August 06, 2010 Damar Software/Claims Midwest

*** DENTAL PAYER LIST ***
06:09:31 PM
693 Payers On-Line

Payer Name Payer
Id
Card
Type
Additional
Enrollment
21st Century Health and Benefits
PAR/CLAIMS/
59069 No
21st Century Insurance and Financial Services
NON/CLAIMS/
Electronic Payer ID for claims printed and mailed to payer.
51028 No
3P Admin
PAR/CLAIMS/
20413 No
A & I Benefit Plan Administrators
PAR/CLAIMS/
93044 No
A & I Benefit Plan Administrators
PAR/CLAIMS/
CX044 No
AAG Benefit Plan Administrators, Inc.
PAR/CLAIMS/
75240 No
AARP
PAR/CLAIMS/
AARP Claims with a mailing address of PO Box 2059, Mechanicsburg, PA
AARP1 No
ACS Benefit Services Inc.
PAR/CLAIMS/
f.k.a. ACS Consulting Services, Inc.
72468 No
ACS Benefit Services a.k.a. NCBCBS - DBS
PAR/CLAIMS/
61474 No
ACS Benefit Solutions
PAR/CLAIMS/
61473 No
AFLAC
PAR/CLAIMS/
58066 No
AFLAC - NY Plan
PAR/CLAIMS/
This plan also shares the same mailing address as payer ID 58066 and the only difference between the plans is that the insured ID for the NY based plan begins with ""PN"" as ""PNxxxxxx"" (followed by 6+ digits)
52080 No
APA Partners, Inc.
PAR/CLAIMS/
16140 No
ASR Corporation
PAR/CLAIMS/
38265 No
AcClaims
PAR/CLAIMS/
64071 No
Acceptius (Benefit Management Inc of MO (BMI)
PAR/CLAIMS/
43178 No
Access Dental
PAR/CLAIMS/
via Performance Health Technology
CX097 No
Activa Benefit Services, LLC/Dental
PAR/CLAIMS/
(Formerly Amway Corporation/Dental)
38255 No
Adminstrative Services Only, Inc.
PAR/CLAIMS/
Additional enrollment is not required by the payer, however, providers wishing to submit Claims electronically must be credentialed with the payer. Please ensure you have successfully process one paper Claims with the payer prior to submitting your firs
CX076 No
Advantage Dental Plan, Inc.
PAR/CLAIMS/
93524 No
Advantage by Superior
PAR/CLAIMS/
CPPSA No
Advantek Benefit Administrators
PAR/CLAIMS/
83077 No
Adventist Health System West - Roseville, CA
PAR/CLAIMS/
95340 No
Aetna
PAR/CLAIMS/
60054 No
Aetna
PAR/ENCOUNTERS/
Use this Payer ID for submitting DMO services only.
68246 No
Aetna Affordable Health Choices (SM) - SRC
PAR/CLAIMS/
57604 No
Affordable Benefits Admin.
PAR/CLAIMS/
95426 No
Alaska Children's Services, Inc.
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
Alaska Electrical Health & Welfare Fund
PAR/CLAIMS/
92600 No
Alaska Laborers Construction Industry Trust
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
Alaska Medicaid
NON/CLAIMS/
CKAK1 No
Alaska Pipe Trades Local 375
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
Alaska United Food & Commercial Workers Health & Welfare Trust
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
Allen Medical Claims Administrator
NON/CLAIMS/
CX016 No
Allied Administrators (San Francisco, CA)
PAR/CLAIMS/
94177 No
Allied Benefit Systems
PAR/CLAIMS/
37308 No
Altus
PAR/CLAIMS/
50503 No
Amalgamated Life - PA Alicare
PAR/CLAIMS/
13343 No
American Administrators (West Des Moines, IA)
PAR/CLAIMS/
Please check the Insured ID card to verify the Payer ID before submitting claims. If you have questions, please contact Provider Relsations at 800-456-4584.
42112 No
American Administrators dba Select Benefit Administrators (West Des Moines, IA)
PAR/CLAIMS/
Please check the Insured ID card to verify the Payer ID before submitting claims. If you have questions, please contact Provider Relsations at 800-456-4584.
42137 No
American Benefit Corporation
PAR/CLAIMS/
Only limited plans may be sent electronically. Group name is required with one of the following plan names: Sheet Metal, Berekely, Boone, Carpenter, Cabell, Clarksbur, Doodridge, Hancock, Harrison, Marion, Monongalia, Mingo, Mineral, Morgan, Nicholas,
CX084 No
American Benefits Management (North Canton, OH)
PAR/CLAIMS/
34187 No
American Medical Security
PAR/CLAIMS/
A United Healthcare Payer
CX001 No
American Postal Workers Union Health Plan
PAR/CLAIMS/
44444 No
Americas TPA
PAR/CLAIMS/
41178 No
Amerihealth Administrators
PAR/CLAIMS/
54763 No
Ameritas Life Insurance Corp.
PAR/CLAIMS/
47009 No
Amway Corporation
PAR/CLAIMS/
(Formerly Amway Corporation/Dental)
38255 No
Anchor Benefit
PAR/CLAIMS/
53085 No
Antares Management Solutions
PAR/CLAIMS/
34192 No
Anthem Blue Cross Blue Shield Connecticut
PAR/CLAIMS/
No FEP Claims. Please send FEP on paper or use Payer ID 06126.
84105 No
Anthem Blue Cross CA
PAR/CLAIMS/
f.k.a. Blue Cross of California; Wellpoint
47198 No
Arizona Medicaid
/ELIGIBILIT/
Yes/No Response
CKAZ1 No
Arkansas Best Corporation - Choice Benefits
PAR/CLAIMS/
75278 No
Ascent Benefits
PAR/CLAIMS/
CX072 No
Association Benefit Plan
PAR/CLAIMS/
Formerly payer ID 62413. Now part of Coventry Consolidate payer ID. Including Combined Government Health Plan & Contract Health Insurance Plan.
25133 No
Association Benefit Plan
/ERA/
Including Combined Government Health Plan & Contract Health Insurance Plan
62413 No
Assurant Employee Benefits
PAR/CLAIMS/
70408 No
Assurant Health
PAR/CLAIMS/
f.k.a. Protective Life
39065 No
Assurant, Inc,
PAR/CLAIMS/
f.k.a. First Fortis Life Insurance
70408 No
Athens Area Health Plan Select
PAR/CLAIMS/
95691 No
Atlantic Dental Inc. (ADI) - Commercial
PAR/CLAIMS/
CX085 No
Atlantic Dental Inc. (ADI) - Medicaid
PAR/CLAIMS/
ADMINISTERED BY DORAL DENTAL
CX052 No
Automated Group Administration, Inc. (AGA)
PAR/CLAIMS/
37280 No
Avesis
PAR/CLAIMS/
86098 No
BCBS of Rochester New York
NON/CLAIMS/
CBNYR No
BCBS of Western NY
PAR/CLAIMS/
CBNYW No
BCI Administrators, Inc.
PAR/CLAIMS/
49153 No
BS of Northeastern NY
PAR/CLAIMS/
CBNYE No
Bell Atlantic
PAR/CLAIMS/
68241 No
BeneCare Dental Plans
PAR/CLAIMS/
23210 No
Benefit Adminstrative Systems
PAR/CLAIMS/
36149 No
Benefit Coordinators Corporation (Pittsburgh, PA)
PAR/CLAIMS/
Payer ID valid only for Claims with a submission address of 111 Ryan Court, Suite 300, Pittsburgh, PA 15205.
25145 No
Benefit Inc.
NON/CLAIMS/
R7003 No
Benefit Management Services of MS
PAR/CLAIMS/
37212 No
Benefit Management Services, Inc.
PAR/CLAIMS/
56139 No
Benefit Management, Inc. of KS
PAR/CLAIMS/
48611 No
Benefit Plan Administrators Co. (Eau Claire, WI)
PAR/CLAIMS/
Payer ID valid only for Claims with a billing submission address of P.O. Box 1128, Eau Claire, WI 54702-1128.
39081 No
Benefit Plan Administrators_VA
PAR/CLAIMS/
37118 No
Benefit Systems & Services, Inc. (BSSI)
PAR/CLAIMS/
36342 No
Benesys, Inc.
PAR/CLAIMS/
58102 No
Best Life & Health Insurance Co.
PAR/CLAIMS/
95604 No
Better Health Plans of South Carolina
PAR/CLAIMS/
32006 No
Blue BeneFit Administrators of MA
PAR/CLAIMS/
a.k.a. CBA Blue
03036 No
Blue Care Family Plan
PAR/CLAIMS/
Administered by Golden West (Well point)
GWD01 No
Blue Care Family Plan (BCBS of CT)
PAR/CLAIMS/
00700 No
Blue Cross of North Dakota (ND Dental Services)
NON/CLAIMS/
CX004 No
Blue Cross Blue Shield of Kansas City MO
PAR/CLAIMS/
47171 No
Blue Cross Blue Shield of Louisiana
PAR/CLAIMS/
23739 No
Blue Cross Blue Shield of Michigan
NON/CLAIMS/
CBMI1 No
Blue Cross Blue Shield of Montana
PAR/CLAIMS/
CBMT1 No
Blue Cross Blue Shield of North Carolina
PAR/CLAIMS/
61473 No
Blue Cross of Alabama
NON/CLAIMS/
CBAL1 No
Blue Cross of Alaska and Washington
PAR/CLAIMS/
47570 No
Blue Cross of Arkansas
NON/CLAIMS/
Mailing address for claims: Dental Claims Administrator PO Box 1206 Elk Grove Village IL 60009-1206.
CBAR1 No
Blue Cross of Colorado
PAR/CLAIMS/
84099 No
Blue Cross of Delaware
PAR/CLAIMS/
53287 No
Blue Cross of Georgia
PAR/CLAIMS/
CBGA1 No
Blue Cross of Idaho
NON/CLAIMS/
CBID1 No
Blue Cross of Illinois
NON/CLAIMS/
CB621 No
Blue Cross of Indiana Anthem
PAR/CLAIMS/
No FEP Claims. Please send FEP on paper or use Payer ID 06126.
84105 No
Blue Cross of Iowa
NON/CLAIMS/
CBIA2 No
Blue Cross of Iowa (FEP Claims Only)
NON/CLAIMS/
FEP Claims only
CBIA1 No
Blue Cross of Kansas
NON/CLAIMS/
CBKS1 No
Blue Cross of Kentucky Anthem
PAR/CLAIMS/
No FEP Claims. Please send FEP on paper or use Payer ID 06126.
84105 No
Blue Cross of Massachusetts
PAR/CLAIMS/
CBMA1 No
Blue Cross of Nebraska
PAR/CLAIMS/
CBNE1 No
Blue Cross of Nevada
PAR/CLAIMS/
No FEP Claims. Please send FEP Claims on paper or use Payer ID 06126.
84101 No
Blue Cross of New Mexico
NON/CLAIMS/
CBNM1 No
Blue Cross of North Carolina Federal Employee Claims
PAR/CLAIMS/
61472 No
Blue Cross of Ohio Anthem
PAR/CLAIMS/
No FEP Claims. Please send FEP on paper or use Payer ID 06126.
84105 No
Blue Cross of Oregon
NON/CLAIMS/
CB850 No
Blue Cross of Rhode Island
NON/CLAIMS/
CB870 No
Blue Cross of Tennessee
NON/CLAIMS/
CBTN1 No
Blue Cross of Texas
NON/CLAIMS/
CB900 No
Blue Cross of Wisconsin
PAR/CLAIMS/
CB950 No
Blue Shield of Idaho
NON/CLAIMS/
CBID2 No
Blue Shield of Pennsylvania Dental Plus
NON/CLAIMS/
CBPA2 No
Boilermakers National Health & Welfare Fund
PAR/CLAIMS/
36609 No
Boon Chapman Benefit Administrators
PAR/CLAIMS/
74237 No
Boulder Administration Services
PAR/CLAIMS/
20381 No
Bridgeport LLC
PAR/CLAIMS/
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 Claims. Pre-determination Claims cannot be sent electronically. Claims where Bridgeport LLC
CX028 No
Brokers National
PAR/CLAIMS/
CX032 No
Broward Health
PAR/CLAIMS/
37314 No
Butler Benefits
PAR/CLAIMS/
42150 No
C. L. Frates
PAR/CLAIMS/
CX075 No
CBA Blue
PAR/CLAIMS/
f.k.a. Comprehensive Benefits Administrators, Inc.
03036 No
CBCA Administrators
PAR/CLAIMS/
55438 No
CBCA Administrators (HRM)
PAR/CLAIMS/
[Formerly Health Risk Management (HRM)
41170 No
CDH (Cigna Dental Health)
PAR/ENCOUNTERS/
10050 No
CDO Technologies
PAR/CLAIMS/
87065 No
CDS Group Health
PAR/CLAIMS/
88022 No
CHAMPVA - HAC
PAR/CLAIMS/
CHAMPVA - HAC is not associated with and does not process Claims for TRICARE (formerly CHAMPUS)
84147 No
CIGNA
PAR/CLAIMS/
62308 No
CIGNA Voluntary
PAR/CLAIMS/
59225 No
Capital Dental
PAR/CLAIMS/
CX037 No
Capitol Administrators
PAR/CLAIMS/
68011 No
Capitol Dental
PAR/CLAIMS/
via Performance Health Technology
CX095 No
CareSource
NON/CLAIMS/
CKOH2 No
Carolina Summit Healthcare
PAR/CLAIMS/
56195 No
Carpenter's Health and Welfare Trust Fund of St. Louis
PAR/CLAIMS/
25125 No
Carpenters Health and Welfare Fund of Philadelphia
PAR/CLAIMS/
CX101 No
Caterpillar Inc.
NON/CLAIMS/
A United Healthcare Payer
37060 No
Cement Masons & Plasterers Health & Welfare Trust
PAR/CLAIMS/
91136 No
Central Reserve Life
PAR/CLAIMS/
34097 No
Central States Health and Welfare Fund
PAR/CLAIMS/
36215 No
Chesterfield Resources, Inc. (Uniontown, OH)
PAR/CLAIMS/
a.k.a. Salvation Army
34154 No
Children of Women Vietnam Veterans - VA HAC
PAR/CLAIMS/
84147 No
Choice Plus (TRW)
PAR/CLAIMS/
68241 No
Christian Brothers Services
PAR/CLAIMS/
61271 No
Citizens Security Life
PAR/CLAIMS/
CX071 No
Civil Service Employees Association (CSEA)
PAR/CLAIMS/
Provider ID number required. Max of 50 procedure lines per Claims. 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
CX054 No
Coastal Administrative Services
PAR/CLAIMS/
77052 No
Community Claims Administration
PAR/CLAIMS/
26231 No
Community Health Electronic Claims/CHEC/webTPA
PAR/CLAIMS/
75261 No
Comp - Ohio (Austintown, OH)
PAR/CLAIMS/
34177 No
CompBenefits
PAR/CLAIMS/
CX021 No
Companion Life
NON/CLAIMS/
77828 No
Connecticut Carpenters Health Fund
PAR/CLAIMS/
37307 No
Connecticut General (CIGNA)
PAR/CLAIMS/
62308 No
Consociate Dansig, Inc
PAR/CLAIMS/
37135 No
Consolidated Group Dental
PAR/CLAIMS/
61305 No
Cook Group Health Plan
PAR/CLAIMS/
35149 No
Cooperative Benefit Administrators (CBA)
PAR/CLAIMS/
52132 No
Core Management Resources Group
PAR/CLAIMS/
58231 No
CoreSource AZ MN
PAR/CLAIMS/
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 No
CoreSource Little Rock
PAR/CLAIMS/
75136 No
CoreSource MD PA IL
PAR/CLAIMS/
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 No
CoreSource NC IN
PAR/CLAIMS/
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 No
CoreSource OH
PAR/CLAIMS/
35183 No
CoreStar
PAR/CLAIMS/
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 No
Coresource Little Rock
/ELIGIBILIT/
Yes/No Response
75136 No
Coresource MD PA IL
/ELIGIBILIT/
Yes/No Response
35182 No
Coresource NC IN
/ELIGIBILIT/
Yes/No Response
35180 No
Coresource OH
/ELIGIBILIT/
Yes/No Response
35183 No
Corporate Benefits Service, Inc. (NC)
PAR/CLAIMS/
56116 No
Covenant Administrators, Inc. (Atlanta, GA)
PAR/CLAIMS/
58102 No
Coventry Health Care
PAR/CLAIMS/
Coventry's consolidated payer ID. Claims for all of these legacy payer IDs may now be submitted to this payer ID. 87043 and 62413
25133 No
Coventry Health Care National Network
PAR/CLAIMS/
Formerly payer ID 87043. Now part of Coventry Consolidated payer ID.
25133 No
Coventry Health Care National Network (f.k.a. First Health)
/ERA/
87043 No
Coventry Health Care of Georgia
PAR/CLAIMS/
25148 No
Coventry HealthCare
/ERA/
f.k.a. Mail Handlers / CAC
62413 No
Coventry Missouri
PAR/CLAIMS/
Formerly payer ID 87043. Now part of Coventry Consolidated payer ID.
25133 No
Creative Plan Administrators
PAR/CLAIMS/
37320 No
Crescent Dental - Meritain Health
PAR/CLAIMS/
CX074 No
Custom Design Benefits Inc. of OH
PAR/CLAIMS/
82056 No
CustomCare
PAR/CLAIMS/
68241 No
DBP - Americhoice (NJ/PA) / UHC (MS)
/ELIGIBILIT/
A United Healthcare Payer. Yes/No Response
52133 No
DH Evans
PAR/CLAIMS/
CX065 No
Dart Management Corp.
PAR/CLAIMS/
06172 No
DeCare Dental Health Insurance
NON/CLAIMS/
07035 No
Delaware Medicaid
NON/CLAIMS/
CKDE1 No
Delta Dental Insurance Co. (DDIC) - All Payers
PAR/CLAIMS/
94276 No
Delta Dental of Alabama (DDIC)
PAR/CLAIMS/
DDAL1 No
Delta Dental of Alaska (DDIC)
PAR/CLAIMS/
DDAK1 No
Delta Dental of Arizona
PAR/CLAIMS/
86027 No
Delta Dental of Arkansas
PAR/CLAIMS/
CDAR1 No
Delta Dental of California - CA00 Claims Office
PAR/CLAIMS/
77777 No
Delta Dental of California/Tricare Retiree Dental
PAR/CLAIMS/
CDCA1 No
Delta Dental of Colorado
PAR/CLAIMS/
84056 No
Delta Dental of Delaware
PAR/CLAIMS/
51022 No
Delta Dental of Florida (DDIC)
PAR/CLAIMS/
DDFL1 No
Delta Dental of Georgia (DDIC)
PAR/CLAIMS/
DDGA1 No
Delta Dental of Idaho
PAR/CLAIMS/
82029 No
Delta Dental of Illinois
PAR/CLAIMS/
05030 No
Delta Dental of Indiana
NON/CLAIMS/
CDIN1 No
Delta Dental of Iowa
PAR/CLAIMS/
CDIA1 No
Delta Dental of Kansas
PAR/CLAIMS/
CDKS1 No
Delta Dental of Kentucky
PAR/CLAIMS/
CDKY1 No
Delta Dental of Louisiana (DDIC)
PAR/CLAIMS/
DDLA1 No
Delta Dental of Maryland (Pennsylvania)
PAR/CLAIMS/
23166 No
Delta Dental of Massachusetts
PAR/CLAIMS/
04614 No
Delta Dental of Michigan
NON/CLAIMS/
CDMI0 No
Delta Dental of Minnesota
NON/CLAIMS/
CDMN1 No
Delta Dental of Mississippi (DDIC)
PAR/CLAIMS/
DDMS1 No
Delta Dental of Missouri
PAR/CLAIMS/
43090 No
Delta Dental of Montana (DDIC)
PAR/CLAIMS/
DDMT1 No
Delta Dental of Nebraska
NON/CLAIMS/
CDNE1 No
Delta Dental of Nevada (DDIC)
PAR/CLAIMS/
DDNV1 No
Delta Dental of New Jersey
PAR/CLAIMS/
22189 No
Delta Dental of New Mexico
PAR/CLAIMS/
85022 No
Delta Dental of New York
PAR/CLAIMS/
11198 No
Delta Dental of North Carolina
PAR/CLAIMS/
56101 No
Delta Dental of North Dakota
NON/CLAIMS/
CDND1 No
Delta Dental of Ohio
NON/CLAIMS/
CDOH1 No
Delta Dental of Oklahoma
NON/CLAIMS/
CDOK1 No
Delta Dental of Oregon (Oregon Dental Service)
NON/CLAIMS/
CDOR1 No
Delta Dental of Pennsylvania
PAR/CLAIMS/
Incl. Maryland
23166 No
Delta Dental of Rhode Island
PAR/CLAIMS/
05029 No
Delta Dental of South Carolina
PAR/CLAIMS/
43091 No
Delta Dental of South Dakota
PAR/CLAIMS/
54097 No
Delta Dental of Tennessee
PAR/CLAIMS/
CDTN1 No
Delta Dental of Texas (DDIC)
PAR/CLAIMS/
DDTX1 No
Delta Dental of Utah (DDIC)
PAR/CLAIMS/
DDUT1 No
Delta Dental of Virginia
NON/CLAIMS/
Effective 1-16-07: electronic payer ID for Claims printed and mailed to Delta Dental Virginia
CDVA1 No
Delta Dental of Washington DC
PAR/CLAIMS/
52147 No
Delta Dental of West Virginia
PAR/CLAIMS/
31096 No
Delta Dental of Wisconsin
PAR/CLAIMS/
39069 No
Delta Dental of Wyoming
PAR/CLAIMS/
CDWY1 No
Delta Health Systems
PAR/CLAIMS/
94235 No
DeltaCare USA Claims
PAR/CLAIMS/
f.k.a. PMI
DDCA2 No
DeltaCare USA Enounters
PAR/ENCOUNTERS/
f.k.a. PMI
DDCA3 No
DentaQuest
PAR/CLAIMS/
04356 No
DentaQuest - Government
PAR/CLAIMS/
ADMINISTERED BY DORAL DENTAL
CX052 No
DentaQuest - Government
PAR/CLAIMS/
ADMINISTERED BY DORAL DENTAL
CKIL1 No
DentaQuest - Government
PAR/CLAIMS/
ADMINISTERED BY DORAL DENTAL
CKKY3 No
DentaQuest - Government
PAR/CLAIMS/
ADMINISTERED BY DORAL DENTAL
CX014 No
Dental Benefit Providers
PAR/CLAIMS/
A United Healthcare Payer
52133 No
Dental Care Plus
PAR/CLAIMS/
CX035 No
Dental Network of MD
NON/CLAIMS/
CX034 No
Dental Select
NON/CLAIMS/
CX093 No
DentalComp
NON/CLAIMS/
CX017 No
Denti-Cal
NON/CLAIMS/
Denti-Cal requires provider enrollment and has special data requirements. Contact Denti-Cal EDI Support at (916) 853-7373.
94146 No
Deseret Mutual Benefit Administrators
NON/CLAIMS/
CX089 No
District of Columbia Medicaid
NON/CLAIMS/
CKDC1 No
Diversified Administration Corporation
PAR/CLAIMS/
CX040 No
Doral Dental Plan of Wisconsin
PAR/CLAIMS/
ADMINISTERED BY DORAL DENTAL
CX014 No
E-V Benefits Management, Inc (Columbus, OH)
PAR/CLAIMS/
34159 No
EBC, Inc.
PAR/CLAIMS/
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 No
EBMC
PAR/CLAIMS/
CX025 No
EBMS (Employee Benefit Management Services, Inc.)
PAR/CLAIMS/
81039 No
EBS Benefit Solutions
NON/CLAIMS/
CX043 No
EHI
PAR/CLAIMS/
73288 No
EMIA (Educators Mutual Insurance Assoc)
NON/CLAIMS/
Prior to accepting claims electronically EMIA requires the provider to call 801-262-7476 or 800-662-5850. Providers should advise EMIA that they will be submitting their claims through Emdeon Business Services, Inc. UHIN submitter ID HT000214-001.
CX079 No
EMPHESYS
PAR/CLAIMS/
73288 No
EQUICOR
PAR/CLAIMS/
62308 No
ES Beveridge and Associates
PAR/CLAIMS/
34108 No
Empire Blue Cross Blue Shield
NON/CLAIMS/
CBNY1 No
Employee Benefit Administrators
NON/CLAIMS/
CX012 No
Employee Benefit Concepts (Farmington Hills, MI)
PAR/CLAIMS/
38241 No
Employee Benefit Consultants
PAR/CLAIMS/
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 No
Employee Benefit Management Corp (EBMC)
PAR/CLAIMS/
CX025 No
Employee Benefit Services of Louisiana, Inc (EBS)
PAR/CLAIMS/
41198 No
Employee Benefits Plan Administration, Inc. (E.B.P.A.)
PAR/CLAIMS/
a.k.a. CBA Blue
03036 No
Employee Group Services
NON/CLAIMS/
CX022 No
Employee Plans, LLC
PAR/CLAIMS/
35112 No
Employer Plan Services, Inc.
PAR/CLAIMS/
CX031 No
Employers Direct Health
PAR/CLAIMS/
75232 No
Employers Health
PAR/CLAIMS/
73288 No
Employers Health Insurance
PAR/CLAIMS/
73288 No
Employers Mutual, Inc.
PAR/CLAIMS/
59297 No
Enstar Natural Gas
PAR/CLAIMS/
91136 No
Equitable Plan Services (Oklahoma City, OK)
PAR/CLAIMS/
Payer ID valid only for Claims with a billing submission address of P.O. Box 720460, Oklahoma City, OK 73172.
73126 No
Essex Dental Benefits
PAR/CLAIMS/
43168 No
ExclusiCare
PAR/CLAIMS/
71412 No
FMH Benefit Services, Inc.
PAR/CLAIMS/
48117 No
Family Dental
PAR/CLAIMS/
via Performance Health Technology
CX096 No
Federated Mutual Insurance
PAR/CLAIMS/
41041 No
First Administrators, Inc.
NON/CLAIMS/
FAMR1 No
First Ameritas Life Insurance Corporation of New York
PAR/CLAIMS/
72630 No
First Care/Southwest Life & Health
PAR/CLAIMS/
CX050 No
First Continental Life & Accident Insurance
PAR/CLAIMS/
CX090 No
First Dental Health of CA
PAR/CLAIMS/
CX086 No
First Health
/ERA/
87043 No
First Reliance Standard Life Ins. Co. (NY Business)
PAR/CLAIMS/
13317 No
Fitzharris & Company, Inc.
PAR/CLAIMS/
11244 No
Flex Compensation
NON/CLAIMS/
R7004 No
FlexCare
PAR/CLAIMS/
68241 No
Florida Power & Light
PAR/CLAIMS/
68241 No
Foreign Service Benefit Plan
PAR/CLAIMS/
Formerly payer ID 62413. Now part of Coventry Consolidated payer ID. Including AFSPA Staff Plan.
25133 No
Foreign Service Benefit Plan
/ERA/
Including AFSPA Staff Plan
62413 No
Formula Card Dental
NON/CLAIMS/
LX050 No
Foundation Benefit Admin (FBA) - Boon Group
PAR/CLAIMS/
BOONG No
Fox Everett, Inc.
PAR/CLAIMS/
64069 No
Fraternal Order of Police - Dental Division (Philadelphia, PA)
PAR/CLAIMS/
CX041 No
Fringe Benefit Management
PAR/CLAIMS/
59069 No
GHI - New York (Group Health Inc.)
PAR/CLAIMS/
13551 No
GIC Indemnity Plan
PAR/CLAIMS/
80314 No
Gerber Life Insurance Company - Student Insurance
PAR/CLAIMS/
A United Healthcare Payer. 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, 809027 Dallas, Tx 75380-9025.
74227 No
Gettysburg
PAR/CLAIMS/
CX064 No
Gilsbar, Inc.
PAR/CLAIMS/
07205 No
Golden West Dental
PAR/CLAIMS/
GWD01 No
Government Employees Hospital Association (GEHA)
PAR/CLAIMS/
44054 No
Great-West Healthcare
PAR/CLAIMS/
f.k.a. General American
63665 No
Great-West Healthcare
PAR/CLAIMS/
80705 No
Group Administrators Ltd.
PAR/CLAIMS/
36338 No
Group Benefit Services
NON/CLAIMS/
CX011 No
Group Dental Services
PAR/CLAIMS/
CX036 No
Group Insurance Service Center, Inc
PAR/CLAIMS/
37276 No
Group Link of Indiana
NON/CLAIMS/
CX015 No
Group and Pension Administrators
PAR/CLAIMS/
48143 No
Guaranty (DINA)
PAR/CLAIMS/
CX090 No
Guardian Life Insurance Company of America
PAR/CLAIMS/
64246 No
H & A Administrators
NON/CLAIMS/
LX059 No
HCS - Health Claims Service (Boise, ID)
PAR/CLAIMS/
82018 No
HRM Claims Management
PAR/CLAIMS/
[Formerly Health Risk Management (HRM)
41170 No
Harvard Pilgrim Health Care (HPHC) - Student Insurance
PAR/CLAIMS/
A United Healthcare Payer. 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, 809027 Dallas, Tx 75380-9025.
74227 No
Health Choice Arizona
PAR/CLAIMS/
62179 No
Health Economics Group, Inc.
NON/CLAIMS/
CX039 No
Health Future LLC
PAR/CLAIMS/
30946 No
Health Network America
PAR/CLAIMS/
20199 No
Health Partners - Jackson, TN
PAR/CLAIMS/
62157 No
Health Partners of Minnesota - Commercial
NON/CLAIMS/
CX009 No
Health Partners of Minnesota - Medicaid
NON/CLAIMS/
CX010 No
Health Plan Services
PAR/CLAIMS/
59140 No
Health Plans Inc.
PAR/CLAIMS/
CX055 No
Health Resources Incorporated (HRI)
PAR/CLAIMS/
CX019 No
Health Risk Management
PAR/CLAIMS/
[Formerly Health Risk Management (HRM)
41170 No
HealthSCOPE Benefits, Inc.(Formerly CNA Health Partners of Arkansas)
PAR/CLAIMS/
71063 No
HealthSmart Benefit Solutions
PAR/CLAIMS/
37283 No
Healthcare Management Administrators, Inc.
PAR/CLAIMS/
The insured ID number is required. Maximum of 25 procedure lines per Claims. Secondary Claims cannot be sent electronically. Claims remarks exceeding 80 bytes in length cannot besent electronically.
HMA01 No
Healthcomp, Inc.
PAR/CLAIMS/
85729 No
Healthfirst of Austin
PAR/CLAIMS/
75289 No
Healthnow of Northeastern NY
PAR/CLAIMS/
CBNYE No
Healthnow of Western NY
PAR/CLAIMS/
CBNYW No
Healthplex, Inc.
PAR/CLAIMS/
11271 No
Healthsource Provident
PAR/CLAIMS/
Claims are edited under CIGNA's payer specific edits, Payer ID 62308.
62308 No
Hometown Health Plans Nevada
PAR/CLAIMS/
88023 No
Hoosier Dental (in Inidanapolis, Indiana)
NON/CLAIMS/
CX015 No
Horizon Healthcare Dental Services
PAR/CLAIMS/
22099 No
Hotel Employees & Restaurant Employees Health Trust
PAR/CLAIMS/
91136 No
Humana
PAR/CLAIMS/
73288 No
I. E. Shaffer (West Trenton, NJ)
PAR/CLAIMS/
22175 No
Illinois Medicaid
PAR/CLAIMS/
ADMINISTERED BY DORAL DENTAL
CKIL1 No
Indiana Childrens Special Healthcare
NON/CLAIMS/
CX070 No
Indiana Teamsters Health Benefits Fund (Indianapolis, IN)
PAR/CLAIMS/
Formerly known as Local 135 Health Benefits Fund (Indianapolis, IN)
35107 No
Insurance Design Administrators
PAR/CLAIMS/
13315 No
Insurers Administrative Corp.
PAR/CLAIMS/
Please visit website prior to submitting Claims: edihelp.iacusa.com
86304 No
Integra Administrative Group (Seaford, DE)
PAR/CLAIMS/
Payer ID valid only for Claims with a billing submission address of 110 S. Shipley Street, Seaford, DE 19973.
51020 No
International Brotherhood of Boilermakers
PAR/CLAIMS/
36609 No
JP Farley Corporation
PAR/CLAIMS/
Payer ID valid only for Claims with a billing submission address of PO Box 458022, Westlake, OH 44145
34136 No
John Alden Life Insurance Co.
PAR/CLAIMS/
41099 No
John Morrell Company - AHBPA
PAR/CLAIMS/
38310 No
Kaiser Permanente Dental Choice
PAR/CLAIMS/
Payer ID valid only for claims with a billing submission address of PO Box 4360 Rockville, MD
CX073 No
Kanawha Insurance Co.
PAR/CLAIMS/
57038 No
Kansas City Life
PAR/CLAIMS/
CX058 No
Kansas Medicaid
NON/CLAIMS/
CKKS1 No
Kempton Company
PAR/CLAIMS/
73100 No
Kempton Group Administrators
PAR/CLAIMS/
73100 No
Kentucky Medicaid
NON/CLAIMS/
CKKY1 No
LBA Healthplans
PAR/CLAIMS/
52193 No
Lake County Physicians Association
PAR/CLAIMS/
37116 No
Liberty Dental Plan
PAR/CLAIMS/
CX083 No
Life Insurance Company of Boston & New York
PAR/CLAIMS/
78140 No
Lifewise Health Plan of Oregon
PAR/CLAIMS/
93093 No
Lincoln Financial Group
PAR/CLAIMS/
f.k.a. Jefferson Pilot
CX061 No
Lincoln National (WI)
PAR/CLAIMS/
73288 No
Line Construction Benefit Fund
PAR/CLAIMS/
LCB01 No
Local 135 Health Benefits Fund (Indianapolis, IN)
PAR/CLAIMS/
35107 No
Louisiana Medicaid (Adult Dental)
NON/CLAIMS/
CKLA2 No
Louisiana Medicaid (EPSDT)
NON/CLAIMS/
CKLA1 No
MAMSI
NON/CLAIMS/
CX033 No
MBA Benefit Administrators, Inc. (Salt Lake City, UT)
PAR/CLAIMS/
87065 No
MBA of Wyoming (Worland, WY)
PAR/CLAIMS/
87065 No
MBS
PAR/CLAIMS/
Formerly MedCost Benefit Services.
56205 No
MCNA DENTAL
PAR/CLAIMS/
65030 No
MEDICA of Minnesota
NON/CLAIMS/
CX026 No
MN Power
NON/CLAIMS/
R7005 No
MPEEBT/ MPE Services, Inc.
PAR/CLAIMS/
37233 No
MVP Health Care
/ELIGIBILIT/
Yes/No Response
14165 No
Machigonne Benefit Administrators
PAR/CLAIMS/
Please include the rendering provider information or the name of the dentist in RTE6. Payer will reject the Claims without this information.
10317 No
Mail Handlers Benefit Plan
PAR/CLAIMS/
Formerly payer ID 62413. Now part of Coventry Consolidated payer ID. Including AFSPA Staff Plan.
25133 No
Mail Handlers Benefit Plan
/ERA/
a.k.a. Mailhandlers / CAC
62413 No
Manulife W. J. Sutton Company
PAR/CLAIMS/
98010 No
Marsh Advantage
PAR/CLAIMS/
CX023 No
Masonry Institute/Administrative D.C. No. 1 Welfare Fund
PAR/CLAIMS/
CX098 No
MedBen (Newark, OH)
PAR/CLAIMS/
74323 No
Medicaid of Alabama
NON/CLAIMS/
CKAL1 No
Medicaid of Arkansas
NON/CLAIMS/
CKAR1 No
Medicaid of California
NON/CLAIMS/
Denti-Cal requires provider enrollment and has special data requirements. Contact Denti-Cal EDI Support at (916) 853-7373.
94146 No
Medicaid of Colorado
NON/CLAIMS/
CKCO1 No
Medicaid of Connecticut
NON/CLAIMS/
CKCT1 No
Medicaid of Florida (FL)
NON/CLAIMS/
CKFL1 No
Medicaid of Georgia (GA)
NON/CLAIMS/
CKGA1 No
Medicaid of Idaho
NON/CLAIMS/
CKID1 No
Medicaid of Indiana
NON/CLAIMS/
CKIN1 No
Medicaid of Iowa
NON/CLAIMS/
CKIA1 No
Medicaid of Kentucky Region #3 (Doral Dental Services)
PAR/CLAIMS/
ADMINISTERED BY DORAL DENTAL
CKKY3 No
Medicaid of Maine
NON/CLAIMS/
CKME1 No
Medicaid of Maryland, DePartment of Health and Mental Hygiene
NON/CLAIMS/
MD Med. claims with DOS prior to 7-1-09 use CKMD1. MD Med. claims with DOS 7-1-09 and later use CX014. MD Med. no longer requires addit'l enrollment for ECS. CX014 does require credentialing.
CKMD1 No
Medicaid of Massachusetts
PAR/CLAIMS/
ADMINISTERED BY DORAL DENTAL.
CKMA1 No
Medicaid of Minnesota
NON/CLAIMS/
CKMN1 No
Medicaid of Missouri
NON/CLAIMS/
CKMO1 No
Medicaid of Nevada
/ELIGIBILIT/
Yes/No Response
CKNV1 No
Medicaid of New Hampshire
NON/CLAIMS/
CKNH1 No
Medicaid of New Jersey
NON/CLAIMS/
CKNJ1 No
Medicaid of New York (Dental Clinics Only)
NON/CLAIMS/
CKNY2 No
Medicaid of North Carolina
NON/CLAIMS/
CKNC1 No
Medicaid of Ohio
NON/CLAIMS/
CKOH1 No
Medicaid of Oklahoma
NON/CLAIMS/
CKOK1 No
Medicaid of Oregon
NON/CLAIMS/
CKOR1 No
Medicaid of Pennsylvania
NON/CLAIMS/
CKPA1 No
Medicaid of Rhode Island
NON/CLAIMS/
CKRI1 No
Medicaid of Texas
NON/CLAIMS/
CKTX1 No
Medicaid of Utah
NON/CLAIMS/
CKUT1 No
Medicaid of Vermont
NON/CLAIMS/
CKVT1 No
Medicaid of Washington
NON/CLAIMS/
CKWA1 No
Medicaid of West Virginia
NON/CLAIMS/
CKWV1 No
Medicaid of Wisconsin
NON/CLAIMS/
CKWI1 No
Medicaid of Wyoming
NON/CLAIMS/
CKWY1 No
Medical Benefit Administrators
NON/CLAIMS/
CX024 No
Medical Benefits Mutual (Neward, OH)
PAR/CLAIMS/
74323 No
Medical Mutual of Ohio (MMO)
PAR/CLAIMS/
29076 No
Medical Mutual of Ohio (MMO)
PAR/CLAIMS/
CB833 No
Medical Network of Colorado Springs
PAR/CLAIMS/
84600 No
Mercer Administrators
PAR/CLAIMS/
CX023 No
Meritain Health Minneapolis
PAR/CLAIMS/
41124 No
MetLife
PAR/CLAIMS/
(formerly Travelers)
65978 No
Methodist First Choice
PAR/CLAIMS/
23550 No
Michigan Medicaid
NON/CLAIMS/
CKMI1 No
Michigan Regional Council of Carpenters Employees Benefit Plan (Troy, MI)
PAR/CLAIMS/
38238 No
Mid-America Associates, Inc.
PAR/CLAIMS/
37281 No
Mid-West National Life Insurance Co. of Tennessee - Student Instuance
PAR/CLAIMS/
A United Healthcare Payer. 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, 809027 Dallas, Tx 75380-9025.
74227 No
Midwest Dental Benefits
PAR/CLAIMS/
41101 No
Mississippi BCBS
NON/CLAIMS/
CBMS1 No
Mississippi Medicaid
NON/CLAIMS/
CKMS1 No
Mississippi Select Health Care
PAR/CLAIMS/
64088 No
Missoula County Medical Benefits Plan
PAR/CLAIMS/
37275 No
Montana Medicaid
NON/CLAIMS/
CKMT1 No
Morris Associates
PAR/CLAIMS/
35092 No
Motorola
PAR/CLAIMS/
36111 No
Mountain States Administrative Services (Tucson, AZ)
PAR/CLAIMS/
86040 No
Mutual of Omaha Commercial
PAR/CLAIMS/
CX087 No
Mutual of Omaha Insurance Company
PAR/CLAIMS/
71412 No
Mutually Preferred
PAR/CLAIMS/
71412 No
N.W. Int Assoc of Machinists & Aerospace Eng Benefits Trust Dental Progam
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
N.W. Ironworkers Health & Security Trust Fund
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
N.W. Roofers & Employers Health & Security Trust Fund
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
N.W. Textile Processors
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
NAA (North America Administrators, L.P.) (Nashville, TN)
PAR/CLAIMS/
65085 No
NABN (Cleveland, OH)
PAR/CLAIMS/
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 No
NCAS - Charlotte
PAR/CLAIMS/
75191 No
NCAS - Fairfax, VA
PAR/CLAIMS/
75190 No
NCBCBS - DBS a.k.a. ACS Benefit Services
PAR/CLAIMS/
61474 No
NGS AMERICAN
PAR/CLAIMS/
38225 No
National Benefit Administrators - New Jersey
PAR/CLAIMS/
56175 No
National Benefit Administrators - North Carolina
PAR/CLAIMS/
56176 No
National Elevator Industry Benefit Plan (NEIB)
PAR/CLAIMS/
CX045 No
National Pacific of TX (NCFLEX)
PAR/CLAIMS/
A United Healthcare Payer
CX057 No
National Rural Letter Carrier Association
PAR/CLAIMS/
71412 No
National Telecommunications Cooperative Association
PAR/CLAIMS/
52120 No
Nationwide Health Plans
PAR/CLAIMS/
31417 No
Nebraska Medicaid
NON/CLAIMS/
CKNE1 No
Netcare Life and Health Insurance (NLH)
PAR/CLAIMS/
66055 No
New England Dental Administrators
PAR/CLAIMS/
43351 No
New Mexico Medicaid
NON/CLAIMS/
CKNM1 No
New York Medicaid
NON/CLAIMS/
CKNY1 No
Nippon Life Insurance Company of America
PAR/CLAIMS/
81264 No
North American Benefits Network ((Cleveland, OH)
PAR/CLAIMS/
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 No
North Broward Hospital District
PAR/CLAIMS/
37314 No
North Carolina Health Choice for Children
PAR/CLAIMS/
61472 No
North Dakota Dental Service
NON/CLAIMS/
CX004 No
North Dakota Medicaid
NON/CLAIMS/
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 Claims.ÿ Provider IDs are always 5 digits long and begin with the number 4.ÿ
CKND1 No
NorthShore University Health System Medical Group
PAR/CLAIMS/
36364 No
NorthStar Administrators
PAR/CLAIMS/
47570 No
Northeast Delta Dental (ME, NH, VT)
PAR/CLAIMS/
02027 No
Northern Illinois Health Plan
PAR/CLAIMS/
36347 No
Northern Minnesota Dental
NON/CLAIMS/
LX062 No
Northern Nevada Trust Fund
PAR/CLAIMS/
Please call (775) 826-7200 to verfiy if you should be sending claims to Northern Nevada Trust Fund.
88027 No
Northwest Dental Services
PAR/CLAIMS/
93525 No
Northwest Suburban IPA
PAR/CLAIMS/
36346 No
Nova Healthcare Administrators, Inc. (Grand Island, NY)
PAR/CLAIMS/
16644 No
Nyhart
PAR/CLAIMS/
37299 No
OK State Employees & Educators (EDS)
PAR/CLAIMS/
22521 No
Operating Engineers Locals 302 & 612 Health & Security Fund
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
Optum Specialty Svcs / Americhoice of NJ
PAR/CLAIMS/
GP133 No
P5 Health Plan Solutions
PAR/CLAIMS/
87068 No
PA Faculty Health & Welfare
PAR/CLAIMS/
CX066 No
PDO
PAR/CLAIMS/
68241 No
PEHP (Public Employees Health Program)
NON/CLAIMS/
Prior to accepting claims electronically PEHP requires the provider to call EDI Support at 801-366-7544 or 800-753-7818. Providers should advise PEHP that they will be submitting their claims through Emdeon Business Services, Inc UHIN submitter ID HT000
CX080 No
POMCO
PAR/CLAIMS/
16111 No
Pacific Union
PAR/CLAIMS/
A United Healthcare Payer
CX056 No
PacificSource Administrators
PAR/CLAIMS/
a.k.a. Select Benefit Administrators
93031 No
PacificSource Health Plans
PAR/CLAIMS/
93029 No
Pacificare Dental and Vision HMO
PAR/CLAIMS/
A United Healthcare Payer
CX060 No
Pacificare Dental and Vision PPO
PAR/CLAIMS/
A United Healthcare Payer
CX053 No
Paragon Benefits
PAR/CLAIMS/
58174 No
Pasport Health Plan
PAR/CLAIMS/
CX091 No
Patient Advocates, LLC
PAR/CLAIMS/
10525 No
Pennsylvania Blue Shield (Camp Hill)
NON/CLAIMS/
CB865 No
Pequot Pharmaceutical
PAR/CLAIMS/
37121 No
Personal Insurance Administrators, Inc
PAR/CLAIMS/
95397 No
Physicians Care Network
PAR/CLAIMS/
36345 No
Physicians Health Associates of Illinois
PAR/CLAIMS/
37136 No
Physicians Health Plan of Northern Indiana, Inc.
PAR/CLAIMS/
12399 No
Physicians Mutual
PAR/CLAIMS/
CX068 No
Pinnacle Claims Management, Inc.
PAR/CLAIMS/
24735 No
Pittman & Associates
PAR/CLAIMS/
37224 No
Planned Administratorss, Inc.
PAR/CLAIMS/
37287 No
Poly America Medical & Dental Benefits Plan
PAR/CLAIMS/
32680 No
Prairie States Enterprises, Inc.
PAR/CLAIMS/
36373 No
Preferred Dental Organization
PAR/CLAIMS/
68241 No
Preferred Health Professionals
PAR/CLAIMS/
a.k.a. Freedom Network Dental
31478 No
Preferred One
PAR/CLAIMS/
41147 No
Premera Blue Cross
PAR/CLAIMS/
47570 No
Premier Access Insurance Company
PAR/CLAIMS/
CX078 No
Premier Dental Plan of MN
NON/CLAIMS/
CX029 No
Primary PhysicianCare, Inc.
PAR/CLAIMS/
56144 No
PrimeWest Health
NON/CLAIMS/
LX049 No
Principal Financial Group
PAR/CLAIMS/
61271 No
Principal Life Insurance Co.
PAR/CLAIMS/
61271 No
Priority Health
PAR/CLAIMS/
38217 No
Professional Benefit Administrators, Inc. (Oak Brook, IL)
PAR/CLAIMS/
Payer ID is valid only for Claims with billing submission name, city, and state of Professional Benefit Administrators, Inc., Oak Brook, IL.
36331 No
Provident Life
PAR/CLAIMS/
Claims are edited under CIGNA's payer specific edits, Payer ID 62308.
62308 No
Prudential HealthCare & Life Ins. Co of America
PAR/CLAIMS/
68241 No
Prudential HealthCare HMO for Small Business
PAR/CLAIMS/
68241 No
Prudential HealthCare Health Maintenance Organization
PAR/CLAIMS/
68241 No
Prudential HealthCare POS for Small Business
PAR/CLAIMS/
68241 No
Prudential HealthCare PPO for Small Business
PAR/CLAIMS/
68241 No
Prudential Healthcare of America Inc.
PAR/CLAIMS/
68241 No
Prudential for Health
PAR/CLAIMS/
68241 No
Puget Sound Benefits Trust
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
Puget Sound Electrical Workers Trust
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
Quad Med LLC (Pewaukee, WI)
PAR/CLAIMS/
39197 No
Quality Plan Administrators Inc
PAR/CLAIMS/
CX077 No
RBMS, LLC
PAR/CLAIMS/
91176 No
RMSCO, INC.
PAR/CLAIMS/
16117 No
Regence Blue Shield
PAR/CLAIMS/
93200 No
Regence Blue Shield FEP
PAR/CLAIMS/
93200 No
Regence Northwest Health
PAR/CLAIMS/
93200 No
Regence UT BCBS
NON/CLAIMS/
CBUT1 No
Regence UT BCBS FEP
NON/CLAIMS/
CBUTF No
Regency Employee Benefits
PAR/CLAIMS/
38221 No
Regional Care, Inc.
PAR/CLAIMS/
47076 No
ReliaStar (now known as CoreStar formerly NW National Life)
PAR/CLAIMS/
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 No
Reliance Standard Life Ins. Co.
PAR/CLAIMS/
36088 No
Reliastar
PAR/CLAIMS/
80314 No
Renaissance Life and Health
NON/CLAIMS/
RLHA1 No
Riverside San Bernardino County Indian Health Inc.
PAR/CLAIMS/
50664 No
Rochester Public Schools
PAR/CLAIMS/
41625 No
Rocky Mountain Life Dental
PAR/CLAIMS/
84102 No
Rural Carrier Benefit Plan
PAR/CLAIMS/
Formerly payer ID 62413. Now part of Coventry Consolidated payer ID. Including NRLCA Staff Plan.
25133 No
Rural Carrier Benefit Plan
/ERA/
Including NRLCA Staff Plan
62413 No
S&S Health Strategies
PAR/CLAIMS/
31441 No
SAMBA
PAR/CLAIMS/
37259 No
STAR +Plus Value Added
PAR/CLAIMS/
CPPSP No
SafeGuard PPO
PAR/CLAIMS/
CX030 No
Safeguard HMO
PAR/CLAIMS/
CX048 No
Sage Technologies
PAR/CLAIMS/
f.k.a. Cannon Cochran Management Services, Inc. Claims with a mailing address of PO Box 17009, Rockford, IL ONLY may be sent electronically with this payer ID.
37105 No
Sage Technologies - PBS
PAR/CLAIMS/
f.k.a. Progressive Benefit Services, Inc. Claims with a mailing address of PO Box 4419, Rockford, IL ONLY may be sent electronically with this payer ID.
37137 No
Salvation Army
PAR/CLAIMS/
a.k.a. Chesterfield Resource, Inc.
34154 No
Sanford Health Plan
PAR/CLAIMS/
91184 No
Scan Health Plan Arizona
PAR/CLAIMS/
73172 No
Scan Long Term Care
PAR/CLAIMS/
20460 No
Seabury & Smith
PAR/CLAIMS/
CX023 No
Secure Health Plan of GA
PAR/CLAIMS/
28530 No
SecureCare Dental
PAR/CLAIMS/
86057 No
Securian
NON/CLAIMS/
93742 No
Security Life Insurance Co of America
PAR/CLAIMS/
CX092 No
Select Administrative Services (SAS)
PAR/CLAIMS/
64088 No
Select Benefit Administrators
PAR/CLAIMS/
a.k.a. PacificSource Administrators
93031 No
Select Health
NON/CLAIMS/
CX107 No
SelectCare (Coca Cola)
PAR/CLAIMS/
68241 No
Self Insured Benefit Administrators (Clearwater, FL)
PAR/CLAIMS/
Payer ID valid only for Claims with a submission address of 18167 US Highway 19 North, Suite 300, Clearwater, FL 33764.
59111 No
Self Insured Services Company (SISCO)
PAR/CLAIMS/
CX020 No
Self-Funded Plans, Inc.
PAR/CLAIMS/
34131 No
Self-Insured Dental Services (SIDS)
PAR/CLAIMS/
Additional enrollment is not required by the payer, however, providers wishing to submit Claims electronically must be credentialed with the payer. Please ensure you have successfully process one paper Claims with the payer prior to submitting your firs
CX076 No
Self-Insured Plans, LLC
PAR/CLAIMS/
36404 No
Sentry Life Insurance Company
PAR/CLAIMS/
39033 No
Serentas Dental Care Solutions
PAR/CLAIMS/
CX038 No
Set Seg
PAR/CLAIMS/
38610 No
Sheffield, Olson and McQueen
NON/CLAIMS/
41143 No
Shenandoah Life Insurance
PAR/CLAIMS/
CX067 No
Sierra Health Services
PAR/CLAIMS/
A United Healthcare Payer
76342 No
Significa Benefits Services, Inc.
PAR/CLAIMS/
f.k.a. Erin Group Admin.
CX046 No
Sinclair Health Plan
PAR/CLAIMS/
84076 No
Solstice Benefits, Inc.
PAR/CLAIMS/
76578 No
South Carolina BCBS
NON/CLAIMS/
38520 No
South Carolina Medicaid
PAR/CLAIMS/
CKSC1 No
South Central Preferred - PPO York, PA (I H S Gateway Payer)
PAR/CLAIMS/
23266 No
South Dakota Medicaid
/ELIGIBILIT/
Yes/No Response
CKSD1 No
South FL Community Care Network - NBHD
PAR/CLAIMS/
37314 No
South Point Hotel & Casino
PAR/CLAIMS/
35227 No
SouthWest Benefits
PAR/CLAIMS/
CX051 No
Southeast Dental Associates
PAR/CLAIMS/
Name required to be listed within the claim using the plan name: SEDA-MHS, SEDA-NHP, SEDA-ICP, SEDA-CCHP, SEDA-DHP, SEDA-UHC or SEDA-AHP.
39148 No
Southern Benefit Services
PAR/CLAIMS/
37318 No
Southwest Service Administrators
PAR/CLAIMS/
CX100 No
Southwestern Bell
PAR/CLAIMS/
68241 No
Southwestern Bell Exec
PAR/CLAIMS/
68241 No
Southwestern Bell Exec. - Custom Care
PAR/CLAIMS/
68241 No
Southwestern Bell Exec. - Southwestern Bell
PAR/CLAIMS/
68241 No
Spina Bifida - VA HAC
PAR/CLAIMS/
84147 No
Standard Ins. Co. (OR Business)
PAR/CLAIMS/
93024 No
Standard Insurance Company (NY)
PAR/CLAIMS/
13411 No
Star Health
PAR/CLAIMS/
Use this payer ID for Dates of Service June 1, 2010 and later.
CPPSH No
Star Health
PAR/CLAIMS/
Use this payer ID for Dates of Service prior to June 1, 2010.
CX090 No
StarDent
PAR/CLAIMS/
CX090 No
State Auto
PAR/CLAIMS/
46450 No
State of Texas Dental Plan
PAR/CLAIMS/
57254 No
Stoner and Associates (Cincinnati, OH)
PAR/CLAIMS/
31121 No
Sun Life and Health Insurance Company (U.S.) (formerly GEGLAC)
PAR/CLAIMS/
f.k.a Genworth Life and Health Insurance Company (GLHIC) (Formerly GEGLAC)
67814 No
Superior Dental Care
PAR/CLAIMS/
31117 No
Surency Life and Health
PAR/CLAIMS/
CX088 No
TDC
PAR/CLAIMS/
73288 No
TPAC/Employee Benefit Management Corp
PAR/CLAIMS/
CX025 No
TR Paul, Inc.
PAR/CLAIMS/
37230 No
Tall Tree Administrators
PAR/CLAIMS/
88067 No
Tennessee Medicaid
/ELIGIBILIT/
Yes/No Response
CKTN1 No
Texas CHIP Dental Services
PAR/CLAIMS/
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 No
The Chesapeake Life Insurance Company - Student Insurance
PAR/CLAIMS/
A United Healthcare Payer. 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, 809027 Dallas, Tx 75380-9025.
74227 No
The Dental Companies
PAR/CLAIMS/
73288 No
The Dental Concern
PAR/CLAIMS/
73288 No
The Loomis Company - TPA Wyomissing, PA (IHS Gateway Payer)
PAR/CLAIMS/
23223 No
The MEGA Life & Health Insurance Company - Insurance Center
PAR/CLAIMS/
59226 No
The MEGA Life & Health Insurance Company - Student Insurance
PAR/CLAIMS/
A United Healthcare Payer. 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, 809027 Dallas, Tx 75380-9025.
74227 No
The Physicians Assurance Corp (TPAC) /Employee Benefit Management Corp (EBMC)
PAR/CLAIMS/
CX025 No
Three Rivers Health Plans, Inc
PAR/CLAIMS/
Now known as Unison Health Plan
25175 No
Time Insurance Company
PAR/CLAIMS/
f.k.a. Fortis Insurance Company
39065 No
Tower Life Insurance Co.
PAR/CLAIMS/
69493 No
TransSmile
PAR/CLAIMS/
Administered by Arkansas Delta Dental
CX069 No
Travelers (now MetLife)
PAR/CLAIMS/
65978 No
Trigon Blue Cross Blue Shield - Colorado Dental Office
PAR/CLAIMS/
Claims Mailing Address: Trigon Dental Admin, 555 Middle Creek Parkway, MS 400, Colorado Springs, CO 80921.
84103 No
Trigon Blue Cross of Virginia (Anth BCBS-VA/ BCBS Anth-VA formerly Trigon)
PAR/CLAIMS/
CB923 No
Trusteed Plans Service Corporation
PAR/CLAIMS/
91078 No
Trustmark Insurance Company
PAR/CLAIMS/
61425 No
UMR - Cincinnati
PAR/CLAIMS/
f.k.a. United Medical Resources
33108 No
UMR - Harrington
PAR/CLAIMS/
f.k.a. Harrington Benefit Services (Westerville)
75196 No
UMR - Harrington
PAR/CLAIMS/
f.k.a. Harrington Benefit Services (Columbus)
95266 No
UMR - Lexington
PAR/CLAIMS/
f.k.a. Commonwealth Administrative Group
37237 No
UMR - Onalaska
PAR/CLAIMS/
f.k.a. Midwest Security of WI
79480 No
UMR - San Antonio
PAR/CLAIMS/
f.k.a. Benefit Planners Inc., UICI Administrators - State of Nevada
74223 No
UMR - Wausau/UHIS
PAR/CLAIMS/
f.k.a. Fiserv Health - Wausau Benefits/Benesight, Employers Insurance of Wisconsin
39026 No
UNICARE
PAR/CLAIMS/
80314 No
Unified Group Services
PAR/CLAIMS/
35198 No
Uniform Medical Plan
PAR/CLAIMS/
f.k.a. Uniform Medical Plan / Harrington Benefit Services
75243 No
Union Security Insurance Company
PAR/CLAIMS/
f.k.a. Fortis Benefits Insurance Company
70408 No
Unison Health Plan/Three Rivers
PAR/CLAIMS/
25175 No
United Concordia (Tricare Dental Plan)
NON/CLAIMS/
CX002 No
United Concordia - Fee for Service
NON/CLAIMS/
CX007 No
United Concordia Dental Plus
NON/CLAIMS/
CX013 No
United HealthCare Insurance Company - Student Insurance
PAR/CLAIMS/
A United Healthcare Payer. 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, 809027 Dallas, Tx 75380-9025.
74227 No
United HealthCare Insurance Company of New York - Student Insurance
PAR/CLAIMS/
A United Healthcare Payer. 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, 809027 Dallas, Tx 75380-9025.
74227 No
United Healthcare of River Valley
PAR/CLAIMS/
A United Healthcare Payer
95378 No
United Medical Alliance
PAR/CLAIMS/
84132 No
United Security Life & Health Ins Co
PAR/CLAIMS/
36362 No
United States Life Insurance Company
PAR/CLAIMS/
f.k.a. American General
13545 No
United of Omaha
PAR/CLAIMS/
71412 No
Unity Health Insurance Corp
PAR/CLAIMS/
Only claims for Oral Surgery, TMJ or Accidents can be sent electronically to this payer ID.
66705 No
University of Missouri
PAR/CLAIMS/
Formerly payer ID 87043. Now part of Coventry Consolidated payer ID.
25133 No
Upper Peninsula Health Group (TPA)
PAR/CLAIMS/
37324 No
VA Fee Basis Programs
PAR/CLAIMS/
12116 No
Varian Health Care Plan
PAR/CLAIMS/
68241 No
Verity National Group
PAR/CLAIMS/
75256 No
Virginia Medicaid
PAR/CLAIMS/
ADMINISTERED BY DORAL DENTAL.
CKVA1 No
Volusia Health Network
PAR/CLAIMS/
59266 No
WEA Trust
PAR/CLAIMS/
39151 No
WI Auto & Truck
NON/CLAIMS/
R7006 No
Washington Dental Service
PAR/CLAIMS/
91062 No
Washington Employers Trust
PAR/CLAIMS/
37294 No
Washington State Council of County & City Employees Dental Trust
PAR/CLAIMS/
Please enter Group Number when submitting Claims.
91136 No
Waterstone Benefit Administrators
PAR/CLAIMS/
73155 No
Web TPA, Inc of TX
PAR/CLAIMS/
59332 No
Wells Fargo Third Party Administrators (f.k.a. JSL Administrators)
PAR/CLAIMS/
37272 No
Wells Fargo Third Party Administrators, Inc (Charleston, WV)
PAR/CLAIMS/
f.k.a. Acordia National
87815 No
WestLake Financial Group, Inc. (Buffalo Grove, IL)
PAR/CLAIMS/
90560 No
Western Grower's Assurance Trust
PAR/CLAIMS/
24735 No
Western Grower's Insurance Company
PAR/CLAIMS/
24735 No
William C. Earhart
PAR/CLAIMS/
93050 No
WilsonMcShane
NON/CLAIMS/
R7002 No
Worksite Benefit Services, LLC
PAR/CLAIMS/
20333 No
Zenith Administrators
NON/CLAIMS/
R7001 No
deneX/SG
PAR/CLAIMS/
CX049 No
webTPA/Community Health Electronic Claims/CHEC
PAR/CLAIMS/
75261 No