS/COMMERCIAL
82018 Y No
HRM Claim Management
PAR/CLAIMS/COMMERCIAL
[Formerly Health Risk Management (HRM)
41170 Y No
Harrington Benefit Services (Columbus, OH)
PAR/CLAIMS/COMMERCIAL
95266 Y No
Harrington Benefit Services (Westerville, OH)
PAR/CLAIMS/COMMERCIAL
75196 Y No
Harrington Benefit Services, Inc. (Oklahoma)
PAR/CLAIMS/COMMERCIAL
59142 Y No
Health Economics Group, Inc.
NON/CLAIMS/COMMERCIAL
CX039 N No
Health Future, LLC.
PAR/CLAIMS/COMMERCIAL
30946 Y No
Health Network America
PAR/CLAIMS/COMMERCIAL
20199 Y No
Health Partners - Jackson, TN
PAR/CLAIMS/COMMERCIAL
62157 Y No
Health Partners of Minnesota - Commercial
NON/CLAIMS/COMMERCIAL
CX009 Y No
Health Partners of Minnesota - Medicaid
NON/CLAIMS/MEDICAID
CX010 Y Yes
Health Plan Services
PAR/CLAIMS/COMMERCIAL
59140 Y No
Health Plan Services of OK
PAR/CLAIMS/COMMERCIAL
59142 Y No
Health Plans Inc.
PAR/CLAIMS/COMMERCIAL
CX055 Y No
Health Resources Incorporated (HRI)
PAR/CLAIMS/COMMERCIAL
CX019 Y No
Health Risk Management
PAR/CLAIMS/COMMERCIAL
[Formerly Health Risk Management (HRM)
41170 Y No
HealthSCOPE Benefits, Inc. (Formerly CNA Health Partners of Arkansas)
PAR/CLAIMS/COMMERCIAL
71063 Y No
Healthcare Management Administrators, Inc.
PAR/CLAIMS/COMMERCIAL
The insured ID number is required. Maximum of 25 procedure lines per claim. Secondary claims cannot be sent electronically. Claim remarks exceeding 80 bytes in length cannot besent electronically.
HMA01 Y No
Healthcomp Inc.
PAR/CLAIMS/COMMERCIAL
85729 N No
Healthplex, Inc.
PAR/CLAIMS/COMMERCIAL
11271 Y No
Healthsource Provident
PAR/CLAIMS/COMMERCIAL
Claims are edited under CIGNA's payer specific edits, Payer ID 62308.
68195 Y No
Hometown Health Plan Nevada
PAR/CLAIMS/COMMERCIAL
88023 Y No
Hoosier Dental (in Indianapolis, Indiana)
NON/CLAIMS/COMMERCIAL
CX015 Y No
Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ)
PAR/CLAIMS/BCBS
22099 Y Yes
Horizon Healthcare of NY
PAR/CLAIMS/BCBS
22099 Y Yes
Hotel Employees & Restaurant Employees Health Trust
PAR/CLAIMS/COMMERCIAL
91136 Y No
Humana
PAR/CLAIMS/COMMERCIAL
73288 Y No
I. E. Shaffer (West Trenton, NJ)
PAR/CLAIMS/COMMERCIAL
22175 Y No
IBI
PAR/CLAIMS/COMMERCIAL
41124 Y No
Illinois Medicaid
PAR/CLAIMS/MEDICAID
ADMINISTERED BY DORAL DENTAL. PLEASE SEE DORAL ON THE PAYER ENROLLMENT FORMS LIST.
CKIL1 Y Yes
Indiana Children's Special Healthcare
NON/CLAIMS/MEDICAID
CX070 Y Yes
Indiana Teamsters Health Benefits Fund (Indianapolis, IN)
PAR/CLAIMS/COMMERCIAL
Formerly known as Local 135 Health Benefits Fund (Indianapolis, IN)
35107 Y No
Insurance Design Administrators
PAR/CLAIMS/COMMERCIAL
13315 Y No
Insurance Management Services (Elko, NV)
PAR/CLAIMS/COMMERCIAL
88006 Y No
Insurers Administrative Corp.
PAR/CLAIMS/COMMERCIAL
Please visit website prior to submitting claims: edihelp.iacusa.com
86304 Y No
Integra Administrative Group (Seaford, DE)
PAR/CLAIMS/COMMERCIAL
Payer ID valid only for claims with a billing submission address of 110 S. Shipley Street, Seaford, DE 19973.
51020 Y No
International Brotherhood of Boilermakers
PAR/CLAIMS/COMMERCIAL
36609 Y No
Iowa Benefits Inc.
PAR/CLAIMS/COMMERCIAL
41124 Y No
JLT Services Corporation
PAR/CLAIMS/COMMERCIAL
14168 Y No
JP Farley Corporation
PAR/CLAIMS/COMMERCIAL
Payer ID valid only for claims with a billing submission address of PO Box 458022, Westlake, OH 44145
34136 Y No
John Alden Life Insurance Co.
PAR/CLAIMS/COMMERCIAL
41099 Y No
Kaiser Permanente Dental Choice
PAR/CLAIMS/COMMERCIAL
Address is P.O. Box 4360, Rockville, MD
CX073 N No
Kanawha Insurance Co.
PAR/CLAIMS/COMMERCIAL
57038 Y No
Kansas City Life
PAR/CLAIMS/COMMERCIAL
CX058 N No
Kansas Medicaid
NON/CLAIMS/MEDICAID
CKKS1 Y Yes
Kempton Company
PAR/CLAIMS/COMMERCIAL
73100 Y No
Kempton Group Administrators
PAR/CLAIMS/COMMERCIAL
73100 Y No
Kentucky Medicaid
NON/CLAIMS/MEDICAID
CKKY1 Y Yes
LBA Health Plans
PAR/CLAIMS/COMMERCIAL
52193 N No
Life Insurance Company of Boston & New York
PAR/CLAIMS/COMMERCIAL
78140 Y No
LifeRe
PAR/CLAIMS/COMMERCIAL
The Insured ID number is required. A maximum of 20 procedure lines per claim.
CX047 Y No
Lincoln Financial Group
PAR/CLAIMS/COMMERCIAL
CX061 Y No
Lincoln National (WI)
PAR/CLAIMS/COMMERCIAL
73288 Y No
Line Construction Benefit Fund
PAR/CLAIMS/COMMERCIAL
LCB01 Y No
Local 135 Health Benefits Fund (Indianapolis, IN)
PAR/CLAIMS/COMMERCIAL
35107 Y No
Louisiana Medicaid (Adult Dental)
NON/CLAIMS/MEDICAID
CKLA2 Y Yes
Louisiana Medicaid (EPSDT)
NON/CLAIMS/MEDICAID
CKLA1 Y Yes
Lovelace Sandia Health Plan
PAR/CLAIMS/COMMERCIAL
90328 Y No
MAMSI
NON/CLAIMS/COMMERCIAL
CX033 N No
MBA Benefit Administrators, Inc. (Salt Lake City, UT)
PAR/CLAIMS/COMMERCIAL
87065 Y No
MBA of Wyoming (Worland, WY)
PAR/CLAIMS/COMMERCIAL
87065 Y No
MBS
PAR/CLAIMS/COMMERCIAL
Formerly MedCost Benefit Services.
56205 Y No
MEDICA of Minnesota
NON/CLAIMS/COMMERCIAL
CX026 Y No
MPEEBT/ MPE Services, Inc.
PAR/CLAIMS/COMMERCIAL
37233 Y No
Machigonne Benefit Administrators
PAR/CLAIMS/COMMERCIAL
Please include the rendering provider information or the name of the dentist in RTE6. Payer will reject the claims without this information.
10317 Y No
Mail Handlers Benefit Plan
PAR/CLAIMS/COMMERCIAL
Also known as Mailhandlers/CAC.
62413 Y No
Managed Health Services - WI State Employees
PAR/CLAIMS/MEDICAID
ADMINISTERED BY DORAL DENTAL. PLEASE SEE DORAL ON THE PAYER ENROLLMENT FORMS LIST.
CX014 Y Yes
Manulife W. J. Sutton Company
PAR/CLAIMS/COMMERCIAL
98010 Y No
Marsh Advantage
PAR/CLAIMS/COMMERCIAL
CX023 Y No
MedBen (Newark, OH)
PAR/CLAIMS/COMMERCIAL
74323 Y No
Medicaid of Alabama
NON/CLAIMS/MEDICAID
CKAL1 Y Yes
Medicaid of Arkansas
NON/CLAIMS/MEDICAID
CKAR1 Y Yes
Medicaid of California
NON/CLAIMS/MEDICAID
Denti-Cal requires provider enrollment and has special data requirements. Contact Denti-Cal EDI Support at (916) 853-7373.
94146 Y Yes
Medicaid of Colorado
NON/CLAIMS/MEDICAID
CKCO1 Y Yes
Medicaid of Connecticut
NON/CLAIMS/MEDICAID
CKCT1 Y Yes
Medicaid of Florida (FL)
NON/CLAIMS/MEDICAID
CKFL1 Y Yes
Medicaid of Georgia (GA)
NON/CLAIMS/MEDICAID
CKGA1 Y Yes
Medicaid of Idaho
NON/CLAIMS/MEDICAID
CKID1 Y Yes
Medicaid of Indiana
NON/CLAIMS/MEDICAID
CKIN1 Y Yes
Medicaid of Iowa
NON/CLAIMS/MEDICAID
CKIA1 Y Yes
Medicaid of Kentucky Region #3 (Doral Dental Services)
PAR/CLAIMS/MEDICAID
ADMINISTERED BY DORAL DENTAL. PLEASE SEE DORAL ON THE PAYER ENROLLMENT FORMS LIST.
CKKY3 Y Yes
Medicaid of Maine
NON/CLAIMS/MEDICAID
CKME1 Y Yes
Medicaid of Maryland, Department of Health and Mental Hygiene
NON/CLAIMS/MEDICAID
CKMD1 N Yes
Medicaid of Massachusetts
PAR/CLAIMS/MEDICAID
ADMINISTERED BY DORAL DENTAL. PLEASE SEE DORAL ON THE PAYER ENROLLMENT FORMS LIST.
CKMA1 Y Yes
Medicaid of Minnesota
NON/CLAIMS/MEDICAID
CKMN1 Y Yes
Medicaid of Missouri
NON/CLAIMS/MEDICAID
CKMO1 Y Yes
Medicaid of Nevada
NON/CLAIMS/MEDICAID
CKNV1 Y Yes
Medicaid of New Hampshire
NON/CLAIMS/MEDICAID
CKNH1 Y Yes
Medicaid of New Jersey
NON/CLAIMS/MEDICAID
CKNJ1 Y Yes
Medicaid of New York (Dental Clinics Only)
NON/CLAIMS/MEDICAID
CKNY2 Y Yes
Medicaid of North Carolina
NON/CLAIMS/MEDICAID
CKNC1 Y Yes
Medicaid of Ohio
NON/CLAIMS/MEDICAID
CKOH1 Y Yes
Medicaid of Oklahoma
NON/CLAIMS/MEDICAID
CKOK1 Y Yes
Medicaid of Oregon
NON/CLAIMS/MEDICAID
CKOR1 Y Yes
Medicaid of Pennsylvania
NON/CLAIMS/MEDICAID
CKPA1 Y Yes
Medicaid of Rhode Island
NON/CLAIMS/MEDICAID
CKRI1 Y Yes
Medicaid of Texas
NON/CLAIMS/MEDICAID
CKTX1 Y Yes
Medicaid of Utah
NON/CLAIMS/MEDICAID
CKUT1 Y Yes
Medicaid of Vermont
NON/CLAIMS/MEDICAID
CKVT1 Y Yes
Medicaid of Washington
NON/CLAIMS/MEDICAID
CKWA1 Y Yes
Medicaid of West Virginia
NON/CLAIMS/MEDICAID
CKWV1 Y Yes
Medicaid of Wisconsin
NON/CLAIMS/MEDICAID
CKWI1 Y Yes
Medicaid of Wyoming
NON/CLAIMS/MEDICAID
CKWY1 Y Yes
Medical Benefit Administrators
NON/CLAIMS/COMMERCIAL
CX024 Y No
Medical Benefits Mutual (Newark, OH)
PAR/CLAIMS/COMMERCIAL
74323 Y No
Medical Mutual of Ohio
PAR/CLAIMS/COMMERCIAL
29076 Y No
Medical Mutual of Ohio (MMO)
PAR/CLAIMS/COMMERCIAL
CB833 Y No
Mercer Administrators
PAR/CLAIMS/COMMERCIAL
CX023 Y No
MetLife
PAR/CLAIMS/COMMERCIAL
(formerly Travelers)
65978 Y No
Methodist First Choice
PAR/CLAIMS/COMMERCIAL
23550 Y No
Michigan Medicaid
NON/CLAIMS/MEDICAID
CKMI1 Y Yes
Michigan Regional Council of Carpenters Employee Benefit Plan (Troy, MI)
PAR/CLAIMS/COMMERCIAL
38238 Y No
Mid-America Associates, Inc.
PAR/CLAIMS/COMMERCIAL
37281 Y No
Mid-West National Life Insurance Co. of Tennessee - Student Insurance
PAR/CLAIMS/COMMERCIAL
Payer ID only valid if the P.O. Box on the Health ID Card matches one of the following P.O. Boxes: P.O. Box 890025, 809067, 809079, 809066, 809036, 809081, Dallas, Tx 75380-9025.
74227 Y No
Midwest Dental Benefits
PAR/CLAIMS/COMMERCIAL
41101 Y No
Mississippi Select Health Care
PAR/CLAIMS/COMMERCIAL
64088 Y No
Missoula County Medical Benefits Plan
PAR/CLAIMS/COMMERCIAL
37275 Y No
Montana Medicaid
NON/CLAIMS/MEDICAID
CKMT1 Y Yes
Motorola
PAR/CLAIMS/COMMERCIAL
36111 Y No
Mountain States Administrative Services (Tucson, AZ)
PAR/CLAIMS/COMMERCIAL
86040 Y No
Mutual of Omaha Insurance Company
PAR/CLAIMS/COMMERCIAL
71412 Y No
Mutually Preferred
PAR/CLAIMS/COMMERCIAL
71412 Y No
N.W. Int Assoc of Machinists & Aerospace Eng Benefits Trust Dental Progam
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
N.W. Ironworkers Health & Security Trust Fund
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
N.W. Roofers & Employers Health & Security Trust Fund
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
N.W. Textile Processors
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
NAA (North America Administrators, L.P.) (Nashville, TN)
PAR/CLAIMS/COMMERCIAL
65085 Y No
NABN (Cleveland, OH)
PAR/CLAIMS/COMMERCIAL
Now known as Meritain Health. Payer ID valid only for claims with billing submission address of P.O. Box 94928, Cleveland, OH 44101-4928 or P.O. Box 89476, Cleveland, OH 44101-5476.
34159 Y No
NC BCBSNC - DBS a.k.a ACS Benefit Services
PAR/CLAIMS/COMMERCIAL
61474 N No
NCAS - Charlotte
PAR/CLAIMS/COMMERCIAL
75191 Y No
NCAS - Fairfax, VA
PAR/CLAIMS/COMMERCIAL
75190 Y No
National Benefit Administrators - New Jersey
PAR/CLAIMS/COMMERCIAL
56175 N No
National Benefit Administrators - North Carolina
PAR/CLAIMS/COMMERCIAL
56176 Y No
National Elevator Industry Benefit Plan (NEIB)
PAR/CLAIMS/COMMERCIAL
CX045 Y No
National Pacific of TX (NCFLEX)
PAR/CLAIMS/COMMERCIAL
CX057 Y No
National Rural Letter Carrier Association
PAR/CLAIMS/COMMERCIAL
71412 Y No
National Telecommunications Cooperative Association
PAR/CLAIMS/COMMERCIAL
52120 Y No
Nationwide Health Plans
PAR/CLAIMS/COMMERCIAL
31417 Y No
Nebraska Medicaid
NON/CLAIMS/MEDICAID
CKNE1 Y Yes
New England Dental Administrators
PAR/CLAIMS/COMMERCIAL
43351 Y No
New Mexico Medicaid
NON/CLAIMS/MEDICAID
CKNM1 Y Yes
New York Medicaid
NON/CLAIMS/MEDICAID
CKNY1 Y Yes
Nippon Life Insurance Company of America
PAR/CLAIMS/COMMERCIAL
81264 Y No
North American Benefits Network ((Cleveland, OH)
PAR/CLAIMS/COMMERCIAL
Now known as Meritain Health. Payer ID valid only for claims with billing submission address of P.O. Box 94928, Cleveland, OH 44101-4928 or P.O. Box 89476, Cleveland, OH 44101-5476.
34159 Y No
North Carolina Health Choice for Children
PAR/CLAIMS/BCBS
61472 Y No
North Dakota Dental Service
NON/CLAIMS/BCBS
CX004 Y Yes
North Dakota Medicaid
NON/CLAIMS/MEDICAID
Additional enrollment is not required by the payer, however, providers wishing to submit claims electronically must submit their ND Medicaid assigned provider ID(s) within the claim. Provider IDs are always 5 digits long and begin with the number 4.
CKND1 Y No
NorthStar Administrators
PAR/CLAIMS/BCBS
47570 Y No
Northeast Delta Dental (ME, NH, VT)
PAR/CLAIMS/DELTA DENT
2027 Y No
Northern Nevada Trust Fund
PAR/CLAIMS/COMMERCIAL
88027 Y No
Northwest Dental Services
PAR/CLAIMS/COMMERCIAL
93525 N No
Northwest Suburban IPA (Illinois)
PAR/CLAIMS/COMMERCIAL
36346 Y No
Nova Healthcare Administrators, Inc. (Grand Island, NY)
PAR/CLAIMS/COMMERCIAL
16644 Y No
Nyhart
PAR/CLAIMS/COMMERCIAL
37299 Y No
OSMA Health - C. L. Frates and Company
PAR/CLAIMS/COMMERCIAL
CX075 Y No
Operating Engineers Locals 302 & 612 Health & Security Fund
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
PA Faculty Health & Welfare
PAR/CLAIMS/COMMERCIAL
CX066 Y No
PDO
PAR/CLAIMS/COMMERCIAL
68241 Y No
PM Group
PAR/CLAIMS/COMMERCIAL
67466 Y No
POMCO
PAR/CLAIMS/COMMERCIAL
Prior to submitting please contact Lynn Wilcox at (315) 432-9171 ext. 255
16111 Y No
Pacific Life & Annuity Company
PAR/CLAIMS/COMMERCIAL
67466 Y No
Pacific Union
PAR/CLAIMS/COMMERCIAL
CX056 Y No
PacificSource Health Plans
PAR/CLAIMS/COMMERCIAL
93029 Y No
Pacificare Dental and Vision HMO
PAR/CLAIMS/COMMERCIAL
CX060 Y No
Pacificare Dental and Vision PPO
PAR/CLAIMS/COMMERCIAL
CX053 Y No
Patient Advocates, LLC
PAR/CLAIMS/COMMERCIAL
10525 Y No
Paul Revere/Provident
PAR/CLAIMS/COMMERCIAL
47009 Y No
Pennsylvania Blue Shield (Camp Hill)
NON/CLAIMS/BCBS
Please contact Dental Electronic Services at (800) 633-5430 to register to send electronic claims.
CB865 Y Yes
Pequot Plus Health Benefit Administrators
PAR/CLAIMS/COMMERCIAL
37121 Y No
Physicians Care Network (Rockford, IL only)
PAR/CLAIMS/COMMERCIAL
36345 Y No
Physicians Health Association of Illinois
PAR/CLAIMS/COMMERCIAL
37136 Y No
Physicians Mutual
PAR/CLAIMS/COMMERCIAL
CX068 Y No
Physicians Plus Insurance, Co., Wisconsin State Employees
PAR/CLAIMS/MEDICAID
ADMINISTERED BY DORAL DENTAL. PLEASE SEE DORAL ON THE PAYER ENROLLMENT FORMS LIST.
CX014 Y Yes
Pinnacle Claims Management, Inc.
PAR/CLAIMS/COMMERCIAL
24735 Y No
Pittman & Associates
PAR/CLAIMS/COMMERCIAL
37224 Y No
Poly America Medical & Dental Benefits Plan
PAR/CLAIMS/COMMERCIAL
32680 Y No
Prairie States Enterprises, Inc.
PAR/CLAIMS/COMMERCIAL
36373 Y No
Preferred Care FL
PAR/CLAIMS/COMMERCIAL
59291 Y No
Preferred Care NC
PAR/CLAIMS/COMMERCIAL
56178 Y No
Preferred Dental Organization
PAR/CLAIMS/COMMERCIAL
68241 Y No
Preferred Health Professionals
PAR/CLAIMS/COMMERCIAL
31478 Y No
Premera Blue Cross
PAR/CLAIMS/BCBS
47570 Y No
Premier Dental Plan of MN
NON/CLAIMS/COMMERCIAL
CX029 Y No
Primary PhysicianCare, Inc.
PAR/CLAIMS/COMMERCIAL
56144 Y No
Prime Care Wisconsin State and Federal Employees and Medicaid
PAR/CLAIMS/MEDICAID
ADMINISTERED BY DORAL DENTAL. PLEASE SEE DORAL ON THE PAYER ENROLLMENT FORMS LIST.
CX014 Y Yes
Principal Financial Group
PAR/CLAIMS/COMMERCIAL
61271 Y No
Principal Life Insurance Co.
PAR/CLAIMS/COMMERCIAL
61271 Y No
Professional Benefit Administrators, Inc. (Oak Brook, IL)
PAR/CLAIMS/COMMERCIAL
Payer ID is valid only for claims with billing submission name, city, and state of Professional Benefit Administrators, Inc., Oak Brook, IL.
36331 Y No
Professional Claim Administrators
PAR/CLAIMS/COMMERCIAL
41163 Y No
Provident Life
PAR/CLAIMS/COMMERCIAL
Claims are edited under CIGNA's payer specific edits, Payer ID 62308.
68195 Y No
Prudential HealthCare & Life Ins. Co of America
PAR/CLAIMS/COMMERCIAL
68241 Y No
Prudential HealthCare HMO for Small Business
PAR/CLAIMS/COMMERCIAL
68241 Y No
Prudential HealthCare Health Maintenance Organization
PAR/CLAIMS/COMMERCIAL
68241 Y No
Prudential HealthCare POS for Small Business
PAR/CLAIMS/COMMERCIAL
68241 Y No
Prudential HealthCare PPO for Small Business
PAR/CLAIMS/COMMERCIAL
68241 Y No
Prudential Healthcare of America Inc.
PAR/CLAIMS/COMMERCIAL
68241 Y No
Prudential for Health
PAR/CLAIMS/COMMERCIAL
68241 Y No
Puget Sound Benefits Trust
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
Puget Sound Electrical Workers Trust
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
Quad Med LLC (Pewaukee, WI)
PAR/CLAIMS/COMMERCIAL
39197 Y No
RBMS, LLC
PAR/CLAIMS/COMMERCIAL
91176 Y No
RMSCO, INC.
PAR/CLAIMS/COMMERCIAL
16117 Y No
Regence Blue Shield
PAR/CLAIMS/BCBS
Unique provider ID required; please call NDEX at (800) 373-1477.
93200 Y Yes
Regence Blue Shield FEP
PAR/CLAIMS/BCBS
Unique provider ID required; please call NDEX at (800) 373-1477. Participating Payer - see last page for definition.
93200 Y Yes
Regence Northwest Health
PAR/CLAIMS/BCBS
Unique provider ID required; please call NDEX at (800) 373-1477. Participating Payer - see last page for definition.
93200 Y Yes
Regency Employee Benefits
PAR/CLAIMS/COMMERCIAL
38221 Y No
Regional Care, Inc.
PAR/CLAIMS/COMMERCIAL
47076 Y No
ReliaStar (now known as CoreStar formerly NW National Life)
PAR/CLAIMS/COMMERCIAL
Only for claims where the ""submit claims to address"" on the medical ID card is a CoreSource address in the states of Arizona or Minnesota. For assistance call 800-698-0106.
41045 Y No
Reliance Standard Life
PAR/CLAIMS/COMMERCIAL
36088 Y No
Reliastar
PAR/CLAIMS/COMMERCIAL
80314 Y No
Rochester Public Schools
PAR/CLAIMS/COMMERCIAL
41625 Y No
Rocky Mountain Life Dental
PAR/CLAIMS/COMMERCIAL
84102 Y No
SAMBA
PAR/CLAIMS/COMMERCIAL
37259 Y No
SC BCBS
NON/CLAIMS/BCBS
38520 Y Yes
SCAN Long Term Care
PAR/CLAIMS/COMMERCIAL
20460 Y No
SET SEG
PAR/CLAIMS/COMMERCIAL
38610 Y No
SafeGuard PPO
PAR/CLAIMS/COMMERCIAL
CX030 Y No
Safeguard HMO
PAR/CLAIMS/COMMERCIAL
CX048 N No
Scan Health Plan Arizona
PAR/CLAIMS/COMMERCIAL
73172 N No
Seabury & Smith
PAR/CLAIMS/COMMERCIAL
CX023 Y No
Select Administrative Services (SAS)
PAR/CLAIMS/COMMERCIAL
64088 Y No
SelectCare (Coca Cola)
PAR/CLAIMS/COMMERCIAL
68241 Y No
Self Insured Benefit Administrators (Clearwater, FL)
PAR/CLAIMS/COMMERCIAL
Payer ID valid only for claims with a submission address of 18167 US Highway 19 North, Suite 300, Clearwater, FL 33764.
59111 Y No
Self Insured Services Company (SISCO)
PAR/CLAIMS/COMMERCIAL
CX020 Y No
Self-Funded Plans, Inc.
PAR/CLAIMS/COMMERCIAL
34131 Y No
Self-Insured Dental Services (SIDS)
NON/CLAIMS/COMMERCIAL
Addt'l enrollment is not required by the payer. Providers wishing to submit claims electronically must be credentialed with the payer. Please ensure you have successfully processed one paper claim prior to submitting your first electronic claim.
CX076 N No
Self-Insured Plans, LLC
PAR/CLAIMS/COMMERCIAL
36404 Y No
Sentry Life Insurance Company
PAR/CLAIMS/COMMERCIAL
39033 Y No
Serentas Dental Care Solutions
PAR/CLAIMS/COMMERCIAL
CX038 Y No
Shenandoah Life Insurance
PAR/CLAIMS/COMMERCIAL
CX067 Y No
Sierra Health Services
PAR/CLAIMS/COMMERCIAL
76342 Y No
Sinclair Health Plan
PAR/CLAIMS/COMMERCIAL
84076 Y No
South Carolina Medicaid
NON/CLAIMS/MEDICAID
CKSC1 Y Yes
South Central Preferred - PPO York, PA (IHS Gateway Payer)
PAR/CLAIMS/COMMERCIAL
23266 Y No
South Point Hotel & Casino
PAR/CLAIMS/COMMERCIAL
35227 Y No
SouthWest Benefits
PAR/CLAIMS/COMMERCIAL
CX051 N No
Southern Benefit Services
PAR/CLAIMS/COMMERCIAL
37318 Y No
Southern Group Administrators
PAR/CLAIMS/COMMERCIAL
56131 Y No
Southwestern Bell
PAR/CLAIMS/COMMERCIAL
68241 Y No
Southwestern Bell Exec
PAR/CLAIMS/COMMERCIAL
68241 Y No
Southwestern Bell Exec. - Custom Care
PAR/CLAIMS/COMMERCIAL
68241 Y No
Southwestern Bell Exec. - Southwestern Bell
PAR/CLAIMS/COMMERCIAL
68241 Y No
Spina Bifida - VA HAC
PAR/CLAIMS/COMMERCIAL
84147 Y No
St. Therese Physician Association
PAR/CLAIMS/COMMERCIAL
37116 Y No
Standard Insurance Company (NY)
PAR/CLAIMS/COMMERCIAL
13411 Y No
Standard Insurance Company (OR)
PAR/CLAIMS/COMMERCIAL
93024 Y No
StarHRG
PAR/CLAIMS/COMMERCIAL
59225 Y No
State of Texas Dental Plan
PAR/CLAIMS/COMMERCIAL
57254 Y No
Stoner and Associates (Cincinnati, OH)
PAR/CLAIMS/COMMERCIAL
31121 Y No
Student Insurance
PAR/CLAIMS/COMMERCIAL
Payer ID only valid if the P.O. Box on the Health ID Card matches one of the following P.O. Boxes: P.O. Box 890025, 809067, 809079, 809066, 809036, 809081, Dallas, Tx 75380-9025.
74227 Y No
Student Insurance - Mid-West National Life Insurance Co. of Tenessee
PAR/CLAIMS/COMMERCIAL
Payer ID only valid if the P.O. Box on the Health ID Card matches one of the following P.O. Boxes: P.O. Box 890025, 809067, 809079, 809066, 809036, 809081, Dallas, Tx 75380-9025.
74227 Y No
Student Insurance - The MEGA Life & Health Insurance Company
PAR/CLAIMS/COMMERCIAL
Payer ID only valid if the P.O. Box on the Health ID Card matches one of the following P.O. Boxes: P.O. Box 890025, 809067, 809079, 809066, 809036, 809081, Dallas, Tx 75380-9025.
74227 Y No
Sun Life Financial
PAR/CLAIMS/COMMERCIAL
47009 Y No
Superior Dental Care - Preferred Plan
PAR/CLAIMS/COMMERCIAL
31117 Y No
TDC
PAR/CLAIMS/COMMERCIAL
73288 Y No
TR Paul Inc.
PAR/CLAIMS/COMMERCIAL
37230 Y No
Texas CHIP Dental Services
PAR/CLAIMS/COMMERCIAL
Providers wishing to submit claims electronically must be credentialed and register for EDI. Providers should call the Texas CHIP Provider Call Center at 866-561-5891.
CPPTX Y Yes
The Chesapeake Life Insurance Company - Student Insurance
PAR/CLAIMS/COMMERCIAL
Payer ID only valid if the P.O. Box on the Health ID Card matches one of the following P.O. Boxes: P.O. Box 890025, 809067, 809079, 809066, 809036, 809081, Dallas, Tx 75380-9025.
74227 Y No
The Dental Companies
PAR/CLAIMS/COMMERCIAL
73288 Y No
The Dental Concern
PAR/CLAIMS/COMMERCIAL
73288 Y No
The Loomis Company - TPA Wyomissing, PA (IHS Gateway Payer)
PAR/CLAIMS/COMMERCIAL
23223 Y No
The MEGA Life & Health Insurance Company - Insurance Center
PAR/CLAIMS/COMMERCIAL
59226 Y No
The MEGA Life & Health Insurance Company - Student Insurance
PAR/CLAIMS/COMMERCIAL
Payer ID only valid if the P.O. Box on the Health ID Card matches one of the following P.O. Boxes: P.O. Box 890025, 809067, 809079, 809066, 809036, 809081, Dallas, Tx 75380-9025.
74227 Y No
The Union Labor Life Insurance Company
PAR/CLAIMS/COMMERCIAL
Payer ID valid for claims with a submission address of P.O. Box 61593, King of Prussia, PA 19406.
13142 Y No
Three Rivers Health Plans, Inc
PAR/CLAIMS/COMMERCIAL
Now known as Unison Health Plan
25175 Y Yes
Time Insurance Company
PAR/CLAIMS/COMMERCIAL
f.k.a Fortis Insurance Company
39065 Y No
Total Admin. Inc. / North Broward Hospital District
PAR/CLAIMS/COMMERCIAL
37314 Y No
Tower Life Insurance Co.
PAR/CLAIMS/COMMERCIAL
69493 Y No
TransSmile
NON/CLAIMS/COMMERCIAL
CX069 Y No
Travelers (now MetLife)
PAR/CLAIMS/COMMERCIAL
65978 Y No
Trigon Blue Cross Blue Shield - Colorado Dental Office
PAR/CLAIMS/BCBS
Claims Mailing Address: Trigon Dental Admin, 555 Middle Creek Parkway, MS 400, Colorado Springs, CO 80921.
84103 Y No
Trigon Blue Cross of Virginia (Anth BCBS-VA/ BCBS Anth-VA formerly Trigon)
NON/CLAIMS/BCBS
CB923 Y Yes
Trusteed Plans Service Corporation
PAR/CLAIMS/COMMERCIAL
91078 Y No
Trustmark Insurance Company
PAR/CLAIMS/COMMERCIAL
61425 Y No
UICI - Administrators - State of Nevada
PAR/CLAIMS/COMMERCIAL
Accepting claims only for the State of Nevada.
74223 Y No
UNICARE
PAR/CLAIMS/COMMERCIAL
80314 Y No
Unified Group Services
PAR/CLAIMS/COMMERCIAL
35198 Y No
Uniform Medical Plan/Harrington Benefit Services
PAR/CLAIMS/COMMERCIAL
75243 Y No
Union Security Insurance Company
PAR/CLAIMS/COMMERCIAL
f.k.a. Fortis Benefits Insurance Company
70408 Y No
Unison Health Plan/Three Rivers
PAR/CLAIMS/COMMERCIAL
25175 Y Yes
United Concordia (Tricare Dental Plan)
NON/CLAIMS/COMMERCIAL
For enrollment, please call United Concordia Electronic Services Division at (800) 633-5430.
CX002 Y Yes
United Concordia - Fee for Service
NON/CLAIMS/COMMERCIAL
For enrollment, please call United Concordia Electronic Services Division at (800) 633-5430.
CX007 Y Yes
United Concordia Dental Plus
NON/CLAIMS/COMMERCIAL
For enrollment, please call United Concordia Electronic Services Division at (800) 633-5430.
CX013 Y Yes
United Healthcare of River Valley
PAR/CLAIMS/COMMERCIAL
formerly John Deere Health Care/Heritage National Healthplan
95378 Y Yes
United Medical Resources
PAR/CLAIMS/COMMERCIAL
33108 Y No
United States Life Insurance Company
PAR/CLAIMS/COMMERCIAL
13545 Y No
United of Omaha
PAR/CLAIMS/COMMERCIAL
71412 Y No
Upper Peninsula Health Group (TPA)
PAR/CLAIMS/COMMERCIAL
37324 Y No
VA Fee Basis Programs
PAR/CLAIMS/COMMERCIAL
12116 Y No
Varian Health Care Plan
PAR/CLAIMS/COMMERCIAL
68241 Y No
Virginia Medicaid
PAR/CLAIMS/MEDICAID
ADMINISTERED BY DORAL DENTAL. PLEASE SEE DORAL ON THE PAYER ENROLLMENT FORMS LIST.
CKVA1 Y Yes
Washington Dental Service
PAR/CLAIMS/COMMERCIAL
91062 Y No
Washington Employers Trust
PAR/CLAIMS/COMMERCIAL
37294 Y No
Washington State Council of County & City Employees Dental Trust
PAR/CLAIMS/COMMERCIAL
Please enter Group Number when submitting claims.
91136 Y No
Waterstone Benefit Administrators
PAR/CLAIMS/COMMERCIAL
73155 Y No
Wellpoint Dental
PAR/CLAIMS/BCBS
47198 Y No
Wells Fargo Third Party Administrators, Inc.
PAR/CLAIMS/COMMERCIAL
87815 Y No
Western Grower's Assurance Trust
PAR/CLAIMS/COMMERCIAL
24735 Y No
Western Grower's Insurance Company
PAR/CLAIMS/COMMERCIAL
24735 Y No
William C. Earhart
PAR/CLAIMS/COMMERCIAL
93050 N No
Worksite Benefit Services, LLC
PAR/CLAIMS/COMMERCIAL
20333 Y No
deneX/SG
PAR/CLAIMS/COMMERCIAL
CX049 Y No
webTPA/Community Health Electronic Claims/CHEC
PAR/CLAIMS/COMMERCIAL
75261 Y No