LX140 Claims Payer 837 List

User Manual: LX140

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

59069
20413
20446
CX044
39640
CXADN
75240
37283
AARP1
LX144
52133
61425
61474
72468
61473
72468
10003
CX052
CX085
CX052
FX036
58066
52080
AFSDC
37280
91136
80705
LX140
LX122
59140
13545
80705
16140
44444
CXARC
63240
TLX61
38265
ASRM1
ATPA1
ATPA1
75261
PHP01
AHP01
43178
CX078
CX097
64071
87815
38255
38265
22384
CX098
CX076
93524
52133

21st Century Health (MedsavUSA)(NJ)
3P Administrators (Onalaska, WI)
6 Degrees Health Inc. (Beaverton, OR)
A & I Benefit Plan Admin, Portland Oregon
A&D Charitable Foundations (Eden Prairie, MN)
A.D.N. Administrators (Southfield, MI)
AAG Benefit Plan Administrators (Dallas, TX)
AAG-American Administrative Group (Lubbock,TX)
AARP Dental Insurance Plan (Mechanicsburg, PA)
ABS - US Health (Oak Park, MI)
ACEC Health Plans (SLC, UT)
ACEC-Healthplan
ACS Benefit Service (PO Box 2400 Winston, NC only)
ACS Benefit Services (Salem Winston, NC)
ACS Benefit Solutions
ACS Consulting, Salem Winston, NC
ACS Hawaii (Honolulu, HI)
AD-Medicaid (Atlantic Dental, Inc)(Mequon, WI)
ADI (Atlantic Dental) PPO (Coral Gables, FL
ADI -Medicaid (Atlantic Dental, Inc)(Coral Gables, FL
ADN (Southfield, MI)
AFLAC of GA (Columbus, GA)
AFLAC of NY (1932 Wynnton Road, Columbus GA)
AFS Insurance Service (PO Box 30430 SLC, UT
AGA (Automated Group Admin (Fort Wayne, IN)
AGC- I.U.O.E Local 701 trust Funds
AH & L (Anthem Health & Life Ins of NJ)(Kennett, MO)
AHCCCS (Phoenix, AZ)
AHL (Richardson TX)
AIG (Las Vegas, NV & Seattle, WA & Tampa, FL)
AIG American General (US Life) (Neptune, NJ & Beattyvil
ALTA Health & Life Ins. Co. (Kennett, MO)
APA Partners, Inc. - Latham, NY
APWU (American Postal Workers (Silver Springs, MD)
ARC Administrators (Lexington, KY)
ARM (Alternative Risk Management (Eagan, MN)
ASEA (AFSCME) Local 52 (Spokane, WA)
ASR Corporation (Grand Rapids, MI)
ASRM (Moorestown, NJ)
ATPA (Associated Third Party Admin)
ATPA (San Diego, CA & Tualatin, OR)
AXA (Web-TPA) Grapevine, TX
Abrazo HealthCare (Phoenix, AZ)
Abri Health Plan (Thiensville, WI)
Acceptius (Benefit Management Inc of MO, Joplin, MO)
Access Administrators (PO Box 659010 Sacramento, CA)
Access Dental (Salem, OR)
Acclaim (Tupelo, MS)
Accordia National (Charleston, WV)
Activa Benefit Services, LLC - Grand Rapids, MI
Administration Systems Research Corp. (Grand Rapids,
Administrative Concepts (Wayne, PA)
Administrative D.C. No 1 Welfare Fund (Des Plaines, IL)
Administrative Services Only (PO Box 9005,9007,9010 Ly
Advantage Dental Plan - Roseburg, OR
Advantage Health Solutions (Salt Lake City, UT)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

CPPSA
83077
43168
60054
95340
75261
54763
60054
57604
57604
128WV
68246
95426
91136
92600
91136
91136
91136
91136
44423
13343
CXALC
81040
CX016
LX139
65074
51037
94177
37308
22155
63240
50503
STR01
13343
86048
86002
86003
86047
Call
75137
42112
75240
37283
74223
CX084
34187
52133
LX016
ADP01
AHG01
660650587
CX001
44444
41178
86001
GP133

Advantage by Superior (PO Box 537030, Sacramento, CA
Advantek Benefit Admin (Fresno, CA)
Advantica Administrative Svcs (St. Louis, MO)
Adventis Risk Management Inc
Adventist Health Claims (Roseville, CA)
Adventist Risk Management (Grapevine, TX) Old PO Box
Adventist Risk Management (Horsham, PA) Old PO Box 4
Aetna
Aetna (SRC)(Blue Bell, PA & Columbia, SC)
Aetna Affordable Health Choices (SRC)(Columbia, SC)
Aetna Better Health of WV (Phoenix, AZ)
Aetna US Healthcare Encounters (PO Box 14530, Lexingt
Affordable Benefits Admin (Burbank, CA)
Alaska Children's Services, Inc.
Alaska Electric Health & Welfare Fund (Anchorage, AK)
Alaska Hotel Restaurant and camp
Alaska Laborers Construction Industry Trust (Seattle, WA
Alaska Pipe Trades Local 375 (Seattle, WA)
Alaska United Food & Comm. Workers Health & Welfare
Alexian Brothers Community Services of TN (Chattanoog
AliCare (Amalgamated Life (New York, NY)
AllCare CCO Dental (Salem, OR)
Allegiance Benefit Plan (Missoula, MT)
Allen Medical Claims Administrator (Fort Valley, GA)
Alliant (Chesire, CT)
Allianz (Miami, FL)
Allied Administrators (Eagan, MN)
Allied Administrators (San Francisco, CA)
Allied Benefit Systems (Chicago, IL)
Allied National (Eagan, MN)
Alternative Risk Management (ARM) Eagan, MN)
Altus Dental - Providence, RI
AlwaysCare Benefits (Baton Rouge, LA)
Amalgamated Life - PA Alicare (New York, NY) (King of P
AmeriChoice - New York Medicaid (Salt Lake City, UT)
AmeriChoice - New York Medicare (Salt Lake City, UT)
AmeriChoice - Pennsylvania Medicare (Salt Lake City, UT
AmeriChoice of NJ Medicaid (salt Lake City, UT)
AmeriHealth Mercy Health Plan
Ameriben Solutions (Boise, ID)
American Admin (West Des Moines, IA)
American Admin Group (AAG)(Dallas, TX)
American Admin Group (PO Box 93670, Lubbock, TX)
American Administrative Group, Inc (AAG)(San Antonio,
American Benefit Corporation (Huntington, WV)
American Benefits Management of (N Canton, OH)
American Choice (Thiensville, WI)
American Dental Network (ADN)(PO Box 610, Southfield,
American Dental Payers of WI
American Health (Maumee, OH)
American Health Medicare
American Medical Security (Green Bay, WI)
American Postal Workers Union Health Plan (Silver Sprin
Americas TPA (Minneapolis, MN)
Americhoice - New Jersey Medicare (Salt Lake City, UT)
Americhoice NJ(Thiensville, Milwaukee WI)

Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

LX010
54763
47009
38255
53085
34192
84103
47198
80705
84105
84105
84105
CB923
34196
LX074
ARGUS
75278
81883
LX035
38416
CX072
16180
25133
50266
AFSDC
ATPA1
ATPA1
70408
LX088
39065
75068
ASHC1
74240
93221
95691
CX085
CX052
LX081
38259
37280
91136
CX022
LX019
86098
LX169
999999
36149
36149
36149
36149
77078
LX070
53021
LX108
49153
CXBMD

Amerihealth (720 Blair, Horsham, PA)
Amerihealth Administrators (Horsham, PA)
Ameritas Life Insurance Corp. (Lincoln, NE)
Amway Corporation (East Ada, MI)
Anchor Benefit Consulting (Maitland, FL & Davenport, LA
Antares Management Solutions (Westlake, OH)
Anthem (PO Box 1115, Minneapolis, MN)
Anthem CA (Po Box 1115, MPLS MN)
Anthem Health & Life Insurance Co of New Jersey/AH&L
Anthem of CT (PO Box 547 North Haven, CT)
Anthem of CT (PO Box 9274, Oxnard, CA)
Anthem of TX (Po box 659444, texas)
Anthem of Virginia (Richmond, VA)
Apex Benefits (Akron, OH)
Argus (Tampa Fl)
Argus (Tampa, FL & Eagan, MN)
Arkansas Best Corp-Choice Benefits-Fort Smith, AR
Arkansas Municipal Health Benefit (N Little Rock AR)
Arm LTD Midwest (Brookfield, WI)
Arm, LTD (Spencer Stuart) (Eagan, MN)
Ascent Benefits (Phoenix, AZ)
Aspen (Redwood City, CA)
Associated Benefit Plan (London, KY)
Associated Benefits (Des Moines, IA)
Associated Foods Service (AFS)(PO Box 30430, SLC, UT)
Associated Third Party Admin (ATPA)(San Diego, CA)
Associated Third Party Admin (ATPA)(Tualatin, OR)
Assurant (PO Box 2940 Clinton, IA)
Assurant Health (Fort Mill SC)
Assurant Health (PO Box 2806, Clinton, IA)
Assurant Health Self Funded (Chicago, IL)
Assurant Supplemental (PO Box 2829 Clinton, IA)
Assured Benefits Administrators (El Paso, TX)
Asuris Northwest Health(PO Box 30271 SLC, UT)
Athens Area Health Plan Select (Athens, GA)
Atlantic Dental Inc - PPO (ADI) (Coral Gables, FL)
Atlantic Dental Inc-Medicaid (Coral Gables, FL)
Aultra ( Canton, OH)
Automated Benefit Services (Oak Park, MI)
Automated Group Admin (Fort Wayne, IN)
Automotive Machinists Local 289 Health & Welfare Trust
Auxiant (Cedar Rapids, IA)
Auxiant (PO Box 90991, Milwaukee, WI)
Avesis (PO Box 7777 Phoenix, AZ)
BAC (PO Box 107, Reynoldsburg, OH)
BAD CARRIER
BAS (Benefit Admin Systems (Farmington Hill, MI)
BAS (Benefit Admin Systems (Homeward, IL)
BAS (Benefit Admin Systems (Milwaukee, WI)
BAS (Benefit Admin Systems)(St. Louis, MO)
BAnner - Medisun (Mesa, AZ)
BCBS KS (Tokepa, KS)
BCBS of LA AdvantagePlans Network
BCBS of WA - FEP (Po Box 31207,SLC, UT)
BCI Administrators Inc (West Bloomfield, MI)
BEAM Dental (Columbus, OH)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

BEAM1
44219
43471
36342
74227
SX145
CB369
CHSBA
CHSBD
68241
LX154
BNMK1
23210
33192
LX165
36149
36149
36149
36149
41205
25145
LX156
56139
LX087
43471
43178
FX012
56139
37212
48611
36459
LX086
37118
39081
74223
36342
R7003
58102
FX022
BMX01
37248
LX152
95604
95604
32006
CX025
83470
BBMDQ
54763
83470
CBC01
53589
CBAL1
47570
83470
BSCA2

BEAM Insurance Adminsitrators (Burlington, KY)
BHP Unity (PO Box 456, Arnold, MD)
BMA (Tampa, FL)
BSSI (Benefit System & Services (Westmont, IN)
Bankers United Life/Student Insurance (Lincoln, NE)
Banner Health Systems (Mesa, AZ)
Barinet (Arnold, MD)
Bay Area Automotive Group (Livermore, CA)
Bay Area Delivery Drivers (Livermore, CA)
Bell Atlantic
Ben-e-lect (Visalia, CA)
BenMark (Mississippi)
BeneCare Dental Plan - Philadelphia, PA
Benecomp National Corporation (St. Petersburg, FL)
Benefit & Risk Mgmt Services - BRMS (Folsom, CA)
Benefit Admin Systems (BAS) (PO Box 2920 Milwaukee,
Benefit Admin Systems (BAS)(Farmington Hill, MNI)
Benefit Admin Systems (BAS)(St. Louis, MO)
Benefit Admin Systems(BAS) (Homewood, IL)
Benefit Administration Services (Eagan, MN)
Benefit Coordinators Corporation (Pittsburgh, PA)
Benefit Coordinators Corporation (Pittsburgh, PA)
Benefit Management (Matthews, NC)
Benefit Management (San Antonio TX)
Benefit Management Admin (BMS-Inetico)(Tampa, FL)
Benefit Management Inc of MO (Joplin, MO)
Benefit Management Services (PO Box 1178, Matthews,
Benefit Management Services, Inc (Charlotte, NC)
Benefit Management Systems (Madison, MS)
Benefit Management, Inc. (Great Bend, KS)
Benefit Mangement Group NV (Las Vegas, NV)
Benefit Plan Adm (Fargo ND)
Benefit Plan Admin (Roanoke, VA)
Benefit Plan Administrators Co. Eau Claire, WI
Benefit Planners, Inc )San Antonio, TX)
Benefit Systems & Services, Inc. (Westmont, IN)
Benefit, Inc. (Roseville, MN)
BenefitStream (Po Box 1990, Jasper GA)
Benefits (PO Box 1175, Maple Grove, MN)
Benemax (Medfield, MA)
Benesys, Inc (LaFayette, LA)
Benicomp, Inc. (Fort Wayne, IN)
Best Life & Health Ins Co. - (Irvine CA)
Best Life & Health Ins. Co (Overland Park, KS)
Better health Plans of South Carolina
Big Lots Associates Benefit Plan (EMBC) Dublin, OH
Blue Advantage (BCBS of AR)(Harrisburg, PA)
Blue Care Network (BCBSM MA/BNCA - Medicare Advant
Blue Cross (Po box 1002, Horsham PA)
Blue Cross AR (Harrisburg, PA)
Blue Cross Dental (Po Box 1126, Elk Grove IL)
Blue Cross of AZ (Phoenix, AZ)
Blue Cross of Alabama (Birmingham, AL)
Blue Cross of Alaska & Washington (Anchorage, AK)
Blue Cross of Arkansas (PO Box 1206 Elk Grove Village, I
Blue Cross of CA (Fed Only)(Chico, CA)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

47198
52133
84099
00700
84105
53287
FX046
76031
CBGA1
LX138
84105
CBID1
CB621
84105
CBIA1
CBIA2
CBKS1
47171
84105
89070
23739
FX136
BBMDQ
89070
FX017
BCAFD
LX021
BME01
CBMA1
CBMI1
CBMS1
CBMT1
52133
61474
00800
55093
CBNY1
55204
CBNE1
84101
BNH01
22099
CBNM1
84100
CBNYW
CBNYE
CBNYR
61473
61472
CX004
00840
LX097
LX034
84105
CB850
LX052

Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue
Blue

Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross
Cross

of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of
of

Req. Enroll.

CA (Oxnard, CA)
CA (PO Box 272590 & 272540, Chico, CA)
Colorado/Anthem - Colorado Springs, CO
Connecticut (Blue Care Family Plan) (North
Connecticut (PO Box 547 North Haven, CT)
Delaware (Wilmington, DE)
FL (Jacksonville, FL)
Florida (Florida Combined Life)(PO Box 100
GA (Columbus, GA)
ID - FEP (PO Box 7408, Boise, ID)
IN (PO Box 188, Mpls., MN)
Idaho (PO Box 7408, Boise, ID)
Illinois (Oak Brooke Terrace, IL)
Indiana Anthem (Louisville, KY)
Iowa (FEP claims only) (Des Moines)
Iowa (Po Box 935 Des Moines, IA)
Kansas (Topeka, KS)
Kansas City (MO)
Kentucky/Indiana/Ohio Anthem - Louisville,
LA Advantage Plan (PO Box 69441)
Louisiana (Baton Rouge, LA)
MD (14111-14116, Lexington, KY)
MI - Medicare Advantage(Milwaukee, WI)
MN (Harrisburg, PA)
MN (PO Box 64338, St. Paul, MN)
MN (PO Box 75, Minneapolis, MN)
MS (Po box 1043, Jackson MS)
Maine
Massachusettes (North Quincy, MA)
Michigan (Detroit, MI)
Mississippi (Jackson, MS)
Montana (Helena, MT)
NC (Mailed to Salt Lake City, UT)
NC (PO Box 2400 Winston, NC only)
NE Nork York (Buffalo, NY)
NY (Empire) Claims sent to MN
NY - Empire
NY(Western)(PO Box 80, Buffalo, NY)
Nebraska (Omaha, NE)
Nevada - Colorado Springs, CO
New Hampshire
New Jersey (Horizon) (Newark, NJ)
New Mexico (Belleville, IL)
New Mexico Dental
New York (1901 Main St. Buffalo, NY)
New York (NorthEast)(Albany NY Only)
New York - Par (PO Box 22999, Rochester,
North Carlonia (Winston Salem, NC)
North Carolina Federal Employee Claims (D
North Dakota (ND Dental Services) (Fargo,
OK (PO Box 23100 Belleville, IL)
OK (Tulsa OK)
OK (Tulsa. OK)
Ohio Anthem (Louisville, KY)
Oregon (Portland, OR & SLC, UT)
Oregon - FEP (Po Box 31105, SLC, UT)

No
No
No
No
No
No
No
No
No
No
No
Yes
No
No
Yes
Yes
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
Yes
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

54771
CB870
CBSD1
CBSD1
38520
CBTN1
CB900
CBUT1
CBUTF
84103
CB923
LX090
CMS01
CB950
47570
93200
47198
BSCA1
94036
52133
CBID2
36609
TLX71
74237
14168
04210
04210
20381
CX028
BRIDG
B2129
51037
CX032
59069
LX169
47009
61492
42150
LX124
CPPCA
CAS89
03036
55438
41124
88019
37105
LX170
00720
88022
84147
10000
LX182
62310
CX075
DESAZ
71063

Blue Cross of PA - Highmark
Blue Cross of Rhode Island (providence, RI)
Blue Cross of SD (PO Box 9291 Des Moines, IA)
Blue Cross of SD (Sioux Falls, SD)
Blue Cross of South Carolina (Columbia/Charleston SC)(P
Blue Cross of Tennessee (Chattanooga, TN)
Blue Cross of Texas (Dallas, TX)
Blue Cross of UT BCBS (PO Box 30270, Salt Lake City, U
Blue Cross of UT-FEP (PO Box 30272, Salt Lake City, UT)
Blue Cross of VA - Trigon (Colorado Springs, CO)
Blue Cross of VA / Anthem (Richmond, VA)
Blue Cross of WA (550 12th St, Washington DC)
Blue Cross of WI (PO Box 10888, Greenbay, WI)
Blue Cross of WI (United)
Blue Cross of Washington & Alaska(Anchorage, AK)
Blue Cross of Washington (PO Box 30271 SLC UT)(PO Bo
Blue Cross/Trust Fund (San Antonio, TX)
Blue Shield CA
Blue Shield CA - NON-FEP (Salt Lake City, UT)
Blue Shield of CA (SLC, UT)
Blue Shield of Idaho(PO Box 31603 Salt Lake City, UT)
Boilermakers Natl Health & Welfare Fund/International B
Bollinger Insurance (PO Box 804, Short Hills, NJ)
Boon Chapman Benefit Administrators (Austin, TX)
Boston Mutual Life Ins (Latham, NY)
Boston Mutual Life Ins Co. (80 East Concord St., Boston,
Boston University Dental Health Plans (80 East Concord
Boulder Admin Services (Boulder, MT)
Bridgeport LLC of Missouri - St Charles, MO
Bridgespan (Lewiston, ID)
Brighter Administrators
Brokerage Concepts (King of Prussia, PA)
Brokers National (Houston TX)
Brown & Brown United Benefits Fringe (PO Box 2480, Da
Business Admin Consultants(BAC)(PO Box 107, Rynoldsb
Businessmen Assurance (NE)
Businessmen's Assurance
Butler Benefits (Davenport, IA, Eagan, MN)
Butler Company
CA Health Families (Sacramento, CA)
CAS Benefits Plans (PO Box 3070, Bellingham, WA)
CBA Blue (Comprehensive Benefits Admin (Burlington, V
CBCA Administrators (TX,NY,KY,GA,MN)
CBSA (Mpls, MN)
CCEA Teachers Health Trust (Las Vegas, NV)
CCMSI (Cannon Cochran Mngmt Serv)(Danville, IL)
CCPOA Benefit Trust Fund (2515 Venture Oaks, Sacrame
CCSTpa (Comprehensive Care Services PO Box 64008, 6
CDS Group Health (Sparks, NV)
CHAMPVA - HAC - Denver, CO
CIGNA (DHMO) (PO Box 188046, Chattanooga, TN)
CIGNA (Heritage Consultant) (Lake Alfred, FL)
CIGNA Flex Care/Lovelace (New Mexico Only)
CL Frates (Oklahoma City, OK)
CMDP (Comprehensive Medical and Dental (Phoenix, AZ)
CNA Health Partners of Arkansas

No
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

37227
DX215
58231
CPPTX
CX054
42141
LX167
33192
33192
CPPCA
LX131
CX061
71057
37105
CBC01
CX037
68011
CX095
CAPHP
FX136
93975
WVCS1
INCS1
DX215
GACS1
KYCS1
CKOH2
56195
CX101
25125
LX091
LX118
37060
91136
66698
75177
LX150
34097
LX103
36215
55731
DX215
34154
84147
EM205
68241
48123
61271
38308
62308
10050
59225
CX071
CX054
CMS01
11752

CNIC Healthcare Services (Englewood/Colorado Springs,
CORE (Frisco, TX)
CORE Administrative Services (Macon, GA)
CPP Texas Chip (PO Box 537014 Sacramento, CA)
CSEA (Civil Service Employes Assoc.) (Latham, NY)
CTI Administrators (Des Moines, IA)
CWI Benefits (Greenville, SC)
Cadent Administrators (St. Petersburg, FL)
Cadent Underwriters (St. Petersburg, FL)
California State Gov. Programs
California Water Service (San Jose CA)
Canada Life Assurance Company(Atlanta, GA)
Cannon Cochran Mgmt Services, Inc. (Metairie, LA)
Cannon Cochran Mngmt Services, Inc - Danville, IL
Capital Blue Cross (Harrisburg, PA)
Capital Dental - Houston, TX
Capitol Administrators (Rancho Cordova, CA)
Capitol Dental (Performance Health Tech) (Salem, OR)
Caprock Health Plans (Eagan, MN)
CareFirst (PO Box 14111 - 14116) (Lexington, KY))
CareOregon (Portland, OR)
CareSource West Virginia (Dayton, OH)
CareSource of IN (JustME)(Dayton, OH)
Careington (Frisco, TX)
Caresource GA (Dayton, OH)
Caresource KY (Dayton, OH)
Caresource- Dayton OH
Carolina Summit HealthCare (Cincinnati, OH)
Carpenters Health & Welfare of PA (Philadelphia, PA)
Carpenters Health Welfare (St. Louis, Hazelwood, MO)
Carpenters Welfare Fund (Chicago IL)
CarringtonWellMed (Kansas City MO)
Caterpillar Inc.
Cement Masons & Plasters Health & Welfare Trust (Seatt
CentraCare (Battle Creek, MI)
Central & Southwest Services
Central Dta Services Downtown (Pittsburgh, PA)
Central Reserve Life (Eagan, MN)
Central Reserve Life (Winston Salem NC)
Central States (Rosemont, IL & PO Box 5104 Des Plaines
Centraol Susquehanna HealthCare (PO Box 668, Arnold,
Chesapeake Life Ins (Frisco, TX)
Chesterfield Resources (Akron, OH)
Children of Women Vietnam Veterans
Childrens Medical Services (CMS) Po Box 917833 El Paso
Choice Plus (TRW)
Christi Hope (Wichita, KS)
Christian Brothers Services (Colorado Springs, CO)
Christian Brothers Services (Romeoville, IL)
Cigna
Cigna DHMO
Cigna Voluntary (Phoeniz, AZ)
Citizens Security Life Ins. (Louisville, KY)
Civil Service Employees Association (CSEA) (Latham, NY)
Claims Management Services (Greenbay, WI)
ClaimsBridge HPN (Arnold, MD)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

33192
CCS01
WDENC
14829
37310
37310
CAS89
77052
59143
LX073
34181
37237
LX166
61948
26231
PHP01
27905
75261
34177
CX021
77828
CX029
CX021
34177
03036
00720
CHCP1
DESAZ
66698
74234
37307
62308
37135
61305
LX146
45321
35245
62308
CPPCC
CPPCH
35149
82347
52132
35182
41045
FX048
LX048
35180
35183
48117
35183
75136
35182
41045
56116
56116

Clarendon's Healthy Kids (St. Petersburg, FL)
Clayton County Self Funded Dental Plan (Jonesboro, GA)
Clear Plan
Co-Ordinated Benefit Plans (Eagan, MN)
Coast Benefits/Coast Hotels and Casinos (Las Vegas, NV)
Coast Hotels and Casinos, Inc./DBA Coast Benefits (Las
Coastal Admin Serv (CAS) (PO Box 3070, Bellingham, W
Coastal Admin Services (Salinas, CA)
Colonial Dental(Harrington Health)(Salt Lake City,. UT)
Combined Insurance (Ocala, FL)
Comerce Benefits Group (Elyria, OH)
Commenwealth Admin, LLC (Lexington, KY)
Commercial Travelers (Utica, NY)
Community Choice Health Plan of Westchester (Yonkers,
Community Claims Administration (Orange, CA)
Community Connection (Phoenix, AZ)
Community Health Alliance (Knoxville, TN)
Community Health Electronic Claims
Comp - Ohio - 33 Fitch Blvd., Austintown OH
CompBenefits - (Chicago, IL & Roswell, GA)
Companion Life (PO Box 100102, Columbia, SC)
Companion Permier (9201 Watson, St Louis)
Compdent - (Chicago, IL & Roswell, GA)
Compensation Programs of Ohio, Inc.
Comprehensive Benefits Admin - Burlington, VT
Comprehensive Care Services (CCSTpa) PO Box 64008, 6
Comprehensive HealthCare Options (Centennial, CO)
Comprehensive Medical and Dental Program (CMDP)(Pho
Comprehensive Senior Care Corp. (Battle Creek, MI)
CompuSys/Erisa Group (Austin, TX)
Connecticut Carpenters Health Fund (Hamden, CT)
Connecticut General (Bloomfield, CT)
Consociate Dansig, Inc. (Decatur, IL)
Consolidated Group Dental (Nashua, NH)
Consolidated Health Plans (Springfiled, MA)
Consumers Choice Health Plan (North Charleston, SC)
Continental Benefits (Brandon, FL)
Continental Dental
(Plantation, FL)
Cook Children's Dental (PO Box 537010, Sacramento, CA
Cook Children's Health Plan (PO Box 537014 Sacramento
Cook Group Health Plan (Bloomington, IN)
Cook Group Solutions (Eagan, MN)
Cooperative Benefit Administrators (CBA) (Lincoln, NE)
Core Source (Po Box 2920, Clinton IA)
CoreSource (AZ, MN)
CoreSource (Mailed to IA)
CoreSource (Mailed to IA)
CoreSource (NC, IN) (Charlotte, NC)
CoreSource (Po Box 279, SHeldon IA)
CoreSource KC(FMH Benefit)(Overland Park, KS)
CoreSource OH - mailed to OH
CoreSource of Little Rock (Little Rock, AR)
CoreSource of PA MD IL (Lancaster, PA)(Clinton, IA)
CoreStar (Minneapolis,MN)
Corporate Benefit Services (Charlotte, NC)
Corporate Benefit Services (Eagan, MN)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

41124
56116
58102
CX049
25133
25133
25133
25133
25133
25133
25148
25133
37320
CX074
56213
20572
39170
68241
82056
LX082
DEW01
00001
CX065
06172
07035
07035
39113
CDIAM
CDIAM
66043
CPPTM
DDCA2
94276
94276
86027
CDAR1
DDCA2
DDCA3
CDCAP
77777
CDCA1
84056
22189
51022
94276
94276
10002
82029
IDIND
05030
CDIN1
CDIA1
CDKS1
CDKY1
94276
02027

Corporate Benefit Services (Mpls, MN)
Corporate Benefit Services(El Paso, TX)
Covenant Admin, Inc - (PO Box 105738 Atlanta, GA)
Coventry (Po Box 7402, London KY)
Coventry Health
Coventry Health & Life OK
Coventry Health (241508 Charlotte, NC)
Coventry Health (PO Box 241508 Charlotte, NC)
Coventry Health (PO Box 8403,8400,8402, London, KY)
Coventry Health (PO box 8403,8400,8402, London, KY)
Coventry Health Care of Georgia (PO Box 7711,7715 Lon
Coventry Health Care of KS
Creative Plan Administrators (Hartford, CT)
Crescent Dental (Amherst, NY & Richardson, TX)
Crescent Health (Asheville, NC)
Crowe Paradis Service Corp (North Reading, MA)
Custom Benefit Adminstrators(Lacrosse, WI)
Custom Care
Custom Design Benefits (3737 West Fork Road, Cincinna
Cypress (Appleton WI)
D. Edward Wright TPA(
DDCA2 Test
DH Evans (Harrisburg, PA)
Dart Management Corp. (Mason, MI)
DeCare (PO Box 1348, Mpls., MN) Northwest Employees
DeCare (Po Box 709, MPLS MN)
Dean Health Plan (Madison, WI)
Delta Dental IA - Dental Wellness Plan (Johnston, IA)
Delta Dental IA - Government Programs (Johnston, IA)
Delta Dental Peurto Rico (San Juan, PR)
Delta Dental TX Medicaid-Childrens(PO Box 537014, Sacr
Delta Dental USA (Cerritos, CA)
Delta Dental of Alabama ( Irving, TX)
Delta Dental of Alaska (Irving, TX)
Delta Dental of Arizona
Delta Dental of Arkansas
Delta Dental of CA (Cerritos, CA)
Delta Dental of CA (Encounter, CAP)(Cerritos, CA)
Delta Dental of CA (PMI) (12898 Towne Center Drive, Ce
Delta Dental of California (PO Box 997330, Sacramento,
Delta Dental of California(Tricare) - PO Box 537007-537
Delta Dental of Colorado (Denver, Co)
Delta Dental of Connecticut (Parsipanny, NJ)
Delta Dental of Delaware (Mailed to Mechanicsburg, PA)
Delta Dental of Florida (Irving, TX)
Delta Dental of Georgia (Alpharetta, GA)
Delta Dental of HI (Honolulu, HI)
Delta Dental of Idaho (Boise, ID)
Delta Dental of Illinois (Individual Plans Only) (PO Box 5
Delta Dental of Illinois (Lisle, IL)
Delta Dental of Indiana (Farmington Hills, MI)
Delta Dental of Iowa (Ankeny, IA)
Delta Dental of Kansas(Whichita, KS)
Delta Dental of Kentucky(Lousiville, KY)
Delta Dental of Louisiana(Irving, TX)
Delta Dental of Maine (Northeast)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

23166
04614
CDMI0
CDMN1
94276
43090
94276
CDNE1
94276
02027
22189
85022
11198
56101
CDND1
CDOH1
CDOK1
CDOR1
23166
660436769
05029
43091
54097
CDTN1
94276
94276
02027
CDVA1
52147
91062
31096
39069
CDWY1
07025
CPPCA
94235
WIMAN
CDMN1
WDENC
DDCA2
CDCAP
LX077
LX038
CX036
CX049
CX014
04356
CX014
EMBDQ
52133
GP133
52133
52133
CX035
58102
64246

Delta Dental of Maryland(Mechanicsburg, PA)
Delta Dental of Massachusetts (Boston, MA, Milwaukee,
Delta Dental of Michigan(Farmington Hills, MI)
Delta Dental of Minnesota(Minneapolis, MN)
Delta Dental of Mississippi (Irving, TX)
Delta Dental of Missouri
Delta Dental of Montana (Sacramento, CA)
Delta Dental of Nebraska(Minneapolis, MN)
Delta Dental of Nevada (Irving TX)
Delta Dental of New Hampshire (Northeast)
Delta Dental of New Jersey (Parsipanny, NJ)
Delta Dental of New Mexico(Albuquerque, NM)
Delta Dental of New York (Mechanicsburg, PA)
Delta Dental of North Carolina(Farmington Hills, MI & Sa
Delta Dental of North Dakota(Bismark ND)
Delta Dental of Ohio(Farmington Hills,MI)
Delta Dental of Oklahoma(Oklahoma City, OK)
Delta Dental of Oregon (Oregon Dental Service)(Portland
Delta Dental of Pennsylvania(Mechanicsburg, PA)
Delta Dental of Peurto Rico
Delta Dental of Rhode Island (Providence, RI)
Delta Dental of South Carolina(Columbia SC)
Delta Dental of South Dakota( Pierre, SD)
Delta Dental of Tennesse (Nashville, TN)
Delta Dental of Texas(Irving TX)
Delta Dental of Utah (Irving TX)
Delta Dental of Vermont (Northeast)
Delta Dental of Virginia (Roanoak, VA)
Delta Dental of Washington DC (Mechanicsburg, PA)
Delta Dental of Washington-State
Delta Dental of West Virginia
Delta Dental of Wisconsin Stevens Point, WI)
Delta Dental of Wyoming
Delta Dental of Wyoming (Cheyenne, WY)
Delta Dental-Healthy Families (Sacramento, CA)
Delta Health Systems (Stockton, CA)
Delta of MI (PO Box 30416, Lansing, MI)
Delta of MN ( Po Box 9120, Farmington Hills, MI)
Delta of WI (PO Box 103 Stevens Point)
DeltaCare (Cerritos, CA)
DeltaCare USA - Encounters Only (12898 Town Center, C
Deltacare (Lansing MI)
Dencap (Detroit, MI)
Denex (Houston, TX & Rockville, MD)
Denex/SG (PO Box 2767, Houston, TX)
DentaQuest
DentaQuest (Boston, MA)
DentaQuest (WI)
DentaQuest-Emblem(Emblem Health)(Milwaukee, WI)
Dental Benefit Providers (CA) (San Fransico, CA)
Dental Benefit Providers (PO Box 427 Thiensville, Milwau
Dental Benefit Providers (Thiensville, WI)
Dental Benefit Providers\United Health - Bethesda, MD,U
Dental Care Plus - (Cincinnati, OH & Sharonville, OH)
Dental Decisions (2600 McCormick) Clearwater, FL)
Dental Guard Preferred (Spokane, WA)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

46278
46278
81264
CX094
CX034
DNOA1
39148
DSL01
DSL01
DSL01
CX004
DTCA7
CX017
67814
88888
43168
22384
94146
DESAZ
CX089
A1004
38238
96400
33192
58102
LX129
37272
HSP01
CX040
25160
DOM01
LX002
DOM01
DOM01
25145
CX014
CX014
CX014
CX014
CX014
CKKY3
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014

Dental Health & Wellness (St. Louis, MO & Milwaukee, W
Dental Health & Wellness (Tampa, FL)
Dental Health Alliance (Shawnee Mission, KS)
Dental Health Services of America (Long Beach, CA)
Dental Network - Towson, MD
Dental Network of America (IL)
Dental Professional of WI (Southeast Dental)(Milwaukee,
Dental Select (Murray,Draper, UT)
Dental Select (Richardson, TX)
Dental Select (SLC, UT)
Dental Service Corp (Fargo, ND)
Dental Transformation Initiative (DTI)
Dentalcomp - Harrisburg, PA
DenteMax (Wellesley Hills)
Dentegra (Alpharetta, GA)
Dentemax (St. Louis, MO)
DentexMax (Wayne, PA)
Denti-Cal (Medicaid of California) (Sacramento, CA)
Department of Economic Security (Phoenix, AZ)
Desert Mutual Benefit Admin (Salt Lake City, UT)
Detroit Laborers (Metropolitan) (Landing, MI)
Detroit Tower Trades( Po Box 99490, Troy MI)
Diego PACE (Eden Prairie, MN)
Direct Assignment Benefit Plan (St. Petersburg, FL)
Direct Assignment Benefits (PO Box 9077 Clearwater, FL
Direct Dental (San Anselmo CA)
Direct Reimbursement Benefits (Newnan, GA)
District Council 37 Health & Welfare Fund
Diversified Admin Corp. - Marlborough, CT
Diversified Group (Maryland) (Harrisburg, PA)
Dominion Dental (115 S Union Ste 300, Alexandria, VA
Dominion Dental (Alexandria, VA)
Dominion Dental (Elk Grove Village, IL)
Dominion Dental (PO Box 1920, Boie, MD)
Dominion Dental Benefit Coordinators Corp. - Pittsburgh,
Doral Dental of Arizona
Doral Dental of Arizona--CIGNA
Doral Dental of Connecticut
Doral Dental of Illinois
Doral Dental of Illinois
Doral Dental of Kentucky / Region 3 (Mequon , WI)
Doral Dental of Maryland Helix
Doral Dental of Maryland Physicians Care
Doral Dental of Maryland Priority partners
Doral Dental of Minnesota
Doral Dental of Minnesota Medicare
Doral Dental of Missouri St. Louis
Doral Dental of Missouri- Kansas City
Doral Dental of Nebraska
Doral Dental of New Jersey Amerigroup
Doral Dental of New Jersey HealthNet
Doral Dental of New Mexico
Doral Dental of New York
Doral Dental of New York Non global Budget
Doral Dental of Ohio
Doral Dental of Oklahoma Community Care

No
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
LX067
35186
34159
LX112
38241
81039
41198
16117
LX107
CX043
EBSRM
73288
36364
CX079
73288
CX037
62308
FX044
34108
55069
08754
CX079
03964
LX136
LX168
A4681
A4681
13551
EMBDQ
55093
41198
38241
37257
37257
37257
37257
37257
37257
CX025

Doral Dental of Oklahoma Heartland
Doral Dental of Oklahoma Non Global Budget
Doral Dental of Oklahoma Unicare
Doral Dental of Oklahoma Unicare non global
Doral Dental of Pennsylvania- Keystone
Doral Dental of Pennysylvania Pittsburgh
Doral Dental of Pennysylvania- AmeriHealth
Doral Dental of Pennysylvania- Healthmate
Doral Dental of Pennysylvania-Philadelphia
Doral Dental of Tennessee Tenn Care
Doral Dental of Virginia (M)
Doral Dental of Virginia- Commercial
Doral Dental of Virginia- Premier
Doral Dental of Virginia- Sentara
Doral Dental of Virginia- Unicare
Doral Dental of Virginia-Commercial
Doral Dental of kansas
Dr Admin Services (Plainview NY)
Dunn and Associates Benefits Administrators, Inc
E-V Benefits Management, Inc. (Columbus, OH)
EBA M Corp (Westlake Village CA)
EBC (Farmington Hills, MI)
EBMS (Emp Benefit Mngmt Serv, Inc.) Billings, MT & Salt
EBS (Employee Benefit Services of Lousiana, Inc) Shreve
EBS (RMSCO)(Syracuse or Liverpool, NY)
EBS (San Antonio TX)
EBS Benefit Solutions (PO Box 4863, Syracuse, NY)
EBS-RMSCO (NY)
EHI Employers Health of Wisconsin (Lexington, KY)
EHN Medical Group IPA (Rockford, IL)
EMIA-Educators Mutual (Murray, UT)
EMPHESYS Employers Health of Wisconsin
EPSI Dental II (Capital Dental)
EQUICOR
ERISA (Austin, TX)
ES Beveridge & Associates (Mansfield, OH)
Ebix Health Admin Exchange (PO Box 211288 Eagan, M
Eddy SeniorCare (Newton Square, PA)
Educators Mutual Ins. Assoc. (Murray, UT)
Elderwood Health (Eden Prairie, MN)
Electrical (2002 London, Duluth, MN)
Electrical Welfare Trust (Lanham, MD)
Electrical Workers (Indianapolis, IN)
Electrical Workers (Indianpolis, IN)
Emblem Health (Group Health)(New York, NY)
Emblem Health Medicaid-DentaQuest(Milwaukee, WI)
Empire BCBS of NY (Minneapolis, MN)
Employee Benefit (Lubbock, TX)
Employee Benefit Consultants (Farmington Hills, MI)
Employee Benefit Consultants(Albuquerque, NM)
Employee Benefit Consultants(Appleton, WI)
Employee Benefit Consultants(Broadview Hts, OH)
Employee Benefit Consultants(Findlay, OH)
Employee Benefit Consultants(Louisville, KY)
Employee Benefit Consultants(Milwaukee, WI)
Employee Benefit Mngmt (EBMC) - Dublin, OH

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

81039
03036
03036
41198
CX012
47009
42149
EDHP1
CX022
35112
29979
CX031
LX042
75232
73288
36659
59297
WDENC
91136
36878
46278
37331
73126
CX046
74234
43168
35605
MNM01
93240
22344
LX183
CBNYR
71412
91136
33033
95411
48117
LX120
CXFMC
CX096
89070
LX055
71056
41041
FDIC1
FX007
72630
LX162
CX050
LX117
75138
64246
CX090
CX086
70408
25133

Employee Benefit Mngmt Serv (EBMS)(Billings, MT)
Employee Benefit Plan Admin (Burlington, VT)
Employee Benefit Plan Administration, Inc (PO Box 2000,
Employee Benefit Services of Louisiana, Inc (EBS) Shrev
Employee Benefit Systems - Pembroke, MA
Employee Benefits Services (Lincoln, NE)
Employee Benefits Systems of IA (Burlington, IA)
Employee Direct Health Plans (PO Box 211003, Eagan, M
Employee Group Services (EGS) PO Box 75008 Cedar Ra
Employee Plans, LLC - PO Box 2362, Fort Wayne, IN
Employee Resource Management (Phoenix, AZ)
Employer Plan Services, Inc - Houston, TX
Employers Direct Health
Employers Direct Health (Dallas, TX)
Employers Health of Wisconsin (EHIC) (EMPHESYS) (Lexi
Employers Midwest Health Benefits (Park Ridge, IL)
Employers Mutual, Inc (Stuart and Jacksonville, FL)
Encara (Stevens Point, WI)
Enstar Natural Gas (Detroit, MI)
Entrust (Eagan, MN)
Envolve (Dental Health & Wellness)
Epoch (St. Louis, MO)
Equitable Plan Services, PO Box 720460, Oklahoma City,
Erin Group Administrators (Lancaster, PA)
Erisa Group/CompuSys (Austin, TX)
Essex Dental Benefits (St Louis, MO)
Everence (Goshen, IN)
Everence (Mennonite Mutual Aid)(Goshen, IN)
Evergreen Health Co-Op (Clinton, IA)
Exceedent (Milwaukee, WI)
Excellus (BCBS)(Eagan, MN)
Excellus (PO Box 22999, Rochester, NY)
ExclusiCare (Charlotte , NC)
FBX North Star Borough/ School District
FCE Benefit Administrators (Eagan, MN & San Antonio, T
FL MCO PHC / PHP (La Verne, CA)
FMH Benefit Services, Inc. of KS (Overland Park, KS)
FMRSD Dental Plan (Walpole NH)
Family Care CCO (Salem, OR)
Family Dental (Salem, OR)
Family Members Dental Plan (Harrisburg, PA)
Fara Benefits (PO Box 8770, Metairie, LA)
FedEx Freight East, Inc (Harrison, AR)
Federated Insurance - Owatonna, MN
Fidelio Dental insurance (Glenside, PA)
Fidelio Laborers (2826 Mt Carmel, Glenside, PA)
First Ameritas Life Ins Corp of New York (Lincoln, NE)
First Benefit Admin (Largo, FL)
First Care / Southwest Life and Health (Austin, TX)
First Choice (Beloit WI)
First Choice of the Midwest, Inc (Sioux Falls, SD)
First CommonWealth(Spokane, WA & Chicago, IL)
First Continental Life & Accident Insurance (SugarLand,
First Dental Health (San Diego, CA)
First Fortis Life Insurance (Clinton, IA)
First Health (Tucson, AZ - London, KY)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

25133
660537624
FP66053762
13317
LX101
ENDVR
74223
39026
FX061
95266
FX061
90328
11244
FX135
LX058
R7004
68241
76031
48116
LX134
68241
25133
60054
25059
LX050
DNOA1
70408
39065
BOONG
64069
LX084
CX041
LX184
31478
LX057
59069
45289
59204
80241
GCU01
06143
75238
67814
57254
44054
LX071
13551
80314
48143
37283
96938
67814
LX161
63665
LX047
67814

First Health - Tucson, AZ - London, KY, Coraoplis, PA)
First Medical (International)
First Plus
First Reliance Standard (Lincoln, NE)
First Service Administrators (Lakeland FL)
First Source (Endeavor) (Lake Katrine, NY)
Fiserv (Benefit Planners) (San Antonio, TX)
Fiserv (Wausau, WI & Pueblo, CO)
Fiserv - Harrington (PO Box 2697, Wichita, KS)
Fiserv - Harrington Benefit (Columbus, OH)
Fiserv-Harrington Health (PO box 30544, Salt Lake City,
Fiserv-Lovelace Health (Westerville, OH)
FitzHarris & Company, Inc(Farmingdale, NY)
FlagShip DeltaCare (Parsppany, NU)
FlagShip Dental Care (PO Box 369) (Parsippany, NJ)
Flex Compensation (Mpls, MN)
FlexCare
Florida Combined Life(Blue Cross of FL)(PO Box 100135,
Florida Hospital Waterman (Tavares,, FL)
Florida League of Cities (Orlando FL)
Florida Power & Light
Foreign Service Benefit Plan (London, KY)
Foreign Service Benefit(Washgington, WA)
Forest County Potawatomi Ins.
Formula Corporation (3265 Northwood Circles, Eagan, M
Fort Dearborn Life Ins
Fortis Benefits/Protective Life - Birmingham, AL
Fortis Insurance Company - WI
Foundation Benefit Admin (FBA) (Austin, TX)
Fox Everett, Inc (Ridgeland & Jackson, MS)
Frank M Vaccaro Asso Mount Laurel NJ)
Fraternal Order of Police - Philadelphia, PA
Freedom Life (Ft Worth, TX)
Freedom Network (Po box 25938) Shawnee, KS)
Freedom of Choice (MHHNP)(PO Box 742567 Houston, T
Fringe Benefit Management (Fl)
Fringe Benefits (Austin, TX)
Fringe Benefits Coorinators of FL (Daytona Beach, Ormo
GBS (Eagan, MN)
GCU Local 8-M & 96B Health & Welfare Fund
GEGA - GE Group Administrators, South Carolina (South
GEGA - GE Group Administrators, Texas
GEGLAC (Genworth Life & Health) GE Group
GEHA - All Plans except PO Box 4665 (Independence, M
GEHA Only (PO Box 4665, Independence, MO)
GEM Group (Claymont, DE)
GHI - New York (Group Health, Inc)(New York, NY)
GIC-Idemnity Plan
GPA (Group Pension Admin)(Richardson, TX)
Gallagher Benefit Administrators (Lisle, IL)
Gateway Health Plan (Milwaukee, WI)
Ge Group Life Assurance Co. Phoenix American Life (Gre
Gem Group (Pittsburgh, PA)
General American Life (Kennett, MO)
Genworth (PO Box 40011, Lynchburg, VA)
Genworth Dental (PO Box 40011, Lynchburg, VA)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

67814
CX064
07205
91136
LX008
52133
GWD01
GWD01
57254
44054
LX098
80705
39640
LX040
75256
36338
72153
LX151
80241
CX011
CB951
CX036
10006
89070
95192
13551
38194
37276
CX015
48143
LX020
LX066
48143
CX061
64246
GI813
60389
60652
LX059
LX093
82018
48330
10004
10001
51037
41170
37224
37256
47738
97258
95266
22521
59142
75243
75196
06131

Genworth Life & Health (GEGLAC)(GE Group LIfe)
Gettysburg (Frederick, MD)
Gilsbar, Inc - Covington, LA & Jackson, MS (Covington, L
Glassworkers Health & Welfare Fund (Seattle, WA)
Golden (Warren MI)
Golden Rule (SLC, UT)
Golden West Dental (21555 Oxnard S, Woodhills, CA)
Golden West Dental (PO Box 5347, Oxnard, CA)
Government Employees Health Assoc. (GEHA)(All Plans e
Government Employees Hospital Assoc (GEHA) Only (PO
Great Cornerstone Life & Health (Edmond OK)
Great-West Life and Annuity Ins. Co. (Kennett, MO)
GreatLakes PACE (Eden Prairie, MN)
Group Admin (San Antonio, TX)
Group Administrators (PO Box 780159, San Antonio, TX)
Group Administrators Ltd. - Schaumburg, IL
Group Benefit Administrators (Henderson, TN)
Group Benefit Administrators (SLC, UT)
Group Benefit Services (Eagan, MN)
Group Benefit Services (East Lansing, MI)
Group Benefit Services (Luterville, MD)
Group Dental Services(Houston, TX & Rockville, MD)
Group Health (Madison, WI)
Group Health Coop. Ind. and Family (PO box 69443)
Group Health Cooperative (Eau Clairie, WI)
Group Health Insurance (New York, NY)
Group Health Managers - Redford, MI
Group Insurance Service Center (Pembroke, MA)
Group Link of Indiana (Indianapolis, IN)
Group Pension Admin (GPA)(Richardson, TX)
Group Pension Admin (PO Box 830248, Richardson, TX)
Group Resources (Dallas, Houston, Atlanta, Pheonix)
Group and Pension Admin (GPA)(Richardson, TX)
Guarantee Life Insurance
Guardian Life Insurance Company of America (Spokane,
Guardian Managed DentalGuard (Sacramento, CA)
Gulf Coast (UCS) Phoenix, AZ)
Gulf South Risk Services (Phoenix, AZ)
H & A Administrators (Plymouth, MN)
HCH Administration Inc (Peoria IL)
HCS (Health Claims Services)(Boise, ID)
HMAA (Hawaii)
HMSA Federal Program
HMSA-Hawaii Medical Services Assoc (Honolulu, HI)
HNAS (Eagan, MN)
HRM Claim Management (Kalamazoo,MI)
HSBS (Health Smart Benefit Solutions (Memphis, TN)
HSBS Oklahoma City (Oklahoma City, OK)
Hamaspik Choice (Monsey, NY)
Hammerman and Gainer (Irving, TX)
Harrington Benefit Services (Columbus, OH)
Harrington Benefit Services (Oklahoma City, OK)
Harrington Benefit Services (Oklahoma City, OK)
Harrington Benefit Services (Seattle, WA)
Harrington Benefit Services (Westerville, OH)
Harrington Benefit Services, Inc (Tampa, FL)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

59143
FX061
10002
86066
25160
71056
LX105
62179
22521
59142
46221
22100
82018
62111
LX114
41178
16112
CX039
75234
30946
CX083
HND1
20199
51037
69821
CX010
CX009
62157
22521
59142
47009
59140
76342
CX055
CX019
25133
41170
37283
37283
37224
41154
71064
85729
20356
95213
34185
75234
75234
25125
59226
52133
HND2
55204
25133
71063
71063

Harrington Health Colonial Dental (Salt Lake City, UT)
Harrington Health-Fiserv (PO Box 520, Pueblo, CO)
Hawaii Dental Service Assoc (Honululu(, HI)
Hawaii-Mainland Admim (Tempe, AZ)
Health Aspex (Maryland)
Health Benefit Claims Dept (Harrison, AR)
Health Care Solutions Group (Muskogee OK)
Health Choice (Medicaid) (Phoenix, Tempe, AZ)
Health Choice (Oklahoma City, OK)
Health Choice (Oklahoma City, OK)
Health Choice Insurance (Phoenix, AZ)
Health Choice Integrated Care (Flagstaff, AZ)
Health Claims Services (Boise, ID)
Health Cost Solutions (Hendersonville, TX 37077)
Health EOS by Multiplan
Health EZ (Americas TPA)(Minneapolis, MN)
Health Economics (Rochester, NY)
Health Economics Group Inc - Rochester, NY
Health First TPA (Eagan, MN & Tyler, TX)
Health Future, LLC Medford, OR
Health Net (Liberty Dental) (Santa Ana, CA & Tamp, FL)
Health Net - Commercial (Van Nuys, CA)
Health Network of America (Ft. Worth, TX)
Health Now (Eagan, MN)
Health Partners - Next Level (Birmingham, AL)
Health Partners of Minnesota (Medicaid) (Minneapolis, M
Health Partners of Minnesota - Commercial (Minneapolis,
Health Partners of Tennessee- Jackson, TN
Health Plan SErvices of OK (Oklahoma City, OK
Health Plan Servces of OK- Oklahoma City, OK
Health Plan Services (Lincoln, NE)
Health Plan Services (Tampa, FL)
Health Plan of NV (Las Vegas, NV)
Health Plans, Inc (Westborough, MA)
Health Resources Incorporated (HRI) - IN (Evansville, IN
Health Right of CT (Medicaid Claims)
Health Risk Management, Inc. (HRM)(Kalamazoo, MI)
Health Smart ( Po Box 93670, Lubbock TX)
Health Smart Benefit (PO Box 167768, Irving TX)
Health Smart Benefit Solutions (HSBS)(Memphis, TN)
Health Traditions (MMSI)(Rochester, MN)
HealthChoice (Lubbock, TX)
HealthComp TPA (PO Box 45018, Fresno, CA)
HealthE Exchange (Kansas City, MO)
HealthEdge Administrators (Bakersfield, CA)
HealthFirst Houston (Houston, TX)
HealthFirst TPA (Eagan, MN)
HealthFirst TPA (Tyler, TX)
HealthLink (St. Louis)
HealthMarkets (MEGA Life)(TX)
HealthNet (SLC, UT)
HealthNet - Gov't Program
HealthNow NY (PO Box 80, Buffalo, NY)
HealthRight of CT (Medicaid claims to First Health Strata
HealthSCOPE Benefits, Inc (Little Rock, AR)
HealthScope Benefits (Po Box 619055, Dallas, TX)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

CXHSC
37256
87815
75237
87815
31172
HMA01
75289
56144
11271
LX041
68195
CPPCA
CARRS
22148
LX037
95378
89070
88023
34150
CX015
22099
22099
22099
91136
LX136
61101
73288
22175
LX145
IAT01
A1117
A1317
A1461
A4681
LX079
64246
LX075
41124
CXIBT
LX141
LX111
41600
FX056
17882
26879
40585
91136
36600
CDOK1
ICW01
CX070
35107
43471
52196
31172

HealthShare CCO (Salem, OR)
HealthSmart (Oklahoma City, OK)
HealthSmart (PO Box 91608, Lubbock, TX)
HealthSmart Accel (Lubbock & Irving, TX)
HealthSmart Benefits(Charleston, WV)
HealthTrans (Innovative Benefit Admin)(Greenwood Villa
Healthcare Management Administrators, Inc (Bellevue,
Healthfirst of Austin (Dallas, TX)
Healthgram Inc. (Primary Physician)(Charlotte, NC)
Healthplex, Inc. (Uniondale, NY)
Healthscape (Bend, OR)
Healthsource/Provident Insurance Co.(Chattanooga, TN)
Healthy Families (Sacramento, CA)
Healthy MI Dental (Detroit, MI)
Heavy and General Labors Fund of New Jersey (Newark,
Heritage Consultants (Auburndale, FL)
Heritage National Healthplan/John Deere Health Care
Highmark/HHIC (PO Box 69433 Harrisbury, PA)
Hometown Health (Reno, NV)
Hometown Health Network (Saint Clairsville, OH)
Hoosier Dental (Indianapolis, IN)
Horizon (Blue Cross of New Jersey) (Indianapolis, IN)
Horizon BCBS NJ ( Po box 1311, MPLS)
Horizon NJ Health (PO Box 299, Milwaukee, WI)
Hotel Employees & Restraunt Employess Health Trust(Se
Hotel Restaurant (2002 London, Duluth, MN)
Humana Medicare/Humana Gold
Humana/Employers Health of WI (Lexington, KY)
I.E. Shaffer (West Trenton, NJ)
IAA (Mt Laurel, NJ)
IATSE - Atlanta Health & Welfare Fund
IBEW Local 117(Carmel, IN)
IBEW Local 38(Carmel, IN)
IBEW Local 461(Carmel, IN)
IBEW Local 481 (Carmel, IN)
IBEW Local Union 577 (Madison WI)
IBEW Welfare Trust Fund (Decatur, IL)
IBEW Welfare Trust NECA (Decatur IL)
IBI ( Minneapolis, MN)
IBT - Local 145 Health Services & Ins Plan (Statford, CT)
IHC Admin Services (Eagan, MN)
IMA (Bossier City LA)
IMCare (Grand Rapids, MN & Birmingham, AL)
IMS (Amarillo, TX)
IMS TPA: Parton Lumber (UCS) (Phoenix, AZ)
IMS TPA: Walker White (USC)(Phoenix, AZ)
INDECS Corp. (Lyndhurst, NJ)
Idaho Pipe Trades
Illinois Central Hospital Association
Indian Health Services (Oklahoma City, OK)
Indiana Carpenters Welfare Fund( Indianapolis, IN)
Indiana Childrens Special HealthCare (Indianapolis, IN)
Indiana Teamsters Health Benefit Funds (Indianapolis, I
Inetico (Tampa, FL)
Informed, LLC
Innovative Benefit Admin (HealthTrans)(Greenwood Villa

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

40025
37279
13315
15688
88006
11889
74385
86304
51020
23229
84137
87765
LX158
IAT01
660537624
IAHFI
36609
A1317
A1461
A4681
41124
41600
61271
14168
79480
34136
14168
LX096
CX061
JEN01
CXJAS
LX119
41099
95378
80314
38310
CHSJT
J1410
CX073
40137
57038
KBT01
CX058
CX058
95279
61453
73100
29979
73100
77894
37217
37323
KEY01
LX043
34145
52193

Innovative Health (PO Box 14094, Lexington, KY)
Insurance Admin of America (Mount Laurel, NJ)
Insurance Design Administrators - Oakland, NJ
Insurance Management Services (Elko, NV)
Insurance Management Services, Elko, NV
Insurance Systems (PO Box 211006, Eagan, MN)
Insurance Systems Inc. (Monroe, LA)
Insurers Administrative Corporation (Phoenix, AZ)
Integra Adminstrative Group - Seaford, DE
Integral Quality Care (Phoenix, AZ)
InterWest Health (Eagan, MN)
Interactive Medical Systems (PO Box 21145, Eagan, MN)
Interactive Medical Systems (Wake Forest, NC)
Interantional Association of Theatrical State Employees (
International (First Medical)
International Assoc. of Health & Frost (Tinley Park, IL)
International Brotherhood of Boilermakers (Kansas City,
International Brotherhood of Electrical Workers (IBEW) L
International Brotherhood of Electrical Workers (IBEW),
International Brotherhood of Electrical Workers (IBEW),
Iowa Benefits, Inc( Minneapolis, MN)
Itasca Medical Care (Grand Rapids, MN & Birmingham, A
J.F. Molloy and Associates, Inc.(Colorado Spring, CO)
JLT Services Corporation (Latham, NY)
JMS-MSA (Po Box 679, Farmington MI)
JP Farley Corporation(West Lake, OH)
Jardine Group Services (Latham, NY)
Jefferson Federation
Jefferson Pilot (Omaha, NE)
Jenkins & Associates (1299 BattleCreek Rd, Ste 200 & P
Jensen Administrative Services (SLC, UT)
Jerrys Home Improvement (Portland OR)
John Alden Life Ins. (501 W Michigan, Milwaukee, WI)
John Deere Health Care/Heritage National Healthpla(Moli
John Hanncock
John Morrell Co. AHBPA (Birmingham, AL)
Joint Benefit Trust (Dublin, CA)
Jopari Careworks (Columbus, OH)
Kaiser Permanente (PO Box 4360, Rockville, MD)
Kalos Health (Niagara Falls, NY)
Kanawha Ins Co. - Lancaster, Greenville, SC
Kansas Building Trades (Topeka, KS)
Kansas City Life (PO Box 9040 Austin, TX)
Kansas City Life Insurance Company (Kansas City, MO)
Keenan Associates (Torrance, CA)
Kemper (Milwaukee, WI)
Kempton Company - OK (Oklahoma City,OK)
Kempton Group (UCS) (Phoenix, AZ)
Kempton Group Administrators (Oklahoma City, OK)
Kentucky Health Co-Op (Fort Mill, SC)
Key Benefit Admin (Milwaukee, WI)
Key Solution (Fort Mill, SC)
Keystone Mercy Health Plan (Milwaukee, WI)
Klais Company (Akron, OH)
Klais and Company (Fairlawn, OH)
LBA HealthPlans, Inc (Timonium, MD)(El Paso, TX)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

25922
25924
25923
59847
76184
A1004
LSH01
37116
90096
CX083
33LGC
78140
71498
RLH01
CX047
EBSRM
37294
27005
93093
CX061
73288
LCB01
NYT01
NYT01
35107
84041
IAHFI
LX092
NYT01
NYT01
NYT01
NYT01
NYT01
NYT01
LX125
NYT01
NYT01
NYT01
NYT01
05030
NYT01
GCU01
LX079
91136
CB752
LX100
45289
45289
FX045
LX045
23223
62310
90328
62310
52133
CX033

LIFE Armstrong (Eden Prairie, MN)
LIFE Beaver & Lawrence (Eden Prairie, MN)
LIFE Butler (Eden Prairie, MN)
LIFE St. Joseph of the Pines (Eden Prairie, MN)
LIFE St. Mary (Eden Prairie, MN)
Laborers Metropolitan Detroit HealthCare Fund (Langsing
Laborers Southeast Health & Welfare Plan
Lake County Physicians Associaton
Land of Lincoln (Chicago, IL)
Liberty Dental Plan (Santa Ana, CA & Tampa, FL)
Life Gift Cards (Woodland Park, CO)
Life Insurance Company of Boston & New York
LifeCircles PACE (Muskegon, MI)
LifeMap (PO Box 1271, Portland, OR & Milwaukee, WI)
LifeRe (San Antonio, TX)
LifeTime Benefits (EBS-RMSCO)(NY)
LifeWise/Washington Employers Trust (Seattle, WA)
Lifestyle Dental (Witcha, KS)
Lifewise Health Plan or Oregon (Bend, OR)
Lincoln National (Omaho, NE & Orlando, FL)
Lincoln National of Wisconsin (Madison or Green Bay)
Line Construction Benefit (Lombard, IL)
Local 1149 Baldwinsville NY
Local 118 Rochester NY
Local 135 Health Benefits - Indianapolis, IN
Local 137 Operating Engineers (Hopatchung, NJ)
Local 17 Fund-Int. Assoc. of Heath & Frost(Tinley Park, I
Local 174 (Joliet IL)
Local 182 Utica NY
Local 264 Cheektowaga NY
Local 294 Albany NY
Local 317 Syracuse NY
Local 375 Buffalo NY
Local 449 Buffalo NY
Local 513 (Bridgeton MO)
Local 529 Elmira NY
Local 669 Albany NY
Local 687 Potsdam NY
Local 693 Binghamton NY
Local 731 (Burr Ridge, IL)
Local 791 Rochester NY
Local 8-M & 96B Health & Welfare
Local Union 577 IBEW (Madison WI)
Locals 302 and 612 of the I.U.O.E
Lockard & Williams (Pascaqoula, MS)
Logistics Health Inc (LaCrosse WI)
LoneStar (Eagan, MN)
LoneStar TPA via ECOM (Tyler, TX)
Loomis (Reading, PA)
Loomis (Reading, PA)
Loomis Company (Wyomissing, PA)
Lovelace Insurance
Lovelace Sandia Health Plan (Westerville, OH)
Lovelace Senior Options(LSO) and Lovelace Senior Plan(L
M-Plan Dental (Salt Lake City, UT)
MAMSI - (Frederick, MD)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

MBAAZ
83028
87065
87065
56205
65030
660396197P
41101
59226
LX057
94276
27401
LX133
10317
41154
89070
R7005
LX159
37233
20572
LX130
10317
91136
CX042
25133
25160
GI813
35162
65030
64246
CX014
98010
4600012
FX032
LX032
LX025
CX098
CX014
LX157
37217
92805
41154
37287
31149
LX164
LX049
EM284
EM843
EM205
EM039
EM522
74323
56205
57016
CX026
CX026

MBA (El Paso, TX)
MBA Benefit Admin (Salt Lake & Murray, UT)
MBA Benefit Administrators (Salt Lake City, UT)
MBA of Wyoming (Worland, WY)
MBS (MedCost Benefit Services(MBS))Winston Salem, NC
MCNA (Managed Care of North America) Fort Lauderdale
MCS / MCS Classic Care
MDB (1335 Industrial Blvd., Ste 100, St. Paul, MN)
MEGA Life & Health Insurance Company (North Richland
MHHNP (Memorial Herman Health)(PO Box 742567 Hous
MHHNP (Po Box 742567, Houston TX)
MI UFCW Union (Madison Heights, MI)
MMA (Goshen IN)
MMEHT (Augusta, ME)
MMSI-Mayo Clinic Health Solutions (Rochester, MN)
MMSO (Military Medical Support) (Po Box 886999)
MN Power (Duluth, MN)
MPE Employee Benefit Services (Jackson, MS)
MPEEBT / MPE Services, Inc (Jackson, MS)
MSA Careguard (North Reading, MA)
MVP Medical (Schenectady NY)
Machigonne Benefit Administators (Portland, ME)
Machinists Health
Mahoney Benefit Admin, LLC of TX(Ft. Lauderdale, FL)
Mail Handlers Benefit Plan (Jacksonville, FL)
Manage Care of America (Pittsburgh, PA)
Manage Dental Guard (Sacramento, CA)
Managed Care Services (Fort Wayne, IN)
Managed Care of North Ameica (MCNA) Fort Lauderdale,
Managed Dental Guard(Woodland Hills, CA)
Managed Health Services - WI State Employees
Manulife, W.J. Sutton Co. - Toronto Ontario, Canada
MapFre
Maritime Association (Houston, TX)
Maritime Association (Houston, TX)
Marsh Advantage (po box 4542, Iowa CIty IA)
Masonry Institute (Des Plaines, IL)
Mass Health (Doral Dental) Hingham, MA
Massachusetts Benefit Admin (Boston, MA)
Maverist (Milwaukee, WI)
Maxor (Amarillo, TX)
Mayo Clinic Health Solutions-MMSI (Rocehster, MN)
McCrew Care (Columbia, SC)
McGregor PACE (Eden Prairie, MN)
McLaren Health Plan (Flint, MI)
McPrime West (1335 Industrial Blvd. Ste 150, Mpls, MN)
Med3000 CMS Safety Net
Med3000 CMS Title 19
Med3000 CMS Title 21
Med3000 Pedicare Title 19
Med3000 Pedicare Title 21
MedBen (Newark, OH)
MedCost Benefit Services (MBS)- Winston Salem, NC
Medi-Cal (PO Box 15559, Sacramento, CA
Medica of MN - PO Box 1328, Mpls, MN
Medica of MN - PO Box 1519, Mpls, MN

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

CKMEH
CX014
CX014
CX014
CX014
CKAZ1
CKAL1
CKAK1
CKAR1
94146
CKCO1
CKCT1
CKDE1
CKDC1
CKFL1
CKGA1
CX014
CKIL1
CKID1
CX014
CKIN1
CKIA1
CKKS1
CKKY1
CKKY3
CX014
CKLA2
CKLA1
CKME1
CX014
CKMA1
CKMI1
CKMN1
CKMS1
CKMO1
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CKMT1
CKNE1
CKNV1
CKNH1
86047
CKNJ1
CKNM1
CX014
CX014
CX014
CKNY1
86048
CKNY2
CKNC1

Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid
Medicaid

No
No
No
No
No
No
Yes
Yes
No
No
No
No
No
Yes
Yes
No
No
No
No
No
No
Yes
No
Yes
No
No
No
No
Yes
No
No
No
Yes
Yes
No
No
No
No
No
No
No
No
No
Yes
Yes
No
No
Yes
Yes
No
No
No
Yes
No
Yes
No

- Maine for FQHC
Pennysylvania Best Health Care Pittsburgh (Do
Pennysylvania Gateway Health Plan (Doral Den
Pennysylvania Health Partners Pittsburgh (Dor
Pennysylvania Oaktree (Doral Dental of WI)
of AZ
of Alabama
of Alaska
of Arkansas
of California (Denti-Cal)
of Colorado
of Connecticut (New Britton, CT)
of Delaware - New Castle, DE
of Disctrict of Columbia (Washington, DC)
of Florida
of Georgia
of Georgia Grady Healthcare Inc (Doral Dental
of IL - Doral Dental of WI (Admin by Doral)
of Idaho (Boise, ID)
of Illinois (Doral Dental of WI)
of Indiana (Boise, ID)
of Iowa (Des Moines, IA)
of Kansas (Mequon, WI)
of Kentucky (Mequon , WI)
of Kentucky Region #2 (Doral Dental Services)
of Kentucky Region #3 (Doral Dental of WI)
of Louisiana (Adult Dental)
of Louisiana (EPSDT) (Baton Rouge, LA)
of Maine
of Maryland-Dept of Health and Ment
of Massachusetts
of Michigan
of Minnesota
of Mississippi
of Missouri (Jefferson City, MO)
of Missouri Blue Advantage (Doral Dental of WI
of Missouri Community Care Plus- St Louis (Dor
of Missouri Community Health PLan (Doral Den
of Missouri First Guard Health Plan (Doral Dent
of Missouri Health Net (Doral Dental of WI)
of Missouri Truman Care- Family Health Partner
of Missouri health Care USA- St.Louis (Doral De
of Montana
of Nebraska (Lincoln, NE)
of Nevada (San Antonio, TX)
of New Hampshire
of New Jersey (Admin by Americhoice)(Salt Lak
of New Jersey (Trenton, NJ)
of New Mexico
of New Mexico Cimmaron Health Plan (Doral D
of New Mexico Loveplace Community health pla
of New Mexico Presbyterian Salud (Doral Denta
of New York
of New York (Administrated by AmeriChoice)
of New York (Dental Clinics Only)
of North Carolina (Raleigh, NC)

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

CKND1
CKOH1
CX014
CX014
CX014
CKOH2
CKOK1
CX014
CX014
CKOR1
CKPA1
CX014
CKRI1
CKSD1
CKSC1
CX014
CKTX1
CKUT1
CKVA1
CKVT1
CX014
CKWA1
CKWV1
CKWI1
CX014
CX014
CKWY1
CX014
MAHC1
LX019
CX024
74323
60221
CB833
84600
660663351
973
23160
59069
LX057
MNM01
LX133
MBAAZ
37264
86052
63002
33628
CX074
41124
23550
65978
A1004
CDMI0
LX116
A1432
38238

Medicaid of North Dakota (Bismark, ND)
Medicaid of Ohio (Administrated by Quadax) (Columbus,
Medicaid of Ohio Emerald HMO and Medicare INC. (Dora
Medicaid of Ohio Health Power HMO Cincinatti (Doral De
Medicaid of Ohio Personal Physicians Care Cleveland (Do
Medicaid of Ohio: Caresource (Dayton, OH)
Medicaid of Oklahoma (Oklahoma City, OK)
Medicaid of Oklahoma Heartland Health PLan (Doral Den
Medicaid of Oklahoma Unicare Health PLan (Doral Dental
Medicaid of Oregon
Medicaid of Pennsylvania (Harrisburg, PA)
Medicaid of Pennysylvania (Doral Dental of WI)
Medicaid of Rhode Island
Medicaid of SD
Medicaid of South Carolina
Medicaid of Tennessee (Doral Dental of WI)
Medicaid of Texas
Medicaid of Utah
Medicaid of VA - Richmond, VA
Medicaid of Vermont
Medicaid of Virginia HealthKeepers Plus (Doral Dental of
Medicaid of Washington
Medicaid of West Virginia (Charelston, WY)
Medicaid of Wisconsin (Madison. WI)
Medicaid of Wisconsin Humana/ TDC (Doral Dental of W
Medicaid of Wisconsin PrimeCare (Doral Dental of WI)
Medicaid of Wyoming (Cheyenne, WY)
Medicaid of ohio United Health Care Inc. Medicare COm
Medical Associate Health Plan (Dubuque, IA)
Medical Benefit Admin (PO Box 90991, Milwaukee, WI)
Medical Benefit Administrators - Madison, WI
Medical Benefits Mutual - Newark, OH
Medical Bridge and Dental Claims (Jackson, MS)
Medical Mutual of Ohio (MMO)
Medical Network of Colorado Springs(Colorado Springs, C
Medicare Dental Network (MDN)
Medicare Optimun / Triple S
Medico Insurance (IA, NE, MN)
MedsavUSA (Fringe Benefit)(FL)
Memorial Hermann (MHHNP)(PO Box 742567, Houston,
Mennonite Mutual Aid (Goshen, IN)
Mennonite Mutual Aid (Goshen, IN)
Merchants Benefit (MultiFlex Dental)(Scottsdale, AZ)
Mercy Benefit Admin (Springfield, MO)
Mercy Care Plan (Phoenix, AZ)
Mercy Life of Alabama (Livonia, MI)
Mercy Maricopa Integrated Care (Phoenix, AZ)
Meritain Health (Amherst, NY & Richardson, TX)
Meritain Health (Minneapolis, MN)
Methodist First Choice (Rockford, IL)
Metlife (El Paso, TX)
Metropolitan Detroit Laborers (Landing, MI)
Michigan Conference of Teamsters (Farmingotn Hills, MI)
Michigan Dental Plan (Clawson MI)
Michigan Laborers (Carmel, IN)
Michigan Regional Council of Carpenters Employee(Troy,

No
No
No
No
No
No
No
No
No
Yes
No
No
Yes
No
No
No
No
Yes
No
Yes
No
No
Yes
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

A1404
27401
LX078
37281
22823
59226
12251
LX085
CX033
74227
41101
61146
LX171
51233
79480
89070
A1402
R7005
64088
37275
25133
SKYGN
CX083
86098
31415
52133
35092
35092
36111
89070
86040
MBAAZ
37256
CX087
71412
34192
91136
91136
91136
91136
65085
34159
58182
23166
LX177
75191
75190
LX075
38225
38225
CKTX1
66055
38238
91136
41045
91136

Michigan State Painters (Carmel, IN)
Michigan UFCW (Madison Heights, MI)
Michigan UFCW (Madsion Heights, MI)
Mid America Associates, Inc (Madison Heights, MI)
Mid America Benefits (Po Box 685, Arnold MD)
Mid West National Life Insurance (MEGALIFE) (N Richlan
Mid-American AAI, Inc (UCS) Phoenix, AZ
Mid-American Benefits In (Omaha NE)
Mid-Atlantic Medical Services, Inc (MAMSI) PO Box 940 F
Mid-West National Life Ins. Co. of TN-Student Ins
Midwest Dental Benefits (1335 Industrial Blvd. Ste 100 S
Midwest Group Benefits, Inc. (Decorah, IA)
Midwest Operating Engineers H&W (6150 Juliet Rd. Cou
Midwest Security Administrators, Inc
Midwest Security of WI (Onalaska, WI)
Military Medical Support (MMSO) (Po Box 886999)
Millwright Local 1102 Health & Welfare Fund (Lansing, M
Minnesota Power (Duluth, MN)
Mississippi Select Healthcare (Gulfport, MS)
Missoula County Benefits Plan
Missouri Department of Transportation/MODot * St Louis
Molina Health Care (Milwaukee, WI)
Molina HealthCare(Liberty Dental) (Santa Ana, CA & Tam
Molina Medicare
Momentum Ins. Plans (Madison, WI)
Morgan White (Salt Lake City, UT)
Morris Associates (PO Box 50440, Indianapolis, IN)
Morris Associates (PO Box 619058 Dallas, TX)
Motorola (Phoenix, AZ)
Mountain State BCBS (MSBCBS(PO Box 69434, Harrisbur
Mountain States Admin Services, Tucson, AZ
MultiFlex Dental (Merchants Benefit)(Scottsdale, AZ)
Mutual Assurance Admin (Oklahoma City, OK & Addison,
Mutual of Omaha (Sherwood, AR & Indianapolis, IN)
Mutual of Omaha/National Rural Letter Carrier (Charlotte
Mututal Health Services (Antares Mgmt)(Westlake, OH)
N.W. Int Assoc of machinists & Aerospace Eng Benefits
N.W. Iron Workers Health & Security Trust Fund (Seattle
N.W. Roofers & Employers Health & Security Trust Fund
N.W. Textile Processors (Seattle, WA)
NAA (TN) North America Administrators, LP - Nashville,
NABN (North American Benefits Network) Cleveland, OH
NAPHCARE (Birmingham, AL)
NAS (Nat'l Auto Sprinklers (Landover, MD)
NCAS (Harrisbury, PA claims only)
NCAS - Charlotte
NCAS - Fairfax, VA
NECA (Decatur IL)
NGS (St Claire Shores & Clinton Township, MI)
NGS American (Lake Forest, IL)
NHIC (Medicaid of TX)
NLH (Netcare Life & Health Ins)
NNEBT Northern NE Benefit Trust (Manchester, NH)
NW Benefit ( Po Box 34176)
NW National Life (MN, AZ)
NW Plumbing and Pipfitting Industry

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

14142
23166
56175
LX172
LX176
56176
75190
CX045
CX057
71412
52120
MBAAZ
314RV
31417
19191
95123
66055
84600
90091
NDB01
43351
66893
LX180
LX181
LX080
NYT01
LX174
69821
81264
65085
34159
LX027
37314
CKNC1
61472
47570
02027
CBNYE
CX099
36347
LX062
LX106
38238
88027
91060
93525
91136
36346
91136
16644
37299
CDOR1
22521
CX075
80705
80705

NY State Dept of Health (Albany, NY)
Nat'l Auto Sprinklers (NAS)(Landover, MD)
Nathional Benefit Adminsitrators (Parsippany, NJ)
Natinoal Assoc. of Letter Carriers(NALC)(Ashbury, VA)
National Automatic Sprinkler (Landover, MD)
National Benefit Administrators, (Charlotte, NC)
National Claims Admin Services (NCAS))(Fairfax, VA)
National Elevator Industry Benefit Plan (NEIB) (Newtown
National Pacific of TX (TX)
National Rural Letter Carrier (Charlotte, NC)
National Telecommunications Cooperative Association (A
Nationwide (El Paso, TX)
Nationwide Employee Benefits (Columbus, OH)
Nationwide Health Plan (Dublin, OH)
Native Care Health, LLC (Quapaw, OK)
Neighborhood Health
Netcare Life and Health Insurance (NLH)
Network Claims (Colorado Springs, CO)
Nevada Health Co Op (Las Vegas, NV)
Neveda Dental Benefits (Las Vegas, NV)
New England Dental Administrators - Concord, NH
New England Financial (Kennet, MO)
New Era Life (Houston, TX)
New Era Life (Valdosta, GA)
New Southland Natl Ins Co (Tuscaloosa AL)
New York State Teamsters Union (Syracuse, NY)
Newman Company (Franklin Square , NY)
Next Level Health Partners (Birmingham, AL)
Nippon Life Insurance Company of America
North America Administrators, LP - Nashville, TN
North American Benefits Network (NABN), Cleveland, OH
North American Health ( Amherst, NY)
North Broward Hospial District (FL)
North Carolina Health Choice (Raleigh, NC)
North Carolina Health Choice for Children
North Star Administrators
NorthEast Delta Dental (ME, NH, VT)
NorthEast NY Blue Shield (Albany, NY)
Northern California Pipe Trades (Concord, CA)
Northern Illinois Health Plan (Freeport, IL)
Northern MN Dental (Duluth, MN)
Northern NE Benefit Trust (Manchester NH)
Northern NE Benefit Trust NNEBT (Manchester, NH)
Northern Nevada Trust Fund - Reno, NV
Northwest Administrators (Seattle, WA)
Northwest Dental Services - Roseburg, OR
Northwest Iron Workers (PO box 34464) Seattle,WA
Northwest Suburban IPA (Rockford, IL)
Nothwest I.A.M. Benefit Trust
Nova Health Administrators, Inc. (Grand Island, NY)
Nyhart (Indianapolis, IN)
ODS Healthplans (Oregon Dental Services/Delta Dental o
OK State Employees & Educators (Oklahoma City, OK)
OK State Medical Assoc. (OSMA)(Oklahoma City, OK
ONE Health Plan Inc of California
ONE Health Plan Inc of Colorado

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
CX075
OAC01
74431
65074
80705
FX026
91136
LX023
LX065
GP133
25449
27267
27277
26224
CDOR1
73624
83926
84104
DX106
87068
CX066
70454
21614
86711
37287
CX065
27277
68241
CX080
LX030
67466
CDCAP
16111
LX149
LX175
67466
CX056

ONE Health Plan Inc of Florida
ONE Health Plan Inc of Georgia
ONE Health Plan Inc of Idaho
ONE Health Plan Inc of Indiana
ONE Health Plan Inc of Iowa
ONE Health Plan Inc of Kentucky
ONE Health Plan Inc of Mississippi
ONE Health Plan Inc of New Jersey
ONE Health Plan Inc of New York
ONE Health Plan Inc of North Carolina
ONE Health Plan Inc of Oklahoma
ONE Health Plan Inc of Texas
ONE Health Plan Inc of The District of Columbia
ONE Health Plan Inc of Vermont
ONE Health Plan Inc of Virginia
ONE Health Plan Inc of Washington
ONE Health Plan Inc of Wisconsin
ONE Health Plan Inc. of Alaska
ONE Health Plan Inc. of Arizona
OSMA (OK State Medical Assoc)(Oklahoma City, OK)
Ohio AFSCME Care Plan
Ohio PPO Connect (PO Box 828, Arnold, MD)
Olympus Managed Health Care (Miami, FL)
One Health Plan Inc of Wyoming
Operating Engineers (Pewaukee, WI)
Operating Engineers Locals 302 & 612 Health & Security
Optima (4417 Corporation Lane, Virignia Beach)
Optima (Troy, MI)
Optum Specialty Svcs (Thiensville, Milwaukee WI)
Oregon Alaska Industrial Hardware (Phoenix, AZ)
Oregon Alaska Rubber & Supply (Phoenix, AZ)
Oregon Cascade Rubber Products (Phoenix, AZ)
Oregon Construction Machinery Industrial (Phoenix, AZ)
Oregon Dental Services & ODS Healthplans (Portland, O
Oregon Peninsula Airways (Phoenix, AZ)
Oregon TDX Corp. (Phoenix, AZ)
Oxford Health Plans
P.R.I.M.E Benefit Systems(PO Box 2239 CedarRapids, IA
P5 Health Plan Solutions (Salt Lake City & West Valley, U
PA Faculty Health & Welfare (Arnold, MO)
PACE CNY (Syracuse, NY)
PACE Greater New Orleans (Norlin)(NewOrleans, LA)
PACE Southest Michigan (Eden Prairie, MN)
PAI (Columbia, SC)
PATH Administrators (Harrisburg, PA)
PBS - Oregon Cascade Rubber Products (Phoenix, AZ)
PDO
PEHP (Public Employees Health Program)(Salt Lake City,
PLUMBERS AND PIPEFITTERS (OKLAHOMA, OK)
PM Group (Phoenix, AZ)
PMI (Delta Dental of CA) (12898 Towne Center Drive Ce
POMCO ( Syracuse, NY)
POMCO Group (Syracuse, NY)
Pacific Dental Benefits (Concord, CA)
Pacific Life & Annuity - Phoenix, AZ
Pacific Union Dental Benefits (LasVegas, NV)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

93031
CXPSC
93029
CX060
CX053
LX054
LX063
04218
06126
58174
58174
35162
PBGSM
23213
CX091
CB733
10525
32069
47009
PRW01
LX148
52133
37121
LX163
67814
PHP01
67814
38265
36345
37136
12399
CX068
47009
CX014
24735
PIP01
PIP02
LX099
37224
37287
PCM01
PCU01
PCU02
32680
23253
36373
41147
16112
59291
56178
68241
LX083
CX090
CB404
31478
LX132

PacificSource Admin (Portland, OR)
PacificSource Community (Salem, OR)
PacificSource Health Plans - Eugene, OR
Pacificare Dental and Vision (HMO Claims Only) (PO Box
Pacificare Dental and vision (PDVA) (Santa Ana, CA)
Paid Dental (PO Box 9150, Austin, TX)
Painters Trust Association (Spokane WA)
Pan American Life Ins. (El Paso, TX)
Paper Claims
Paragon Benefits, Inc. (Columbus, GA)
Paragon Benefits, Inc. (Po Box 981600, El Paso TX)
Parkview Health Plans (Fort Wayne, IN)
Partners Benefit Group (Southborough, MA)
Partners Health Plan (Philadelphia, PA)
Passport Health (London, KY & Fort Lauderdale, FL)
Patient Services (Midlothian, VA)
Patients Advocates, LLC (Portland & Gray, ME)
Patriot Mutual Dental Programs(PO Box 192, MPLS, MN)
Paul Revere / Provident
Pavers and Road Builders Welfare Fund
Pekin Life Insurance (Pekin, IL)
Peoples Benefit Life Ins. Co. (Salt Lake City, UT)
Pequot Plus Health (PO Box 3559 Manshantucket, CT)
Personal Insurance Administrators (Agoura Hills, CA)
Phoenix American (Greenfield, MA)
Phoenix Health Plan (PHP) (AZ) (Richardson, TX)
Phoenix Home Life (Greenfield, MA)
Physicians Care (Grand Rapids, MI)
Physicians Care Network (Rockford, IL)
Physicians Health Assoc. (Rockford, IL)
Physicians Health Plan of Northern IN(Fort Wayne, IN)
Physicians Mutual (Lincoln, NE)
Physicians Mutual (Lincoln, NE)
Physicians Plus Insurance Co., Wisconsin State Employee
Pinnacle Claims Management (Fresno, CA)
Pipe Trades Industry Health & Welfare Fund
Pipefitters 597 (45 N Ogden Ave. Chicago, IL 60607)
Pipestone Industry Benefit Trust (Tulsa OK)
Pittman & Associates (Memphis, TN)
Planned Administrators, Inc.
Plasters & Cement mason Local 148 Health & Welfare Fu
Point Comfort Underwriters (Indianapolis, IN)
Point Comfort Underwriters (PO Box 211745, Eagan, MN
Poly America Medical & Dental Benefits-Grand Prairie, TX
Populytics (Spectrum Admin (Allentown, PA)
Prairie States Enterprises, Inc ( Sheboygan, WI)
Preferred (PO Box 59212) Mpls, MN
Preferred Care (Rochester, NY)
Preferred Care FL (Tampa, FL)
Preferred Care NC (Tampa, FL)
Preferred Dental Organization
Preferred Group Plans Inc (Albany NY)
Preferred Health (PO Box 436987 Louisville, KY)
Preferred Health Plan of the Carolinas (Charlotte, NC)
Preferred Health Professionals (Freedom Dental)(Overlan
Preferred One Auxiant (Cedar Rapids IA)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

47570
CX078
CX029
56144
LX049
PCA01
CX014
61271
38217
LX095
36331
LX001
41163
37137
88029
70408
PAS01
68195
60054
68241
CX080
91136
39197
89461
CX077
46571
95266
91176
16117
93200
RLH01
93200
93200
38221
47076
80314
36088
41045
41045
41045
RLHA1
73066
CB695
LX094
999998
37331
91176
50664
41625
84102
RR001
25133
31441
37259
SCION
SCION

Premera Blue Cross (Seattle, WA)
Premier Access Insurance (PO Box 659010 Sacramento,
Premier Dental Group - MN (Plymouth, MN)
Primary Physician Care, Inc. - Charlotte, NC
Prime West (1335 Industrial Blvd., Ste 150, MPls, MN)
PrimeCare Admin (Las Vegas, NV)
PrimeCare, Wisconsin State and Federal Employees and
Principal (Coloradp Springs, CO& DesMoines, IA)
Priority Health (Grand Rapids, MI)
Pro Claim Plus Inc (Fort Wayne IN)
Professional Benefit Administrators, Inc. (Oak Brook, IL)
Professional Claims (10560 Wayzata, Minnetonka, MN)
Professional claims Administrators (Minnetonka, MN)
Progressive Benefits Services (Peoria, IL)
Prominence Health Plan (Reno & Henderson, NV)
Protective Life/Fortis (Birmingham, AL)
Providence Admin Services (Eagan, MN)
Provident\Healthsource (Memphis TN)
Prudential
Prudential (Blue Bell, PA)
Public Employees Health Program (PEHP)(Salt Lake City,
Puget Sound Benefits Trust (Seattle, WA)
QuadMed (West Alis, WI)
Quality Care Partners (PO Box 595, Arnold, MD)
Quality Plan Admin (Washington, DC)
Quartz ASO (Sauk City, WI)
R.E. Harrington Inc (Colombus, OH)
RBMS, LLC (Anchorage, AK)
RMSCO (Syracuse or Liverpool, NY)
Regence (FEP Po Box 857, ID)
Regence (PO Box 1271, Portland, OR)
Regence Blue Shield (PO Box 30271 SLC UT)(PO Box 21
Regence Blue Shield WA- FEP(PO Box 30271 SLC, UT)(P
Regency Employee Benefits - Port Huron, MI
Regional Care Inc. (Scottsbluff, NE)
ReliaStar
Reliance Standard (PO Box 82510 Lincoln, NE)
Reliastar (146 Industrial Park Rd, Jackson, MN)
Reliastar (7830 East Broadway, Tucson, AZ)
Reliastar (PO Box 1195, Mpls, MN)
Renaissance Life and Health (Indianpolis, IN)
Reserve National Insurance Company
Resolve (Solarte Health, Inc)(Arnold, MD)
Resource One Admin (Buckeystown MD)
Returned Claims
RightChoice Benefit Admin (Troy, MI)
Risk and Benefit Mgmt Services (Anchorage, AK)
Riverside San Bernardino Cty Indian Health, (Banning, C
Rochester Public Schools (Rochester, MN)
Rocky Mountain Life Dental (Colorado Springs, CO)
Royale Resources (Perham, MN)
Rural Carrier Benefit Plan (Charlotte, NC)
S & S Health (Cincinnati, OH)
SAMBA (Rockville, MD)
SCION Dental (Milwaukee, WI)
SCION Dental (Thiensville, WI)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

38610
03699
LX128
CPPSH
CX030
CX048
CX030
37105
37137
96400
91184
37288
77024
73172
20460
LX089
SDCOM
CX023
86057
28530
93742
35202
LX126
LX053
CX092
77024
CX109
64088
42137
CX107
68241
DX215
59111
CX076
36404
CX020
34131
34131
LX155
36426
15682
LX135
39033
39033
39033
CX038
75280
LX024
FX024
LX127
SMW01
41143
81434
CX067
76342
CX046

SET SEG (Lansing, MI)
SIEBA (Endicott, NY)
SIHO Member Services (Columbus IN)
STAR Health (PO Box 537030, Sacramento, CA)
Safeguard (Po Box 981987, El Paso, TX)
Safeguard HMO (PO Box 30920 Laguna Hills, CA)
Safeguard PPO -(PO box 30930 Laguna Hills & Aliso Viej
Sage Technologies (Cannon Cochran)(Danville, IL)
Sage Technologies (Peoria, IL)
San Diego PACE (Eden Prairie, MN)
Sanford Health Plan (Sioux Falls, SD)
Santa Barbara Cottage Hospital (Santa Barbara, CA)
Sante Health System (SeeChange)(Fresno, CA)
Scan Health Plan Arizona (PO Box 61450 Phoenix, AZ)
Scan Long Term Care (PO Box 61450 Phoenix, AZ)
School Claims Service LLC (New Cumberland PA)
Scion Dental (Milwaukee, WI)
Seabury & Smith - Iowa City, IA
Secure Care (Phoenix, AZ)
Secure Health Plan of GA (Macon, GA)
Securian Dental Plans (PO Box 9385, MPLS, MN) Delta of
Security Adminstrative Services (Marshfield, WI)
Security Health Fund (Marshfield WI)
Security Life (NY)
Security Life Insurance (Schenectady, NY)
SeeChange (Sante Health System)(Fresno, CA)
Sele-Dent (Lynbrook, NY)
Select Administrative Services (Gulfport, MS)
Select Benefit Admin (PO Box 8339, Des Moines, IA)
Select Health (Salt Lake City, UT)
SelectCare (Coca Cola)
SelectCare (Frisco, TX)
Self Insured Benefit Admin - (Clearwater, FL)
Self Insured Dental Services (PO Box 9005,9007,9010 Ly
Self Insured Plans LLC (Naples, FL)
Self Insured Services Company (SISCO) - Dubuque, IA
Self-Funded Plans (St. Charles, IL)
Self-Funded Plans of OH - Cleveland, OH
Seminole Tribe of FL (Fort Lauderdale, FL)
Sendero Health Plans (Austin, TX)
Senior Network Health (Utica, NY)
Sentry Insurance (Roanoke, VA)
Sentry Insurance A Mutual Company (Stevens Point, WI)
Sentry Insurance Company (Stevens Point, WI)
Sentry Life of NY (Stevens Point, WI)
Serentas Dental Care Solutions - Louisville, KY
Shasta Admin Services (Redmond, OR)
Sheet Metal Workers (PO Box 1449, Goodlettsville TN)
Sheet Metal Workers (PO Box 1449, Goodlettsville, TN)
Sheet Metal Workers Local 265 (Carol Stream IL)
Sheet Metal Workers Local 91 (West Burlington, IA)
Sheffield, Olson & McQueen (2145 Ford Pkwy, St. Paul,
Shelte Point Life (Great Neck, NY)
Shenandoah Life Insurance (Roanoke, VA)
Sierra Health Services (Las Vegas, NV)
Significa Benefits Services

No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

58102
41101
84076
SKYGEN
SKYGN
CB695
76578
91136
TPC11
23266
LX179
35227
CX051
39148
SEI01
37318
SEF01
56131
77153
CX050
CX100
68241
23253
38416
84147
37116
13411
69019
93024
CPPSP
59225
STR01
46450
57254
31121
58128
64246
LX014
74227
R7003
LX142
86083
37301
67814
47009
47009
67814
31117
CPPSW
CX088
98010
73288
TIC01
LX147
LX178
60054

Simple (1745 N Brown Rd, Lawrencevill GA)
Simple Benefits- (Duluth, GA)
Sinclair Health Plan (Salt Lake City, UT)
Skygen USA
Skygen USA (Milwaukee, WI)
Solarte Health, Inc (Resolve)(Arnold, MN)
Solstice Benefits
South Bay H.E.R.E. Funds
South Carolina Healthy Connections
South Central Preferred (Hingham, MA)
South Country Health Alliance ( Owatonna, MN)
South Point Hotel & Casino (LasVegas, NV)
SouthWest Benefits
Southeast Dental Associates (Milwaukee, WI)
Southeaster Service Employees International (SEIU)
Southern Benefits Services (Lafayette, LA)
Southern Electrical Health Fund (Chattanooga, TN)
Southern Group Admin - Winston-Salem, NC
Southern Indiana Health (Columbus, IN)
Southwest Life and Health / First Care (Austin, TX)
Southwest Service Admin (Phoenix, AZ)
Southwestern Bell Exec
Spectrum Admin (Allentown, PA)
Spencer Stuart (Arm LTD) (Eagan, MN)
Spina Bifida - VA HAC
St Therese Physician Assoc. (Rockford, IL)
Standard Ins Co. of New York (PO Box 82520, Lincoln, N
Standard Insurance ( Lincoln, NE)
Standard Insurance of Oregon (PO Box 82622 Lincoln, N
Star + Plus Value Added (PO Box 537014, Sacramento,
StarHRG (Phoenix, AZ)
Starmount Life Insurance Company (Baton Rouge, LA)
State Auto (Columbus, OH)
State of TX Dental Plan - All Plans except PO Box 4665 (
Stoner and Associates - Cincinnati, OH
Stowe Associates of GA (Atlanta, GA)
Strategic Ourtsourcing Inc. (SOI) (Charolotte, NC)
Strategic Resouce (PO Box 23759, Columbia, SC)
Student Insurance (Lincoln, NE)
Sturm & Associates (Edina, MN)
Stylmark (Mpls.-Fridley, MN)
Summit Admin Services, Inc. (Scottsdale, AZ)
Summit America Insurance Services (Overland Park, KS)
Sun Life (Po Box 81633, Wellesley Hills)
Sun Life Canada
Sun Life Financial
Sun Life and Health (Formerly Genworth)
Superior Dental Care
SuperiorSTAR Pregnant Women (Sacramento, CA)
Surency Life and Health (Wichita, KS)
Sutton Special Risk (Buffalo, NY)
TDC (PO Box 1100 Employers Blvd, Green Bay, WI)
TIC International, Inc (Carmel, IN)
TLC Benefit Solutions (Valdosta, GA)
TR Paul (Newtown, PA)
TRW

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

73288
CPPTM
88067
LX102
88019
LX113
41147
CDMI0
TXABA
LX013
79480
CPPTX
68423
74227
73288
73288
TDN01
LX173
LX110
34150
CRIHB
23223
74227
59226
68423
13142
CHSTS
06131
25175
CMS01
ASHC1
37314
TCS01
CX112
CX112
84076
LX153
69493
37284
CX069
65978
25348
36397
CHSWT
31144
31144
73288
89070
CDCA1
84103
CB923
973
ILDTA
91078
61425
97802

TSRDP Dental Claims (PO Box 1100 Employers Blvd, Gre
TX Medicaid - Delta CA - Childrens (PO Box 537014, Sacr
Tall Tree Administrators (Salt Lake City, UT)
Taylor Benefit Resource (Thomasville GA)
Teachers Health Trust (CCEA)(Las Vegas, NV)
Teamster Local 463 (Pennsauken NJ)
Teamsters (Po Box 7078) Duluth MN
Teamsters Welfare Fund (Farmington Hills, MI)
Texas Ag Benefit Admin (PO Box 211575, Eagan, MN)
Texas Municipal League (TML) (PO Box 149190, Austin,
Texas Municipal League (TML) Austin, TX
Texas-CHIP Dental Services (Sacramento, CA)
The Care Network (PO Box 788, Arnold, MD)
The Chesapeake Life Insurance Co.-Student Ins.
The Dental Companies (PO Box 1100 Employers Blvd, Gr
The Dental Concern (PO Box 1100 Employers Blvd, Gree
The Dental Network (7400 York Raod, Suite 200, Towso
The Dental Network of MD(Out of state dentists, NOT in
The Dental Shop (Amherst NY)
The Health Plan Upper Ohio Valley (Saint Clairsville, OH)
The Humboldt-DelNorte (Eureka, CA)
The Loomins Company (Wyomissing, PA)
The MEGA Life & Health Ins. Co.-Student Ins.
The MEGA Life & Health Insurance Co. (North Richlands
The Savannah Business Group (PO Box 788, Arnoold, M
The Union Labor Life Insurance Co. (King of Prussia, PA)
Theatrical and Stage Local 16 (Dublin, CA)
Third Party Claims Management (Tampa, FL)
Three Rivers Health Plan - (Monroeville, PA)
Three Rivers Health Plan, Inc. (WI
Time Ins (Milwaukee, WI)
Total Claims Admin. Inc/North Broward Hospital District
Total Claims Solutions (Green Bay, WI)
Total Dental Admin (Elk Grove, IL)
Total Dental Admin (PO Box 44035 Phoenix, AZ)
Total Dental Admin (Salt Lake City, UT)
Total Plan Services, Inc. (Addison, TX)
Tower Life Insurance (San Antonio, TX)
TransChoice Key Benefit Admin (Milwaukee, WI)
TransSmile (Sherwood, AR)
Travelers (El Paso, TX)
Travis County Map-Mediview
Trellis Health Partners (Rolling Meadows, IL)
Tri-Counties Welfare Trust Fund (Dublin, CA)
TriState Benefit Solutions (Cincinnati, OH)
TriState Benefit Solutions (Eagan, MN)
Tricare Active Reservists (PO Box 1100 Employers Blvd,
Tricare Dental Plan (UCCI) Harris burg, PA)
Tricare Retiree Dental-Delta Dental of CA - PO Box 5370
Trigon - Blue Cross and Blue Shield (Colorado Springs, C
Trigon Blue Cross of Virginia (Now Anthem BCBS of Virgi
Triple S / Medicare Optimun
TruAssure (Lisle, IL)
Trusteed Plan Service Corporation (Tacoma, WA)
Trustmark Insurance - Lake Forest, IL
UABT - United Ag-Superior Insurance (Irvine, CA)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

89789
89070
80085
36659
LX078
LX029
A5205
CX111
UFC01
UFC02
62308
GP133
87726
74223
LX104
74223
33108
37237
95266
79480
74223
39026
39026
75196
52180
65099
23281
93092
CX110
41206
80314
47009
35198
75243
52133
13142
70408
52133
25175
97802
59069
20090
89070
70408
UFC01
UFC02
36659
UGP19
GP133
52133
95378
87726
84132
33108
36362
FX028

UC Health Plan Administrators (Englewood, CO)
UCCI (United Concordia)
UCS International Medical Group: FBOP Honolula (Phoeni
UFCW (United Food & Commerical Workers)(Park Ridge,
UFCW Dentemax (Madison Hgts MI)
UFCW LOCAL 56 ( PENNSAUKEN, NJ)
UFCW Local 400-5205 (Carmel, IN)
UFCW Locals (400, 534, 655, 881)(Manchester, MO)
UFCW of Central Ohio
UFCW of Cleveland
UFT Welfare Fund
UHC (United HealthCare)(Milwaukee, WI)
UHC/Medica Po Box 30990 SLC UT
UICI - Administrators - State of Nevada (San Antonio, TX
UMC Dental Reimbursement Plan (Lubbock TX)
UMR (PO Box 2838 Clinton, IA)
UMR - Cincinnati (Cincinatti, OH)
UMR - Lexington (Lexington, KY)
UMR-Harrington Benefits (PO Box 30530,33,34,40, Salt L
UMR-Onalaska (Onalaska, WI)
UMR-San Antonio (San Antonio, TX)
UMR-Wausau (Salt Lake City, UT)
UMR-Wausau (Wausau, WI & Pueblo, Co)
UMR-Westerville (Westerville, OH)
UMWA Health & Retirement (Lubbock, TX)
UNICARE Special Accounts
UPMC Health Plan (Pittsburg, PA)
US Benefits, Inc. (Portland, OR)
UT Chips (Salt Lake City, UT)
UltraBenefits, Inc (Westborough, MA)
Unicare
Unifi Companies (Lincoln, NE)
Unified Group Services (Anderson, IN)
Uniform Medical Plan/Harrington Benefit Services (Seattl
Unimerica Dental (Salt Lake City, UT)
Union Labor Life Insurance Co - King of Prussia, PA
Union Security (Clinton, IA)
Unique DentaCare (Salt Lake City, UT)
Unison - (Monroeville, PA)
United Ag - Superior Insurance Services (Irvine, CA)
United Benefits (Ormond Beach, FL)
United Claim Solutions (Phoenix, AZ)
United Concordia (UCCI)
United Dental - Texas (Clinton, IA)
United Food & Commerical Workers Union of Central Ohi
United Food & Commerical Workers Union of Cleveland(
United Food & Commerical Workers(UFCW) (Park Ridge,
United Group Program
United Health Care (Milwaukee, WI)
United Health Care - MD, UT (Salt Lake City, UT)
United Health Care of River Valley (Moline, IL)
United Health Care, GA, PA
United Medical Alliance (Fort Collins, CO)
United Medical Resources (Cincinatti, OH)
United Security Life & Health (Clinton, IA)
United South Central Workers (Dallas, TX)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

LX028
13545
71412
UNITY
16105
91136
89070
37324
LX151
12116
64009
89070
VHP01
72128
68241
72187
75256
48123
LX139
LX123
59266
39151
LX160
LX150
91062
37294
91136
73155
39026
59332
75261
10050
CX083
47198
87815
87815
37272
91136
90560
93128
24735
TLW33
LX150
91060
93200
CXWVC
93050
98010
R7002
R7006
FX031
LX006
20333
CX014
LX143
LX063

United South Central Workers (Dallas, TX)
United States Life - Neptune, NJ
United of Omaha (Charlotte, NC)
Unity Health Plans-Dental Health (Fairfield, NJ)
Univera of New York (Baldwinsville, NY)
University of Washington Students & Graduate Appts.(Se
Unum
Upper Peninsula Health Group (Marquette, MI)
Utah Idaho Teamsters (SLC, UT)
VA Fee Basis Programs (St Paul, MN)
Valir PACE (Oklahoma City, OK)
Valley Baptist Health Plan (PO Box 69442)
Valley Health Plan (GreenBay, WI)
Vantage Health Plan (Monroe, LA)
Varian Health Care Plan
Varipro (Eagan, MN)
Verity National Group (San Antonio, TX)
Via Christi Hope (Wichita, KS)
Voluntary Benefits Plan (Chesire, CT)
Volunteer Benefits (Waterbury CN)
Volusia Health Network (Daytona Beach, FL)
WEA Insurance Group (Madison, WI)
WMI Mutual Insurance Company (Brownville, NY)
WPEE Insurance Trust Fund (Pittsburgh, PA)
Washington Dental Service (Seattle, WA)
Washington Employers Trust (Seattle, WA)
Washington State Council of County & City Employees D
Waterstone Benefit Administrators (Oklahoma City, OK)
Wausau Insurance Companies, Wausau, WI
Web TPA, Inc. (Grand Prairie, TX)
WebTPA/Community Health Electronic Claims/CHEC (Gra
Webster Dental
WellCare(Liberty Dental)(Santa Ana, CA & Tampa, FL)
Wellpoint (CA) (Oxnard, CA)
Wells Fargo (Anchorage, AK)
Wells Fargo (Charleston, WV)
Wells Fargo TPA (JSL Administrators) (Newnan, GA)
West Coast Stationary Engineers health & Security Trust
WestLake Financial Group (Buffalo Grove, IL)
Western Grocers Employee Benefit (PO Box 22166, Portl
Western Growers Insurance (Newton Beach, CA)
Western PA Teamsters Fund (50 Penn, Pittsburgh, PA)
Western Pennsylvania Electric (Pittsburgh, PA)
Western Teamsters (Seattle, WA)
Whatcom Medical Bureau (Bellingham, WA)
Willamette Valley (Salem, OR)
William C Earhart (Portland, OR)
William J Sutton & Co. Ltd (Buffalo, NY & Toronto, CA)
Wilson, McShane (Mpls, MN)
Wisconsin Auto & Truck (WATDA) (Madison, WI)
Wisconsin Carpenters (Eau Claire, WI)
Wisconsin Electric (2730 Dairy, 2802 Coho St, Madison,
Worksite Benefit Services (PO Box 707 Tifton, GA)
Xantus Health PLan- Tennessee
Zelis Payments
Zenith Admin (AZ,CA,CO,NV,WA)

No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

LX060
R7001
33884

Zenith Admin (MD,IL,IN,KY,LA,MA,MI,MO,OK,TX,WI)
Zenith Administrators (Mpls, MN)
iCircle Care of NY (Webster, NY)

No
No
No
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