Conduent EDI Solutions, Inc. Conduent EDI Solutions, Inc. Eligibility (270/271) Claim Status (276/277) Payer List Conduent EDI Solutions, Inc. Payer List - 270/271 Transactions 12/6/2017

Conduent EDI Solutions, Inc.Eligibility (270/271) Claim Status (276/277) Payer List

Conduent EDI Solutions, Inc.Payer List - 270/271 Transactions 12/6/2017 1

Payer Name - 270/271 Transactions Payer IDAARP 10431Absolute Total Care 10560ACS Benefit Services 11009 Administrative Services, Inc. 10619Advantage by BridgewayHealthSolutions 10561Advantage by Buckeye Community Health Plan 10562Advantage by Managed Health Services 10563Advantage by Superior Health Plan 10564Advantage Health 10583Advantra (TX, NM, AZ Only) 10447Advantra Freedom 10307Advantra Savings 10419Aetna AETNAAetna Retiree Medical Plan - Administrator 10891Aetna Better Health 10894Aetna Better Health (FL) 11099Aetna Better Health (IL) 10892Aetna Better Health (LA) 11008 Aetna Better Health (KY) 11119Aetna Better Health (MI) 11026Aetna Better Health (NE) 10976Aetna Better Health (TX) 10895Aetna Better Health (TX) CHIP 10896Aetna Better Health of MO 11064Aetna Better Health (VA) 00190Aetna Better Health (WV) 11154Aetna Long Term Care 10397Aetna Senior Supplemental 10897Aetna Signature Administrators 10983 Affinity Essentials 11115Affinity Health Plan 10594Affinity Health Plan Medicare 10661AFLAC 10955AFLAC – Dental 10398AFLAC – Medicare Supplemental 10663AGIA,Inc. 11149Alabama Medicaid 00000000817Alan Sturm and Associates – Dental 10798Alaska Medicaid 11016 All Savers Life Insurance 11027Allegiance Benefit Plan Management 10654



Payer Name - 270/271 Transactions Payer IDAlliant Health Plans 11109Allied Benefit Systems 10898AlohaCare 11017 Alternative Insurance Resources, Inc. 11002Altius Health Plans 00364Altus Dental 10786Ambetter Superior Health Plan (TX) 11082AmeriBen 10985American Income Life Insurance Company 10986American Medical Security (AMS) 10829American National Insurance Company 10595American National Life Insurance Company of Texas 10596American Network Ins. Medicare Supplement 10899American Postal Workers Union 00360American Retirement Life Ins Co Medicare Supp 10538AmeriChoice of New Jersey (Commercial) 00091Americo Financial Life & Annuity 11085Amerigroup Corporation AMGRPAmeriHealth (DE, NJ, PA) 10974AmeriHealth Administrators 10416AmeriHealth Caritas DC 11193AmeriHealth Caritas Iowa 11142AmeriHealth Caritas Louisiana (LaCare) 10640AmeriHealth Caritas VIP Care Plus 11151AmeriHealth Northeast Pennsylvania 11189AmeriHealth VIP Care 11152Ameritas Life Insurance Co. 00425Anthem Vivity 10993Arbor Health Plan 10641Arise Health Plan Medicare Select Policy 10868Arise Health Care 11181Arizona Medicaid (AHCCCS) 869Arizona Physicians IPA (APIPA) 00322Arkansas Medicaid 00000000695Associacion De Maestros Puerto Rico 10957Asuris Northwest Health 10529Aultcare 10472Automated Benefit Services 10890Auxiant 10900Avera Health Plans 10869AvMed Health Plans AVMED



Payer Name - 270/271 Transactions Payer IDBankers Life and Casualty 10813Banner Health Plans 10707BCBS of Alabama 00000000590BCBS of Arizona 00000000567BCBS of Arkansas BCARKBCBS of Central New York 10461BCBS of Colorado 10029BCBS of Connecticut 4816BCBS of Florida AV294BCBS of Georgia BCBSGBCBS of Hawaii 10530BCBS of Illinois 00000000551BCBS of Indiana 4820BCBS of Iowa 10396BCBS of Kansas 4923BCBS of Kansas City 10473BCBS of Kentucky 4821BCBS of Louisiana 564BCBS of Maine 4818BCBS of Massachusetts 00139BCBS of Michigan Institutional 10519BCBS of Michigan Professional 00000000558BCBS of Minnesota 10039BCBS of Mississippi 00000000581BCBS of Missouri 4921BCBS of Nebraska 10384BCBS of Nevada 10260BCBS of New Hampshire 4817BCBS of New Jersey (Horizon) 00087BCBS of New Mexico 4609BCBS of New York (Empire) 00000002560BCBS of North Carolina BCBSNBCBS of North Dakota 10478BCBS of Ohio 4823BCBS of Oklahoma 10582BCBS of Oregon (Regence) 772BCBS of Pennsylvania (Highmark Institutional) 10524BCBS of Pennsylvania (Highmark Professional) 10046BCBS of Rhode Island 10304BCBS of South Carolina BCBSSBCBS of South Dakota (Wellmark) 10395



Payer Name - 270/271 Transactions Payer IDBCBS of Tennessee 10430BCBS of Texas 00000000562BCBS Texas Medicaid STAR CHIP 11196BCBS of Western New York (HealthNow) 10498BCBS of the Rochester Area (NY) 10469BCBS of Utah 10618BCBS of Utica Watertown (NY) 10470BCBS of Vermont 10624BCBS of Virginia (Wellpoint) BCBSVBCBS of West Virginia 10462BCBS of Wisconsin (Wellpoint Anthem) BCBSWBCBS of Wyoming 10480Benefit Management Inc. 10665Best Choice Health Plan 00000000820Best Life and Health 00257Better Health Plans (Unison Health Plan) 00199Better Health Plans of Florida 10999Blue Benefit Administrators of Mass 10803Blue Cross Community Options 11183Blue Cross Independence (Pennsylvania) 00000002426Blue Cross Northeastern Pennsylvania 00000000981Blue Cross of California BCCALBlue Cross of Idaho 10638Blue Cross of Washington and Alaska (Premera) 2650BlueCross Medicare Advantage 11174Blue Cross Pennsylvania (Capital) 582Blue Shield of California 1044Blue Shield of Idaho (Regence) 10052Blue Shield of Northeastern New York 10499Blue Shield of Washington (Regence) 5504BlueChoice Health Plan South Carolina Medicaid 10504Bluegrass Family Health 10429BMC HealthNet 10556Boon Chapman Benefit Admin 10414Boon Group 10821Bravo Health 10399Bridgespan 10827Bridgeway Arizona 10565Brokers National – Dental 10783Buckeye Community Health 10566California Medicaid (Medi-Cal) AIDCA



Payer Name - 270/271 Transactions Payer IDCal-Viva 11070Capital District Physicians Health Plan 10458Capitol Administrators 10903CAPROCK 10660Care1st Health Plan Arizona 10981Carefirst Blue Cross Blue Shield (DC) 11102Carefirst Blue Cross Blue Shiled (MD) 10270Caremore 11080 Care Improvement Plus 10806CarePlus Health Plan 00324CarePoint Medicare Advantage 10822CareSource Health (OH) 994Carpenters Health and Welfare Trust Fund of St Louis 11161Carolina Care Plan, Inc. (CCP) 10762CDS Group Health 10667Celtic Insurance 10668Celticare 10589Cencal 11106Cenpatico - Arizona 10567Cenpatico - Florida 10568Cenpatico - Georgia 10569Cenpatico - Illinois 10631Cenpatico - Indiana 10570Cenpatico - Kansas 10571Cenpatico - Kentucky 10632Cenpatico - Massachusetts 10588Cenpatico - Mississippi 10769Cenpatico - Missouri 10768Cenpatico - New Hampshire 10770Cenpatico - Ohio 10572Cenpatico - South Carolina 10573Cenpatico - Texas 10633Cenpatico - Wisconsin 10634Cenpatico Behavioral Health 10766Cenpatico Behavioral Health Texas 10767Centene - Advantage by Peach State 10763Centene - Advantage by Sunshine State 10764Centene - Ambetter Sunshine Health 11126Centene - California Health & Wellness 10759Centene - Coordinated Care 10761Centene - Granite State Health Plan 10765



Payer Name - 270/271 Transactions Payer IDCentene - Home State Health Plan 10760Centene - IlliniCare Health Plan 10757Centene - Kentucky Spirit Health Plan 10620Centene - Louisiana Healthcare Connections 10756Centene - Magnolia Health Plan 10704Centene - Michigan Fidelis Secure Care 11034Centene - Peach State Health Plan 10590Centene - Sunflower State Health (Kansas) 10758Centene - Sunshine State Health Plan 10451Centene - Total Care Carolina 10866Centene Advantage Plans 10771CenterLight Healthcare 10666Central California Alliance for Health 10884Central Senior Care 10904Central States Fund 10486Central Reserve Life Ins Co. Medicare Supplement 10539Central States Indemnity 10744Cerner Health Plan 11018 CHAMPVA/Spina Bifida/Children of Women Vietnam Vets 00232Chesapeake National Life 00207Children’s Mercy PCN 10906CHP Direct 10907Christian Brothers Services 10908Christie Student Health Plans 11113CHRISTUS Health Plan Medicaid 11105CHRISTUS Health Plan New Mexico 11006CHRISTUS Health Plan NM Medicare Advantage 11007Cigna-GWH 00001Claims Management Service Inc. 11001CMFG Life Insurance 10909Colonial Penn Life 10852Colorado Access 0000002356Colorado Medicaid 00000000968Community Care of Oklahoma 10066Community Health First Medicare Advantage 10421Community Health Group 11087Community Health Plan of Washington (CHPW) 2641ConnectiCare 10303ConnectiCare-Medicare 10517Connecticut Medicaid 10067Consolidated Associates Railroad 10669



Payer Name - 270/271 Transactions Payer IDConstellation Health (INMEDIATA HEALTH GROUP) 11042Consumers Life 10911Consumers Mutual Insurance of Michigan 11051Continental General Ins Co Medicare Supp 10540Cook Children’s Health Plan 10610Cooperative Benefits Administrators 00223CoreSource MD/PA/IL/NC/IN/AZ/MN 00236NGS CoreSource 00239Corporate Benefit Service 10411Country Life Insurance Company 10670CountyCare 11143Covenant Administrators (TPA) 10880Coventry Health &Life – Nevada 10448Coventry Health and Life (Oklahoma) 00441Coventry Health and Life (Tenn) 10405Coventry Health Care Carelink Medicaid 00182Coventry Health Care Federal 10481Coventry Healthcare - Delaware 00166Coventry Healthcare - Georgia 00154Coventry Healthcare - Kansas 10208Coventry Healthcare - Louisiana 00158Coventry Healthcare - Missouri 10449Coventry Healthcare - Nebraska 00176Coventry HealthCare Carelink (Advantra) 00160Coventry Healthcare National Network 10084Coventry Iowa 00170CoventryCares of Kentucky 10642CoventryOne 10440Cox Health Plan 10838CSI Life Insurance Company 11160CSA Fraternal Life Medicare Supplement 10541Culinary Health Fund UNITE HERE Health 10775DakotaCare 10577DeCare Dental Health Insurance 10780Definity Health 10828Delaware Medicaid 3018Delta Dental Ins. Co. - Alabama 10709Delta Dental Ins. Co. - Florida 10710Delta Dental Ins. Co. - Georgia 10711Delta Dental Ins. Co. - Louisiana 10712Delta Dental Ins. Co. - Mississippi 10713



Payer Name - 270/271 Transactions Payer IDDelta Dental Ins. Co. - Montana 10714Delta Dental Ins. Co. - Nevada 10715Delta Dental Ins. Co. - Texas 10716Delta Dental Ins. Co. - Utah 10717Delta Dental of California 10705Delta Dental of Colorado 10718Delta Dental of Delaware 10720Delta Dental of Hawaii 10721Delta Dental of Indiana 10722Delta Dental of Maryland 10723Delta Dental of Michigan 10724Delta Dental of Minnesota 10725Delta Dental of Nebraska 10726Delta Dental of New Jersey 10727Delta Dental of New Mexico 10728Delta Dental of New York 10729Delta Dental of North Carolina 10730Delta Dental of North Dakota 10731Delta Dental of Ohio 10732Delta Dental of Oklahoma 11175Delta Dental of Pennsylvania 10733Delta Dental of Rhode Island 10734Delta Dental of Tennessee 10735Delta Dental of Virginia 10736Delta Dental of Washington DC 10737Delta Dental of Washington State 10738Delta Dental of West Virginia 10739DeltaCare USA - Claims 10740DeltaCare USA - Encounters 10741Dental Benefit Providers 10787Denver Health Medical Plan 0000001321Deseret Mutual (DMBA) 10578Diamond Plan (Maryland Medicaid) 00177Director’s Guild 10077District No. 9, I. A. of M. & A W. Welfare Trust 11098District of Columbia Medicaid 77033Diversified Administration Corp 11166Driscoll Health Plan 11090EBMS 10862Educators Mutual Insurance (EMI) 11135Elderplan 11010



Payer Name - 270/271 Transactions Payer IDEmblem Health 10616Employee Benefit Services – Dental 10784EPIC Life Insurance 10914EPSI, Inc. 11011 Equitable Life Casualty Insurance Company 11153Essence Healthcare 10601Evercare 10807Everence Financial 10772Evergreen Health 11136Evergreen Health Co-Op 10860Expert Benefit Solutions 11019 Fallon Community Health Plan 00272Family Care 10427Farm Bureau Health Plans 11167FCE Benefit Administrators 11003Federated Insurance Company 00262Fidelis Care New York 10459First Ameritas of New York 00426First Medical Network 10916First Reliance Standard Life 00428First United American Insurance Company 10987FirstCare 10870First Health Network (Coventry National) 11190FISERV WAUSAU 11068Flex Compensation – Dental 10799Florida Combined Life – Dental 10811Florida Health Care Plans 10615Florida Medicaid 77027Florida True Health 10839Florida/Vista/Summit 10551Food Employers & Bakery Confectionary Workers Benefit 10776Freedom Blue 10502Frensenius Health 11130Fringe Benefits 11069FSL Admin by KBA 11052Gateway Health Plan 10629Geisinger Health Plan 10611Geisinger Health Plan Gold 10612GEMCare 11065Georgia Medicaid 00000000760GHI – Group Health Incorporated 10808



Payer Name - 270/271 Transactions Payer IDGilsbar 10509Globe Life & Accident Insurance Company 10988Government Employees Health Association (GEHA) 10394G.M.P. Employers Retiree Trust 11144Great American Life Insurance Co Medicare Supplement 10543Greek Catholic Union of the USA 11156Group and Pension Administrators 10174Group Dental Service 11188Kaiser Foundation Health Plan of Washington 10608Group Health Northwest 11041Group Health Plan (GHP) 00184Guardian Life Insurance Co. of America – Dental 10788Harken Health 11110Harmony Health Plan 10514HMA (Hawaii Mainland Admin) 11112Hawaii Medicaid 6093Hawaii Medical Assurance Association 11125Health Alliance Medical Plan (IL) 10871Heartland National Life Insurance Company 11155Health Alliance Medical Plans (HAP) 00000002077Health Choice Arizona 00329Health Cost Solutions 11012Health First Insurance 10674Health First Health Plan 10673Health First New Jersey 10438Health First New York 00240Health Choice Oklahoma 11148Health Net National 10385Health New England 10627Health Partners (Minnesota) 10484Health Partners Philadelphia 00288Health Plan of San Mateo 10362Health Services for Children with Special Needs 10584Health Share of Oregon 10823HealthAmerica&HealthAssurance 00148HealthCare Inc. (Promina) 00193Healthcare Management Administrators 11084 Healthcare USA(HCUSA) 00186HealthComp Administrators 11020 HEALTHe Exchange 10597HealthEase 10510



Payer Name - 270/271 Transactions Payer IDHealthEase Kids 10511HealthEdge Administrators 11036Healthgram (formerly Primary PhysicianCare) 10692Health Plan of Nevada 10804Health Plan Upper Ohio Valley 10657HealthPlans Inc. 10802HealthPlus of Michigan 1311HealthScope (Morris Assoc, Central Benefits, Employer’s Health, Plan Handlers) 10621HealthSmart Benefit Solutions 11079Healthsource Provident – Dental 10789HealthSpring 10552Healthy Texas 10824Heritage Physician Network (Houston) 10918Hershey Healthsmile – Dental 10795HIPNY 10406HM Care Advantage Admin by KBA 11053Hometown Health 3597Horizon NJ Health 2840HSBS Oklahoma City 11169Hudson Health Plan 11046Humana 00041Humana CareSource (KY) 10920IBEW Local 508 Health Plan 10855Concentrix Insurance Solutions 10861Idaho Medicaid 2896Ideal Life Insurance 10747Illinois Medicaid 4812Independence Administrators 10417Indiana Medicaid 10103Inland Empire Health 1081Insurers Administrative Corporation (IAC) 11021 INTEGRA Administrative Group Inc 11054Integrated Mental Health Services 10585Inter Valley Health Plan 1052International Medical Card Inc. 11028Iowa Medicaid 00000001264Island Home Insurance 10675Jai Medical System 11147John Alden Insurance Company (JALIC) 00254John Hopkins Health Plan 00000002613John Hopkins HealthCare LLC 11132



Payer Name - 270/271 Transactions Payer IDKaiser Foundation Health Plan of Colorado 10110Kaiser Foundation Health Plan of Hawaii 00278Kaiser Foundation Health Plan of Hawaii (DHMO Choice) 10676Kaiser Foundation Health Plan of the Mid Atlantic 00276Kaiser Foundation Health Plan of the Northwest 00279Kaiser Permanente of Georgia 00281Kaiser Permanente of Northern CA 00282Kaiser Permanente of Southern CA 00283Kansas Medicaid 1243Katy Medical Group 10921Kentucky Medicaid 00000000945Key Benefit Administrators – 37216 11067Key Benefits Administrators (IN) 10754KeySolution 11055Keystone Mercy Health 2232Keystone VIP Care 11182Kitsap Physician Services 2644KSKJ Life 10748Land of Lincoln 11118Leggett & Platt 10975Leon Medical Centers Health Plan 10677Liberty National Life Insurance Company 10989Lifetime Benefit Solutions (RMSCO) 10978Lifewise Arizona 10843LifeCare Assurance Company 11170Lincoln Financial 10678Lincoln Heritage 10749Local 1199 10979LoneStar TPA 11013 Loomis Company 10755Louisiana Health Exchange 10830Louisiana Medicaid 1164Loyal American Life Insurance Co Medicare Supp 10544Loyal Christian Benefit Association 11159Magellan Behavioral Health 10649Magnacare 10867Mail Handlers Benefit Plan 00251Mainte Community Health Options 11122Maine Medicaid 388Managed Care of America 10885Managed Health Network (MHN) 10863



Payer Name - 270/271 Transactions Payer IDManaged Health Services Indiana 10586Managed Health Services Wisconsin 10587MAPFRE Life Puerto Rico 10679Maricopa Health Plan Arizona 10434Maryland Medicaid 00000002257Massachusetts Medicaid 334MDWise Medicaid Health Plans 11172MDWise Exchange 11173MedBen – Newark OH 10681MedCost Benefit Services 10272Medica 00404Medica2 11171Medica Health Plans 11029Medical Associates Health Plan/Health Choices 10683Medical Card System 10952Medical Mutual of Ohio 00211Medicare CMSMedicare Advantage - Pennsylvania 11000Medicare y Mucho Mas (INMEDIATA HEALTH GROUP) 10960Medigold Health Plans 10800Med-Pay, Inc. 10682MedStar Family Choice 10844MedStar Health Plan 10845Mercy Care Plan (Arizona) 00340MercyCare Health Plan (Wisconsin) 11141Mercy Health Care Plan 10465Meridian Health Plan of Illinois 10644Meritain Health 10635Meritus Health Partners 10980MetLife Dental Family 10134MetroPlus Health Plan 10846Metropolitan Health Plan (MHP) 2548MHNet Behavioral Health 10659Michigan Medicaid 947Michigan Medicaid Pending Eligibility 10392Michigan MI Child 10138Mid Atlantic Medical Services, LLC (MAMSI) MAMSIMid-West National Life 00206Minnesota Medicaid 00000001257Mississippi Medicaid 00000000786Mississippi State Employees and Teachers 10142



Payer Name - 270/271 Transactions Payer IDMissouri Care 10702Missouri Medicaid 00000000684MMSI (Mayo Health) 10144Moda Health 11005Molina Healthcare of California 00222Molina Healthcare of Florida 10445Molina Healthcare of Illinois 10685Molina Healthcare of Michigan 00226Molina Healthcare of New Mexico 10146Molina Healthcare of Ohio 00445Molina Healthcare of Puerto Rico 11031Molina Healthcare of South Carolina 10815Molina Healthcare of Texas 10391Molina Healthcare of Utah 00227Molina HealthCare of Washington 10253Molina Healthcare of Wisconsin 10628Montana Medicaid 10147Montifiore CMO 11035Municipal Health Benefit Fund 10687Mutual Assurance Administrators 10872Mutual Health Services 10686Mutual of Omaha 10382MVP Healthcare 00432National Association of Letter Carriers (NALC) 00214National Telecommunications Cooperative Association (NTCA) 10812Nebraska Medicaid 101182Nebraska Total Care 11180NEHEN Harvard Pilgrim Health Care 00000002393NEHEN- Neighborhood Health Plans 00000002395Neighborhood Health Plan (RI) 10630Network Health Plan of WI 10706Nevada Medicaid 2573New Era Life Insurance Company 10991New Hampshire Medicaid 00000000022New Hampshire Healthy Families 10865New Jersey Medicaid 00000000829New Mexico Health Connections 11123New Mexico Medicaid 00000001234New York Medicaid 2935NGS American 10873North Carolina Medicaid AID21



Payer Name - 270/271 Transactions Payer IDNorth Dakota Medicaid 10157Northwest Administrators 11038Nova Healthcare Administrators 10537NovaSys Health 10466Ohana 10515Ohio Medicaid 00000000594Oklahoma Employees Group Insurance Division 10995Oklahoma Medicaid 3411OmniCare (Michigan) 00284Operating Engineers Local 428 Health and Welfare 10777Optima/Sentara 10477Orange County Fire Authority 10951Oregon Medicaid 2434Oregon's Health CO-OP 11124Oscar 10881Oxford Health Plans 00016Pacific Source Health Plan 2597PacificSource Administrators 11177PacificSource Medicare 11178PacificSource Community Solutions (Medicaid) 11091Panamerican Life Puerto Rico 10689Pan-American Life Insurance Company 11114Paramount Health 10854Partners National Health Plans of NC 10383Partnership Health Plan of California 1035Kentucky Passport 2841Patriot Dental 10782Penn Treaty Network America Ins Medicare Supp 10924Pennsylvania Medicaid AIDPAPeople First 11022 Peoples Health 10636Personal Insurance Administrators (PIA) 10492PersonalCare/Coventry Health of Illinois 00179Physicians Health Plan Northern IN (PHPNI) 10658Physicians Health Plan of Mid-Michigan 11015 Physicians Mutual Insurance Company 00287Physicians Plus Insurance Corp 11004Piedmont (GA) 10882Piedmont Wellstar HealthPlans 10825Pinnacle Physician Management Org 10926Pittman and Associates 10408Plan de Salud Hospital Menonita 10958



Payer Name - 270/271 Transactions Payer IDPlanned Administrators Inc. 10886Plumbers and Pipefitters Local Union 525 Health & Welfare Trust 10778Preferred Care Partners 10691Preferred Health System of Kansas 10847Preferred Medicare Choice (PMC) (INMEDIATA HEALTH GROUP) 10959Preferred One 00371Premier Health 10848Prestige Health Choice 10965PrimeWest Health 10494Principal Financial Group (Nippon Life) 00144Principal Financial Group (Principal Life) - Dental & Vision 10171Priority Health 10490Professional Benefits Administrators 10242Prominence Health Plan of Texas 11199Prominence Health Plan of Nevada 11198Providence Health Plan 2598Provident American Life & Health Ins Co Medicare Supp 10545Provident Preferred Network – Dental 10790Public Employee Benefit Authority 11043Public Employees Health Plan (PEHP) 10574Puerto Rico Medicaid 10173Puritan Life Insurance 10743Qualcare 10637Qualchoice 10553QuikTrip Corporation 10508Reliance Standard Life 00427Reserve National Insurance Company 11127RightCare from Scott and White Health Plan 11116Rocky Mountain Health Plan 00347Royal Neighbors of America 10751S and S Healthcare Strategies 10875San Joaquin Health Plan 1046Sanford Health Plan 10533Santa Clara Family Health Plan 10876SBLI USA Life Insurance Company, Inc. 11162Schaller Anderson Aetna Better Health of New York 10816Schaller Anderson Aetna Better Health of OH 10887Schaller Anderson Delaware Physicians, Inc. 10817Schaller Anderson MajestaCare VA 10818Schaller Anderson Maryland Physicians Care 10693Schaller Anderson Mercy Care 10694



Payer Name - 270/271 Transactions Payer IDSchaller Anderson Missouri Care 10695Schaller Anderson Parkland Community Health Plan 10643Schaller Anderson Texas CHRISTUS 10696Scott & White Health Plan 00000002076Security Health Plan 10864Secure Health Plans of Georgia 10883Secure Health Plans of Wisconsin 11056Securian – Dental 10792Securian/Patriot – Dental 10793Select Health SC 10520Select Health Utah 10575Select Senior Clinic 10927SelectCare of Texas (Beaumont) 10928SelectCare of Texas (Golden Triangle) 10929SelectCare of Texas (Houston) 10930SelectCare of Texas (Integranet) 10931SelectCare of Texas (Kelsey-Seybold) 10932SelectCare of Texas (Memorial Clinical Assoc) 10933SelectCare of Texas (Northwest Diagnostic) 10934Selman & Company 11150Senior Care Action Network (SCAN) HMO 00350Senior Dimensions 11023 Senior Health Services Center – Universal American Family of Companies 10697Senior Whole Health 10962Sendero Health Plans 11117Sharp Health Plan 10967Shenandoah Life Insurance 10752Sierra Health Services 10282Significa 00191SisCo Benefits 11129Soundpath Health 10935South Carolina Medicaid 1263South Dakota Medicaid 10180Southern Health Services (SHS) 00156Special Agents Mutual Benefit Association 10591Spectrum Health 10936SPJST Medicare Supplement 10546Standard Insurance 00429Standard Insurance of New York 00430Standard Life and Accident Insurance Company 10593State Mutual (Lincoln Novation) 10982



Payer Name - 270/271 Transactions Payer IDState Mutual Med Supp. 10750Staywell 10512Staywell Kids 10513Stewart C Miller and Co 10937Stonebridge Life Insurance Company 11032Student Insurance 00290StudentResources 10938SummaCare 00000002514Summit America Insurance Service 11073Sun Orthopaedic Group, Inc 10939Superior Health Plan Texas 10592Sutter Select 10941S. USA Life Insurance Company, Inc. 11163TennDent 107934Tennessee Medicaid 00000001139Texas First Health Plan (TOPA) 10944TexanPlus (Integranet) 10942TexanPlus (Kelsey-Seybold) 10943TexanPlus North Texas Area 10604TexanPlusSoutheast Texas Area 10605Texas Medicaid AIDTXTexas Medicaid LTC AIDTXLTCThe Kempton Company 10698The ULLICO Family of Companies 10945Three Rivers Health Plans 00198Thrivent 11158TMG Network Health Insurance 10688Today’s Option 10505TransactRX Part D 11037TransAmerica Admin by KBA 10946Transamerica Premier Life Insurance Company 11100Tribute/Select Care of Oklahoma 10607Tricare TRICRTRICARE for Life 10879TRICARE Overseas 10947Trillium Community Health Plan 11120Triple-S Salud (BCBS Puerto Rico) 10953Trustmark 00233Tufts Health Plan 10379Ucare of Minnesota 2596Ultimate Health Plans 10888



Payer Name - 270/271 Transactions Payer IDUMR (Wausau) 10501UMWA Health and Retirement Funds 11121Underwriters Safety and Claims 10246Unicare UCAREUNICARE – Dental 10791Unified Life Insurance Company 11086 Union Pacific Railroad Employees Health Systems 10599Union Security Insurance Company (FBIC) 00253United American Insurance Company 10990United Concordia Companies, Inc. 10810United Concordia Federal Employees Program 10809United Healthcare 00112United Healthcare - Optum Behavioral Solutions 11076United Healthcare – West 11077United Healthcare Plan River Valley 00335United Healthcare SecureHorizons 10655United Teacher Assoc Insurance Co Medicare Supp 10547UnitedHealthcare Community Plan – Kansas 10835UnitedHealthcare Community Plan – TN 11025UnitedHealthcare Facets Detroit Community and State 10836UnitedHealthcare Facets Pittsburgh Community and State 10834UnitedHealthcare Nevada Market 10837United Health Group - Community Plan 11107Unity Health Plan 00000000780Universal Benefit Corp 11033Universal Care of California 1054University Care Advantage Arizona 10699University Family Care 00353University of Arizona Health Plan-UHM 10889University of Missouri 10428University of Utah Health Plans 10977University Physicians Care Advantage (AZ) 10433UPMC Health Plan (Tristate) 10288USAA Life Insurance Company 10195Utah Medicaid 10648VA Fee Basis Program 00231VA Health Administration Center 10956VA Healthcare 10850Valley Care Program 10948Valley Health Plan 10949Vantage Health Plan, Inc. 10858



Payer Name - 270/271 Transactions Payer IDVermont Medicaid 10197Village Family Practice 10950Virginia Medicaid 00000001213VIVA Health 10468VNS Choice 10600VYTRA 10407Washington Medicaid 00000000693Washington National 10853WEA Trust 10554WEB- TPA 10532Well Sense 10814Wellcare Health Plans 10488WellPath Select (Carolinas) 00164Health Smart Benefit Solutions (Wells Fargo TPA) WV 10003West Virginia Medicaid 00000000828Western Health Advantage 1043Western & Southern Financial Group 11111Wilson McShane 10797Wisconsin Medicaid 00000000867WPS Health Insurance 10878Wyoming Medicaid 77046YourCare Health Plan 11089

Conduent EDI Solutions, Inc.Eligibility (270/271) and Claim Status (276/277) Payer List


Payer Name - 276/277 Transactions Payer IDAARP 10431Access Medicare 11030ACS Benefit Services 11009Advantage by Bridgeway Health Solutions 10561Advantra- (Texas, New Mexico, Arizona only) 10447Advantra Freedom 10307Aetna 10004Aetna Better Health (FL) 11099Aetna Better Health (IL) 10892Aetna Better Health (KY) 11119Aetna Better Health (LA) 11008Aetna Better Health (MI) 11025Aetna Better Health (NJ) 10994Aetna Better Health of MO 11064Aetna Better Health of NE 10976Aetna Better Health of PA 10894Aetna Better Health of WV 11154Aetna Long Term Care 10397Aetna Signature Administrators 10983Affinity Health Plan Medicare 10661AFLAC 10955AFLAC - Medicare Supplemental 10663Alabama Medicaid 10007Allegiance Benefit Plan Management 10654Alternative Insurance Resources, Inc. 11002Altius Health Plans 00364AMC – American General Life and Accident 00237AMC Health Future 00246AMC- Poly America 00244AmeriBen 10985American National Insurance Company 10595American National Life Insurance Company of Texas 10596American Network Ins. Medicare 10899American Postal Workers Union Health (APWU) 00360American Retirement Life Ins Co Medicare Supp 10538AMERIGROUP 10019AmeriHealth 10974AmeriHealth Caritas Iowa 11142AmeriHealth Caritas Louisiana (LaCare) 10640Amerihealth Caritas Pennsylvania 10340Ameritas Life 00425



Payer Name - 276/277 Transactions Payer IDAnthem Vivity 10993Apex Benefits Services 10708Arbor Health Plan 10641ARISE Health Plan-Medicare 10868Arkansas Medicaid 10023Asuris Northwest Health 10529AultCare 10472Automated Benefit Services 10890Avalon Administrative Services 11145Bankers Life & Casualty 10813Banner Health Plans 10707BCBS AR BCARKBCBS Mississippi 10040BCBS of Alabama 10025BCBS of Alabama [Institutional] 10609BCBS of Colorado (Wellpoint) 10029BCBS of Connecticut (Wellpoint) 4816BCBS of Florida AV294BCBS of Georgia (Wellpoint) 10032BCBS of Illinois 00000000551BCBS of Indiana (Wellpoint) 4820BCBS of Iowa 10396BCBS of Kansas 4923BCBS of Kansas City 10473BCBS of Kentucky (Wellpoint) 4821BCBS of Maine (Wellpoint) 4818BCBS of Massachusetts 00139BCBS of Minnesota 10039BCBS of Missouri (Wellpoint) 4921BCBS of Nebraska 10384BCBS of Nevada (Wellpoint) 10260BCBS of New Hampshire (Wellpoint) 4817BCBS of New Jersey (Horizon) 00087BCBS of New Mexico 10042BCBS of New York (Empire) 10043BCBS of New York (Excellus) 10323BCBS of North Carolina 10383BCBS of Ohio (Wellpoint) 4823BCBS of Oklahoma 10582BCBS of Oregon (Regence) 10045BCBS of South Carolina 10047



Payer Name - 276/277 Transactions Payer IDBCBS of South Dakota 10395BCBS of Tennessee 10430BCBS of Texas 10048BCBS of Vermont 10624BCBS of Virginia BCBSVBCBS of Wisconsin (Wellpoint) BCBSWBCBS Texas Medicaid STAR CHIP 11196Benefit Management Inc. 10665Best Life and Health 00257Better Health Plans (Unison Health Plan) 00199Blue Cross of California (Wellpoint) BCCALBlue Cross Medicare Advantage 11174Blue Cross of Utah (Regence) 10618Blue Cross of Washington and Alaska (Premera) 10326Blue Cross Pennsylvania (Capital) 582Blue Shield of California 10053Blue Shield of Idaho (Regence) 10052Blue Shield of Washington (Regence) 10054Boon Group 10821Bravo Health 10399Bridgespan 10827C and O Employees’ Hospital Association Plan 10997Care1st Health Plan Arizona 10981Care Improvement Plus 10806Carefirst Blue Cross Blue Shield (DC) 11102CarePlus Health Plan 00324CarePoint Medicare Advantage 10822CareSource Health 10057Carolina Care Plan, Inc. (CCP) 10762Carpenter’s Health and Welfare Trust Fund of St. Louis 10555CDS Group Health 10667Cenpatico - Georgia 10569Cenpatico - Mississippi 10769Cenpatico - Missouri 10768Cenpatico - New Hampshire 10770Cenpatico Behavioral Health 10766Cenpatico Behavioral Health Texas 10767Centene - Advantage by Peach State 10763Centene - Advantage by Sunshine State 10764Centene - California Health & Wellness 10759Centene - Coordinated Care 10761



Payer Name - 276/277 Transactions Payer IDCentene - Granite State Health Plan 10765Centene - Home State Health Plan 10760Centene - IlliniCare Health Plan 10757Centene - Kentucky Spirit Health Plan 10620Centene - Louisiana Healthcare Connections 10756Centene - Magnolia Health Plan 10704Centene - Michigan Fidelis Secure Care 11034Centene - Peach State Health Plan 10590Centene - Sunflower State Health (Kansas) 10758Centene - Sunshine State Health Plan 10451Centene - Total Care Carolina 10866Centene - Texas 10633Centene Advantage Plans 10771Central California Alliance for Health 10884Central Reserve Life Ins Co Medicare Supp 10539Central States Fund 10486CHAMPVA/Spina Bifida/Children of Women Vietnam Vets 00232CHC - CoventryOne 10440CHC - Florida/Vista/Summit 10551CHC - PersonalCare/Coventry Health of Illinois 00179CHC Carelink (Advantra) 00160CHC Carelink Medicaid 00182CHC- Mail Handler’s Benefit Plan 00251CHC of Delaware 00166CHC of Georgia 00154CHC of Iowa 00170CHC of Kansas 10208CHC of Louisiana 00158CHC of Nebraska 00176CHCCares- South Carolina 10420Christie Student Health Plans 11113CHRISTUS Health Plan Medicaid 11105CHRISTUS Health Plan New Mexico 11006CHRISTUS Health Plan NM Medicare Advantage 11007CIGNA 00001CMFG Life Insurance 10909Colonial Penn Life 10852Colorado Medicaid 10065Community Care of Oklahoma 10066Community Health Group 11087ConnectiCare 10303



Payer Name - 276/277 Transactions Payer IDContinental General Ins Co Medicare Supp 10540Cooperative Benefit Administrators 00223CoreSource FMH 00204CoreSource Little Rock 00205NGS Coresource 00239CoreSource-MD/PA/IL/NC/AZ/IN/MN 00236Coventry Advantra Savings 10419Coventry Health and Life (Nevada) 10448Coventry Health and Life (OK only) 00441Coventry Health Care Federal 10481Coventry Health Life- TN only 10405Aetna Better Health (VA) 00190Coventry Healthcare National Network 10084Coventry Missouri 10449Coventry Nebraska Medicaid 10548CoventryCares 10614Culinary Health Fund 10775Dean Health Plan 10653Definity Health 10828Denver Health Medical Plan 0000001321Diamond Plan (Maryland Medicaid) 00177Director's Guild 10077District No. 9, I. A. of M. & A W. Welfare Trust 11098Driscoll Health Plan 11090Easy Choice 10703EBMS (Employee Benefit Management Services) 10862Emblem Health 10616Essence Healthcare 10601Everence Financial 10772Evergreen Health Co-Op 10860Expert Benefit Solutions 11019Fallon Community Health Plan 10082Federated Insurance Company 00262Fidelis SecureCare of Michigan 10859First Ameritas of New York 00426First Reliance Standard Life 00428Florida Health Care Plans 10615Florida Medicaid 77027Florida True Health 10839Food Employers & Bakery Workers Benefit 10776Frensenius Health 11130



Payer Name - 276/277 Transactions Payer IDGeorgia Medicaid 10088Gilsbar 10509Globe Life & Accident Ins.Co. 10988Golden Rule Insurance 10652Government Hospital Employees Association (GEHA) 10394Great American Life Assurance Co Medicare Supp 10542Group Health Plan (GHP) 00184Group Dental Service 11188Harmony Health Plans 10514Health First Health Plans 10673Health First Insurance 10674Health Partners of Philadelphia 10098Health Services for Children with Spec. 10584HealthAmerica and Health Assurance 00148Healthcare Inc (Promina) 00193Healthcare USa (HCUSA) 00186HealthChoice AZ 00329HealthEase 10510HealthEase Kids 10511Healthfirst NJ 10438Healthfirst NY 00240Healthgram (formerly Primary PhysicianCare) 10692HealthMarketsHealthPlan Services - Celtic Insurance Company 10856HealthSmart Benefit Solutions 11079Health Smart Benefit Solutions (Wells Fargo TPA) WV 10003HealthSpring 10464Heritage Physician Network (Houston) 10918HMA (Hawaii Mainland Adminstrators) 11112Horizon New Jersey Health 2840HSBS Oklahoma City 11169Humana 00041Humana CareSource 10920IBEW Local 508 Health Plan 10855Concentrix Insurance Solution 10861IHC Health Solutions 10998Illinois Medicaid 10102Independent Health 10536Indiana Medicaid 10103Kaiser Foundation Health Plan of Colorado 10110Kaiser Foundation Health Plan of Washington 10608



Payer Name - 276/277 Transactions Payer IDKentucky Health Exchange 10857Kentucky Medicaid 00000000945Key Benefits Administrators (IN) 10754Leon Medical Centers Health Plan 10677Liberty National Life Ins.Co. 10989Lifewise Health Plan of Oregon 10651Lifewise Health Plan of Washington 10650Lincoln Financial 10678Loyal American Life Ins Co Medicare Supp 10544Magnacare 10867Managed Health Network 10863Maricopa Health Plan Arizona 10434Massachusetts Medicaid 10124MDWise Hoosier Alliance 10598MedBen (Newark OH) 10681Medica 00404Medica Health Plans 11029Medical Mutual of Ohio 00211Med-Pay, Inc. 10682Mega Life Insurance Oklahoma City 00365Meritain Health 10635Meritus Health Partners 10980MetroPlus 861Mid Atlantic Medical Services, LLC (MAMSI) MAMSIMississippi Medicaid 00000000786Missouri Care 10702Missouri Medicaid 00000000684MMSI (Mayo Health) 10144Molina Healthcare of California 00222Molina Healthcare of Florida 10445Molina Healthcare of Illinois 10685Molina Healthcare of Michigan 00226Molina Healthcare of New Mexico 10146Molina Healthcare of Ohio 00445Molina Healthcare of Puerto Rico 11031Molina Healthcare of SC 10815Molina Healthcare of Texas 10391Molina Healthcare of Utah 00227Molina Healthcare of Washington 00228Mutual Health Services 10686MVP Health Care (New York) 00432



Payer Name - 276/277 Transactions Payer IDNaphCare, Inc. 10992National Association of Letter Carriers (NALC) 00214Network Health Plan of WI 10706New Era Life Insurance Company 10991New Mexico Medicaid 10247Nippon Life Insurance Co of America 00144Northwest Administrators 11038Ohana Health Plans 10515Ohio Medicaid 10158Oklahoma Employees Group Insurance Division 10995Omnicare (Michigan) 00284Operating Engineers Local No. 428 10777Orange County Fire Authority 10951Pacificare of California (HMO) 10268Pacificare of Oklahoma (HMO) 10373Pacificare of Oregon (HMO) 10374Pacificare of Texas (HMO) 10371Pacificare of Washington (HMO) 10370PacificSource Administrators 11177PacificSource Community Solutions(Medicaid) 11091PacificSource Medicare 11178Pan-American Life Insurance Company 11114Partnership Health Plan of California 10164Passport Health Plan 10368PENN Treaty Network Medicare Supp. 10924Personal Insurance Administrators (PIA) 10492Physicians Mutual Insurance Company 00287Pinnacle Physician Management Org 10926Pittman and Associates 10408Planned Administrators Inc. 10886Plumbers and Pipefitters Local Union 525 10778Preferred Care Partners 10691Prestige Health Choice 10965Principal Life Insurance Company 00143Prominence Health Plan of Nevada 11198Prominence Health Plan of Texas 11199Provident American Life & Health Ins Co Medicare Supp 10545QuikTrip Corporation 10508Reliance Standard Life 00427Reserve National Insruance Company 11127Sanford Health Plan 10533



Payer Name - 276/277 Transactions Payer IDSanta Clara Family Health Plan 10876Schaller Anderson Aetna Better Health of OH 10887Schaller Anderson Aetna Better 10816Schaller Anderson Delaware Phys 10817Schaller Anderson MajestaCare VA 10818Schaller Anderson Maryland Physicians Care 10693Schaller Anderson Mercy Care 10694Schaller Anderson Mercy Maricopa 10996Schaller Anderson Missouri Care 10695Schaller Anderson Parkland Community 10643Schaller Anderson Texas CHRISTUS 10696Select Health of SC 10520SelectCare of Texas (Beaumont) 10928SelectCare of Texas (Houston) 10930SelectCare of Texas (Integranet) 10931Senior Health Services Center-Universal American Family of Companies 10697Senior Whole Health 10962Sharp Health Plan 10967Significa Benefit Services 00191Simply Healthcare Plans 10826Southern Health Services (SHS) 00156SPJST Medicare Supplement 10546Standard Insurance 00429Standard Insurance of New York 00430Staywell 10512StayWell Kids 10513Stonebridge Life Insurance Company 11032SummaCare Health Plan 10294Summit America Insurance Service 11073TexanPlus (Integranet) 10942TexanPlus (Kelsey-Seybold) 10943TexanPlus North Texas Area 10604TexanPlus South Texas Area 10605The Kempton Company 10698The ULLICO Family of Companies 10945Three Rivers Health Plans (Unison Health Plan) 00198TMG Network Health Insurance 10688Today’s Options 10505Triad Healthcare, Inc. 10963Transamerica Premier Life Insurance Company 11100Tribute/SelectCare of Oklahoma 10607



Payer Name - 276/277 Transactions Payer IDTricare 10189Trillium Community Health Plan 11120Trustmark 00233Ultimate Health Plans 10888UMR (Wausau) 10501Unicare UCAREUnion Pacific Railroad Employee Health Systems 10599United American Insurance Company 10990United Healthcare 00112United Healthcare Community Plan – Kansas 10835United Healthcare Facets Detroit Community and State 10836United Healthcare Facets Pittsburgh Community and State 10834United Healthcare Nevada Market 10837United Healthcare Plan of River Valley 10192United Teacher Assoc Insurance Co Medicare Supp 10547Univera 10535Universal Benefit Corp 11033University Care Advantage Arizona 10433University Care Advantage Arizona 10699University Family Care Arizona 10194University of Arizona Health Plan- UHM 10889University of Missouri 10428University Physicians Healthcare Group Arizona 10439UPMC Health Plan (Tristate) 10288USAA Life Insurance Company 10195UMWA Health and Retirement Funds 11121VA Fee Basis Program 00231

Conduent EDI Solutions, Inc. Conduent EDI Solutions, Inc. Eligibility (270/271) Claim Status (276/277) Payer List Conduent EDI Solutions, Inc. Payer List - 270/271 Transactions 12/6/2017

Documents