Page 1
eClaims Medical Payer List Information
For any questions please contact PTOS Support at 800.475.5036.
Payer List Includes: Commercial Payers Blue Cross Blue Shield Payers Medicaid Payers Medicare Payers Champus Payers Automobile Medical Payers Workers Compensation Payers
Payer ID SPRNT: Use this eClaim payer id for those insurance companies that are not on the eClaim Payer List
Enroll Column: This column indicates whether or not the payer requires enrollment P, R, and A = Provider registration is required
1. Within PTOS go to Help – Online Center- FAQ 2. Under the Search by Keyword field type 13138 3. Click on the eClaims Insurance Enrollment Link
N = No paperwork is required
Additional Information Column: This column includes important information specific to the insurance companies
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Americas 1st Choice Health Plans of North Carolina Inc. 26078 COMMERCIAL N
Americas 1st Choice Health Plans of South Carolina Inc. 20553 COMMERCIAL N
Arroyo Vista Family Health Center NMM01 COMMERCIAL N
Lakeside Medical Group 66125 COMMERCIAL N
Optimum Healthcare Inc. 20133 COMMERCIAL N
Primary Care Associates Medical Group IP079 COMMERCIAL N
Texas First Health Plans (TIOPA) 76046 COMMERCIAL N
1-888-OHIOCOMP (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
1199 National Benefit Fund 13162 COMMERCIAL N
1st MN--Atlanta GA 29076 COMMERCIAL N
1st Medical Network is part
of the Medical Mutual Family
of Companies. Former payer
ID 58203.
1st Medical Network - Atlanta GA 29076 COMMERCIAL N
1st Medical Network is part
of the Medical Mutual Family
of Companies. Former payer
ID 58203.
21st Century Health and Benefits 59069 COMMERCIAL N
21st Century Insurance and Financial Services 51028 COMMERCIAL N For Minnesota Only
3-Hab (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
3P ADMIN 20413 COMMERCIAL N
A & I Benefit Plan Administrators 93044 COMMERCIAL N
A.G.I.A. Inc. 95241 COMMERCIAL N
Claims are printed and mailed
to the payer.
AAG Benefit Plan Administrators Inc. 75240 COMMERCIAL N
AAG-American Administravie Group ( Formerly Icon Benefit Admin)75185 COMMERCIAL N
ABMA (Alta Bates Medical Assocs) Medical Corp (Hnet Sr. and Secure Horizon)E3510 COMMERCIAL P
Only claims from providers in
Northern California. Please
contact the EDI Dept for
North American Medical
Management (NAMM) -
Northern California
Lead/Supervisor at 1-800-956-
8000 prior to initial
submission of claims.
ACMG 37118 COMMERCIAL N
Claims are processed by
Benefit Plan Administrators
ACMG COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
ACS Benefit Services Inc. 72467 COMMERCIAL N
DO NOT send ACS/Health Net
or ACS Inc. Medicaid claims
to this payer ID. This payer ID
is for ACS Benefit Services.
Inc. ONLY.
ADOC (Affiliated Doctor's of Orange County) ADOCS COMMERCIAL N
ADVANCED DATA SOLUTIONS 58202 COMMERCIAL N
ADVANTICA BENEFITS 59374 COMMERCIAL N
AFFINITY MEDICAL GROUP 46594 COMMERCIAL N
AFTRA Health Fund 13346 COMMERCIAL N
AGA 37280 COMMERCIAL N
AHPO (Cleveland OH) 31138 COMMERCIAL N
AKM Medical Group CAPMN COMMERCIAL N
ALICARE 13550 COMMERCIAL N
ALPS CompCare (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
AMA Insurance Agency TH071 COMMERCIAL N
AMCO 62176 COMMERCIAL N
AMERIGROUP Community Care of New Mexico 27514 COMMERCIAL N
AMERIGROUP Georgia 27514 COMMERCIAL N
AMVI CAPMN COMMERCIAL N
AMVI/Prospect Health Network (Prospect Medical Group)PROSP COMMERCIAL N
APAC (Pinnacle Health Resources) (Prospect Medical Group)PROSP COMMERCIAL N
APS Healthcare Inc. 54160 COMMERCIAL N
APS Paper Claim 54100 COMMERCIAL N
Claims will be printed and
mailed to APS Paper Claim
54100.
ARAZ Group 16120 COMMERCIAL N
ARM Grp 88035 COMMERCIAL N
ASC of Oho Call COMMERCIAL N
To obtain the payer ID please
call (440) 262-1160.
ASR 38265 COMMERCIAL N
ASR Corporation 38265 COMMERCIAL N
ASR Health Benefits 38265 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
ATA-FL 65064 COMMERCIAL N
ONLY Physical Occupational
and Speech Therapy Claims
for the following FLORIDA
Health Plans should be
submitted to this payer ID:
Aetna Health Plan CarePlus
JMH Health Plan Sunshine
State Health Plan WellCare
Health Plan
AXA Assistance_USA 65101 COMMERCIAL N
Abrazo Advantage Health Plan 3443 COMMERCIAL N
Absolute Total Care 68055 COMMERCIAL N
Prior to submitting claims
please call Provider Relations
Dept at 1-866-433-6041 to
verify your provider info is on
file in the claim system. This
will prevent rejections and
allow payments to be made
in a timely manner.
Access Administrators TH067 COMMERCIAL N
Access IPA CM001 COMMERCIAL N
Access IPA REGAL COMMERCIAL N
Acclaim 64071 COMMERCIAL N
Acclaim Repricing 21356 COMMERCIAL N
Activa Benefit Services 88056 COMMERCIAL N
Administration Systems Research Corporation 38265 COMMERCIAL N
Administrative Concepts Inc. 22384 COMMERCIAL N
Administrative Services Inc. 59141 COMMERCIAL N
Advanced Medical Management AMM01 COMMERCIAL N
Advantage Health Solutions 35209 COMMERCIAL N
Advantage Med Grp NMM01 COMMERCIAL N
Advantage Preferred Plus 77070 COMMERCIAL N
Advantage by Bridgeway Health Solutions 68056 COMMERCIAL N
Advantage by Buckeye Community Health Plan 68056 COMMERCIAL N
Advantage by Managed Health Services 68056 COMMERCIAL N
Advantage by Superior HealthPlan 68056 COMMERCIAL N
Advantek Benefit Administrators 83077 COMMERCIAL N
Advantra Freedom 25133 COMMERCIAL N
Formerly payer ID 25152.
Now part of Coventry
Consolidated payer ID.
Advantra Savings 25133 COMMERCIAL N
Formerly payer ID 25152.
Now part of Coventry
Consolidated payer ID.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Adventist Health System West - Roseville CA 95340 COMMERCIAL N
AdvoCare Incorporated (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Advocate Health Centers 36320 COMMERCIAL N
Please contact Advocate
Physician Partners Debbie
Motz at (847)635-4182 for
questions or more
information for both payer
IDs.
Advocate Physician Partners 65093 COMMERCIAL N
Please contact Advocate
Physician Partners Debbie
Motz at (847)635-4182 for
questions or more
information for both payer
IDs.
Aetna 60054 COMMERCIAL N
Aetna Affordable Health Choices (SM) - SRC 57604 COMMERCIAL N
Affiliated Doctors of Orange County (ADOC) ADOCS COMMERCIAL N
Affiliated Physicians Group APG01 COMMERCIAL N
Affinity Health Plan 13334 COMMERCIAL P
Please contact Affinity's EDI
Coordinator before
submitting claims
electronically at
[email protected] or call
(718)794-7592.
Affinity Medicare Advantage 13333 COMMERCIAL N
When submitting to this
payer ID please ensure the
following: The claim is for a
Medicare Advantage Member
the date of service is equal to
or greater than 1/1/10 and
the subscriber ID you submit
is 9 characters in length.
Affordable Benefit Administrators Inc. 95426 COMMERCIAL N
Claims with the following
address should only be sent
to this payer id. ABA P.O. Box
10787 Burbank CA 91510-
0787
Agate Resources Inc. (LIPA) 20048 COMMERCIAL N
Please contact Risa Rhodes at
(514) 762-2165 for the Agate
Resources Inc. (LIPA) Payer ID
Agency Services Inc 64158 COMMERCIAL N
Now known as Meritain
Health
Alaska Carpenters Trust 91136 COMMERCIAL N
Please enter Group Number
(F40) when submitting claims.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Alaska Children's Services Inc. 91136 COMMERCIAL N
Please enter Group Number
(P68) when submitting
claims.
Alaska Electrical Health & Welfare Fund 92600 COMMERCIAL N
Alaska Laborers Construction Industry Trust 91136 COMMERCIAL N
Please enter Group Number
(F23) when submitting claims.
Alaska Pipe Trades Local 375 91136 COMMERCIAL N
Please enter Group Number
(F24) when submitting claims.
Alaska United Food & Commercial Workers Health & Welfare Trust91136 COMMERCIAL N
Please enter Group Number
(F45) when submitting claims.
Allegiance Benefit Plan Management Inc. 81040 COMMERCIAL N
Alliance Healthcare/Florida for Stones River Regional IPA13079 COMMERCIAL N
This Payer ID should be used
for Stones River Regional IPA -
Alliance Healthcare Florida
claims only.
Alliance The (A Wisconsin provider network) Call COMMERCIAL N
ID cards should show mailing
address of PO Box 44365
Madison WI 53744. Call Dave
Sell at 608-210-6656 to
obtain Payer ID.
Alliant Health Plans of Georgia 58234 COMMERCIAL N
Allied Administrators (San Francisco CA) 94177 COMMERCIAL N
Allied Benefit Systems 37308 COMMERCIAL N
Allied Health Systems Chiropractic SX156 COMMERCIAL N
Allied Physicians NMM01 COMMERCIAL N
Alpha Data TH085 COMMERCIAL N
Alta Bates Medical Group A0701 COMMERCIAL N
Payer ID is only for dates of
service after 7/1/2010.
Alta Bates Medical Group Call COMMERCIAL P
Network ID required on all
claims. Call Sutter Connect
EDI Department at (800) 611-
5191 to obtain Network ID
prior to first submission.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Alta Senior Care (Hnet Sr and Secure Horizons only) E3510 COMMERCIAL P
Only claims from providers in
Northern California. Please
contact the EDI Dept for
North American Medical
Management (NAMM) -
Northern California
Lead/Supervisor at 1-800-956-
8000 prior to initial
submission of claims.
Altius (Utah) 25133 COMMERCIAL N
Formerly Payer ID SX113.
Now part of the Consolidated
payer ID.
Amalgamated Life 13550 COMMERCIAL N
Amalgamated Life - PA / Alicare 13343 COMMERCIAL N
AmeraPlan 38219 COMMERCIAL N
Claims are printed and mailed
to the payer.
AmeriBen Solutions Inc. 75137 COMMERCIAL N
AmeriChoice of New Jersey Personal Care Plus (Medicare)86001 COMMERCIAL N
All claims submitted require
your AmeriChoice assigned
Provider ID Number. Please
contact AmeriChoice at (888)
362-3368 for your Provider ID
Number.
AmeriChoice of New Jersey Inc. (Medicaid NJ) 86047 COMMERCIAL N
AmeriChoice of New York Personal Care Plus (Medicare)86002 COMMERCIAL N
All claims submitted require
your AmeriChoice assigned
Provider ID Number. Please
contact AmeriChoice at (866)
362-3368 for your Provider ID
Number.
AmeriChoice of New York Inc. (Medicaid NY) 86048 COMMERCIAL N
AmeriChoice of Pennsylvania Personal Care Plus (Medicare)86003 COMMERCIAL N
All claims submitted require
your AmeriChoice assigned
Provider ID Number. Please
contact AmeriChoice at (800)
345-3627 for your Provider ID
Number.
AmeriChoice of Pennsylvania Inc. (Medicaid PA) 86049 COMMERCIAL N
AmeriHealth Administrators 54763 COMMERCIAL N
AmeriHealth HMO New Jersey and Delaware 23037 COMMERCIAL N
AmeriHealth Mercy Health Plan 22248 COMMERCIAL N
Medicaid managed care. For
EDI support please e-mail
[email protected] .
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
America's PPO 16120 COMMERCIAL N
America's TPA 41178 COMMERCIAL N
Americaid Community Care (Maryland) 27517 COMMERCIAL N
Americaid Community Care (New Jersey) 27516 COMMERCIAL N
American Administrative Group 75240 COMMERCIAL N
American Administrators (West Des Moines Iowa) 42112 COMMERCIAL N
Please check the Insured ID
card to verify the Payer ID
before submitting claims. If
you have questions please
contact Provider Relations at
800-456-4584.
American Administrators dba Select Benefit Administrators (W.DesMoines IA)42137 COMMERCIAL N
Please check the Insured ID
card to verify the Payer ID
before submitting claims. If
you have questions please
contact Provider Relations at
800-456-4584.
American Behavioral 63103 COMMERCIAL N
American Behavioral FEP/ITS 63106 COMMERCIAL N
American Behavioral-LifeSynch 63101 COMMERCIAL N
American Benefit Plan Administrators 95170 COMMERCIAL N
American Benefits Management (North Canton OH) 34187 COMMERCIAL N
Payer ID valid only for claims
with a billing submission
address of P.O. Box 35008 N.
Canton OH 44735
American Chiropractic Network (ACN) 41161 COMMERCIAL N
American Chiropractic Network IPA of NY (ACNIPA) 41160 COMMERCIAL N
American Community Mutual Insurance 60305 COMMERCIAL N
American Family Health Providers CAPMN COMMERCIAL N
American Family Insurance TH095 COMMERCIAL N
American Family PPO Policies Administered by Am Rep 56071 COMMERCIAL N
American General 62030 COMMERCIAL N
American Healthcare Alliance 1066 COMMERCIAL N
American Imaging Management Inc. 36369 COMMERCIAL N
Assigned Group Policy Plan ID
is required. To obtain please
call American Imaging
Management Inc. at (800)
252-2021.
American International Group Inc. (AIG) 87726 COMMERCIAL N Plan of UnitedHealthcare
American Medical Security Inc. 81400 COMMERCIAL N
American Medical and Life Insurance 23212 COMMERCIAL N
American National Ins. Co. (ANICO) 74048 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
American Postal Workers Union Health Plan 44444 COMMERCIAL N
Claims for the state of Maine
ONLY must be sent on paper
to MedNet P. O. Box 15440
Portland ME 04112.
American Progressive Life and Health Insurance Company48055 COMMERCIAL N
American Republic Insurance 42011 COMMERCIAL N
Payer does not accept
Secondary/Tertiary claims
electronically.
American Whole Health Networks TH117 COMMERCIAL N
American Worker Health Plan 37322 COMMERCIAL N
Amerigroup Community Care 27514 COMMERCIAL N
Amerigroup Corporation (Ft Worth) 27514 COMMERCIAL N
Formally Americaid
Community Care (Dallas/Ft.
Worth).
Amerigroup Corporation (Houston) 27515 COMMERCIAL N
Formerly Americaid
Community Care (Houston).
Amerigroup Florida 27519 COMMERCIAL N
Amerigroup Illinois 27518 COMMERCIAL N
Amerigroup Ohio 27518 COMMERCIAL N
Amida Care 24818 COMMERCIAL N Formerly known as VidaCare
Anchor Benefit Consulting Inc. 53085 COMMERCIAL N
Ancillary Benefit Services (ABS) 86062 COMMERCIAL N
Ancillary Care Management/ACM 3172 COMMERCIAL N
Angeles IPA (SynerMed) SYMED COMMERCIAL N
Antares Management Solutions 34192 COMMERCIAL N
Apex Benefit Services 34196 COMMERCIAL N
Apex is also a Medicaid payer
and will accept claims with
either a Medicaid or
Commercial classification
AppleCare Medical Management APP01 COMMERCIAL N
Arcadian Management Services Inc 77045 COMMERCIAL N
Arizona Foundation for Medical Care (AFMC) 86062 COMMERCIAL N
Arizona Physicians IPA 3432 COMMERCIAL N
Arizona Priority Care Plus 27154 COMMERCIAL N
Arkansas Best Corporation - Choice Benefits 75278 COMMERCIAL N
Associates for Health Care Inc. (AHC) 36326 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Association Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry
Consolidated payer ID.
Including Combined
Government Health Plan &
Contract Health Insurance
Plan.
Assurant Health 39065 COMMERCIAL N
Assurant Health Self-Funded (Ft. Mill SC) 37313 COMMERCIAL N
MUST VERIFY ALL CLAIMS
SHOULD GO TO PAYER IN FT.
MILL SC
Assured Benefits Administrators 74240 COMMERCIAL N
Asuris Northwest/MedAdvantage SX179 COMMERCIAL N
Payer must receive
REF*1B*Provider ID in Billing
and Rendering even when
NPI is submitted.
Athens Area Health Plan Select 95691 COMMERCIAL N
Atlantic Medical Insurance 22285 COMMERCIAL N
Atlantis Health Plan 13853 COMMERCIAL N
Atlantis Health is now doing
business as Easy Choice
Health plan of New York
Atlas Administrators TH004 COMMERCIAL N
Currently only accepts UCO
Providers. The group number
must be 8 characters in
length. Only one of the
characters can be a dash. If
the group number is entered
then the group name must
also be entered.
AultComp Managed Care Organization (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Aultra Administrative Group 37242 COMMERCIAL N
Payer ID valid only for claims
with a billing submission
address of P.O. Box 35276
Canton OH 44735-5276
Automated Benefit Services 38259 COMMERCIAL N
Automated Group Administration Inc. 37280 COMMERCIAL N
Please send these EDI claims
to the Payer ID of the PPO
shown on the Member's ID
Card. If you have any
questions please call 260-489-
6447 (703).
AvMed Inc. 59274 COMMERCIAL N
The Insured ID and Patient ID
fro this payer must be the 11-
digit Member ID.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Avalon IPA CAPMN COMMERCIAL N
Avalon Medical Group CAPMN COMMERCIAL N
AvatarComp (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Avera Health Plans 46045 COMMERCIAL N
AveraAdvantage 48055 COMMERCIAL N
Averde Health 26355 COMMERCIAL N
Avesis Third Party Administrators 87098 COMMERCIAL N
These payer is live for VISION
CLAIMS ONLY.
BCI Administrators Inc. 49153 COMMERCIAL N
BEACON HEALTH STRATEGIES 43324 COMMERCIAL N
Beacon requires submission
of the member's Plan ID.
Please follow the link to our
payer fact sheet for ID's and
further instructions.
BENEFIT MANAGEMENT ADMINISTRATORS 74266 COMMERCIAL N
BENEFIT MANAGEMENT SERVICES Call COMMERCIAL N
Please contact Chris Burak at
(704) 321-3156 for payer id
information.
BHP-Unity 44219 COMMERCIAL N
BHSG of Tennessee SX002 COMMERCIAL N
BMC HealthNet Plan 13337 COMMERCIAL N
Submissions to BMCHP must
include the correct 12 digit
BMCHP Provider ID #
including all leading zeros.
BPA/Benefit Plan Administrators (North Dakota) 37286 COMMERCIAL N
BPS Inc. COMMERCIAL N
BSI Call COMMERCIAL N
To obtain the payer ID please
call (440) 262-1160.
Bakersfield Family Medical Center BKRFM COMMERCIAL N
Banner Health AZ SX145 COMMERCIAL N
Banner Health Co - ROCKY MOUNTAIN HMO GREELEYSX145 COMMERCIAL N
Banner Health Co. - ANTERO GREELEY SX145 COMMERCIAL N
Banner Health Co. - ANTERO HIGH PLAINS SX145 COMMERCIAL N
Banner Health Co. - ANTERO MOUNTAIN SHADOWSSX145 COMMERCIAL N
Banner Health Co. - CHOICE PLUS SX145 COMMERCIAL N
Banner Health Co. - HMO GREELEY SX145 COMMERCIAL N
Banner Health Co. - HMO HIGH PLAINS SX145 COMMERCIAL N
Banner Health Co. - HMO MOUNTAIN SHADOWS SX145 COMMERCIAL N
Banner Health Co. - PACIFICARE GREELEY SX145 COMMERCIAL N
Banner Health Co. - PACIFICARE HIGH PLAINS SX145 COMMERCIAL N
Banner Health Co. - PACIFICARE MOUNTAIN SHADOWSSX145 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Banner Health Co. - ROCKY MOUNTAIN HMO HIGH PLAINSSX145 COMMERCIAL N
Banner Health Co. - SECURE HORIZONS GREELEY SX145 COMMERCIAL N
Banner Health Co. - SECURE HORIZONS HIGH PLAINSSX145 COMMERCIAL N
Banner Health Co. - SECURE HORIZONS MOUNTAIN SHADOWSSX145 COMMERCIAL N
Banner Medisun 77078 COMMERCIAL N
Bascom Palmer Eye Care Network - New Century HealthNCH06 COMMERCIAL N
Bass Administrators Inc. 37248 COMMERCIAL N
Beech Street 95377 COMMERCIAL N
Behavioral Health Systems 63100 COMMERCIAL N
Bellflower Hospital (Synermed) SYMED COMMERCIAL N
Bencomp National Corporation 33192 COMMERCIAL N
Benefit Admin Services 88055 COMMERCIAL N
Benefit Administrative Systems 36149 COMMERCIAL N
Benefit Coordinators Corporation (Pittsburgh PA) 25145 COMMERCIAL N
Payer ID valid only for claims
with a billing submission
address of 111 Ryan Court
Suite 300 Pittsburgh PA
15205.
Benefit Management Services Inc. 999 COMMERCIAL N
Benefit Management Systems Inc 37212 COMMERCIAL N
Benefit Management Inc. of KS 48611 COMMERCIAL N
This payer will only accept
medical and hospital claims
for these groups listed:
BMI187BMI219BMI234BMI23
6BMI214.BMI241BMI617
BMI245.BMI246
Benefit Plan Administrators 88052 COMMERCIAL N
Benefit Plan Administrators Co. (Eau Claire WI) 39081 COMMERCIAL N
Payer ID valid only for claims
with a billing submission
address of P.O. Box 1128 Eau
Claire WI 54702-1128.
Benefit Plan Administrators Inc 37118 COMMERCIAL N
Benefit Planners Inc. 74223 COMMERCIAL N
Benefit Systems & Services Inc. 36342 COMMERCIAL N
Now known as Total Broker
Benefits Payer ID 36342
Benesight 87265 COMMERCIAL N (Formerly known as The TPA)
Benesys 37248 COMMERCIAL N
Benesys Inc. 37248 COMMERCIAL N
Berkshire Health Partners - PPO Wyomissing PA (IHS Gateway Payer)23243 COMMERCIAL N
Berkshire Intergroup 10956 COMMERCIAL N
Berkshire Lehigh Partners 95606 COMMERCIAL N
Best Life & Health Insurance Co. 95604 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Better Health Plans of South Carolina 32006 COMMERCIAL N
Better Health Plans Inc. 62183 COMMERCIAL N
Now known as Unison Health
Plan
Blue Benefit Administrators of MA 3036 COMMERCIAL N
Blue Grass Family Health/SRRIPA ONLY 15754 COMMERCIAL N
This Payer ID should be used
for Stones River Regional IPA -
Blue Grass Family Health
claims
Bluegrass Family Health 61124 COMMERCIAL N
Boilermakers National Health & Welfare Fund 36609 COMMERCIAL N
Boon-Chapman Benefit Administrators Inc. 74238 COMMERCIAL N
Boston Medical Center Health Plan Inc. 13337 COMMERCIAL N
Submissions to BMCHP must
include the correct 12 digit
BMCHP Provider ID #
including all leading zeros.
Boulder Administration Services 20381 COMMERCIAL N
Bravo Health 52192 COMMERCIAL N
Bravo Health 52192 COMMERCIAL N
Bravo Health Star Plus 52192 COMMERCIAL N
Bridgestone/Firestone See Comments COMMERCIAL N
Please call Bridgestone
Customer Service Center at
330-379-4500 for Customer
Support.
Bridgeway Arizona 68054 COMMERCIAL N
Prior to submitting claims
please call Provider Relations
Dept. at 1-866-475-3129 to
verify your provider info is on
file in the Health Plans claim
system. This will prevent
rejections and allow
payments to be made in a
timely manner.
BritCay 22286 COMMERCIAL N
Brockerage Concepts Inc. 51037 COMMERCIAL N
Brodart 35182 COMMERCIAL N
Brokerage Service Inc Call COMMERCIAL N
To obtain the payer ID please
call (440) 262-1160.
Broward Health 37314 COMMERCIAL N
Brown & Toland Medical Group 94316 COMMERCIAL N
Brown and Toland Medical Group BTSS1 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Buckeye Community Health 32004 COMMERCIAL N
Prior to submitting claims
please call Provider Relations
Dept at 1-866-296-8731 to
verify your provider info is on
file in the claim system. This
will prevent rejections and
allow payments to be made
in a timely manner.
Butler Benefit 42150 COMMERCIAL N
C&O Employees Hospital Association 23708 COMMERCIAL N
C. L. Frates & Co - OSMA Health 73071 COMMERCIAL N
CAP Management CAPMN COMMERCIAL N
CAP Management Systems 95399 COMMERCIAL N
CAPSTONE HEALTH PLAN INC 86044 COMMERCIAL N
CARE 1ST HEALTH PLAN OF CA 57115 COMMERCIAL N
CBA Blue 3036 COMMERCIAL N
Formerly known as
Comprehensive Benefits
Administrator Inc.
CBCA Administrators 55438 COMMERCIAL N
CDO Technologies 83028 COMMERCIAL N
CDPHP SX065 COMMERCIAL N Par for Billing
CDS Group Health 88022 COMMERCIAL N
CHA Health 23171 COMMERCIAL N
CHAMPVA - HAC 84146 COMMERCIAL N
CHAMPVA - HAC is not
associated with and does not
process claims for TRICARE
(formerly CHAMPUS).
CHCcares of South Carolina 25151 COMMERCIAL N
CHOC - Children's Hospital Of Orange County Health Alliance33065 COMMERCIAL N
CHP DIRECT SUPERMED 90441 COMMERCIAL N
CHP/RPU (FABOH) Call COMMERCIAL N
Payer ID rendering provider
and location number
required to submit claims.
Please call Dave Sell at (608)
210-6656 to obtain.
CIGNA 62308 COMMERCIAL N
CIGNA - PPA 62308 COMMERCIAL N
CIGNA - PPO 62308 COMMERCIAL N
CIGNA Behavioral Health SX071 COMMERCIAL N
CIGNA Health Plan - HMO 62308 COMMERCIAL N
CIGNA Medicare Advantage 86033 COMMERCIAL N
CM Administrators Inc 56211 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
COOPERATIVE MANAGED CARE SERVICES 35199 COMMERCIAL N
To obtain the payer ID for
this payer please contact
CMCS Customer Service at
(800) 352-7502
CRA Managed Care (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
CTI ADMINISTRATORS INC. 42141 COMMERCIAL N
CWIBENEFITS INC. 57080 COMMERCIAL N
Cadent Administrators 33192 COMMERCIAL N
Cadent Underwriters 33192 COMMERCIAL N
Cal-Optima Direct CALOP COMMERCIAL N
California Eye Care - New Century Health NCH05 COMMERCIAL N
Cannon Cochran Management Services Inc. Metairie LA 71057 COMMERCIAL N
Capital Community Health Plan 87726 COMMERCIAL N
Capital District Physician's Health Plan SX065 COMMERCIAL N Par for Billing
Capital Health Plan 95112 COMMERCIAL N
Payer will accept either
rendering provider UPIN or
NPI on claims. Before
submitting NPI please call
Capital Health Plan at 850-
523-7361 to register your NPI
numbers with them.
Capitol Administrators 68011 COMMERCIAL N
Care 1st Health Plan of Arizona 57116 COMMERCIAL N
Care Improvement Plus 77082 COMMERCIAL N
Care To Care 41222 COMMERCIAL N
Care Wisconsin Health Plan (Trizetto) 27004 COMMERCIAL N
CareCentrix 11345 COMMERCIAL P
Enrollment required prior to
claim submission. Please
contact
[email protected]
CareCore National 14182 COMMERCIAL N
CareCore National LLC (Aetna Radiology Claims) 14179 COMMERCIAL N
CareCore National LLC (Oxford Radiology Claims) 14180 COMMERCIAL N
CareCore/WCNY RAD 14188 COMMERCIAL N
WellCare New York POS 11
Radiology Claims Only. Claims
for members in the following
counties should be submitted
to WellCare: Monroe Erie
Wayne and Onondaga.
CareFirst Administrators/NCAS 75191 COMMERCIAL N
CareFlorida 65088 COMMERCIAL N
CareOregon Inc. 93975 COMMERCIAL N
CarePlus Cardiology - New Century Health NCH04 COMMERCIAL N
CarePlus Dermatology - New Century Health NCH01 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 14
Page 16
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
CarePlus Health Plans Inc. 65031 COMMERCIAL N
(Formerly Physicians
Healthcare Plans Inc)
CarePlus Oncology - New Century Infusion SolutionsNCH07 COMMERCIAL N
CarePlus Urology - New Century Health NCH03 COMMERCIAL N
CareSource OH 31114 COMMERCIAL N
CareWorks (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Carelink Health Plan 25133 COMMERCIAL N
Formerly payer ID 25139.
Now part of Coventry
Consolidated payer ID.
Carelink Commercial &
Advantra claims only. For
Carelink Medicaid send
claims to payer ID 25140
Carelink Medicaid 25133 COMMERCIAL N
Formerly Payer ID 25140.
Now part of Coventry
Consolidated payer ID.
Carelink Medicaid 25140 COMMERCIAL N
The go forward payer ID for
this plan is 25133. Please see
new entry under that ID on
the payer list.
Carelink Medicaid 25140 COMMERCIAL N
The go forward payer ID for
this plan is 25133. Please see
new entry under that ID on
the payer list.
Caremore CM001 COMMERCIAL N
Carenet 25133 COMMERCIAL N
Formerly Payer ID 25142.
Now part of Coventry
Consolidated payer ID.
Carenet 25142 COMMERCIAL N
The go forward payer ID for
this plan is 25133. Please see
new entry under that ID on
the payer list.
Carenet 25142 COMMERCIAL N
The go forward payer ID for
this plan is 25133. Please see
new entry under that ID on
the payer list.
Careworks 10010 COMMERCIAL N
Payer is receiving NSF 3.0.
eMCDS file is sent to OKC and
then translated to NSF3.0.
Files are then pushed to
Careworks' Production
Server.
Carilion Clinic Medicare Health Plan 77015 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 15
Page 17
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Carolina Care Plan 29076 COMMERCIAL N
Carolina Care Plan is part of
the Medical Mutual Family of
Companies. Former payer ID
57105.
Carolina Crescent Health Plan Inc. SX191 COMMERCIAL N
Enrollment forms are
available on our website
Carolina Summit Healthcare Inc. 56195 COMMERCIAL N
Carpenter's Health and Welfare Trust Fund of St. Louis 25125 COMMERCIAL N Utilizes the CMR Network.
Carpenters Health and Welfare Fund of PhiladelphiaCX101 COMMERCIAL N
Cedars-Sinai Medical Network Services 95166 COMMERCIAL N
CeltiCare 68060 COMMERCIAL N
Celtic Insurance 68063 COMMERCIAL N
Cement Masons & Plasterers Health & Welfare Trust 91136 COMMERCIAL N
Please enter Group Number
(F16) when submitting claims.
Cenpatico - Arizona 68048 COMMERCIAL N
Prior to submitting claims
please call Provider Relations
Dept at 1-866-495-6748 to
verify your provider info is on
file in the claim system. This
will prevent rejections and
allow payments to be made
in a timely manner.
Cenpatico - FL 68058 COMMERCIAL N
Cenpatico - Georgia 68050 COMMERCIAL N
Prior to submitting claims
please call Provider Relations
Dept at 1-800-947-0633 to
verify your provider info is on
file in the claim system. This
will prevent rejections and
allow payments to be made
in a timely manner.
Cenpatico - Indiana 68052 COMMERCIAL N
Prior to submitting claims
please call Provider Relations
Dept at 1-877-647-4848 to
verify your provider info is on
file in the claim system. This
will prevent rejections and
allow payments to be made
in a timely manner.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 16
Page 18
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Cenpatico - Kansas 68047 COMMERCIAL P
Prior to submitting claims
please call Provider Relations
Dept at 1-866-896-7293 to
verify your provider info is on
file in the claim system. This
will prevent rejections and
allow payments to be made
in a timely manner.
Cenpatico - OHIO 68051 COMMERCIAL N
Cenpatico Behavioral Health - Wisconsin 68046 COMMERCIAL N
Cenpatico Behavioral Health Texas 68053 COMMERCIAL N
Prior to submitting claims
please call Provider Relations
Dept at 1-800-716-5650 to
verify your provider info is on
file in the claim system. This
will prevent rejections and
allow payments to be made
in a timely manner.
Cenpatico Kentucky 68068 COMMERCIAL N
Cenpatico Massachuetts 68061 COMMERCIAL N
Cenpatico South Carolina 68059 COMMERCIAL N
Centene Advantage Plans 68056 COMMERCIAL N
Central Benefits Life 31118 COMMERCIAL N
Central Benefits Mutual 31118 COMMERCIAL N
Central Benefits National 31118 COMMERCIAL N
Central Reserve Life 34097 COMMERCIAL N
Non Medicare Supplement
Payer does not accept
Secondary/Tertiary claims
electronically.
Central SeniorCare 62218 COMMERCIAL N
Central States Health & Welfare Funds 36215 COMMERCIAL N
Central Susquehanna Healthcare Providers (CSHP) 55731 COMMERCIAL N
Central Valley Medical Group 77035 COMMERCIAL N
Central Valley Medical Group E3510 COMMERCIAL P
Only claims from providers in
Northern California. Please
contact the EDI Dept for
North American Medical
Management (NAMM) -
Northern California
Lead/Supervisor at 1-800-956-
8000 prior to initial
submission of claims.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 17
Page 19
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Centre for Health Care Call COMMERCIAL N
To obtain Payer ID and enroll
with payer California
providers should contact
Tristin Rausche 858-824-7100
[email protected]
Century Health Solutions 48120 COMMERCIAL N
Cerner HealthPlan Services 20356 COMMERCIAL N
Chautauqua County Healthcare Plan (Mayville NY) 16600 COMMERCIAL N
Chesapeake Life Insurance Company - Insurance Center 59223 COMMERCIAL N
Payer ID valid only if the
address on the Health ID Card
matches the following: P.O.
Box 982017 North Richland
Hills TX 76182.
Chesterfield Resources Inc. 34154 COMMERCIAL N
Child Health and Disability Prevention Treatment AMM03 COMMERCIAL N
Children First Medical Group 94321 COMMERCIAL N
For questions regarding claim
status providers will need to
contact payer: CFMG
Provider Customer Service
510-428-3154.
Children of Women Vietnam Veterans-VA HAC 84146 COMMERCIAL N
Children's Medical Services - Broward NORTH 37314 COMMERCIAL N
Childrens Physician Medical Group CPMG1 COMMERCIAL N
Childrens Specialist of San Diego CSSD2 COMMERCIAL N
Chinese Community Health Plan 94302 COMMERCIAL N
Choice One/UTMB CHIP Health Plan 76049 COMMERCIAL N
Christian Brothers Services 38308 COMMERCIAL N
Christian Brothers Services 61271 COMMERCIAL N
Cincinnati Financial Corporation 46871 COMMERCIAL N
Citrus Health TH130 COMMERCIAL N
Citrus Valley Physicians Medical Group CMSI1 COMMERCIAL N
Citrus Valley Physicians Medical Group CVPG1 COMMERCIAL N
City of Amarillo TH107 COMMERCIAL N
City of Visalia TKFMC COMMERCIAL N
Claims Management Services 39141 COMMERCIAL N
ClaimsWare Inc. dba ManageMed 57080 COMMERCIAL N
Claimsbridge West 11752 COMMERCIAL N
Claimshop- Employers Coalition on Health 27008 COMMERCIAL N
Clarendon's Healthy Kids 33192 COMMERCIAL N
Clarian Health Plans Inc. 95444 COMMERCIAL N
Clearchoice Health Plan / COIHS 77201 COMMERCIAL N
ClubMD 37272 COMMERCIAL N
Coastal Administrative Services 77052 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 18
Page 20
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Cofinity 38335 COMMERCIAL N
Colonial Healthcare 37123 COMMERCIAL N
Colonial Medical 22284 COMMERCIAL N
Colorado Access 84129 COMMERCIAL N
Columbia United Providers 91162 COMMERCIAL N
Combined Management Services CMSI1 COMMERCIAL N
Commerce Benefits Group 34181 COMMERCIAL N
Commonwealth Care Alliance 14315 COMMERCIAL N
Community Care BHO 23282 COMMERCIAL N
Community Care Inc. - Family Care (Wisconsin) 60995 COMMERCIAL N
Community Care Inc. (Wisconsin) 39126 COMMERCIAL N
Community Care Managed Health Care Plans of Oklahoma73143 COMMERCIAL N
Community Choice of Michigan 38325 COMMERCIAL N
Community Family Care (SynerMed) SYMED COMMERCIAL N
Community First TH005 COMMERCIAL N
Community Health Alliance 35193 COMMERCIAL N
Community Health Choice 48145 COMMERCIAL N
Community Health Electronic Claims/CHEC/webTPA 75261 COMMERCIAL N
Community Health Network of CT 62149 COMMERCIAL N
Community Health Plan Washington SB613 COMMERCIAL N
Community Medical Group of the West Valley Inc. 66121 COMMERCIAL N
CommunityConnect HealthPlan 95192 COMMERCIAL N
Provider Services: (877) 350-
6074
Comp - Ohio (Austintown OH) 34177 COMMERCIAL N
Comp One (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
CompBenefits Corporation 37297 COMMERCIAL N
CompManagement Health Systems Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
CompManagement/Integrated Comp (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Compcare (Wisconsin BadgerCare only) 95192 COMMERCIAL N
Provider Services: (866) 563-
3020
Complimentary Health Plan Call COMMERCIAL N
Comprehensive Behavioral Care 59314 COMMERCIAL N
Comprehensive Medical Care (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
ConnectiCare Inc 6105 COMMERCIAL N
Connecticare - Medicare 78375 COMMERCIAL N
Connecticut Carpenters Health Fund 37307 COMMERCIAL N
Connecticut General (CIGNA) 62308 COMMERCIAL N
Consociate Group 37135 COMMERCIAL N
Consolidated Associates Railroad 75284 COMMERCIAL N
Consolidated Health Plans 87843 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 19
Page 21
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Consumers Life Insurance Company 29076 COMMERCIAL N
Consumers Life insurance
Company is part of the
Medical Mutual Family of
Companies.
Continental General Insurance Company 71404 COMMERCIAL N
Non Medicare Supplement
Payer does not accept
Secondary/Tertiary claims
electronically.
Continental Key Family 35315 COMMERCIAL N
Contractors Laborers Teamsters & Engineers 47046 COMMERCIAL N
Conversion Plan-APWU 55544 COMMERCIAL N
Claims are printed and mailed
to the payer.; For conversion
plan members only. If filing a
claim for a federal plan
member please use payer ID
44444.
Cook Children's Health Group TH104 COMMERCIAL N
Cook Group Health Plan 35149 COMMERCIAL N
Cooperative Benefit Administrators (CBA) 52132 COMMERCIAL N
Coordinated Medical Specialists 58204 COMMERCIAL N
Core Administrative Services 58231 COMMERCIAL N
CoreSource AZ MN 35182 COMMERCIAL N For assistance 800-689-0106
CoreSource Little Rock 75136 COMMERCIAL N
Only for claims where the
"submit claims to address" on
the medical ID card is a
CoreSource address in Little
Rock Arkansas. For assistance
call 800-689-0106.
CoreSource MD PA IL 35182 COMMERCIAL N For assistance 800-689-0106
CoreSource NC IN 35182 COMMERCIAL N For assistance 800-689-0106
CoreSource OH 35183 COMMERCIAL N
Only for claims where the
"submit claims to address" on
the medical ID card is a
CoreSource address in the
state of Ohio. For assistance
call 800-689-0106.
CoreSource-Internal 35187 COMMERCIAL N
Corizon Health Inc. CORIZ COMMERCIAL N
Corizon Inc. 43160 COMMERCIAL N
Cornerstone Benefit Adminstrators 35202 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 20
Page 22
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Corporate Benefits Service Inc. (NC) 56116 COMMERCIAL N
Payer ID valid only for claims
with a claims submission
address of P.O. Box 12953
Charlotte NC 28220.
Corporate Systems Administration 37246 COMMERCIAL N
Corvel Corporation (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Country Life Insurance Company 62553 COMMERCIAL N
Covenant Administrators Inc. (Atlanta GA) 58102 COMMERCIAL N
Covenant Management Systems TH108 COMMERCIAL N
Coventry Advantra Texas 25133 COMMERCIAL N
Coventry Health & Life (Oklahoma) 25133 COMMERCIAL N
Coventry Health & Life (Oklahoma) 25133 COMMERCIAL N
Now part of Coventry
Consolidated payer ID
Coventry Health Care 25133 COMMERCIAL N
Coventry's consolidated
payer ID. Claims for all of
these legacy payer IDs may
now be submitted to this
payer ID. 25126 25127 25128
25129 25130 25132 25135
25136 25139 25141 25146
25149 25152 62413 87043.
Coventry Health Care National Network 25133 COMMERCIAL N
Formerly payer ID 87043 Now
part of Coventry
Consolidated payer ID.
Coventry Health Care National Network 25133 COMMERCIAL N
Formerly payer ID 87043.
Now part of Coventry
consolidated payer ID.
Coventry Health Care Nevada 25133 COMMERCIAL N
Formerly Payer ID 25149.
Now part of the Consolidated
payer ID.
Coventry Health Care of Florida Inc. 25133 COMMERCIAL N
Formerly Vista Health Plan
Inc. Now part of Coventry
Consolidated Payer ID.
Coventry Health Care of Georgia Inc. 25133 COMMERCIAL N
Formerly payer ID 25127.
Now part of Coventry
Consolidated payer ID.
Coventry Health Care of Iowa Inc. 25133 COMMERCIAL N
Formerly payer ID 25132.
Now part of Coventry
Consolidated payer ID.
Coventry Health Care of Kansas Inc. 25133 COMMERCIAL N
Now part of Coventry
Consolidated payer ID
Coventry Health Care of Kansas Inc. 25133 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 21
Page 23
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Coventry Health Care of Louisiana Inc. 25133 COMMERCIAL N
Formerly payer ID 25135.
Now part of Coventry
Consolidated payer ID.
Coventry Health Care of Nebraska Inc. 25133 COMMERCIAL N
Formerly payer ID 25136.
Now part of Coventry
Consolidated payer ID.
Coventry Health Plan of Florida 25133 COMMERCIAL N
Formerly Vista Health Plan of
South Florida Inc. Now part
of Coventry Consolidated
Payer ID.
Coventry Health and Life Insurance Company administered by PersonalCare25133 COMMERCIAL N
Coventry Health and Life Insureance (Tennessee) 25133 COMMERCIAL N
Formerly payer ID 25141 Now
part of Coventry
Consolidated payer ID.
Coventry Missouri 25133 COMMERCIAL N
Formerly payer ID 87043 Now
part of Coventry
Consolidated payer ID.
Coventry Nebraska 25133 COMMERCIAL N
Coventry Summitt Health Plan Inc. 25133 COMMERCIAL N
Formerly Summitt Health
Plan Inc. Now part of
Coventry Consolidated Payer
ID.
Coventry of Health Care Delaware Inc. 25133 COMMERCIAL N
Formerly payer ID 25130.
Now part of Coventry
Consolidated payer ID.
CoventryCares 25133 COMMERCIAL N
Now part of Coventry
Consolidated payer ID
CoventryCares of Kentucky 25133 COMMERCIAL N
Crawford & Company (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Creative Medical Systems 64068 COMMERCIAL N
Creative Plan Administrators 37320 COMMERCIAL N
Crescent PPO Inc. See Comments COMMERCIAL N
Please register at
www.crescenths.com prior to
claim submission.
Croy-Hall Mgmt. Inc. 37266 COMMERCIAL N
Please enter the unique
policy number or ID card
when submitting claims.
Payer ID valid only for claims
with a billing submission
address of PO Box 982005 Ft.
Worth TX 76182.
Custom Design Benefits Inc. 82056 COMMERCIAL N
D.H. EVANS & ASSOC. Call COMMERCIAL N
Call Jessica Picarde @ 410-
349-3222 for Payer id.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 22
Page 24
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
DC Chartered Health Plan Inc. (Medicaid & Alliance) 95748 COMMERCIAL N
PLEASE CONTACT Ronald
Gray at 202-408-2229 TO
JOIN CHARTERED HEALTH
PLANS EDI NETWORK
DELANO IPA 77124 COMMERCIAL N
DRISCOLL CHILDREN'S HEALTH PLAN 74284 COMMERCIAL N
Dart Container Corporation DARTC COMMERCIAL N
Dart Container Corporation TH073 COMMERCIAL N
Dart Management Corporation 6172 COMMERCIAL N
Dean Health Plan 39113 COMMERCIAL N
Definity Health 64159 COMMERCIAL N
Delaware Physicians Care Inc. 27009 COMMERCIAL N
Delta Health Systems 94235 COMMERCIAL N
Denver Health - Indigent 84134 COMMERCIAL N
Denver Health Medical Plan 84135 COMMERCIAL N
Denver Health Medical Plan Inc. - Medicare Choice 84131 COMMERCIAL N
Denver Health and Hospital Authority 84133 COMMERCIAL N
Deseret Mutual SX105 COMMERCIAL R
Desert Medical Group DESRT COMMERCIAL N
Detroit Medical Center 56240 COMMERCIAL N
DiaTri LLC 36439 COMMERCIAL N
Diamond Plan 25131 COMMERCIAL N
The go forward payer ID for
this plan is 25133. Please see
new entry under that ID on
the payer list.
Diamond Plan 25131 COMMERCIAL N
The go forward payer ID for
this plan is 25133. Please see
new entry under that ID on
the payer list.
Diamond Plan (Maryland Medicaid) 25133 COMMERCIAL N
Formerly Payer ID 25131.
Now part of Coventry
Consolidated payer ID.
Directors Guild of America - Producer Health Plan 23706 COMMERCIAL N
Diversified Administration Corporation 6102 COMMERCIAL N
Please verify the Payer ID on
the Member ID card in
addition to the Payer City and
State before submitting
claims to Diversified Admin
(Payer ID 06102)
Doctor's Choice 39044 COMMERCIAL N
Downey Select IPA (Applecare Medical Managment)APP01 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 23
Page 25
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Dr. Rivera Call COMMERCIAL N
To obtain Payer ID and enroll
with payer California
providers should contact
Tristin Rausche 858-824-7100
[email protected]
Dreyer Health DREYR COMMERCIAL N
Dunn and Associates Benefits Administrators Inc. 35186 COMMERCIAL N
E-V Benefits Management Inc (Columbus OH) 34159 COMMERCIAL N
Now known as Meritain
Health.
E.S. BEVERIDGE & ASSOCIATES 34108 COMMERCIAL N
EBC Mid-America Call COMMERCIAL N
To obtain the payer ID please
call (440) 262-1160.
EBC Inc. Call COMMERCIAL N
To obtain the payer ID please
call (440) 262-1160.
EBMC 31074 COMMERCIAL N
EBMS SX182 COMMERCIAL N
EMI-KP Ambulance Claims 59299 COMMERCIAL N
EQUICOR 62308 COMMERCIAL N
EQUICOR - PPO 62308 COMMERCIAL N
ERISA TH110 COMMERCIAL N
ESSENCE HEALTHCARE 20818 COMMERCIAL N
Early Intervention Central TH084 COMMERCIAL N
East Bay Medical Network Call COMMERCIAL P
Network ID required on all
claims. Call Sutter Connect
EDI Department at (800) 611-
5191 to obtain Network ID
prior to first submission.
Eastland Medical Group 66122 COMMERCIAL N
Eastland Medical Group CMSI1 COMMERCIAL N
Educators Mutual (EMIA) SX110 COMMERCIAL N
El Paso First - Chip TH090 COMMERCIAL N
ElderPlan Inc. 31625 COMMERCIAL N
Elderplan no longer requires
enrollment & individual
provider testing; However
Elderplan Provider ID is
necessary on all claim
submissions. If you do not
know your provider Id
contact (718) 921-7979.
Elmcare LLC 36399 COMMERCIAL N
Elmco 37253 COMMERCIAL N
Emerald Health Network Inc. (All PPO Business) 34167 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 24
Page 26
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Emergency Medical Services Fund (EMSF) AMM03 COMMERCIAL N
Empire Physician's Medical Group EMP01 COMMERCIAL N
Employee Benefit Administration & Management CorporationPilot COMMERCIAL N
Employee Benefit Claims - Mid-America Call COMMERCIAL N
To obtain the payer ID please
call (440) 262-1160.
Employee Benefit Claims of WI Call COMMERCIAL N
To obtain the payer ID please
call (440) 262-1160.
Employee Benefit Claims of Wisconsin Call COMMERCIAL N
To obtain the payer ID please
call (440) 262-1160.
Employee Benefit Concepts (Farmington Hills MI) 38241 COMMERCIAL N
Employee Benefit Consultants Inc. Call COMMERCIAL N
To obtain the payer ID please
call (440) 262-1160.
Employee Benefit Management Corp (EBMC) 31074 COMMERCIAL N
Employee Benefit Services (Ft. Mill SC) 37216 COMMERCIAL N
MUST VERIFY ALL CLAIMS
SHOULD GO TO PAYER IN FT.
MILL SC
Employee Benefit Services of Louisiana Inc (EBS) 41198 COMMERCIAL N
Employee Benefit Services of San Antonio TH109 COMMERCIAL N
Employee Benefit Systems 42149 COMMERCIAL N
Employee Benefits Administration and Management Corp.22262 COMMERCIAL N
Employee Benefits Plan Administration Inc. (E.B.P.A.) 3036 COMMERCIAL N
Employee Health System SYMED COMMERCIAL N
Employee Plans LLC 35112 COMMERCIAL N
Employer Plan Services 74212 COMMERCIAL N
Employer's Direct Health - Employee Plan 75236 COMMERCIAL N
Employer's Direct Health - FI 75235 COMMERCIAL N
Employer's Direct Health - SF 75233 COMMERCIAL N
Employers Direct Health 75232 COMMERCIAL N
Employers Mutual Inc (Jacksonville Florida) 59298 COMMERCIAL N
Employers Mutual Inc. (Stuart Florida) 59331 COMMERCIAL N
For plan and claim
requirements please contact
the Employers Mutual Inc.
(Stuart FL) Customer Service
Department at (772) 287-
7650 ext. 4052.
Encircle PPO 35206 COMMERCIAL N
Encore Health Network 35206 COMMERCIAL N
Enstar Natural Gas 91136 COMMERCIAL N
Please enter Group Number
(P61) when submitting
claims.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 25
Page 27
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Entrust 36878 COMMERCIAL N
Electronic Payer ID for Claims
printed and mailed to payer.
Equitable Plan Services (Oklahoma City OK) 73126 COMMERCIAL N
Payer ID valid only for claims
with a billing submission
address of P.O. Box 720460
Oklahoma City OK 73172.
Evercare 87726 COMMERCIAL N
Everence 35605 COMMERCIAL N
Evolutions Healthcare Systems (New Port Richey FL) 59313 COMMERCIAL N
Payer ID valid for claims with
a submission address of PO
Box 5001 New Port Richey FL
34656.
Excel MSO EXC01 COMMERCIAL N
Exceptional Care Medical CAPMN COMMERCIAL N
ExclusiCare 71412 COMMERCIAL N
FABOH (CHP/RPU) Call COMMERCIAL N
Payer ID rendering provider
and location number
required to submit claims.
Please call Dave Sell at (608)
210-6656 to obtain.
FACS Group 37300 COMMERCIAL N
FCE Benefit Administrators 33033 COMMERCIAL N
FIRST ADMINISTRATORS INC FAMR1 COMMERCIAL N
FMH Benefit Services Inc. 48117 COMMERCIAL N
For assistance send email to
[email protected]
FOUNDATION BENEFIT ADMINISTRATORS/CONTRACTOR EMPLOYEE BENEFITS ADMINBOONG COMMERCIAL N
Facey Medical Foundation 95432 COMMERCIAL N
Fallon Community Health Plan 22254 COMMERCIAL N
Family Health Alliance CAPMN COMMERCIAL N
Family Health Partners - Healthwave of Kansas 31472 COMMERCIAL N
Family Health Partners/MC+ Missouri 43173 COMMERCIAL N
Family Health Plan TH045 COMMERCIAL N
Family Health Plan (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Farm Family Life 14140 COMMERCIAL N
Federated Benefits 37300 COMMERCIAL N
Federated HR Services 37300 COMMERCIAL N
Federated Mutual Insurance 41041 COMMERCIAL N
Fidelis Care New York 11315 COMMERCIAL N
Fidelis Secure Care 77054 COMMERCIAL N
First Carolina Care 56196 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 26
Page 28
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
First Choice Health Administrators 91131 COMMERCIAL N
First Choice Health Network 91131 COMMERCIAL N
First Choice of Midwest (PPO) 75138 COMMERCIAL N
First Health Network (f.k.a. CCN Managed Care Inc. & PPO Oklahoma)73159 COMMERCIAL N
First Health Network (f.k.a. CCN Managed Care Inc. & PPO Oklahoma)73159 COMMERCIAL N
First Medical Network (FMN) - Atlanta GA 29076 COMMERCIAL N
1st Medical Network is part
of the Medical Mutual Family
of Companies. Former payer
ID 58203.
First Priority 23241 COMMERCIAL P
Beginning 1/8/2007 all new
providers must enroll with
First Priority Health/Blue
Cross of Northeastern PA
prior to submitting electronic
claims. Enrollment form
available at:
http://www.bcnepa.com/EDI
/registrationForm.aspx
First Service Administrator's Inc Lakeland Florida 59276 COMMERCIAL N
Third Party Administrator's
Also formally known as
Florida 1st Florida First
FirstCare TH003 COMMERCIAL N
Fitzharris & Company Inc. 11244 COMMERCIAL N
Florida Health Care Plan 59322 COMMERCIAL N
Florida Hospital Healthcare Systems 59321 COMMERCIAL N
If Bill Prov NPI not present
Render Prov NPI required -or-
If Render Prov NPI is not
present either Render Prov
Network ID (REF*N5) or
Commercial Num (REF*G2) is
required. FHHS member ID
must be 11 digits.
Florida Hospital Waterman 48116 COMMERCIAL N
For assistance send email to
[email protected]
Florida League of Cities Inc. 59698 COMMERCIAL N
Foreign Service Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry
Consolidated payer ID.
Including AFSPA Staff Plan
Foundation for Medical Care of Tulare & Kings CountyTKFMC COMMERCIAL N
Fox-Everett Inc. 64069 COMMERCIAL N
Freedom First 31313 COMMERCIAL N
Freedom Health Plan 41212 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 27
Page 29
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Fresenius Medical Care 23130 COMMERCIAL N
Friant Water Users TKFMC COMMERCIAL N
Fringe Benefit Management 59069 COMMERCIAL N
Fringe Benefits Coordinators 59204 COMMERCIAL N
FrontPath Health Coalition 34171 COMMERCIAL N
GATES MCDONALD HEALTH PLUS INC 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
GEMCare (Golden Empire Managed Care System) MCS01 COMMERCIAL N
GENEX Care of Ohio (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
GHI - Medicare Private Fee for Service 22937 COMMERCIAL N
GHI - New York (Group Health Inc.) 13551 COMMERCIAL N
GHI HMO 25531 COMMERCIAL N
GHP (Group Health Plan) 25133 COMMERCIAL N
Formerly payer ID 25141 Now
part of Coventry
Consolidated payer ID.
GIC Indemnity Plan 80314 COMMERCIAL N
GMS Inc. 47083 COMMERCIAL N
GOOD SHEPHERD HOSPICE INC 76923 COMMERCIAL N
Galveston County Indigent Health Care 30005 COMMERCIAL N
Gates McDonald Health Plus Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Gateway Health Plan - Medicare Assured 60550 COMMERCIAL N
Gateway Health Plan -
Medicare Assured; 60550
(Yellow Card). Please check
the ID card to verify the Payer
ID before submitting claims. If
you have questions please
contact Gateway Provider
Servicing Department at 1-
800-685-5205.
Gateway Health Plan Medicaid PA 25169 COMMERCIAL N
Caution: Gateway Health Plan
has several different Payer ID
numbers please look for the
Payer ID on the ID card
before submitting. PA
Medicaid 25169(Green Card).
If you have questions contact
Gateway Provider Servicing
Department at 1-800-685-
5205.
Gateway IPA (Pinnacle Health Resources) (Prospect Medical Group)PROSP COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 28
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Geisinger Health Plan 75273 COMMERCIAL P
Prior enrollment required.
Please contact Geisinger
Health Plan at 1-888-281-
5338 option 3 to confirm
credentialing prior to
completing EDI Enrollment
Forms.
Gemcare Health Plan 20376 COMMERCIAL N
Gemcare Health Plan MCS03 COMMERCIAL N
Gemcare IPA 27133 COMMERCIAL N
Generations Healthcare 46050 COMMERCIAL N
Generations-Hillcrest 46051 COMMERCIAL N
Genesis Healthcare PROSP COMMERCIAL N
Gilsbar Inc. 7205 COMMERCIAL N
Glendale Physician's Alliance AMM02 COMMERCIAL N
Global Care Inc. 7689 COMMERCIAL N
Global Excel Management GEM01 COMMERCIAL N
Golden Rule Insurance Company 37602 COMMERCIAL N
Golden State Medical Group MBA01 COMMERCIAL N
Golden Triangle Physician Alliance/SelectCare of Texas (GTPA)72189 COMMERCIAL N
Good Samaritan Medical Practice Association AMM01 COMMERCIAL N
Government Employees Hospital Association (GEHA) 44054 COMMERCIAL N
Great Lakes Health Plan 95467 COMMERCIAL N
Great-West Healthcare 80705 COMMERCIAL N
Great-West Healthcare (formerly American General) 63665 COMMERCIAL N
Greater L.A. Health CAPMN COMMERCIAL N
Greater Orange County Medical Group NMM01 COMMERCIAL N
Greater San Gabriel Med Grp NMM01 COMMERCIAL N
Greater San Gabriel Valley Physicians CAPMN COMMERCIAL N
Group Administrators Ltd. 36338 COMMERCIAL N
Group Health Cooperative - WA State 91051 COMMERCIAL N
All GHC products; GHC Group
Individual Medicare + Choice
and Healthy Options can be
submitted electronically
Group Health Cooperative of Eau Claire 95192 COMMERCIAL N
Provider Services: (866) 563-
3020
Group Health Cooperative of South Central Wisconsin 39167 COMMERCIAL N
Group Health Cooperative of South Central Wisconsin 39168 COMMERCIAL N
Group Health Inc. 22937 COMMERCIAL N
Group Health Managers 38194 COMMERCIAL N
Group Health Options - WA State 91051 COMMERCIAL N
All GHO products; Options
and Alliant can be submitted
electronically
Group Insurance Service Center Inc. 37276 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 29
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Group and Pension Administrators 48143 COMMERCIAL N
Guardian Healthcare INC. (SC) 77010 COMMERCIAL N
Guardian Life Insurance Company of America 64246 COMMERCIAL N
H.E.R.E.I.U Welfare Pension Funds 37114 COMMERCIAL N
HAA Preferred Partners 65101 COMMERCIAL N
HAP/AHL/Curanet 38224 COMMERCIAL N
HCHA Albq-Self Funded 37329 COMMERCIAL N
HCS - Health Claims Service (Boise ID) 82018 COMMERCIAL N
HDPC - Premier Healthcare 90023 COMMERCIAL N
HDPC/Alliance Physicians 20257 COMMERCIAL N
HEALTH CARE DISTRICT Call COMMERCIAL N
Call Provider Services at 866-
930-1002 for EDI Enrollment
HFN Inc. 36335 COMMERCIAL N
HIP - Health Insurance Plan of Greater New York 55247 COMMERCIAL N
HMA Hawaii 86066 COMMERCIAL N
HPS Paradigm Inc. 58227 COMMERCIAL N
HSHS Medical Group IPA 37137 COMMERCIAL N
Harrington Health Non-EPO 59143 COMMERCIAL N
Harrington Health-Kansas (formerly known as Fiserv Health-Kansas)62061 COMMERCIAL N
(Formerly Willis
Administrative Services
Corporation)
Harvard Pilgrim Health Care 4271 COMMERCIAL N
Hawaii Medical Assurance Association (HMAA/HWMG) 99208 COMMERCIAL N
Health America Inc./Health Assurance/Advantra 25133 COMMERCIAL N
Formerly payer ID 25126.
Now part of Coventry
Consolidated payer ID.
Health Care Network of Wisconsin (HCN) 42102 COMMERCIAL N
Health Choice Arizona 62179 COMMERCIAL N
Health Choice Generations 62180 COMMERCIAL N
Health Cost Solutions 62111 COMMERCIAL N
Health Design Plus (Hudson OH) 34158 COMMERCIAL N
Health Management Administrators (HMA) TH049 COMMERCIAL N
Health Management Solutions (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Health Net of Arizona 38309 COMMERCIAL N Payer requires NPI
Health Net of California and Oregon - Claims 95567 COMMERCIAL N
Health Net of the Northeast Inc. 6108 COMMERCIAL N Payer requires NPI.
Health Network One 65062 COMMERCIAL N
Health New England Call COMMERCIAL N
To obtain payer id please
contact Joanne Shaw 413-233-
3444 [email protected]
Health Options of Florida SX030 COMMERCIAL N
Health Options of Illinois 36368 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 30
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Health Partners - Jackson TN 62157 COMMERCIAL N
Health Partners PA 80142 COMMERCIAL N
Health Payment Systems Inc. 20270 COMMERCIAL N
Health Plan Management Services (HPMS) 63719 COMMERCIAL N
Health Plan of Michigan 83253 COMMERCIAL N
Health Plan of San Joaquin 68035 COMMERCIAL N
Health Plan of San Mateo Call COMMERCIAL N
CONTACT PAYER FOR
REGISTRATION AND PAYER
ID. Endry Lo: 650-616-2017 or
Ken Cottrell: 650-616-2021
Health Plans Inc. 44273 COMMERCIAL N
Health Plus PHSP (Brooklyn NY) 11324 COMMERCIAL P
Providers must contact
Health Plus at 718-491-8355
prior to submitting claims.
Health Services Consulting Group Inc. 20896 COMMERCIAL N
Health Services Management 41150 COMMERCIAL R
Health Services Preferred (HSP) by Emerald Health 34167 COMMERCIAL N
Health Services for Children with Special Needs 37290 COMMERCIAL N
Health Strategies SX044 COMMERCIAL N
HealthCare Partners IPA 11328 COMMERCIAL N
Formerly Heritage New York
Medical Group.
HealthEZ 41178 COMMERCIAL N
HealthEdge Administrators (Bakersfield CA) 95213 COMMERCIAL N
Payer ID valid for claims with
a submission address of PO
Box 11210 Bakersfield CA
93389.
HealthFirst TPA (Houston TX) 34185 COMMERCIAL N
HealthGroup Limited 23274 COMMERCIAL N
HealthPartners MN SX009 COMMERCIAL R
Payer must be requested via
the Provider Setup Form and
Payer Reqistration completed
prior to electronic claims
submission. Provider Forms
can be found:
www.emdeon.com/enrollme
nt
HealthPlan Services 59140 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 31
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
HealthPlus of Michigan 38216 COMMERCIAL R
HealthPlus requires a Trading
Partner Agreement. Providers
should contact the EDI
department at (810-230-
2084) upon billing via
Emdeon to request a TPA
form.
HealthSCOPE Benefits Inc. 71063 COMMERCIAL N
HealthSmart -Noble Mid Orange HSM01 COMMERCIAL N
HealthSmart Benefit Solutions 37283 COMMERCIAL N
HealthSmart Preferred Care Inc. 75250 COMMERCIAL N
HealthSpan Network Repricing HSPAN COMMERCIAL N
HealthSpring HMO/HealthSpring Medicare+Choice 63092 COMMERCIAL N
It is no longer necessary to
notify HealthSpring before
submitting claims
electronically. HealthSpring
encourages electronic
submission of all claims. Be
sure to submit only the
HealthSpring
subscriber/member ID
number found on the
HealthSpring ID card
HealthStar Inc. 36332 COMMERCIAL N
Healthcare Partners HCP01 COMMERCIAL N
Healthcare Resources NW 56731 COMMERCIAL N
Healthcare Solutions Group 73147 COMMERCIAL N
Healthcare Transaction Processing Inc (HTP) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Healthcare USA 25133 COMMERCIAL N
Formerly Payer ID 25141.
Now part of Coventry
Consolidated payer ID.
Healthcare USA 25143 COMMERCIAL N
Healthcare USA 25143 COMMERCIAL N
Healthcomp Inc. 85729 COMMERCIAL N
Healthfirst Health Plan of New Jersey 80141 COMMERCIAL N
Healthfirst TPA (Tyler TX) 75234 COMMERCIAL N
Healthfirst of Austin 75289 COMMERCIAL N
Healthfirst Inc. (New York) 80141 COMMERCIAL N
Healthlink HMO 96475 COMMERCIAL N
Please call Provider Relations
Dept at (800) 624-2356 for
unique provider number.
Healthlink PPO 90001 COMMERCIAL N
Customer Service phone
number: (800 624-2356)
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 32
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Healthnow Division 55204 COMMERCIAL R
Provider id = 12 digits with G2
qualifier
Healthscope Benefits - EHC Repricing 52429 COMMERCIAL N
Healthsmart Accel 75237 COMMERCIAL N
Healthsource CMHC 2041 COMMERCIAL N
Healthsource Massachusetts Inc. 2041 COMMERCIAL N
Healthsource Provident 68195 COMMERCIAL N
Claims are edited under
CIGNA's payer specific edits
Payer ID 62308.
Healthsource AR (Med) (CIGNA) 71075 COMMERCIAL N
Claims are edited under
CIGNA's payer specific edits
Payer ID 62308.
Healthsource GA (CIGNA) 58210 COMMERCIAL N
Claims are edited under
CIGNA's payer specific edits
Payer ID 62308.
Healthsource KY 61127 COMMERCIAL N
Healthsource ME 1041 COMMERCIAL P
Healthsource N. TX (CIGNA) 75255 COMMERCIAL N
Claims are edited under
CIGNA's payer specific edits
Payer ID 62308.
Healthsource NC (CIGNA) 56147 COMMERCIAL N
Claims are edited under
CIGNA's payer specific edits
Payer ID 62308.
Healthsource NH 2038 COMMERCIAL N
Healthsource OH 31141 COMMERCIAL N
Healthsource SC 6119 COMMERCIAL N
Healthsource Network
Providers Only
Healthsource TN (CIGNA) 62129 COMMERCIAL N
Claims are edited under
CIGNA's payer specific edits
Payer ID 62308.
Healthspring EM216 COMMERCIAL N
Healthways WholeHealth Networks 58213 COMMERCIAL N
Healthy Palm Beaches Call COMMERCIAL N
Call Provider Services at 866-
930-1002 for EDI Enrollment.
Healthy Texas 68064 COMMERCIAL N
Heritage Consultants 59230 COMMERCIAL N
For faster payment please be
sure to use only the 9-digit
subscriber ID on all claims.
Heritage Physician Network TH011 COMMERCIAL N
Heritage Provider Network DESRT COMMERCIAL N
Heritage Provider Network REGAL COMMERCIAL N
High Desert Primary Care 33069 COMMERCIAL N
Highmark- Key Family 35145 COMMERCIAL N
Hill Physicians Medical Group 46 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 33
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Hinsdale Physician Healthcare 36385 COMMERCIAL N
Hispanic Physicians IPA HPIPA COMMERCIAL N
Hollywood Presbyterian (Synermed) SYMED COMMERCIAL N
Holy Cross Health Partners 36412 COMMERCIAL N
Hometown Health Plan Nevada 88023 COMMERCIAL N
Hometown Health Providers 88537 COMMERCIAL N
Horizon Inner Circle Tier 1/Rayant 22304 COMMERCIAL N
Horizon NJ Health 22326 COMMERCIAL N
Medicaid managed care. For
EDI support please e-mail
[email protected]
om ; Formerly Horizon Mercy
Health Plan
Hospital Benefits Inc. 37274 COMMERCIAL N
Hotel Employees & Restaurant Employees Health Trust 91136 COMMERCIAL N
Please enter Group Number
(F19) when submitting claims.
Hudson Health Plan 13335 COMMERCIAL R
Humana Dermatology - New Century Health NCH02 COMMERCIAL N
Humana Emphesys 61101 COMMERCIAL N
Humana Employers Health Insurance 61101 COMMERCIAL N
Humana Inc. 61101 COMMERCIAL N
Humana Insurance Company Choice Care Network 61101 COMMERCIAL N
Does not include Humana
ChoiceCare of Cincinnati -
(Humana Health Plans of
Ohio)
Humana Veterans Healthcare Services 61160 COMMERCIAL N
Humboldt-Del Norte Foundation for Medical Care 94154 COMMERCIAL N
Huntington Park Mission Medical Group CAPMN COMMERCIAL N
I'Mcare 41600 COMMERCIAL N
I. E. Shaffer (West Trenton NJ) 22175 COMMERCIAL N
IAA 37279 COMMERCIAL N
IHG Direct 75274 COMMERCIAL N
Valid for claims with the
following mailing address:
P.O. Box 2388 Stow OH
44224
ILCBH 68065 COMMERCIAL N
IMS Management Services TH099 COMMERCIAL N
IMX Easy 86070 COMMERCIAL N
INDECS Corporation 40585 COMMERCIAL N
INETICO INC. 43471 COMMERCIAL N
IU Medical Group Primary Care SX172 COMMERCIAL N
IlliniCare 68066 COMMERCIAL N
Illinois Health Solutions 86069 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 34
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Imperial County Physicians Medical Group Call COMMERCIAL N
To obtain Payer ID and enroll
with payer California
providers should contact
Tristin Rausche 858-824-7100
[email protected]
Independence Medical Group MHM01 COMMERCIAL N
Independence Medical Group - Tulare 26274 COMMERCIAL N
Independent Health SX073 COMMERCIAL P
Indian Health Services SX171 COMMERCIAL N
Enrollment is required.
Providers should contact
BCBSNM Customer Service
Department at 1-800-225-
0241
Indiana Department of Health - Children's Health - Claims35600 COMMERCIAL R
Indiana ProHealth Network 35161 COMMERCIAL N
Indiana Teamsters Health Benefits Fund (Indianapolis IN)35107 COMMERCIAL N
Formerly known as Local 135
Health Benefits Fund
(Indianapolis IN)
Individual Health Insurance Companies 31053 COMMERCIAL N
Payer ID 31053 is for State
Farm - Health line of
business.
InforMed LLC 96490 COMMERCIAL N
Informed UHC 50946 COMMERCIAL N
Informed LLC 52196 COMMERCIAL N
Ingalls Provider Group 36348 COMMERCIAL N
Injured Workers Insurance Fund 52212 COMMERCIAL N
Injured Workers Insurance
Fund requires first time
submitters to contact Grace
Sobrio at (410) 494-2045
prior to submitting claims.
Inland Empire Health Plan IEHP1 COMMERCIAL N
Innovante Benefit Administrators 31172 COMMERCIAL N
Innovative Healthware Services Inc. Call COMMERCIAL N
Before submitting contact
Jessica Picarde at (410) 349-
3222
Insurance Administrators of America Inc. 37279 COMMERCIAL N
Insurance Design Administrators 13315 COMMERCIAL N
Insurance Management Services (Amarillo TX) 15688 COMMERCIAL N
This Payer ID is only valid for
claims with submission
address of P.O. Box 15688;
Amarillo TX 79105
Insurance Services of Lubbock TH012 COMMERCIAL N
InsuranceTPA.com 39182 COMMERCIAL N
Insurdata/Insurnational SX011 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 35
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Insurers Administrative Corp. 86304 COMMERCIAL N
Please visit website prior to
submitting claims:
edihelp.iacusa.com
Integra Administrative Group (Seaford DE) 51020 COMMERCIAL N
Payer ID valid only for claims
with a billing submission
address of 110 S. Shipley
Street Seaford DE 19973.
Integra Group 31127 COMMERCIAL N
Integra Group-CHA 31129 COMMERCIAL N
Integrated Care Network (ICN) by Emerald Health 34167 COMMERCIAL N
InterCare Health Plans Inc. 37227 COMMERCIAL N
InterWest Health (Acceptius Gateway payer) 84137 COMMERCIAL N
Interactive Medical Systems 56132 COMMERCIAL N
Interface EAP (IEAP) 60280 COMMERCIAL N
Intergroup Services Corporation 23287 COMMERCIAL N
International Brotherhood of Boilermakers 36609 COMMERCIAL N
International Brotherhood of Boilermakers Employee Health Care Plan(IBBEHC)48603 COMMERCIAL N
International Educational Exchange Services Inc. (IEES) 16158 COMMERCIAL N
International Medical Group TH105 COMMERCIAL N
Iowa Health Solutions 86068 COMMERCIAL N
J. F. Molloy and Associates Inc. 61271 COMMERCIAL N
J. Smith Lanier & Co. Administrators 37272 COMMERCIAL N
JI Specialties TH033 COMMERCIAL N
JMH - SFCCN PHT (PSN CMSN) 9822 COMMERCIAL N
JMH HEALTH PLAN COMMERCIAL HMO 5014 COMMERCIAL N
JOHN MORRELL COMPANY CO. - AHPBA 38310 COMMERCIAL N
JOHN MUIR TRAUMA PHYSICIANS Call COMMERCIAL N
Please contact John Muir
Trauma Physicians at 925-947-
5288 for Payer id
information.
JP Farley Corporation 34136 COMMERCIAL N
JSL Administrators 37272 COMMERCIAL N
John Alden Life Insurance Co. 41099 COMMERCIAL N
John Muir Mt. Diablo Health System 68036 COMMERCIAL N
Providers who have never
submitted claims to John
Muir are required to register
Tax ID prior to initial claims
submission. Please fax W-9
along with contact name and
number to the attention of
Patty Kan at (925) 941-2026.
Allow 2 days for processing
bef
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 36
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
John Muir Physician Network 68036 COMMERCIAL N
Providers who have never
submitted claims to John
Muir are required to register
Tax ID prior to initial claims
submission. Please fax W-9
along with contact name and
number to the attention of
Patty Kan at (925) 941-2026.
Allow 2 days for processing
bef
Johns Hopkins Healthcare (EHP/PP) 52189 COMMERCIAL P
New submitters should send
in their Billing NPI and
Rending/Servicing NPI.
Johns Hopkins Healthcare (USFHP) 52123 COMMERCIAL N
New submitters should send
in their Billing NPI and
Rending/Servicing NPI.
Joplin Claims / Benefit Management Inc 43178 COMMERCIAL N
KEY GAP 35317 COMMERCIAL N
KPS-Kitsap Physician Services KPS01 COMMERCIAL N
Kaiser CSI-California Select for Individuals (formerly known as Kaiser PPO)94320 COMMERCIAL N
Kaiser Foundation Health Plan of Colorado 91617 COMMERCIAL N
Kaiser Foundation Health Plan of Northern CA Region 94135 COMMERCIAL N
Please call (510) 987-4639 for
approval prior to submitting
Northern California referral
claims.
Kaiser Foundation Health Plan of Ohio 34092 COMMERCIAL N
Kaiser Ohio will be receiving
Extend Content. E-tactic
Billing Service participating in
Pilot.
Kaiser Foundation Health Plan of Southern CA Region 94134 COMMERCIAL N
For more information please
call (866) 285-0361
Kaiser Foundation Health Plan of the Mid-Atlantic States Inc.52095 COMMERCIAL N
For more information please
contact Kenya Neal at Kaiser
at (301) 625-2264.
Kaiser Foundation of the Northwest 93079 COMMERCIAL N
This payer id can only be
used to submit claims for
Oregon and Washington
Kaiser Permanente members.
Kaiser Permanente of Georgia 21313 COMMERCIAL N
Kanawha HealthCare Solutions Inc. 57038 COMMERCIAL N
Kanawha Insurance Co. 57038 COMMERCIAL N
Katy Medical Claims 81812 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 37
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Kaweah Delta TKFMC COMMERCIAL N
Kempton Company 73100 COMMERCIAL N
Kempton Group Administrators 73100 COMMERCIAL N
Kentucky Health Administrators Inc. 27215 COMMERCIAL N
Kentucky Spirit Health Plan 68067 COMMERCIAL N
Kern County CDCR 28021 COMMERCIAL N
Kern Health Systems 77039 COMMERCIAL N
Key Benefit Administrators (Indianapolis IN) 37217 COMMERCIAL N
MUST VERIFY AL CLAIMS
SHOULD GO TO PAYER IN
INDIANAPOLIS IN
Key Health Pilot COMMERCIAL N
Key Medical Group IP082 COMMERCIAL N
Key Select 37321 COMMERCIAL N
Keystone Mercy Health Plan 23284 COMMERCIAL N
Medicaid managed care. For
EDI support please e-mail
[email protected] .
Klais & Company 34145 COMMERCIAL N
Klais & Company (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Korean American Medical Group KAMG1 COMMERCIAL N
LA Care Health Plan LACAR COMMERCIAL N
LACare 27357 COMMERCIAL N
LBA Health Plans 52193 COMMERCIAL N
LHP Claims Unit 37248 COMMERCIAL N
LIFE Pittsburgh 25181 COMMERCIAL N
LIPA/Agate Resources TH106 COMMERCIAL N
Lake County Physicians Association 37116 COMMERCIAL N
Lakeside Comprehensive Healthcare 66127 COMMERCIAL N
Lakeside Health Services LMG11 COMMERCIAL N
Lancaster General Health Group - Preferred Health Care (IHS Payer)Call COMMERCIAL N
Contact Sherry Wolgemuth
Vice President of Claims
Operations for Preferred
Health Care at (717) 560-
9290 ext. 124 for approval
and the Payer ID.
Landmark Healthcare Inc LNDMK COMMERCIAL N
Lawndale Christian Health Center 36333 COMMERCIAL N
Leon Medical Center Health Plan 37316 COMMERCIAL N
Liberty Health Advantage 87071 COMMERCIAL N
Liberty Union 37281 COMMERCIAL N
Life Assurance Company 37281 COMMERCIAL N
Life Gift Cards 33LGC COMMERCIAL N
Life Investors Insurance TH120 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 38
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Life Investors of America - Long Term Care TH093 COMMERCIAL N
Life Trac 41136 COMMERCIAL N
LifePath Hospice Inc 76870 COMMERCIAL N
LifeWise Healthplan of Oregon 93093 COMMERCIAL R
Payer EDI agreement must be
processed thru Emdeon's
Enrollment Dpt. Do not send
EDI Agreement to Payer.
Applies to all providers
(including those adding site
id's) enrolling for Electronic
submission thru WebMD.
Questions: (800) 845-6592
Local 135 Health Benefits Fund (Indianapolis IN) 35107 COMMERCIAL N
Loma Linda University Adventist Health Sciences Center Employee Health Plan37267 COMMERCIAL N
Loma Linda University Adventist Health Sciences Centers37267 COMMERCIAL N
Loma Linda University Behavioral Medicine Center Employee Health Plan37267 COMMERCIAL N
Loma Linda University Employee Health Plan 37267 COMMERCIAL N
Loma Linda University Health Care Employee Health Plan37267 COMMERCIAL N
Loma Linda University Healthcare - ManagedCare Claims33036 COMMERCIAL N
Claims are printed and mailed
to the payer.
Loma Linda University Medical Center Employee Health Plan37267 COMMERCIAL N
Loma Linda University Medical Center Residents Health Plan37267 COMMERCIAL N
Loma Linda University Student Health Plan 37267 COMMERCIAL N
Lone Star TPA 45289 COMMERCIAL N
Louisiana Healthcare Connections 68069 COMMERCIAL N
Lovelace Salud SX159 COMMERCIAL N
Lovelace Sandia Health Plan 90328 COMMERCIAL N
MAMSI Life and Health Insurance Co. (MLH) 52148 COMMERCIAL N
MBA of Wyoming (Worland WY) 87065 COMMERCIAL N
Payer ID valid for claims with
a submission address of PO
Box 98 Worland WY 82401
MBS 56205 COMMERCIAL N Formerly Payer ID 56151
MCA ADMINISTRATORS 25160 COMMERCIAL N
MD - Individual Practice Association Inc. (M.D. IPA) 52148 COMMERCIAL N
MDI Custom Provider Network (Formerly MPA - Custom Provider Network)80900 COMMERCIAL N
MDI Holdings (Formerly Medical Partners of America) 80026 COMMERCIAL N
MDWise Hoosier Alliance 20475 COMMERCIAL N
MED PAY 88058 COMMERCIAL N
MED3000 CMS EARLY STEPS EM350 COMMERCIAL N
MED3000 CMS SAFETY NET EM284 COMMERCIAL N
MED3000 CMS TITLE 19 REFORM EM843 COMMERCIAL N
MED3000 CMS TITLE 21 EM205 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 39
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
MED3000 COVENTRY HEALTHY KIDS EM521 COMMERCIAL N
MED3000 PEDICARE TITLE 19 EM039 COMMERCIAL N
MED3000 PEDICARE TITLE 21 EM522 COMMERCIAL N
MEDICA HEALTH CARE PLAN INC. 78857 COMMERCIAL N
MEDICAL ASSOCIATES HEALTH PLAN MAHC1 COMMERCIAL N
MEDICAL DEVELOPMENT INTERNATIONAL 52181 COMMERCIAL N
MEMIC 1047 COMMERCIAL N
MEMORIAL INTEGRATED HEALTHCARE Call COMMERCIAL N
PLEASE EMAIL TRACY
HARSWICK AT
[email protected] FOR
PAYER ID INFORMATION
MFC & HealthPlus Peoria 23550 COMMERCIAL N
MHNET 74289 COMMERCIAL N
MHP Systems 64068 COMMERCIAL N
MIPS COMMERCIAL N
MMA 35316 COMMERCIAL N
MMAC (Managed Medical Assurance Co. Ltd.) (Ohio BWC)31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
MMSI 41154 COMMERCIAL N
Mayo Management Services
Inc.
MOLINA HEALTHCARE Of WI ABRI1 COMMERCIAL N
MORRIS ASSOCIATES 35092 COMMERCIAL N
MPE Services Inc. 37233 COMMERCIAL N
MPEEBT 37233 COMMERCIAL N
MVP Health Plan of NY 14165 COMMERCIAL N
MVP Health Rochester SX089 COMMERCIAL N
Formerly known as Preferred
Care NY
Mabuhay Medical Group CAPMN COMMERCIAL N
MacNeal Health Providers- CHS 36334 COMMERCIAL N
Magellan Health Services 1260 COMMERCIAL N
Magnacare 11303 COMMERCIAL N
Magnolia 68062 COMMERCIAL N
Mail Handlers Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry
Consolidated payer ID.
Including AFSPA Staff Plan.
a.k.a. Mailhandlers CAC.
Maksin Management Corporation 22195 COMMERCIAL N
Managed Care Services LLC 35162 COMMERCIAL N
Managed Care Systems (Delano Regional Medical Group)MCS02 COMMERCIAL N
Managed Care Systems (Gemcare) MCS01 COMMERCIAL N
Managed Health Network 22771 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 40
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Managed Health Services Indiana (Medicaid HMO) 39186 COMMERCIAL P
Prior to submitting claims
please call Provider Relations
Dept at 877.647.4848 to
verify your provider info is on
file in the claim system. This
will prevent rejections and
allow payments to be made
in a timely manner.
Managed Health Services Wisconsin 39187 COMMERCIAL P
Prior to submitting claims
please call Provider Relations
Dept at 1-800-547-1647 to
verify your provider info is on
file in the claim system. This
will prevent rejections and
allow payments to be made
in a timely manner.
Manatee Service Center (Bradenton FL) 41555 COMMERCIAL N
Manulife W. J. Sutton Company 98010 COMMERCIAL N
Marquette Life Insurance Company 48055 COMMERCIAL N
Marsh Advantage COMMERCIAL N
Maryland Physicians Care 22348 COMMERCIAL N
Rendering provider id must
contain 1D qualifier. Payer
accepts zero dollar service
line charges. Payer
Registration not required.
Autoenroll payer.
Mashantucket Pequot Tribal Nation 37121 COMMERCIAL N
Master Mates & Pilots Program TH111 COMMERCIAL N
McKinley Medical Group MHM02 COMMERCIAL N
MedAdmin Solutions 58202 COMMERCIAL N
MedAdmin Solutions 58204 COMMERCIAL N
MedBen (Newark OH) 74323 COMMERCIAL N
MedCom 59231 COMMERCIAL N
MedCost Inc. 56162 COMMERCIAL N
For questions on claim
submission please contact
Customer Service 800-824-
7406
MedDirect 38353 COMMERCIAL N
MedPartners Administrative Services 35205 COMMERCIAL N
Payer ID is only for claims
with mailing address of: PO
Box 2602 Fort Wayne IN
46801
MedSolutions Inc 62160 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 41
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Medfocus 95321 COMMERCIAL N
Medica 94265 COMMERCIAL N
Medicaid Hawaii Waivers 77059 COMMERCIAL R
Medical Administrators Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Medical Benefit Administrators Inc/dba MBA of MD Inc 37298 COMMERCIAL N
Medical Benefits Administration MBA01 COMMERCIAL N
Medical Benefits Administrators Inc. (Newark OH) 74323 COMMERCIAL N
Medical Benefits Companies (Newark OH) 74323 COMMERCIAL N
Medical Benefits Mutual (Newark OH) 74323 COMMERCIAL N
Medical Benefits Mutual Life Insrance Co. 74323 COMMERCIAL N
Medical Mutual of Ohio 29076 COMMERCIAL N
Medical Network of Colorado Springs 84600 COMMERCIAL N
Medical Reimbursements of America 62177 COMMERCIAL N
Medical Services Initiative 12057 COMMERCIAL N
Medical Value Plan - Ohio (MVP) 38224 COMMERCIAL N
Medicina Familiar Medical Group CAPMN COMMERCIAL N
Mega Life & Health Insurance Company - Insurance Center59221 COMMERCIAL N
Payer ID valid only if the
address on the Health ID Card
matches the following: P.O.
Box 982009 North Richland
Hills TX 76182.
Memorial Clinical Associates/ SelectCare of Texas (MCA)62181 COMMERCIAL N
Memorial Herman Health Network Providers TH092 COMMERCIAL N
Memorial PSN/CMS Call COMMERCIAL N
Please contact Memorial
Enrollment department at
954-276-3176 for payer ID
information.
Mercer Administrators COMMERCIAL N
Mercy Care Plan (AHCCCS) 86052 COMMERCIAL N
Mercy Health Plans 43166 COMMERCIAL N
MercyCare Call COMMERCIAL N
Please call 608-758-7739 for
payer id.
Meridian Health Plan 13189 COMMERCIAL N
Meritain Health / Agency Services 64158 COMMERCIAL N
Formerly know as Agency
Services Inc.
Meritain Health Minneapolis 41124 COMMERCIAL N
Meritain Health/North American Administrators 64157 COMMERCIAL N
Formerly know as North
American Administrators Inc.
Methodist Associate Health Plan Pilot COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 42
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
MetroPlus Health Plan 13265 COMMERCIAL N
Registration and submission
of the Billing Provider's NPI is
required. If you have not
registered please contact
MHP Customer Service at
(800) 303-9626. Claims will
reject if the NPI is not
registered and/or submitted
on claims sent electronically.
Metropolitan Health Plan 10850 COMMERCIAL N
Metrowest HealthPlan TH068 COMMERCIAL N
Metrowest Star Medicaid TH069 COMMERCIAL N
Michael Reese Physicians Group 37127 COMMERCIAL N
Mid America Benefits Call COMMERCIAL N
Please call Jessica Picarde
Manager of Claims
Operations (410) 349-3222
for Payer ID information.
Mid Atlantic Psychiatric Services Inc. (MAPSI) 52149 COMMERCIAL N
Mid-America Associates Inc. 37281 COMMERCIAL N
Mid-County Physicians Medical Group (San Diego) (Synermed)SYMED COMMERCIAL N
Mid-West National Life Insurance Co. of Tennessee - Insurance Center59224 COMMERCIAL N
Payer ID valid only if the
address on the Health ID Card
matches the following: P.O.
Box 982017 North Richland
Hills TX 76182.
Mid-West National Life Insurance Co. of Tennessee - Student Insurance74227 COMMERCIAL N
Payer ID only valid if the P.O.
Box on the Health ID Card
matches one of the following
P.O. Boxes: P.O. Box 890025
809067 809079 809066
809036 809081 Dallas Tx
75380-9025.
MidCities IPA CAPMN COMMERCIAL N
MidCoast IPA 77012 COMMERCIAL N
Midlands Choice Inc. 47080 COMMERCIAL N
Midwest Health Partners 76079 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 43
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Midwest Health Plans Inc. TH074 COMMERCIAL P
Accepts NPI only. Require
the billing NPI to be the
group NPI if using a Business
Tax id. Service provider NPI
required in servicing provider
loop. No longer require 6
digit provider identifier.
Provider must complete
enrollment form on payers
website.
Mills Peninsula Health Services MPHS1 COMMERCIAL N
Mills Peninsula Medical Group MPMG1 COMMERCIAL N
Mission (St. Joseph Heritage Healthcare) STJOE COMMERCIAL N
Mississippi Health Partners 64068 COMMERCIAL N
Mississippi Physicians Care Network 64084 COMMERCIAL N
Mississippi Public Entity Employee Benefit Trust 37233 COMMERCIAL N
Mississippi Select Health Care 64088 COMMERCIAL N
Also doing business as Select
Administrative Services (SAS).
Missoula County Medical Benefits Plan 37275 COMMERCIAL N
Missouri Care/MC 43179 COMMERCIAL N
Molina Healthcare Utah (aka: American Family Care)SX109 COMMERCIAL N
Molina Healthcare of CALIFORNIA 38333 COMMERCIAL N
Molina Healthcare of Florida 51062 COMMERCIAL N
Molina Healthcare of MICHIGAN 38334 COMMERCIAL N
Molina Healthcare of Missouri 71079 COMMERCIAL N
Please note the payer name
changed effective 4/1/10.
For questions please contact
Molina Healthcare of
Missouri. Please refer to the
Member ID cards for payer
contact information.
Molina Healthcare of Nevada 20676 COMMERCIAL N
Molina Healthcare of New Mexico - Salud 9824 COMMERCIAL N
Molina Healthcare of New Mexico -SCI 4423 COMMERCIAL N
Molina Healthcare of Ohio 20149 COMMERCIAL N
Molina Healthcare of Texas 20554 COMMERCIAL N
Molina Healthcare of WASHINGTON 38336 COMMERCIAL N
Monarch IPA IP095 COMMERCIAL N
Mondial Assistance 50749 COMMERCIAL N
Montefiore Contract Management Organization 13174 COMMERCIAL N
Monumental Life Insurance Company TH094 COMMERCIAL N
Monumental Life Insurance Company TH121 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 44
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Mosaic IPA Medical Group IP083 COMMERCIAL N
Motion Pictures Industry 99282 COMMERCIAL N
Mountain States Administrative Services (Tucson AZ) 86040 COMMERCIAL N
Multicultural Primary Care Medical Group (San Diego) (Synermed)SYMED COMMERCIAL N
Multiplan Wisconsin Preferred Provider Network 34080 COMMERCIAL N
Municipal Health Benefit Fund 81883 COMMERCIAL N
Mutual Assurance Administrators 37256 COMMERCIAL N
Mutual Group (The) (US) 59140 COMMERCIAL N
Mutual of Omaha Insurance Company 71412 COMMERCIAL N
Mutually Preferred 71412 COMMERCIAL N
N.W. Ironworkers Health & Security Trust Fund 91136 COMMERCIAL N
Please enter Group Number
(F15) when submitting claims.
N.W. Roofers & Employers Health & Security Trust Fund91136 COMMERCIAL N
Please enter Group Number
(F26) when submitting claims.
N.W. Textile Processors 91136 COMMERCIAL N
Please enter Group Number
(F14) when submitting claims.
NAA (North America Administrators L.P.) (Nashville TN) 65085 COMMERCIAL N
NABN (Cleveland OH) 34159 COMMERCIAL N
Now known as Meritain
Health. Payer ID valid only
for claims with billing
submission address of P.O.
Box 94928 Cleveland OH
44101-4928 or P.O. Box
89476 Cleveland OH 44101-
5476.
NALC/Affordable 53011 COMMERCIAL N
NCAS - Fairfax VA 75190 COMMERCIAL N
NEW AVENUES INC. 95998 COMMERCIAL N
NGS American Inc 38225 COMMERCIAL N
NHBCAUX 88050 COMMERCIAL N
NHP/SHP (Neighborhood Health Providers and Suffolk Health Plan)11325 COMMERCIAL P
NJ Carpenters Health Fund 22603 COMMERCIAL N
NMCI Pilot COMMERCIAL N
NORTHWEST COMMUNITY HEALTH PARTNERS 36234 COMMERCIAL N
Naperville Healthcare TH088 COMMERCIAL N
National Association of Letter Carriers 53011 COMMERCIAL N
National Association of Letter Carriers/NALC 53011 COMMERCIAL N
National Benefit Administrators - New Jersey 56175 COMMERCIAL N
National Benefit Administrators - North Carolina 56176 COMMERCIAL N
National Capital Preferred Provider Organization (NCPPO)90001 COMMERCIAL N
Customer Service phone
number: (800 272-5911)
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 45
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
National Imaging Associates SX190 COMMERCIAL N
National Rural Electric Coop (NRECA) 52132 COMMERCIAL N
National Telecommunications Cooperative Association 52120 COMMERCIAL N
National Telecommunications Cooperative Association (NTCA - Staff)52104 COMMERCIAL N
National Telecommunications Cooperative Association (NTCA)52103 COMMERCIAL N
Nationwide Health Plans 31417 COMMERCIAL N
Neighborhood Health Partnership of Florida 96107 COMMERCIAL N
Payer ID is valid for claims
submission address PO Box
025680 Miami FL 33102-
5680. Any questions should
be directed to (305)715-4334.
Neighborhood Health Plan (Boston MA) 4293 COMMERCIAL N
Neighborhood Health Plan of Rhode Island (NHPRI) 5047 COMMERCIAL N
Please call NHPRI at 1-401-
459-6020 to obtain or
confirm your provider and
vendor number prior to your
initial claims submission.
Nesika Health Group 37255 COMMERCIAL N
Netcare Life and Health Insurance (Hagatna Guam) 66055 COMMERCIAL N
Network Health 4332 COMMERCIAL P
Before initiating submissions
please go to www.network-
health.org and go to the
Providers Tab then forms
then Claims Forms and then
EDI setup forms or email
Network Health at
[email protected] for
an EDI setup form.
Network Health Insurance Corp-Medicare 77076 COMMERCIAL N
Network Health Plan of Wisconsin Inc. 39144 COMMERCIAL N
Payer id is valid only if the
claim submission address on
the back of the member's
card is PO Box 568 Menasha
WI 54952.
Network Medical Management NMM01 COMMERCIAL N
Network TPA LLC 58204 COMMERCIAL N
NevadaCare 86067 COMMERCIAL N
New Century Health - IEHP Oncology NCH11 COMMERCIAL N
New Century Health - Vista Cardiology NCH09 COMMERCIAL N
New Era Employee Welfare Benefit Plan Trust 76031 COMMERCIAL N
New Era Life Insurance Company 75281 COMMERCIAL N
New Market Dimensions 65056 COMMERCIAL N
New West Health Services SX164 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 46
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
New York Life TH122 COMMERCIAL N
New York Network Management 11334 COMMERCIAL N
New York Presbyterian System Select Health 24819 COMMERCIAL N
Nippon Life Insurance Company of America 81264 COMMERCIAL N
Noble AMA Select IPA PDT01 COMMERCIAL N
Noble Community Medical Associates LA CAPMN COMMERCIAL N
North American Administrators Inc. 64157 COMMERCIAL N
Now known as Meritain
Health
North American Benefits Network (Cleveland OH) 34159 COMMERCIAL N
Now known as Meritain
Health. Payer ID valid only
for claims with billing
submission address of P.O.
Box 94928 Cleveland OH
44101-4928 or P.O. Box
89476 Cleveland OH 44101-
5476.
North American Health Plan 64157 COMMERCIAL N
Now known as Meritain
Health
North American Medical Management (NAMM) - Northern CaliforniaE3510 COMMERCIAL P
Please contact the EDI Dept
for North American Medical
Management (NAMM) -
Northern California
Lead/Supervisor at 1-800-956-
8000 prior to initial
submission of claims.
North American Medical Management (NAMM) - Southern CaliforniaE3510 COMMERCIAL P
North American Preferred 64157 COMMERCIAL N
Now known as Meritain
Health
North Broward Hospital District 37314 COMMERCIAL N
North County Health Services Call COMMERCIAL N
To obtain Payer ID and enroll
with payer California
providers should contact
Tristin Rausche 858-824-7100
[email protected]
North Suburban Associated Physicians 36392 COMMERCIAL N
North Texas Healthcare Network 35212 COMMERCIAL N
North West Orange County Medical Group PROSP COMMERCIAL N
NorthShore University Health System Medical Group 36364 COMMERCIAL N
NorthStar Advantage NSA01 COMMERCIAL N
Northern California Sheet Metal Workers Health Care Plan38238 COMMERCIAL N
Payer ID valid for claims with
a submission address of PO
Box 1138 San Ramon CA
94583.
Northern Illinois Health Plan 36347 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 47
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Northern Nevada Trust Fund 88027 COMMERCIAL N
Please call (775) 826-7200 to
verfiy if you should be
sending claims to Northern
Nevada Trust Fund.
Northridge Medical Group NMG01 COMMERCIAL N
Northstar Advantage 60058 COMMERCIAL N
Northwest Administrators Inc. See Comments COMMERCIAL N
Claims are printed and mailed
to the payer.
Northwest Diagnostic Clinic/SelectCare of Texas (NWDC)62119 COMMERCIAL N
Northwest Suburban IPA (Illinois) 36346 COMMERCIAL N
Nova Casualty Company 16114 COMMERCIAL N
Novanet 6226 COMMERCIAL N
Novasys Health Network 71080 COMMERCIAL N
Nuestra Familia Medical Group (Prospect Medical Group)PROSP COMMERCIAL N
Nyhart 37299 COMMERCIAL N
OAK WEST PRIMARY PHYSICIAN ASSOCIATION 36402 COMMERCIAL N
ODS Health Plan 13350 COMMERCIAL N
OK State Employees & Educators (EDS) 22521 COMMERCIAL N
OMNI/Medicore HP 68037 COMMERCIAL N
OSF Health Plans 62171 COMMERCIAL N
OSMA Health - C. L. Frates 73071 COMMERCIAL N
Oasis IPA DESRT COMMERCIAL N
Occupational Health Mgmt Inc. (HealthManage) (Ohio BWC)31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Office of Group Benefits- Louisiana 72087 COMMERCIAL N
Office of Group Benefits is
located in the state of
Louisiana. This payer is
currently not sending 997's.
Syntax errors will be worked
on with payer tech.
Ohio BWC 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Ohio Comp Choice Inc. (HMS) (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Ohio Employee Health Partnership (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Ohio Health Choice PPO 34189 COMMERCIAL N
Payer ID valid only for claims
with a billing submission
address of PO Box 3619
Akron OH 44309-3619 or PO
Box 93538
Ohio Health Group 95435 COMMERCIAL N
Ohio PPO Connect 74431 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 48
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Omnicare 25133 COMMERCIAL N
Formerly Payer ID 25150.
Now part of Coventry
Consolidated payer ID.
Omnicare Medical Group (OMNI) IP088 COMMERCIAL N
Omnicare A Coventry Health Plan 25150 COMMERCIAL N
The go forward payer ID for
this plan is 25133. Please see
new entry under that ID on
the payer list.
Omnicare A Coventry Health Plan 25150 COMMERCIAL N
The go forward payer ID for
this plan is 25133. Please see
new entry under that ID on
the payer list.
OneNet PPO LLC. 52149 COMMERCIAL N
Name effective from
9/1/2006. Previous name
Alliance PPO LLC.
Operating Engineers Locals 302 & 612 Health & Security Fund91136 COMMERCIAL N
Please enter Group Number
(F12) when submitting claims.
OptiCare Managed Vision 56190 COMMERCIAL N
Optima Health Plan 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is
reqd. Field must be 5-7 chars
positions 1-5 must be
numeric only and positions
6&7 (if applicable) must be
alpha only. Please contact
Ydsia Slagle-Provider
Relations at (757) 552-7477.
Optima Insurance Company 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is
reqd. Field must be 5-7 chars
positions 1-5 must be
numeric only and positions
6&7 (if applicable) must be
alpha only. Please contact
Ydsia Slagle-Provider
Relations at (757) 552-7477.
Optimum Choice of the Carolinas Inc. (OCCI) 52152 COMMERCIAL N
Optimum Choice Inc. (OCI) 52148 COMMERCIAL N
OptumHealth - CMC 41194 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 49
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Orthonet - Uniformed Services Family Health Plan 13382 COMMERCIAL N
Claims are printed and mailed
to the payer. For Payable
USFHP (NY & NJ) outpatient
therapy claims only. Contact
Theresa Malgioglio at (914)
681-8800.
Orthonet Corporation - CIGNA 13381 COMMERCIAL N
Orthonet- Aetna 13383 COMMERCIAL N
Orthonet-HealthNet 25681 COMMERCIAL N
Oxford Health Plans 6111 COMMERCIAL N
P5 Health Plan Solutions of Utah 87068 COMMERCIAL N
PAI 37287 COMMERCIAL N
PEHP - Utah Public Employee Health Plan Call COMMERCIAL P
Call EDI at 801-366-7544 or
email [email protected]
to obtain the payer id.
PHCS Claims (formerly American LIFECARE) 72099 COMMERCIAL N
Please enter the Group
Number from ID card when
submitting claims. Payer ID
only valid for claims with a
billing submission address of
PO Box 5007 DePere WI
54115 (1100 Poydras Street
Suite 2600 New Orleans LA
70163-2602 is no longer an
active claim
PHCS Savility Payers 13306 COMMERCIAL N
PHP of South Michigan 87726 COMMERCIAL N
PHP of Southwest Michigan 87726 COMMERCIAL N
PHP of West Michigan 87726 COMMERCIAL N
PIMA Health 9861 COMMERCIAL R
PODIATRY NETWORK FL 59324 COMMERCIAL N
POMCO 16111 COMMERCIAL N
PPOM LLC 38335 COMMERCIAL N
PPOPlus LLC 72148 COMMERCIAL N
PSYCHCARE LLC 51052 COMMERCIAL N
PacifiCare Behavioral Health 33053 COMMERCIAL N
PacifiCare PPO - All States 95999 COMMERCIAL N
For payable PPO claims only.
NOT for Pacificare/Secure
Horizons HMO claims. For
further questions you may
inquire via email at
[email protected] .
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 50
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
PacifiCare of Arizona - Claims 95964 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS
claims only. Not for PPO
claims. For further questions
you may inquire via email at
[email protected]
PacifiCare of California - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only.
NOT for PPO claims. For
further questions you may
inquire via email at
[email protected] .
PacifiCare of Colorado - Claims 95962 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS
claims only. Not for PPO
claims. For further questions
you may inquire via email at
[email protected]
PacifiCare of Oklahoma - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only.
NOT for PPO claims. For
further questions you may
inquire via email at
[email protected] .
PacifiCare of Oregon - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only.
NOT for PPO claims. For
further questions you may
inquire via email at
[email protected] .
PacifiCare of Texas - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only.
NOT for PPO claims. For
further questions you may
inquire via email at
[email protected] .
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 51
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
PacifiCare of Washington - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only.
NOT for PPO claims. For
further questions you may
inquire via email at
[email protected] .
Pacific Alliance Medical Group and Hospital (Synermed)SYMED COMMERCIAL N
Pacific IPA PCFCI COMMERCIAL N
PacificSource Health Plans 93029 COMMERCIAL N
Payer does not accept COB
claims electronically
Paragon Benefits Inc. 58174 COMMERCIAL N
Paramount SX158 COMMERCIAL N
Paramount Preferred Network (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Park Terrace/Encompass Medical Group Call COMMERCIAL N
To obtain Payer ID and enroll
with payer please contact
Tristin Rausche 858-824-
7100 [email protected]
Parkland Community Health Plan 66917 COMMERCIAL N
Pasadena Primary Care Physicians CAPMN COMMERCIAL N
Passport Advantage 76569 COMMERCIAL N
Only claims with a DOS
and/or Admit Date on or
after 1/1/2010 shall be
submitted to this new Payer
ID.
Passport Health Plan 61129 COMMERCIAL N
Medicaid managed care. For
EDI support please e-mail
[email protected] .
Patient Advocates LLC 10525 COMMERCIAL N
Peach State Health Plan 68049 COMMERCIAL P
Prior to submitting claims
please call Provider Relations
Dept at 1-866-874-0633 to
verify your provider info is on
file in the claim system. This
will prevent rejections and
allow payments to be made
in a timely manner.
Pegasus Medical Group PROSP COMMERCIAL N
Pennsylvania Pace 20172 COMMERCIAL N
Pennsylvania's Preferred Health Network Call COMMERCIAL N
Call Jessica Picarde Manager
of PPHN Claims
Operations(410) 349-3222
Peoples Health Network 72126 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 52
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
PerformCare-Select Health MH/SA 25176 COMMERCIAL N
For Behavioral Health EDI
support please e-mail
[email protected]
Personal Insurance Administrators Inc. (Agoura Hills CA)95397 COMMERCIAL N
PersonalCare 25133 COMMERCIAL N
Formerly payer ID 25146 Now
part of Coventry
Consolidated payer ID.
Phoenix Health Plan 3440 COMMERCIAL N
Phyicians Health Plan (PHP) Mid-Michigan 37330 COMMERCIAL N
Physician Associates of Louisiana 58204 COMMERCIAL N
Physician Associates of the Greater San Gabriel ValleyCall COMMERCIAL N
Please call David McGee 626-
817-8354 or Art Tarin 626-
817-8318 to obtain the Payer
Id
Physician Associates of the Greater San Gabriel ValleyPA513 COMMERCIAL N
Physician Care Network LLC 58204 COMMERCIAL N
Physician's Data Trust PDT01 COMMERCIAL N
Physicians Alliance/Stones River Regional IPA 15749 COMMERCIAL N
Physicians Care (ASR Corporation) 38265 COMMERCIAL N
Note: This is Physicians Care
Network located in Michigan
Physicians Care Health Plans (ASR Corporation) 38265 COMMERCIAL N
Note: This is Physicians Care
Network located in Michigan
Physicians Care Network (ASR Corporation) 38265 COMMERCIAL N
Note: This is Physicians Care
Network located in Michigan
Physicians Care Network (Rockford IL only) 36345 COMMERCIAL N
Physicians Health Association of Illinois 37136 COMMERCIAL N
Physicians Health Choice - Encounters TH114 COMMERCIAL N
Physicians Health Claims - Claims TH113 COMMERCIAL N
Physicians Health Collaborative 20398 COMMERCIAL N
Physicians Health Network MHM03 COMMERCIAL N
Physicians Health Plan (PHP) - SC 9173 COMMERCIAL N
Physicians Health Plan PHP South Michigan 37330 COMMERCIAL N
Physicians Medical Group of San Jose EXC01 COMMERCIAL N
Physicians Mutual Insurance Company 47027 COMMERCIAL N
Please send all PPO and
dental claims to the address
on the back of the insured's
ID Card
Physicians Plus Insurance Corporation 39156 COMMERCIAL N
Physicians United Plan TH131 COMMERCIAL N
Piedmont Behavioral Health 6607 COMMERCIAL N
Pinnacle Claims Management Inc. 24735 COMMERCIAL N
Pinnacle Health Resources (Prospect Medical Group)PROSP COMMERCIAL N
Pinnacle Physician Management ORG 45985 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 53
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Pinnacol Assurance 84109 COMMERCIAL N
Pioneer Medical Group PIONR COMMERCIAL N
Pittman & Associates 37224 COMMERCIAL N
Pittsburgh Care Partnership Inc. 23283 COMMERCIAL N
Pivotal Plan 64160 COMMERCIAL N
Planned Administrators Inc. 37287 COMMERCIAL N
Providers submitting claims
as a Preferred Blue provider
should not submit claims
using payer ID 37287
Podi Care Managed Care 58204 COMMERCIAL N
Pomona Valley Medical Group IP057 COMMERCIAL N
Practicare Inc 4334 COMMERCIAL N
Prairie States Enterprises Inc. 36373 COMMERCIAL N
Preferred Benefits Administrator 61665 COMMERCIAL N
Preferred Care Partners Florida 65088 COMMERCIAL N
Preferred Community Choice/PCCSelect/CompMed 73145 COMMERCIAL N
Preferred Health Care - PPO Lancaster PA (IHS Gateway Payer)Call COMMERCIAL N
Contact Sherry Wolgemuth
Vice President of Claims
Operations for Preferred
Health Care at (717) 560-
9290 ext. 124 for approval
and the Payer ID.
Preferred Health Plan (Louisville KY) 61106 COMMERCIAL N
Preferred Health Professionals 31478 COMMERCIAL N
Preferred Health Systems Insurance Company 60110 COMMERCIAL N
Preferred IPA PFIPA COMMERCIAL N
Preferred Network Access Inc. 36401 COMMERCIAL N
Preferred Plus of Kansas 60110 COMMERCIAL N
PreferredOne (MN) 41147 COMMERCIAL N
Premier Benefits Inc. 43166 COMMERCIAL N
Premier Comp of Hometown Health Network (Ohio BWC)31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Premier Eye Care 65054 COMMERCIAL N
Participating Providers WITH
a signed ECS agreement ONLY
Premier Health Plans 43166 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 54
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Premier Health Systems Inc 90440 COMMERCIAL N
Premier Health Systems Inc.
is part of the Medical Mutual
Family of Companies. For
claims with DOS prior to
4/1/09 use payer ID 90440.
Claims with DOS 4/1/09 and
after use their new payer ID
29076.
Premier Health Systems Inc. 29076 COMMERCIAL N
Premier Health Systems Inc.
is part of the Medical Mutual
Family of Companies. Former
payer ID 90040. Use Payer ID
20976 for claims with DOS
4/1/09 and after. For claims
with DOS prior to 4/1/09 use
former payer ID 90440.
Premier Managed Care Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Premier Physicians Network & Valley Division (PPN) CAPMN COMMERCIAL N
Presbyterian (NM) 5003 COMMERCIAL N
Prestige Health Choice 45056 COMMERCIAL N
Prevea Health Plan 39185 COMMERCIAL N
Prima Health IPA IP096 COMMERCIAL N
Primary Care & Pediatrics IPA (PCPIPA) CAPMN COMMERCIAL N
Primary Health Network 82048 COMMERCIAL N
Primary PhysicianCare Inc. 56144 COMMERCIAL N
Prime West Health Plan 61604 COMMERCIAL N
PrimeSource Health Network (PSHN) - PPO Harrisburg PA (IHS Gateway Payer)Call COMMERCIAL N
Before submitting contact
Jessica Picarde at (410) 349-
3222
Principal Financial Group 61271 COMMERCIAL N
Priority Health 38217 COMMERCIAL N
Prism Network Inc. 37268 COMMERCIAL N
Prism-First Health 37303 COMMERCIAL N
Prism-Univera 37315 COMMERCIAL N
Pro Care Health Plan Inc. (Detroit MI) 38329 COMMERCIAL N
Payer ID valid for claims with
the following submission
addresses: PO Box 3160
Detroit MI 48203 AND PO Box
3590 Detroit MI 48203.
ProCare (Prospect) PROSP COMMERCIAL N
ProCare Health Plan Medicaid 70259 COMMERCIAL N
ProMed HealthCare Administrators IP057 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 55
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Professional Benefit Administrators (Winter Park FL) 59296 COMMERCIAL N
Professional Benefit Administrators Inc. (Oak Brook IL) 36331 COMMERCIAL N
Payer ID is valid only for
claims with billing submission
name city and state of
Professional Benefit
Administrators Inc. Oak Brook
IL.
Professional Risk Management 34134 COMMERCIAL N
Prospect Health Network PROSP COMMERCIAL N
Prospect Medical Group PROSP COMMERCIAL N
Prospect Sherman Oaks Medical Group (Prospect Medical Group)PROSP COMMERCIAL N
Protective Life Insurance Company 37309 COMMERCIAL N
Protegrity Services (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
ProviDRs Care Network 48100 COMMERCIAL N
Providence PPO SX187 COMMERCIAL N
For Claims Status please
contact Susan Naanes @ 503-
574-7441 or Debra
Wallenstein at 503-574-7450
.
Providence of Oregon Health Plan SX133 COMMERCIAL N
For Claims Status please
contact Susan Naanes @ 503-
574-7441 or Debra
Wallenstein at 503-574-7450.
Puget Sound Benefits Trust 91136 COMMERCIAL N
Please enter Group Number
(F25) when submitting claims.
Puget Sound Electrical Workers Trust 91136 COMMERCIAL N
Please enter Group Number
(F33) when submitting claims.
Pyramid Life Insurance Company 48055 COMMERCIAL N
QUALITY HEALTH PLANS INC. 59375 COMMERCIAL N
QVI Risk Solutions Inc. 57117 COMMERCIAL N
Quad Med LLC (Pewaukee WI) 39197 COMMERCIAL N
Qual Choice of Arkansas 35174 COMMERCIAL N
QualCare Inc. 23342 COMMERCIAL P
New Providers must enroll
with QualCare at (800) 992-
6613 option 5.
Quality Care Partners 89461 COMMERCIAL N
QuikTrip 73067 COMMERCIAL N
E-print address: QuikTrip P.O.
Box 733 Buckeystown MD
21717
R&N Market TKFMC COMMERCIAL N
RADCON INC. Call COMMERCIAL N
Please contact Kathy King @
(856) 608-1350 for Payer Id
information.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 56
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
RBMS LLC 91176 COMMERCIAL N
RIVERSIDE SAN BERNARDINO COUNTY INDIAN HEALTH INC.Call COMMERCIAL N
RMSCO INC. 16117 COMMERCIAL N
RWDSU BENEFIT FUND 63070 COMMERCIAL N
Redlands IPA (Synermed) SYMED COMMERCIAL N
Regal Medical Group REGAL COMMERCIAL N
Regency Employee Benefits 38221 COMMERCIAL N
Regional Care Inc. 47076 COMMERCIAL N
Renaissance Physicians Organization 76066 COMMERCIAL N
Reserve National Insurance 73066 COMMERCIAL N
For claims rejections please
contact Reserve National
Customer Service at (405)
848-7931
ResourceOne Administrators 37278 COMMERCIAL N
Resurrection Health Care Preferred/FKA Family Medical Network36396 COMMERCIAL N
Please call (773) 572-8311 or(
773) 572-8309 prior to your
first submission of claims
Retiree Health Trust 26316 COMMERCIAL N
Right Care from Scott & White 74205 COMMERCIAL N
RightChoice Benefit Administrators 37331 COMMERCIAL N
Rocky Mountain Health Plan - Grand Junction SX141 COMMERCIAL R
Rooney Life Inc. 37602 COMMERCIAL N
Rural Carrier Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry
Consolidated payer ID.
Including NRLCA Staff Plan.
Rush Prudential Health Plans (HMO Only) 36389 COMMERCIAL N
Ryan White Network AMM03 COMMERCIAL N
S & S Healthcare Strategies 31441 COMMERCIAL N
SAINT MARY'S HEALTH PLAN 88029 COMMERCIAL N
SANFORD HEALTH PLANS - Repriced Claims TP984 COMMERCIAL N
SANTA CLARA FAMILY HEALTH PLAN 24077 COMMERCIAL N
SCAN ENCOUNTERS 99157 COMMERCIAL N Diversified Data Design (DDD)
SCAN Health Plan 72261 COMMERCIAL N
SCAN Long Term Care 20460 COMMERCIAL N
SCHC Total Care Inc. Claimsnet is the Gateway 16146 COMMERCIAL N
SENIOR WHOLE HEALTH 83035 COMMERCIAL N
Sagamore Health Network 35164 COMMERCIAL N
Sage Technologies 37105 COMMERCIAL N
Samaritan Health Plans CP001 COMMERCIAL N
San Diego County Coverage Initiative (CI) MSO77 COMMERCIAL N
San Diego County Medical Services (CMS) MSO11 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 57
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
San Diego County Ryan White Care Act MSO33 COMMERCIAL N
San Diego Physicians Call COMMERCIAL N
To obtain Payer ID and enroll
with payer California
providers should contact
Tristin Rausche 858-824-7100
[email protected]
San Diego Physicians Medical Group Central Region Call COMMERCIAL N
To obtain Payer ID and enroll
with payer California
providers should contact
Tristin Rausche 858-824-7100
[email protected]
San Joaquin Health Administrators 68035 COMMERCIAL N
San Judas Medical Group IPA HSM01 COMMERCIAL N
San Louis Obispo Select 33072 COMMERCIAL N
Sanford Health Plan 91184 COMMERCIAL N
Sante Health System and Affiliates 77038 COMMERCIAL N
Scan Health Plan Arizona 73172 COMMERCIAL N
Scott & White TH002 COMMERCIAL N
Seabury & Smith COMMERCIAL N
Seaview IPA SVIPA COMMERCIAL N
Secure Health Plans of Georgia LLC 28530 COMMERCIAL N
Secure Horizons Arizona - Claims 95964 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS
claims only. Not for PPO
claims. For further questions
you may inquire via email at
[email protected]
Secure Horizons California - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only.
NOT for PPO claims. For
further questions you may
inquire via email at
[email protected] .
Secure Horizons Colorado - Claims 95962 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS
claims only. Not for PPO
claims. For further questions
you may inquire via email at
[email protected]
Secure Horizons Lifeprint Arizona LIFE1 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 58
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Secure Horizons Washington - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only.
NOT for PPO claims. For
further questions you may
inquire via email at
[email protected] .
Secure Horizons of Oklahoma - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only.
NOT for PPO claims. For
further questions you may
inquire via email at
[email protected] .
Secure Horizons of Oregon - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only.
NOT for PPO claims. For
further questions you may
inquire via email at
[email protected] .
Secure Horizons of Texas - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only.
NOT for PPO claims. For
further questions you may
inquire via email at
[email protected] .
Security Health Plan 39045 COMMERCIAL N
SeeChange 77024 COMMERCIAL N
Select Administrative Services (SAS) 64088 COMMERCIAL N
Also known as Mississippi
Select Health Care.
Select Benefit Administrators of America 37282 COMMERCIAL N
Payer ID valid only for claims
with a billing submission
address of P.O. Box 440
Ashland WI 54806.
Select Benefit Administrators Inc. 93031 COMMERCIAL N
Select Health of South Carolina 23285 COMMERCIAL N
For EDI support please e-mail
[email protected] .
Select Senior Clinic 20415 COMMERCIAL N
SelectCare 14 COMMERCIAL N
SelectCare of Texas (HPN) Heritage Physicians Network 76045 COMMERCIAL N
SelectCare of Texas (Kelsey-Seybold) 61225 COMMERCIAL N
SelectHealth SX107 COMMERCIAL N
SelectHealth was formerly
Intermountain Healthcare
(IHC)
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 59
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Self Insured Benefit Administrators (Clearwater FL) 59111 COMMERCIAL N
Payer ID valid only for claims
with a submission address of
18167 US Highway 19 North
Suite 300 Clearwater FL
33764.
Self Insured Plans (Naples FL) 36404 COMMERCIAL N
Payer ID valid only for claims
with a submission address of
1016 Collier Center Way Suite
200 Naples FL 34110. Please
call Customer Service at (239)
403-7884 to verify claims
submission to Self Insured
Plans - Payer ID 36404
(Naples FL).
Self-Funded Plans Inc. 34131 COMMERCIAL N
Sendero Health 36426 COMMERCIAL N
Senior Care Partners 36390 COMMERCIAL N
Senior Health Partners (SHP) 80141 COMMERCIAL N
Senior Health Partners is
effective 05/01/2011.
Sentara Family Care 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is
reqd. Field must be 5-7 chars
positions 1-5 must be
numeric only and positions
6&7 (if applicable) must be
alpha only. Please contact
Ydsia Slagle-Provider
Relations at (757) 552-7477.
Sentara Health Management 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is
reqd. Field must be 5-7 chars
positions 1-5 must be
numeric only and positions
6&7 (if applicable) must be
alpha only. Please contact
Ydsia Slagle-Provider
Relations at (757) 552-7477.
Sentinel Management Services 23249 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 60
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Sentry Insurance a Mutual Company 39033 COMMERCIAL N
Claims must have the Sentry
Life Insurance Co. Group and
Subscriber Numbers. To
verify you are using the
correct number you may
contact Sentry's Customer
Service Department at 1-800-
426-7234
Sentry Life Insurance Company 39033 COMMERCIAL N
Claims must have the Sentry
Life Insurance Co. Group and
Subscriber Numbers. To
verify you are using the
correct number you may
contact Sentry's Customer
Service Department at 1-800-
426-7234
Sentry Life of New York 39033 COMMERCIAL N
Claims must have the Sentry
Life Insurance Co. Group and
Subscriber Numbers. To
verify you are using the
correct number you may
contact Sentry's Customer
Service Department at 1-800-
426-7234
Seoul Medical Group CAPMN COMMERCIAL N
Sequoia Beverage TKFMC COMMERCIAL N
Seton CHIP 76056 COMMERCIAL N
Seton Employee Plan TH080 COMMERCIAL N
Seton Health Plan - Exclusive TH079 COMMERCIAL N
Seton MAP Program TH081 COMMERCIAL N
Seven Corners 25404 COMMERCIAL N
Shasta Administrative Services 75280 COMMERCIAL N Jeld-Wen Claims Only
Sheakley UNICOMP (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Sheet Metal Workers Local 104 Health Care Plan (San Ramon CA)38238 COMMERCIAL N
Payer ID valid for claims with
a submission address of PO
Box 1618 San Ramon CA
94583.
Sheffield Olson & McQueen Inc Call COMMERCIAL N
Please contact Cate Ahlquist
at Sheffield Olson &
McQueen Inc. prior to
submitting claims
electronically. Phone number
is 651-695-2602
Sierra Family Network (Prospect Medical Group) PROSP COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 61
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Sierra Health Services 76342 COMMERCIAL N
Sierra Nevada Medical Association MBA01 COMMERCIAL N
Signature Health Alliance 62159 COMMERCIAL N
Valid only for HCFA-1500
claims currently mailed to
Signature Health Alliance P.O.
Box 22419 Nashville TN
37202-2419.
Significa Benefits Services Inc. 23250 COMMERCIAL N
Silver Cross Managed Care Organization 36387 COMMERCIAL N
Sinclair Health Plan 84076 COMMERCIAL N
Sloans Lake Preferred Health Networks 84096 COMMERCIAL N
Smith Administrators 2057 COMMERCIAL N
Solano Regional Medical Group Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval
from us prior to sending
claims to a clearinghouse.
Contact Sutter Connect EDI
Dept @ (800)611-5191 for
payer ID.
Solidarity Managed Care Organization (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Solstice Benefits 76578 COMMERCIAL N
Sound Health (now known as First Choice Health Network)91131 COMMERCIAL N
Soundpath Health 42172 COMMERCIAL N
Formerly known as Puget
Sound Health Partners Inc.
South Central Preferred - PPO York PA (IHS Gateway Payer)Call COMMERCIAL N
Call Jane Grove at Provider
Relations for South Central
Preferred (717) 851-6715
South FL Community Care Network - NBHD 37314 COMMERCIAL N
South Haven Community Hospital Call COMMERCIAL N
South Indiana Health Operations - HMO SX142 COMMERCIAL N
South Indiana Health Options - Prime Care Choice SX143 COMMERCIAL N
South Indiana Health Options - TPA SX144 COMMERCIAL N
South Point Hotel & Casino 35227 COMMERCIAL N
SouthCare/Healthcare Preferred 25147 COMMERCIAL N
SouthCare/Healthcare Preferred 25147 COMMERCIAL N
Southeast Texas Govt Employees Benefit Pool TH116 COMMERCIAL N
Southern Benefit Services 37318 COMMERCIAL N
Southern Benefit Services will
no longer process claims from
the following Provider
Groups: Brockman
Enterprises and SPS
International.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 62
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Southern CA Children's Network (SynerMed) SYMED COMMERCIAL N
Southern Cal Physicians Managed Care Services SCP01 COMMERCIAL N
Southern Health Service Inc. 25133 COMMERCIAL N
Formerly payer ID 25128.
Now part of Coventry
Consolidated payer ID.
Southwest Administrators California SWSTA COMMERCIAL N
Southwest Administrators Nevada SWSTA COMMERCIAL N
Southwest Service Life 37266 COMMERCIAL N
Please enter the unique
policy number or ID card
when submitting claims.
Payer ID valid only for claims
with a billing submission
address of PO Box 982005 Ft.
Worth TX 76182.
Special Risk International 52190 COMMERCIAL N
Spectrum Administrators Inc. - TPA Allentown PA (IHS Gateway Payer)23253 COMMERCIAL N
Spina Bifida - VA HAC 84146 COMMERCIAL N
Spohn Health TH100 COMMERCIAL N
St Francis IPA APP01 COMMERCIAL N
St Joseph IPA STJOE COMMERCIAL N
St Jude Yorba Linda STJOE COMMERCIAL N
St. Anthony Memorial Healthcare Centers - MDWISE 35199 COMMERCIAL N
To obtain the payer ID for
this payer please contact
CMCS Customer Service at
(800) 352-7502
St. Barnabas System Health Plan 22240 COMMERCIAL N
St. Catherine Hospital PHO - MDWISE 35199 COMMERCIAL N
To obtain the payer ID for
this payer please contact
CMCS Customer Service at
(800) 352-7502
St. Francis Health Network 35199 COMMERCIAL N
To obtain the payer ID for
this payer please contact
CMCS Customer Service at
(800) 352-7502
St. John's Claims Administration 37264 COMMERCIAL N
St. Joseph Heritage Healthcare STJOE COMMERCIAL N
St. Jude (St. Joseph Heritage Healthcare) STJOE COMMERCIAL N
St. Margaret Mercy Healthcare Centers - MDWISE 35199 COMMERCIAL N
To obtain the payer ID for
this payer please contact
CMCS Customer Service at
(800) 352-7502
St. Vincent IPA PDT01 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 63
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Star HRG 59225 COMMERCIAL N
Payer ID valid only if the
address on the Health ID Card
matches one of the following
P.O. Boxes: P.O. Box 55270
30870 30888 54150 30069
55400 Phoenix AZ 85270-
5270.
Starmark 61425 COMMERCIAL N
Starmark 61425 COMMERCIAL N
State Auto Insurance Companies 46450 COMMERCIAL N
State Farm (Casualty & Property Claims) 31059 COMMERCIAL N
State Farm - Property &
Casualty line of business is
Payer ID 31059.
State Farm Insurance Companies 31053 COMMERCIAL N
Payer ID 31053 is for State
Farm - Health line of
business.
State of Texas Dental Plan 57254 COMMERCIAL N
States General Life Insurance 75087 COMMERCIAL N
Sterling Medicare Advantage 67829 COMMERCIAL N
Sterling Option 1 91151 COMMERCIAL N
To register for ERA (sent
directly from Sterling to the
provider) please go to
https://providernet.adminiso
urce.com/. If you have any
questions support is available
by phone at 877-389-1160.
Stoner and Associates (Cincinnati OH) 31121 COMMERCIAL N
Stones River Regional IPA- Windsor 15752 COMMERCIAL N
Student Insurance - Mid-West National Life Insurance Co. of Tenessee74227 COMMERCIAL N
Payer ID only valid if the P.O.
Box on the Health ID Card
matches one of the following
P.O. Boxes: P.O. Box 890025
809067 809079 809066
809036 809081 Dallas Tx
75380-9025.
Student Insurance - The MEGA Life & Health Insurance Company74227 COMMERCIAL N
Payer ID only valid if the P.O.
Box on the Health ID Card
matches one of the following
P.O. Boxes: P.O. Box 890025
809067 809079 809066
809036 809081 Dallas Tx
75380-9025.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 64
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Suburban Health Organization 35199 COMMERCIAL N
To obtain the payer ID for
this payer please contact
CMCS Customer Service at
(800) 352-7502
SummaCare Health Plan 95202 COMMERCIAL N
Summerlin Life & Health Insurance 86071 COMMERCIAL N
Summit America Insurance Services Inc. 37301 COMMERCIAL N
Student Accident and
Sickness College Sports and
NASCC claims only
SummitCorp (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Sunshine State Health Plan 68057 COMMERCIAL N
Superior Administrators Inc (Santa Ana CA) 23218 COMMERCIAL N
Payer ID valid for claims with
a submission address of P.O.
Box 27730 Santa Ana CA
92799-7730
Superior Health Plan Texas 39188 COMMERCIAL P
Prior to submitting claims
please call Provider Relations
Dept at 1-800-218-7453 to
verify your provider info is on
file in the claim system. This
will prevent rejections and
allow payments to be made
in a timely manner.
Sutter Delta Medical Group 77318 COMMERCIAL N
Sutter East Bay Medical Foundation 94269 COMMERCIAL N
Sutter Gould Medical Foundation Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval
from us prior to sending
claims to a clearinghouse.
Contact Sutter Connect EDI
Dept @ (800)611-5191 for
payer ID.
Sutter Independent Physicians Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval
from us prior to sending
claims to a clearinghouse.
Contact Sutter Connect EDI
Dept @ (800)611-5191 for
payer ID
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 65
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Sutter Medical Foundation Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval
from us prior to sending
claims to a clearinghouse.
Contact Sutter Connect EDI
Dept @ (800)611-5191 for
payer ID.
Sutter Medical Group of the Redwoods Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval
from us prior to sending
claims to a clearinghouse.
Contact Sutter Connect EDI
Dept @ (800)611-5191 for
payer ID.
Swedish Covenant Hospital 36411 COMMERCIAL N
Synermed SYMED COMMERCIAL N
TASEBA TKFMC COMMERCIAL N
TBT 94304 COMMERCIAL N
TEXAS CHILDRENS HEALTH TXCSM COMMERCIAL N
TN IPA 15750 COMMERCIAL N
This Payer ID should be used
for Stones River Regional IPA -
BC/BS Tennessee claims.
TOUCHSTONE HEALTH/HEALTH NET SMART CHOICE 13402 COMMERCIAL N
TPAC/Employee Benefit Management Corp 31074 COMMERCIAL N
TR Paul Inc. 37230 COMMERCIAL N
TRIHEALTH PHYSICIAN SOLUTIONS 31144 COMMERCIAL R
Payer registration is required
prior to claims submission.
Forms are located at
www.emdeon.com/enrollme
nt.
TRIHEALTH PHYSICIAN SOLUTIONS - CONCERN 31143 COMMERCIAL N
TRLHN/AS 98514 COMMERCIAL N
TRLHN/EB 62777 COMMERCIAL N
Talbert Medical Group TALMG COMMERCIAL N
Tall Tree Administrators 88067 COMMERCIAL N
Tarrant Health Services 37228 COMMERCIAL N
Teachers Health Trust 88019 COMMERCIAL N
Team Choice Gold 75139 COMMERCIAL N
Team Choice PNS 75133 COMMERCIAL N
Teamcare 36215 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 66
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Teamster Construction Industry Welfare Trust See Comments COMMERCIAL N
Claims are printed and mailed
to the payer.
Teamsters Benefit Trust 94304 COMMERCIAL N
Tethys Health Ventures 20212 COMMERCIAL N
Texas Children's Health Plan 76048 COMMERCIAL N
Texas Children's Star Call COMMERCIAL N
Provider ID required for all
THIN payers.
Texas Childrens Health Plan (Medicaid) 75228 COMMERCIAL N
Texas Christus 45210 COMMERCIAL N
Texas HealthSpring 33104 COMMERCIAL N
Texas Premier Plan TH089 COMMERCIAL N
Texas True Choice TH055 COMMERCIAL N
TexasFirst Health Plan (NTX) 13185 COMMERCIAL N
The Care Network/The Savannah Business Group 68423 COMMERCIAL N
The Chesapeake Life Insurance Company - Student Insurance74227 COMMERCIAL N
Payer ID only valid if the P.O.
Box on the Health ID Card
matches one of the following
P.O. Boxes: P.O. Box 890025
809067 809079 809066
809036 809081 Dallas Tx
75380-9025.
The City of Odessa 75600 COMMERCIAL N
The Ford Meter Box Company Inc. 37305 COMMERCIAL N
The Health Exchange (Cerner Corporation) 20356 COMMERCIAL N
The Health Plan (Massillon Ohio and St. Clairsville Ohio only)34150 COMMERCIAL N
Services ordered by outside
provider require referring
provider on a HCFA and
attending physician on a UB.
Pease provide physician
name and UPIN if available.
The Health Plan (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
The Healthcare Group 35206 COMMERCIAL N
The Integrity Benefit Group Inc. 58200 COMMERCIAL N
The Loomis Company - TPA Wyomissing PA (IHS Gateway Payer)23223 COMMERCIAL N
The MEGA Life & Health Insurance Company - Insurance Center59221 COMMERCIAL N
Payer ID valid only if the P.O.
Box on the Health ID card
matches the following P.O.
Box: P.O. Box 982009 North
Richland Hills TX 76182
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 67
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
The MEGA Life & Health Insurance Company - Starbridge StarHRG59225 COMMERCIAL N
Payer ID valid only if the
address on the Health ID Card
matches one of the following
P.O. Boxes: P.O. Box 55270
30870 30888 54150 30069
55400 Phoenix AZ 85270-
5270.
The MEGA Life & Health Insurance Company - Student Insurance74227 COMMERCIAL N
Payer ID only valid if the P.O.
Box on the Health ID Card
matches one of the following
P.O. Boxes: P.O. Box 890025
809067 809079 809066
809036 809081 Dallas Tx
75380-9025.
The MEGA Life & Health Insurance Company-OKC 59227 COMMERCIAL N
If the P.O. Box on the health
ID card matches the following
P.O. Box: P.O. Box 548801
Oklahoma City OK 73154
The National Radiology Network 59087 COMMERCIAL N
Electronic Payer ID for Claims
printed and mailed to payer
The Perfect Health Insurance Co. 13522 COMMERCIAL N
The Physicians Assurance Corp (TPAC) /Employee Benefit Management Corp (EBM31074 COMMERCIAL N
The Preferred Healthcare System (TPHS) - PPO Altoona PA (IHS GatewayPayer)Call COMMERCIAL N
Before submitting contact
Jessica Picarde at (410) 349-
3222
Therapy Review Systems 75305 COMMERCIAL N
This payer id is valid for
contracted Therapy Review
Systems Georgia providers
only.
Thomas H. Cooper SX160 COMMERCIAL N
Three Rivers Health Plans Inc 25175 COMMERCIAL N
Now known as Unison Health
Plan
Time Insurance Company 39065 COMMERCIAL N
Today's Health Wisconsin 20081 COMMERCIAL N
Today's Options (American Progressive and Pyramid Life)48055 COMMERCIAL N
Today's Options powered by CCRX 48055 COMMERCIAL N
Tongass Timber Trust 92620 COMMERCIAL N
Tooling & Manufacturing Association 61425 COMMERCIAL N
Torrance Hospital IPA THIPA COMMERCIAL N
Total Broker Benefits 36342 COMMERCIAL N
f.k.a. Benefit Systems &
Services Inc.
Total Claims Administration 37314 COMMERCIAL N
Total Community Care 31182 COMMERCIAL N
Total Health Management - PBM (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 68
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Total Healthcare Inc. 38201 COMMERCIAL N
Touchpoint Health Plan HMO 97910 COMMERCIAL N
Touchstone Health PSO 23856 COMMERCIAL N
Tower Life Insurance Co. 69493 COMMERCIAL N
Town & Country TKFMC COMMERCIAL N
TransAmerica Assurance Company (TLIN3) TH127 COMMERCIAL N
TransAmerica Assurance Company (TLINS) TH126 COMMERCIAL N
TransAmerica Assurance Company (TSAA2) TH124 COMMERCIAL N
TransAmerica Assurance Company (TSAAC) TH125 COMMERCIAL N
TransAmerica Life Insurance Company 59222 COMMERCIAL N
Payer ID valid only if the
address on the Health ID Card
matches the following: P.O.
Box 982009 North Richland
Hills TX 76182.
TransAmerica Occidental Life Insurance (TOLIC) TH128 COMMERCIAL N
TransChoice-Key Benefit Administrators 37284 COMMERCIAL N
Transchoice or TransSmile - First Service Administrator's Inc20807 COMMERCIAL N
Trellis Health Partners 36397 COMMERCIAL N
TriCities IPA PDT01 COMMERCIAL N
Tribute /SelectCare of Oklahoma 73117 COMMERCIAL N
True Choice USA 54210 COMMERCIAL N
True Choice USA TH083 COMMERCIAL N
Trusteed Plans Service Corporation 91078 COMMERCIAL N
Trustmark Insurance Company 61425 COMMERCIAL N
Tufts Health Plan Call COMMERCIAL P
Please contact the Tufts
Health Plan EDI Operations
Department at 888-880-8699
ext. 4042. for payer id.
UBH - United Behavioral Health (Health Plan - HMO) 87726 COMMERCIAL N
UBH - United Behavioral Health (former MetraHealth - UNET)87726 COMMERCIAL N
UCARE of Minnesota SX178 COMMERCIAL N
UICI - Administrators - State of Nevada 74223 COMMERCIAL N
Accepting claims only for the
State of Nevada.
UMC HEALTH PLAN 75130 COMMERCIAL N
UMR - Cincinnati (formerly known as United Medical Resources)31107 COMMERCIAL N
This Payer ID is valid for all
claims addresses on UMR
Member ID cards with a listed
Payer ID of 31107.
UMR - Harrington (formerly known as Harrington Benefit Services-Columbus)95266 COMMERCIAL N Harrington; RE Harrington
UMR - Lexington (formerly known as CommonWealth Administrative Group)37237 COMMERCIAL N
UMR - Onalaska (formerly known as Midwest Security of WI)79480 COMMERCIAL N
UMR - Wausau/UHIS (formerly Fiserv Health - Wausau Benefits/Benesight)39026 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 69
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March 2012
Payer ID State Model Enroll Additional Information
UMR -Harrington (formerly known as Harrington Benefit Services-Westerville)75196 COMMERCIAL N
Centra; Centra Benefit
Services
UMWA Health & Retirement Funds 52180 COMMERCIAL N
UNICARE 80314 COMMERCIAL N
UNION PACIFIC RAILROAD EMPLOYES Health Systems 87042 COMMERCIAL N
UNITED FOOD & COMM. WORKERS MIDWEST UNIONS 36659 COMMERCIAL N
UNIVERSITY OF MIAMI BEHAVIORAL HEALTH 92579 COMMERCIAL N
UPMC Health Plan 23281 COMMERCIAL N
UPMC Vision Advantage 25184 COMMERCIAL N
US Benefits 93092 COMMERCIAL N
US Family Health Plan (USFHP) TH103 COMMERCIAL N
USAA (United Services Automobile Association) 74095 COMMERCIAL N
Property and Casualty
Division Only
USC Health Services TH021 COMMERCIAL N
USFHP - St. Vincent Catholic Medical Centers of New York13407 COMMERCIAL N
Serving parts of New York
NYC all of New Jersey
Southeastern Pennsylvania
and Western Connecticut.
For member eligibility call 1-
800-241-4848
UT- Altius (UHIN) 25133 COMMERCIAL N
Formerly Payer ID 12X38.
Now part of the Consolidated
payer ID.
UW Graduate Appointee Plan 91136 COMMERCIAL N
Please enter Group Number
(F72) when submitting claims.
Unified Group Services 35198 COMMERCIAL N
Unified Health Services 62170 COMMERCIAL N
Worker's Compensation
Claims Only.
Unified Physicians Network 34638 COMMERCIAL N
For claims rejections please
contact Unified Physicians
Claims Department at 847-
763-1700
Uniform Medical Plan/Harrington Benefit Services 75243 COMMERCIAL N
Harrington; Uniform Medical
Plan; Centra
Union Pacific IPA Call COMMERCIAL N
To obtain Payer ID and enroll
with payer California
providers should contact
Tristin Rausche 858-824-7100
[email protected]
Union Security Insurance Company 70408 COMMERCIAL N
Unison Health Plan/Better Health Plans 62183 COMMERCIAL N
Unison Health Plan/Three Rivers 25175 COMMERCIAL N
United Agriculture Benefit Trust UAGBT COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 70
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March 2012
Payer ID State Model Enroll Additional Information
United Care Medical Network CAPMN COMMERCIAL N
United Healthcare Ovations Insurance Solutions (AARP) 36273 COMMERCIAL N
United Healthcare of River Valley 95378 COMMERCIAL P
Prior to initial submission
provider must first contact
John Deere at (309) 765-1593
- toll free (866) 509-1593 - to
verify NPI registration is
complete
United Medical Alliance 84132 COMMERCIAL N
United Security Life & Health Ins Co 36362 COMMERCIAL N
Please do not submit claims
on or after 1/1/2011 using
payer ID 36362. Claims will
need to be submitted on
paper to United Security Life
and Health PO Box 24655
Seattle WA 98124-0655. For
questions call 1-800-875-
4422.
United of Omaha 71412 COMMERCIAL N
UnitedHealthcare 87726 COMMERCIAL N
UnitedHealthcare 87726 COMMERCIAL N
[former The Travelers
Travelers Health Network
(HMO & Care Option
Travelers/CGT - PPO
MetraHealth - UNET]
UnitedHealthcare 87726 COMMERCIAL N
[former MetraHealth
Healthcare Network PPO
New York State Employees
(Empire) Travelers Ins Co
Travelers Plan
Administrators]
UnitedHealthcare Plans of Puerto Rico 87726 COMMERCIAL N
UnitedHealthcare of Alabama 87726 COMMERCIAL N
UnitedHealthcare of Arizona Inc. 87726 COMMERCIAL N
UnitedHealthcare of Arkansas 87726 COMMERCIAL N
UnitedHealthcare of California - Northern California 87726 COMMERCIAL N
UnitedHealthcare of California - Southern California 87726 COMMERCIAL N
UnitedHealthcare of Colorado Inc. 87726 COMMERCIAL N
UnitedHealthcare of Florida 87726 COMMERCIAL N
UnitedHealthcare of Georgia 87726 COMMERCIAL N
UnitedHealthcare of Illinois 87726 COMMERCIAL N
UnitedHealthcare of Kentucky Ltd. 87726 COMMERCIAL N
UnitedHealthcare of Louisiana 87726 COMMERCIAL N
UnitedHealthcare of Mississippi 87726 COMMERCIAL N
UnitedHealthcare of New England 87726 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 71
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
UnitedHealthcare of New York (includes New York and New Jersey)87726 COMMERCIAL N
UnitedHealthcare of North Carolina Inc. 87726 COMMERCIAL N
UnitedHealthcare of Ohio 87726 COMMERCIAL N
UnitedHealthcare of Tennessee 87726 COMMERCIAL N
UnitedHealthcare of Texas - Dallas 87726 COMMERCIAL N
UnitedHealthcare of Texas - Houston 87726 COMMERCIAL N
UnitedHealthcare of Upstate New York 87726 COMMERCIAL N
UnitedHealthcare of Utah 87726 COMMERCIAL N
UnitedHealthcare of Virginia 87726 COMMERCIAL N
UnitedHealthcare of Wisconsin Inc. 87726 COMMERCIAL N
UnitedHealthcare of the Mid-Atlantic 87726 COMMERCIAL N
UnitedHealthcare of the Midlands - HMO (Choice Select)87726 COMMERCIAL N
UnitedHealthcare of the Midlands - PPO(Choice PlusSelect PlusSelf Funded)87726 COMMERCIAL N
UnitedHealthcare of the Midwest - Choice Choice Plus Select Select Plus87726 COMMERCIAL N
UnitedHealthcare of the Midwest - Medicare Complete 87726 COMMERCIAL N
Unity Health Insurance 66705 COMMERCIAL N
Before submitting claims
please go to
http://www.unityhealth.com
/Providers/AdminResources/
EDI/index.htm and complete
EDI Sign Up Form and NPI
Appendix A documents.
Univera - Health Care Plan/ChoiceCare Buffalo SX087 COMMERCIAL R
Univera - Pre Paid Health Plan of NY SX086 COMMERCIAL R
Univera - Univera Health Southern Tier SX088 COMMERCIAL R
Univera SSA ENY SX090 COMMERCIAL R
Univera SSA WNY SX091 COMMERCIAL R
Universal Care - California 33001 COMMERCIAL N
Universal Health Care Inc 50528 COMMERCIAL N
The payer ID's of the TH057
and 12t36 will no longer be
active please use the new
payer ID of the 50528 for all
EDI submissions to Emdeon.
University Comp Care (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
University Family Care 9830 COMMERCIAL N
University Family Care - Healthcare Group 7503 COMMERCIAL N
University Family Care - Maricopa Health Plan 9908 COMMERCIAL N
University Health Alliance 99026 COMMERCIAL R
Payer Registration is
required. EDI Enrollment
form is available at
www.emdeon.com
University of Illinois at Chicago Div of Specialized Care for Children37601 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 72
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March 2012
Payer ID State Model Enroll Additional Information
University of Missouri 25133 COMMERCIAL N
Formerly payer ID 87043 Now
part of Coventry
Consolidated payer ID.
University of Utah Health Plans SX155 COMMERCIAL N
Upland Medical Group IP056 COMMERCIAL N
Upper Peninsula Health Group (TPA) 37324 COMMERCIAL N
Upper Peninsula Health Plan (Medicaid) 38337 COMMERCIAL N
VA Fee Basis Programs 12115 COMMERCIAL N
VHAMA-WATERSTONE BENEFITS Call COMMERCIAL N
VNS CHOICE Medicare 77073 COMMERCIAL N
Formerly listed as Visiting
Nurses Service
VOLUSIA HEALTH NETWORK 59266 COMMERCIAL N
Valley Baptist Health Plan TH022 COMMERCIAL N
Valley Care IPA VCIPA COMMERCIAL N
Valley Mental Health 94293 COMMERCIAL N
Valley Preferred - PPO Allentown PA (IHS Gateway Payer)23253 COMMERCIAL N
Value Options - Commercial SX173 COMMERCIAL R
Enrollment is required and
forms can be located on
www.emdeon.com/enrollme
nt
Vantage Health Plan Inc. 72128 COMMERCIAL N
Vantage Health Plan Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp
Claims ONLY.
Vantage Medical Group PPM01 COMMERCIAL N
VentureNet Healthcare 86062 COMMERCIAL N
Verdugo Hills Medical Group 66126 COMMERCIAL N
Verity National Group 75256 COMMERCIAL N
Victor Valley IPA VVIPA COMMERCIAL N
Victor Valley IPA VVMG1 COMMERCIAL N
Village Family Practice 73743 COMMERCIAL N
Virginia Medicaid CVAK1 COMMERCIAL N
Virginia Premier Health Plan 54176 COMMERCIAL R
Virginia Premier enrollment
forms located on
www.emdeon.com/enrollme
nt
Vison Care Incorporated 37297 COMMERCIAL N
Vista Health Plan 25133 COMMERCIAL N
Formerly payer ID 55248.
Now part of Coventry
Consolidated payer ID. Plan
name is now Coventry Health
Care of Florida Inc.
Vista Oncology - New Century Infusion Solutions NCH08 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 73
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Viva Health Plan 63114 COMMERCIAL N
VIVA Health requires a
complete member ID number
including suffix on all claim
submissions. Pls use the
following site to verify
member information:
https://estepp.cschcg.com/T
RI_provider/doEntry.jsp
Vytra Healthcare 22264 COMMERCIAL N
WEA Insurance Group 39151 COMMERCIAL N
On 24/7 SR ticket needs to be
opened in order to add
submitter id to approved
table in order to send claims
to this payer
WINhealth Partners/Wyoming Health Solutions 27327 COMMERCIAL N
WPP-ElderCare Wisconsin 77080 COMMERCIAL N
WPS - Tricare for Life SX176 COMMERCIAL N
WPS Commercial SX022 COMMERCIAL R
Subscriber id = 9 digits
Provider id qualifier = G2
WRHN BEECHSTREET COMMERCIAL N
Wabash Memorial Hospital Association 85256 COMMERCIAL N
Washington Teamster Welfare Trust See Comments COMMERCIAL N
Claims are printed and mailed
to the payer.
Waterstone Benefit Administrators 73155 COMMERCIAL N
Weiss Health Providers 36337 COMMERCIAL N
WellMed TH023 COMMERCIAL N
WellNet Health Plans Call COMMERCIAL N
Please call 1-800-442-1101
for approval and the Payer ID
WellPath 25133 COMMERCIAL N
Formerly payer ID 25129.
Now part of Coventry
Consolidated payer ID.
Wellcare Private Fee for Service Plans 77072 COMMERCIAL N
Wells Fargo Third Party Administrators Inc. 87815 COMMERCIAL N
Wells Fargo Third Party Administrators Inc. (Formerly JSL Administrators)37272 COMMERCIAL N Newnan GA & Fayetteville NC
Wenatchee Valley Medical Center 91064 COMMERCIAL N
West Covina Medical Group 66124 COMMERCIAL N
West Covina Medical Group CMSI1 COMMERCIAL N
West Suburban Health Providers 80942 COMMERCIAL N
WestLake Financial Group Inc. 90560 COMMERCIAL N
Western Grower's Assurance Trust 24735 COMMERCIAL N
Western Grower's Insurance Company 24735 COMMERCIAL N
Western Health Advantage 68039 COMMERCIAL N
Western Health Inc 37306 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 74
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Western Mutual Insurance 37247 COMMERCIAL N
Western Southern Financial Group (Cincinnati OH) 31048 COMMERCIAL N
Western Teamster Welfare Trust See Comments COMMERCIAL N
Claims are printed and mailed
to the payer.
Weyco Inc. 38232 COMMERCIAL N
William C. Earhart 93050 COMMERCIAL N
Wilson-McShane 41095 COMMERCIAL N
Windsor Medicare Extra 62153 COMMERCIAL N
Wisconsin Auto and Truck Dealers 39200 COMMERCIAL N
Wisconsin Department of Corrections 74101 COMMERCIAL R
Wisconsin Physicians Service - Third Party Pricing SX162 COMMERCIAL N
Women's Integrated Network Inc. (WIN Fertility) 13413 COMMERCIAL N WIN Healthcare
Workers Comp of West Virginia SX067 COMMERCIAL A
Worksite Benefit Services LLC 20333 COMMERCIAL N
World Insurance Company 75276 COMMERCIAL N
Payer does not accept
Secondary/Tertiary claims
electronically
Writers' Guild - Industry Health Plan 23710 COMMERCIAL N
Yale University Heath Plan 60646 COMMERCIAL N
Yavapai County 9829 COMMERCIAL N
Yorba Park STJOE COMMERCIAL N
Yorba Park (St. Joseph Heritage HealthCare) STJOE COMMERCIAL N
iCare Health Options TPA 26054 COMMERCIAL N
webTPA/Community Health Electronic Claims/CHEC 75261 COMMERCIAL N
AmeriHealth - Delaware (Non-HMO Claims) SX074 DE BLUE CROSS/BLUE SHIELD N
AmeriHealth - New Jersey (Non-HMO Claims) SX075 NJ BLUE CROSS/BLUE SHIELD N
Anthem Blue Cross 47198 CA BLUE CROSS/BLUE SHIELD N
California License number
required.
Anthem Blue Cross Blue Shield of Connecticut SB560 CT BLUE CROSS/BLUE SHIELD N
Anthem Blue Cross and Blue Shield (Virginia) SB923 VA BLUE CROSS/BLUE SHIELD N
Always bill with type 1 npi
however there are some
exceptions. Please refer back
to credentialing with Anthem.
Please call Provider
enrollment for credentialing
@ 800-533-1120.
Anthem Blue Cross and Blue Shield - Indiana SB630 IN BLUE CROSS/BLUE SHIELD N
This is for secondary Claim
volume
Anthem Blue Cross and Blue Shield - Kentucky SB660 KY BLUE CROSS/BLUE SHIELD N
This is for secondary Claim
volume
Anthem Blue Cross and Blue Shield of Ohio SB338 OH BLUE CROSS/BLUE SHIELD N
Arkansas Blue Cross and Blue Shield SB520 AR BLUE CROSS/BLUE SHIELD R
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 75
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
BCBSPA - BlueCard Par Point of Service (POS) SX168 BLUE CROSS/BLUE SHIELD R
No special enrollment
required on Synaptek but
must have the BCBSPA step in
production in provider's
enrollment for claims to go
electronically. This payer id is
to be used for member id
alpha prefixes of:AMS ATS
NJP NRG or YHF.
BLUE CARE NETWORK (BLUE CROSS BLUE SHIELD OF MICHIGAN)SB711 MI BLUE CROSS/BLUE SHIELD N
Blue CHiP of Rhode Island SB871 RI BLUE CROSS/BLUE SHIELD A
Blue Care Family/Anthem Medicaid SB562 CT BLUE CROSS/BLUE SHIELD N
Blue Choice Network SB900 TX BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield - Montana SB751 MT BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield Mississippi State and Teacher EmployeesSB731 MS BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield NC BlueMedicare HMO/PPO Call NC BLUE CROSS/BLUE SHIELD P
This is Blue Cross Blue Shield
NC Medicare Advantage Plan.
Please call BCBSNC
BlueMedicare HMO/PPO
Provider Services Department
at (888)296-9790 option 0 for
electronic claims set up.
Blue Cross Blue Shield Wyoming SB960 WY BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Alabama SB510 AL BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Arizona SB530 AZ BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Colorado SB550 CO BLUE CROSS/BLUE SHIELD N
Secondary claims accepted
electronically only when
Medicare is primary.
Blue Cross Blue Shield of Connecticut SB563 CT BLUE CROSS/BLUE SHIELD N (FEP Product)
Blue Cross Blue Shield of Delaware SB570 DE BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Florida SB590 FL BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Georgia (Atlanta) SB600 GA BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Illinois SB621 IL BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Kansas SB650 KS BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Kansas City SB740 MO BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Kansas HMO FEP SB651 KS BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Kansas HMO Regular SB652 KS BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Kansas HMO Senior Plan SB653 KS BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Louisiana 23738 LA BLUE CROSS/BLUE SHIELD P
For enrollment information
call (225) 295-2427.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 76
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March 2012
Payer ID State Model Enroll Additional Information
Blue Cross Blue Shield of Maine SB680 ME BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Massachusetts SB700 MA BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Michigan SB710 MI BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Minnesota SB720 MN BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Mississippi SB730 MS BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Missouri SB741 MO BLUE CROSS/BLUE SHIELD N
NPI only is required when
submitting claims to
BCBSMO. Emdeon requires a
provider set up form to be
completed before initial
claims submission.
Blue Cross Blue Shield of Missouri (Blue Choice) SB742 MO BLUE CROSS/BLUE SHIELD N
NPI only is required when
submitting claims to
BCBSMO. Emdeon requires a
provider set up form to be
completed before initial
claims submission.
Blue Cross Blue Shield of Nebraska SB760 NE BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Nevada SB765 NV BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of New Hampshire SB770 NH BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of New Mexico SB790 NM BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of North Carolina SB810 NC BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of North Dakota SB820 ND BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Oklahoma SB840 OK BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Rhode Island SB870 RI BLUE CROSS/BLUE SHIELD A
Blue Cross Blue Shield of South Carolina - Companion HealthcareSX085 SC BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of South Carolina - Companion TechnologiesSB880 SC BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of South Carolina - Consolidated Benefits Inc.SX108 SC BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of South Carolina - Federal Employee Program (FEP)SX084 SC BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of South Carolina - Planned Administrators Inc.SX104 SC BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of South Carolina - State Health PlanSX103 SC BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of South Dakota (Sioux Falls) SB889 SD BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Tennessee (Chattanooga HMO Plans)SB891 TN BLUE CROSS/BLUE SHIELD R
Multiple plans. Please call
(423) 755-5717 for plan code
information. Single
Enrollment with BCBSTN
enables electronic claim
submission for all BCBSTN
payer ID's listed (enrollment
is not 'plan specific').
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 77
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Blue Cross Blue Shield of Tennessee (Chattanooga) SB890 TN BLUE CROSS/BLUE SHIELD R
Single Enrollment with
BCBSTN enables electronic
claim submission for all
BCBSTN payer ID's listed
(enrollment is not 'plan
specific').
Blue Cross Blue Shield of Tennessee (Memphis) SB892 TN BLUE CROSS/BLUE SHIELD R
Single Enrollment with
BCBSTN enables electronic
claim submission for all
BCBSTN payer ID's listed
(enrollment is not 'plan
specific').
Blue Cross Blue Shield of Texas SB900 TX BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Vermont SB915 VT BLUE CROSS/BLUE SHIELD N
Blue Cross and Blue Shield United of Wisconsin/Comp CareSB950 WI BLUE CROSS/BLUE SHIELD N
Blue Cross and Blue Shield of Arizona 53589 AZ BLUE CROSS/BLUE SHIELD N
Blue Cross of Idaho Health Services Inc SB612 ID BLUE CROSS/BLUE SHIELD R
Capital Blue Cross - Facility 24705 PA BLUE CROSS/BLUE SHIELD P
Capital Blue Cross/CAIC 23045 PA BLUE CROSS/BLUE SHIELD N
Providers must contact
Capital Blue Cross to enroll at
(800) 874-8433 or by email at
provider.automation@capblu
ecross.com.
CareFirst BlueCross BlueShield MD Region SB690 MD BLUE CROSS/BLUE SHIELD N
CareFirst BlueCross BlueShield NCA Region SB580 DC BLUE CROSS/BLUE SHIELD N
Includes coverage for DC and
Northern Virginia.
Empire Blue Cross and Blue Shield of New York SB803 NY BLUE CROSS/BLUE SHIELD N
Excellus - BCBS Utica Watertown SB806 NY BLUE CROSS/BLUE SHIELD R
Excellus - Blue Cross Blue Shield of Central New YorkSB805 NY BLUE CROSS/BLUE SHIELD R
Excellus - Blue Cross/Blue Shield Rochester Area SB804 NY BLUE CROSS/BLUE SHIELD R
Freedom Blue Medicare Advantage Claims SB942 BLUE CROSS/BLUE SHIELD N
Gateway SX078 PA BLUE CROSS/BLUE SHIELD R
Hawaii Medical Service Association (HMSA) SB971 HI BLUE CROSS/BLUE SHIELD R
Payer requires provider level
testing.
HealthNow - BCBS Northeastern NY SB800 NY BLUE CROSS/BLUE SHIELD R
HealthNow - Blue Cross Blue Shield of Western NY SB801 NY BLUE CROSS/BLUE SHIELD R
Highmark Blue Cross & Blue Shield of Pennsylvania SB865 PA BLUE CROSS/BLUE SHIELD R
Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ)22099 NY BLUE CROSS/BLUE SHIELD P
Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ)22099 NJ BLUE CROSS/BLUE SHIELD P
Horizon Healthcare of NY 22099 NJ BLUE CROSS/BLUE SHIELD P
Participating Payer - see last
page for definition.
Horizon Healthcare of NY 22099 NY BLUE CROSS/BLUE SHIELD P
Participating Payer - see last
page for definition.
IBC Personal Choice SX083 PA BLUE CROSS/BLUE SHIELD N
Independence Administrators TA720 BLUE CROSS/BLUE SHIELD N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 78
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Inter-County Health Plan SX079 PA BLUE CROSS/BLUE SHIELD R
Keystone Health Plan East SX055 PA BLUE CROSS/BLUE SHIELD N
Keystone Health Plan West SX056 PA BLUE CROSS/BLUE SHIELD R
Medicare Blue SX263 BLUE CROSS/BLUE SHIELD N
Medicare Blue Private SX262 BLUE CROSS/BLUE SHIELD N
Mountain State Blue Cross and Blue Shield SB941 WV BLUE CROSS/BLUE SHIELD P
Testing Required: 25 Claims.
Test claims should be
representative of production
claims.
Regence Blue Cross Blue Shield of Oregon SB850 OR BLUE CROSS/BLUE SHIELD N
Regence Blue Cross Blue Shield of Utah SB910 UT BLUE CROSS/BLUE SHIELD P
Regence Blue Shield of Idaho SB611 ID BLUE CROSS/BLUE SHIELD N
Regence Blue Shield of Washington SB931 WA BLUE CROSS/BLUE SHIELD N
Select Advantage SA704 BLUE CROSS/BLUE SHIELD N
Texas Health Insurance Risk Pool SB900 TX BLUE CROSS/BLUE SHIELD N
Trigon Blue Cross and Blue Shield (Virginia) SB924 VA BLUE CROSS/BLUE SHIELD N
Triple-S Inc. SB980 BLUE CROSS/BLUE SHIELD P
Payer requires enrollment via
forms or by calling 1-787-479-
4067.
WA - Premera Blue Cross SB930 AK BLUE CROSS/BLUE SHIELD R
Payer Enrollment form is
listed under the Alaska BCBS
http://www.emdeon.com/en
rollment/MED/SB930CLMP_2
.pdf
WA - Premera Blue Cross SB930 WA BLUE CROSS/BLUE SHIELD R
Payer Enrollment form is
listed under the Alaska BCBS
http://www.emdeon.com/en
rollment/MED/SB930CLMP_2
.pdf
WellChoice of NJ SB803 NY BLUE CROSS/BLUE SHIELD N
Wellmark BCBS - Medicare COB SB645 BLUE CROSS/BLUE SHIELD N
Use payer id when Medicare
has processed as Primary
Wellmark Blue Cross and Blue Shield of Iowa (IASD) SB640 IA BLUE CROSS/BLUE SHIELD R
Aetna - IL Medicaid 26337 MEDICAID N
Aetna Better Health - PA Medicaid 23228 MEDICAID N
Aetna Better Health Connecticut Medicaid 23225 MEDICAID N
Aetna TX Medicaid & CHIP 38692 MEDICAID N
Alabama Medicaid SKAL0 AL MEDICAID N
Alaska Medicaid SKAK0 AK MEDICAID R
Arizona Medicaid SKAZ0 AZ MEDICAID N
Arkansas Medicaid SKAR0 AR MEDICAID N
Azeros Health Plans Inc. 16644 NY MEDICAID N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 79
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Better Health Plan of Florida 20488 MEDICAID N
Please note for claims
rejections please contact
Better Health of Florida at 1-
800-514-4561 and select the
provider services option.
Blue Choice Medicaid Managed Care 403 MEDICAID N
CBHNP - HealthChoices 65391 MEDICAID N
CHS of America - LA Medicaid plan 61733 MEDICAID N
California Medicaid (Medi-Cal) SKCA0 CA MEDICAID R
Additional Enrollment
Requirement for Providers in
LA County. Please call (916)
636-1000 and ask for LA
County Unit.
Central California Alliance for Health SX169 CA MEDICAID N
Alliance EDI Support Unit -
831-430-5510
Colorado Medicaid SKCO0 CO MEDICAID R
Connecticut Medicaid SKCT0 CT MEDICAID P
DC Medicaid SKDC0 DC MEDICAID N
DC Medicaid SKDC0 MD MEDICAID N
Delaware Medicaid SKDE0 DE MEDICAID R
Florida Medicaid SKFL0 FL MEDICAID R
Georgia Medicaid SKGA0 GA MEDICAID R
Providers must delegate
Emdeon to receive payer
reports by selecting the Trade
Files Download option on the
payer's web portal.
Hawaii Medicaid SKHI0 HI MEDICAID R
Health Network One 65063 MEDICAID N
Idaho Medicaid SKID0 ID MEDICAID P
Illinois Medicaid SKIL0 IL MEDICAID N
Indiana Medicaid SKIN0 IN MEDICAID N
Integral Quality Care 23229 MEDICAID N
Iowa Medicaid SKIA0 IA MEDICAID R
JMH Health Plan Medicaid HMO 16001 MEDICAID N
Kansas Medicaid SKKS0 KS MEDICAID N
Kentucky Medicaid SKKY0 KY MEDICAID P
Unysis is fiscal agent until
11/30/05. After 12/1/05 fiscl
agent will be EDS.
Louisiana Medicaid SKLA0 LA MEDICAID P
Louisiana Medicaid - Ambulance claims SKLA2 LA MEDICAID R
Payer Enrollment required
utilize form for SKLA0 to
complete enrollment for
SKLA2 and SKLA3
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 80
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Louisiana Medicaid - DME Claims SKLA1 MEDICAID R
Payer Enrollment required
utilize form for SKLA0 to
complete enrollment for
SKLA1
Louisiana Medicaid - KidMed Claims SKLA3 LA MEDICAID R
Payer Enrollment required
utilize form for SKLA0 to
complete enrollment for
SKLA2 and SKLA3
MEDICAID ILLINOIS IDPA 621 MEDICAID N
MPlan (Medicaid) 35177 IN MEDICAID N
Edits to mirror current edits
submitted for 1st payer id
95444.
Maine Medicaid SKME0 ME MEDICAID N
MaineCare asks all providers
to re-enroll in MIHMS.
Enrollment forms can be
found
at:https://mainecare.maine.g
ov/Default.aspx
MajestaCare Virginia 26372 MEDICAID N
Maryland Medicaid SKMD0 MD MEDICAID A
Maryland Public Mental Health SX069 MD MEDICAID A
Massachusetts Medicaid SKMA0 MA MEDICAID P
Providers must email
([email protected]
) or fax (617-988-8971) a
letter stating they would like
to submit claims to payer via
Emdeon/WebMD. They must
include their provider ID and
Emdeon's Trading Partner #
of 9900756
MedStar Family Choice 39190 MEDICAID R
Medi-Cal (Vision) SKCA1 CA MEDICAID R
Medicaid New York (eMedNY Test System) SKNYT MEDICAID N
NY Medicaid offers a provider
test enviroment as a platform
to enable providers to test
claims using the same
validation and adjudication
methods as the NY Medicaid
production enviroment.
Michigan Medicaid SKMI0 MI MEDICAID P
Minnesota Medicaid SKMN0 MN MEDICAID P
Mississippi Medicaid SKMS0 MS MEDICAID A
Missouri Medicaid SKMO0 MO MEDICAID N
Montana Medicaid SKMT0 MT MEDICAID N
NYS DOH UCP 14142 MEDICAID N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 81
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Nebraska Medicaid SKNE0 NE MEDICAID R
Nevada Medicaid: First Health Services SKNV0 NV MEDICAID A
New Hampshire Medicaid SKNH0 NH MEDICAID R
New Jersey Medicaid SKNJ0 NJ MEDICAID R
New Mexico Medicaid SKNM0 NM MEDICAID N
New York Medicaid SKNY0 NY MEDICAID R
North Carolina Medicaid SKNC0 NC MEDICAID P
North Dakota Medicaid (Medical) SKND0 ND MEDICAID N
Ohio Medicaid SKOH0 OH MEDICAID N
Oklahoma Medicaid SKOK0 OK MEDICAID N
Oregon Medicaid SKOR0 OR MEDICAID R
Partnership Health of California-CAPHP SX140 CA MEDICAID R
NEW PROVIDERS ONLY: Payer
requires EDI enrollment and
testing. Please see the
following link for more
information:
www.emdeon.com/enrollme
nt/MED/SX140CLMP.pdf
Pennsylvania Medicaid SKPA0 PA MEDICAID N
Rhode Island Medicaid SKRI0 RI MEDICAID R
Simply Healthcare 27094 MEDICAID N
South Carolina Medicaid SKSC0 SC MEDICAID N
South Dakota Medicaid SKSD0 SD MEDICAID R
Secondary claims note: Only
accepts Medicare Crossover
claims
Tennessee Medicaid SKTN2 TN MEDICAID N
Texas Medicaid SKTX0 TX MEDICAID N
Utah Medicaid SKUT0 UT MEDICAID P
ValueOptions/MBHP (MA Behavioral Health Partnership)43307 MEDICAID R
For claims rejections please
contact e-
support.Services@valueoptio
ns.com or 888-247-9311
(8am-6pm M-F)
Vermont Medicaid SKVT0 VT MEDICAID P
Virginia Medicaid SKVA0 VA MEDICAID N
WASHINGTON State Dept of LABOR & INDUSTRY SX063 WA MEDICAID R
Provider must reside in the
state of WA
Washington Medicaid (Provider One) SKWA0 WA MEDICAID R
West Virginia Medicaid SKWV0 WV MEDICAID N
Wisconsin Medicaid SKWI0 WI MEDICAID N
Any questions about provider
enrollment should be
directed to the Medicaid WI's
provider helpdesk: 800-947-
9627
Wyoming Medicaid SKWY0 WY MEDICAID R
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 82
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
ZEPHERELLA 26335 MEDICAID N
AK Medicare Part B (J2) SMAK0 AK MEDICARE R
AL Medicare Part B (J10 - Cahaba) SMAL0 AL MEDICARE R
AR Medicare Part B (J7) SMAR0 AR MEDICARE R
AZ Medicare Part B (J3 - Noridian) SMAZ0 AZ MEDICARE R
CA Medicare Part B North (J1 - PGBA) SMCA1 CA MEDICARE R
CA Medicare Part B South (J1 - PGBA) SMCA2 CA MEDICARE R
Includes coverage for
Southern CA. Please indicate
Southern CA on the WebMD
Envoy Set Up Form.
CO Medicare Part B (J4 - Trailblazer) SMCO0 CO MEDICARE R
CT Medicare Part B (J13 - NGS) SMCT0 CT MEDICARE R
DC Medicare Part B (J12 - Highmark) SMDC0 DC MEDICARE P
Includes coverage for DC and
Northern Virginia.
DE Medicare Part B (J12 - Highmark) SMDE0 DE MEDICARE P
DME Region D (DMERC D) SDMED US MEDICARE P
Educators Mututal Medicare Advantage SX111 MEDICARE N
FL Medicare Part B (J9 First Coast) SMFL0 FL MEDICARE R
FamilyCare Inc 93087 MEDICARE N
GA Medicare Part B (J10 - Cahaba) SMGA0 GA MEDICARE R
HI Medicare Part B (J1 - PGBA) SMHI0 HI MEDICARE R
HMSO-Highline Medical Service Organization 91164 MEDICARE N
Highline Medical Service Organization - PSHP 91161 MEDICARE N
IA Medicare Part B (J5 - WPS) SMIA0 IA MEDICARE R
ID Medicare Part B (J2) SMID0 ID MEDICARE R
IL Medicare Part B (J6) SMIL0 IL MEDICARE P
IN Medicare Part B (J8) SMIN0 IN MEDICARE P
JMH Medicare Advantage 59171 MEDICARE N
KS Medicare Part B (J5 - WPS) SMKS0 KS MEDICARE R
KY Medicare Part B (J15) SMKY0 KY MEDICARE R
LA Medicare Part B (J7) SMLA0 LA MEDICARE R
MA Medicare Part B (J14 - NHIC) SMMA0 MA MEDICARE R
MD Medicare Part B (J12 - Highmark) SMMD0 MD MEDICARE P
ME Medicare Part B (J14 - NHIC) SMME0 ME MEDICARE R
MI Medicare Part B (J8) SMMI0 MI MEDICARE R
MN Medicare Part B (J6) SMMN0 MN MEDICARE R
MO Medicare Part B East (J5 - WPS) SMMO0 MO MEDICARE R
MO Medicare Part B West (J5 - WPS) SMKC0 MO MEDICARE R
New Provider Enrollments
please complete payer
enrollment forms for
SMMO0.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 83
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
MO Medicare Part B West (J5 - WPS) SMKC0 KS MEDICARE R
New Provider Enrollments
please complete payer
enrollment forms for
SMMO0.
MS Medicare Part B (J7) SMMS0 MS MEDICARE R
MT Medicare Part B (J3 - Noridian) SMMT0 MT MEDICARE R
Medicare DME (JA - CEDI/NHIC) SDMEA US MEDICARE P
Medicare DME (JB - CEDI/NGS) SDMEB US MEDICARE P
Medicare DME (JC - CEDI/CGS) SDMEC US MEDICARE P
Medicare Plus Blue SX170 MI MEDICARE R
Provider enrolls at
https://editest.bcbsm.com/tp
aLogon.html OR by calling
248-486-2292 opt 1. Emdeon
PSF required.
NC Medicare Part B (J11) SMNC0 NC MEDICARE R
ND Medicare Part B (J3 - Noridian) SMND0 ND MEDICARE R
NE Medicare Part B (J5 - WPS) SMNE0 NE MEDICARE R
NH Medicare Part B (J14 - NHIC) SMNH0 NH MEDICARE R
NJ Medicare Part B (J12 - Highmark) SMNJ0 NJ MEDICARE R
NM Medicare Part B (J4 - Trailblazer) SMNM0 NM MEDICARE R
NV Medicare Part B (J1 - PGBA) SMNV0 NV MEDICARE R
NY Medicare Part B Downstate (J13 - NGS) SMNY0 NY MEDICARE P
NY Medicare Part B Queens (J13 - NGS) SMNY2 NY MEDICARE P
NY Medicare Part B Upstate (J13 - NGS) SMNY1 NY MEDICARE P
OH Medicare Part B (J15) SMOH0 OH MEDICARE R
OK Medicare Part B (J4 - Trailblazer) SMOK0 OK MEDICARE R
OR Medicare Part B (J2 - Noridian) SMOR0 OR MEDICARE R
PA Medicare Part B (J12 - Highmark) SMPA0 PA MEDICARE R
PR Medicare Part B (J9 - First Coast) SMPR0 MEDICARE R
Payer approval required prior
to submitting claims.
PacificSource Medicare 20377 MEDICARE N
RI Medicare Part B (J14 - NHIC) SMRI0 RI MEDICARE R
Railroad Medicare (PGBA) SRRGA US MEDICARE P
RailRoad Medicare requires
EDI registration available
online.
SC Medicare Part B (J11) SMSC0 SC MEDICARE R
SD Medicare Part B (J3 - Noridian) SMSD0 SD MEDICARE R
TN Medicare Part B (J10 - Cahaba) SMTN0 TN MEDICARE R
TX Medicare Part B and Indian Health Services (J4 - Trailblazer)SMTX0 TX MEDICARE A
UT Medicare Part B (J3 - Noridian) SMUT0 UT MEDICARE R
VA Medicare Part B (J11) SMVA0 VA MEDICARE R
Includes coverage for All
Regions (except Northern
Virginia).
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 84
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
VI Medicare Part B (J9 - First Coast) SMVI0 MEDICARE R
Payer approval required prior
to submitting claims.
VT Medicare Part B (J14 - NHIC) SMVT0 VT MEDICARE R
Virginia Premier Gold SX198 MEDICARE N
WA Medicare Part B (J2 - Noridian) SMWA0 WA MEDICARE R
WI Medicare Part B (J6) SMWI0 WI MEDICARE R
WV Medicare Part B (J11) SMWV0 MEDICARE R
Enrollment is required and
forms and can be located at
www.emdeon.com
WY Medicare Part B (J3 - Noridian) SMWY0 WY MEDICARE R
Humana Military - Tricare South 61125 US CHAMPUS N
Participating Payer for Tricare
South including AL AR FL GA
LA MS OK SC TN and East TX.
Tricare North Region 57106 US CHAMPUS N
TRICARE North Region
includes - CT DE IL IN KY MA
MD ME MI NC NH NJ NY OH
PA RI VA VT WI WV and some
zip codes in IA/MO/TN -
contact Tricare North at (877)
874-2273 for details.
WPS Tricare TriWest SCWI0 US CHAMPUS N West Region
Auto Club Association (ACG) 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Uvalde CISD J1204 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 85
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
''Nova Pro Risk Solutions (San Diego) J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
'Hortica Florist Mutual Insurance 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
AAA Chicago 11983 AUTOMOBILE MEDICAL N
This payer id is for
Automobile Medical claims
Only. You and/or your
vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's
transact Website for contacts
and additional informati
AAA Chicago Motor Club 11983 AUTOMOBILE MEDICAL N
This payer id is for
Automobile Medical claims
Only. You and/or your
vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's
transact Website for contacts
and additional informati
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 86
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
AAA Michigan 11983 AUTOMOBILE MEDICAL N
This payer id is for
Automobile Medical claims
Only. You and/or your
vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's
transact Website for contacts
and additional informati
AAA Minnesota/Iowa 11983 AUTOMOBILE MEDICAL N
This payer id is for
Automobile Medical claims
Only. You and/or your
vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's
transact Website for contacts
and additional informati
AAA Nebraska 11983 AUTOMOBILE MEDICAL N
This payer id is for
Automobile Medical claims
Only. You and/or your
vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's
transact Website for contacts
and additional informati
AAA North Dakota 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 87
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
AAA Wisconsin 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
ACIA 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
AIG 19402 WORKERS COMPENSATION N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List
at:www.emdeon.com/PayerLi
sts/payerlists.phpSearch the
Payer List using the above
Payer ID(s) to identify them
Abilene ISD Run-Off J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Abilene ISD Self-Insured J1121 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 88
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Abilene Independent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Accuride Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Alamo Heights I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Aledo I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 89
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Allianz Global Risk US Insurance Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Alvey Systems (AON Risk) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
America First J1427 WORKERS COMPENSATION N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List
at:www.emdeon.com/PayerLi
sts/payerlists.phpSearch the
Payer List using the above
Payer ID(s) to identify them
American Coin Merchandising Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
American Cyanamid TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 90
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
American Hardware Mutual Insurance J1203 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
American National Property and Casualty Company (ANPAC)See Comments AUTOMOBILE MEDICAL N
Please call 1-800-333-2860 if
you would like to submit
claims to ANPAC.
American Specialty Companies TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
American Specialty Ins. / MIB TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Ameriprise Auto & Home Ins. C1004 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Amica 12287 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 91
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Atlantic Mutual Insurance 19895 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Auto Club Group 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Auto Club Group Insurance Company 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Auto Club Property-Casualty Insurance Company 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Ayers Trucking J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 92
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Beall's Inc / Midwest Employers TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Bellville I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Benavides I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Berkley Specialty Underwriters 25224 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 93
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Berwind Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Big Spring I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Birdville Independendent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Brackett I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 94
Page 96
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Brady I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Breckenridge ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Brooks County I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Brownfield I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 95
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Brownfield ISD J1123 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Brownyard Group Inc. (Arch Insurance) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Brunswick Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Burleson County Alternative School J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 96
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Burleson-Milam Special Svcs Co-Op J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Burlington Coat Factory Wareho TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
CAREWORKS ODRC ONLY J1410 WORKERS COMPENSATION N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists
/payerlists.php Search the
Payer List using the above
Payer ID(s) to identify the
CCMSI J1010 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
CNA Insurance 20443 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 97
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
CVS Pharmacy TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Caldwell I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Canyon I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Carrizo Springs CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 98
Page 100
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Cendant Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Centennial Insurance Company 19895 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Center Point ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Central Hockey League TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Charming Shoppes Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 99
Page 101
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
City Of Arlington J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
City Of El Paso J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
City of Plano 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Clarksville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Classic Residence By Hyatt TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 100
Page 102
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Coca-Cola Enterprises Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Columbia Sussex Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
CompTech 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Compass Group Usa Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Contech Construction Products TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 101
Page 103
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Continental Airlines TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Convergys Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Correctional Management Service TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Corrections Corp of America TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Cotulla ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 102
Page 104
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Coworx Staffing LLC TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Crum & Forster Indemnity Company 31348 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Crystal City ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Dalhart ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 103
Page 105
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Danaher Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
De Bartolos Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
De Soto ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Del Valle ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 104
Page 106
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Denver City I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Denver City ISD J1124 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Dilley ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Directory Distributing Assoc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 105
Page 107
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Discover Re (Burger King) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Dumas I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Dunn-Edwards Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Dustrol 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Dynamex Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 106
Page 108
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
EMC Insurance Companies 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
ERMC J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
ESIS TP043 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
ESIS (First American Insurance Co) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Eagle Mt-Saginaw ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 107
Page 109
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Edinburg CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Edwards Claim Administration J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
El Paso Community College (Tx Jur) J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
El Paso Water Util Tx Jur J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 108
Page 110
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Electric Insurance (EIC) 21261 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Employers Insurance Group J1232 WORKERS COMPENSATION N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists
/payerlists.php Search the
Payer List using the above
Payer ID(s) to identify the
Employers Mutual Casualty 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Envirosource TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Esurance Inc. 30210 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 109
Page 111
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Evolution Insurance Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
F.A. Richard & Associates (FARA) TP044 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
FARMERS INSURANCE C1025 WORKERS COMPENSATION N
Payer id is for Workers Comp
MN claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
FKI Industries Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Factory 2 U J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 110
Page 112
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Federated J1297 WORKERS COMPENSATION N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List
at:www.emdeon.com/PayerLi
sts/payerlists.phpSearch the
Payer List using the above
Payer ID(s) to identify them
Federated Rural Electric (TX) 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Federated Services Insurance Company 13935 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Fireman's Fund Insurance Company 21873 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Fireman's Fund Insurance Company C1019 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 111
Page 113
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Firstcomp J1011 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Floresville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Forney ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Frank Gates Service Company TP056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 112
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Frenship I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Frenship ISD J1125 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Frio County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Ft Sam Houston ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 113
Page 115
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
GAB Robbins Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Gainesville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Gallagher Bassett TP057 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Garner I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 114
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Gates Corp Dba Gates Rubber Co TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Georgetown ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Godley ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Golden Corral Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 115
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Graford ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Grange 10322 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Graphic Arts Mutual 25984 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Great American Alliance Ins Co. 26832 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Great American Assurance Company 26344 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 116
Page 118
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Great American Ins. Co. of N.Y. 22136 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Great American Ins. Company 16691 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Great Divide Insurance 25224 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Gruver I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Gse Lining Technology Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 117
Page 119
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Health Partners Managed Care 44547 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Heritage Group TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Hidalgo ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Holly Farms Corp. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Household Merch Nni TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 118
Page 120
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Housing Authority El Paso (TX) J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Houston Hunters Patrol Inc J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Howard County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Hudspeth County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 119
Page 121
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Huffman ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Hughes Tool Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
IDS PROPERTY CASUALTY INSURANCE COMPANY 12504 WORKERS COMPENSATION N
Payer id is for Workers Comp
MN claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Insilco Corp TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Integrity Mutual Insurance Company 10322 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 120
Page 122
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Irex Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Ironworking Contract I.P. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
J B Hunt Transport Inc. J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
JI Specialty Services J1006 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Jones Truck LinesInc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 121
Page 123
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Junction ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Juvenile Jail Facility Managem TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
KCI Holdings USA TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Karnes City ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 122
Page 124
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Ken Davis Industries Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Kennedale ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
La Vernia ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
La Villa ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 123
Page 125
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Lackland ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Lago Vista I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Landstar Bco Wc Program TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Levelland I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 124
Page 126
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Levelland ISD J1126 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Lewisville ISD Self-Insured J1122 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Lewisville Independent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Liberty Mutual 33600 WORKERS COMPENSATION N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List
at:www.emdeon.com/PayerLi
sts/payerlists.phpSearch the
Payer List using the above
Payer ID(s) to identify them
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 125
Page 127
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Liberty-Eylau ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Lsg Sky Chefs International TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
MCMC LLC J1007 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Major League Baseball 8 TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 126
Page 128
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Marble Falls I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Marlin ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Matrix Absence Management TP075 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Maxim Crane Works TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 127
Page 129
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Mc Donald'S-Mcopco TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Member Select Insurance Company 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Mendota Insurance Company 33650 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Mercedes ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Metropolitan Property and Casualty Insurance CompanyC1011 AUTOMOBILE MEDICAL N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 128
Page 130
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Metropolitan Transit Athority J1238 WORKERS COMPENSATION N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists
/payerlists.php Search the
Payer List using the above
Payer ID(s) to identify the
Mexia I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Midland County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Midwest Drywall 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 129
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Midwest Insurance 10895 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Millsap I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Mission CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Mission Consolidated Independent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 130
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Mitchell Energy & Devel TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Montgomery County Texas J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Moody ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Morris Material Handling TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Morrison Health Care Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 131
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Morton ISD J1127 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Motorist Mutual Insurance J1203 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Muleshoe I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Muleshoe ISD J1128 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Munford Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 132
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Nacogdoches ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Nap Tools 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Natalia ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
National Interstate (TX) 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 133
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
National Loss Prevention Inc J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
New Caney ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
New Caney ISD Self-Insured J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
New York State Insurance Fund (NYSIF) 45052 WORKERS COMPENSATION N
Payer id is for Workers Comp
NY claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 134
Page 136
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Norwood TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Nova Pro Risk Solutions J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Old Republic Insurance Co TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
One Beacon Insurance 20621 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
One Call Medical 22321 WORKERS COMPENSATION N
Orica Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 135
Page 137
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Papa John's International Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Paradigm J1001 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Pearsall ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Peg Discover Re TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Peg Discover Re( Food Merchant) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 136
Page 138
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Pegi-Family Dining TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Perryton I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Phh Fleetamerica TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Plains I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 137
Page 139
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Plemons-Stinnett-Phillips CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Poolville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Poth ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Potter County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 138
Page 140
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Preferred Employers TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Preferred Employers Group TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
RIver Road ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
RSC Insurance Services Ltd. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
RTW (Return to Work) J1202 WORKERS COMPENSATION N
Payer id is for Workers Comp
MN claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 139
Page 141
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Rampart Insurance Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Randall County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Recovery & Claim Services AKA Mayo Clinic 41193 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Red Oak Independent School District J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Republic Franklin Insurance 12475 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 140
Page 142
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Republic Indemnity J1008 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Residential Services Group TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Restaurant Reinsurance Limited TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Rhone-PoulencInc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Rieth-Riley Construction Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 141
Page 143
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Risk Transfer Technologies Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Roth Staffing Companies J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Ryder Services Inc. J1009 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
SRS Hilton Worldwide Inc J1237 WORKERS COMPENSATION N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists
/payerlists.php Search the
Payer List using the above
Payer ID(s) to identify the
SUA Insurance Company 40134 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 142
Page 144
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
SafeCo Insurance 24740 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Safety-Kleen Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
San Angelo ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Schlumberger Technology TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Scotts Miracle-Gro Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 143
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Secura J1379 WORKERS COMPENSATION N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List
at:www.emdeon.com/PayerLi
sts/payerlists.phpSearch the
Payer List using the above
Payer ID(s) to identify them
Selective 39926 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Seminole I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Silsbee ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 144
Page 146
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Slaton I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Snap-On Incorporated TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Solvay America Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Somerset ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 145
Page 147
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
South Plains School WC Program J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Southland ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Southside ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Southwest Airlines J1233 WORKERS COMPENSATION N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists
/payerlists.php Search the
Payer List using the above
Payer ID(s) to identify the
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 146
Page 148
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Spearman I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Springtown I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Stant Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Stockdale ISD J1204 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 147
Page 149
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Stratford I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Summit Health Ltd TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Sunray I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Swift Transportation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 148
Page 150
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Synder ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Tarrant Appraisal District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Texas A&M TAMU A0235 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Texas Association of School Boards A0234 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 149
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Texas Municipal League IRP A0245 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Texas Mutual Insurance Company 22945 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Texas Small Business Pool TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
The Auto Club Group 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
The Beacon Mutual Ins Co J1234 WORKERS COMPENSATION N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists
/payerlists.php Search the
Payer List using the above
Payer ID(s) to identify the
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 150
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
The Hartford J1422 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
The Scotts Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
The Zenith 13269 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Total Petroleum Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Travelers 19046 WORKERS COMPENSATION N
Triple A 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 151
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
US Foodservice Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
US National Resources (Aigrm) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
UTICA (C1027) C1027 AUTOMOBILE MEDICAL N
The above Payer Name(s)
may represent multiple
Accounts (employers). For a
complete list please refer
directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists
/payerlists.php Search the
Payer List using the above
Payer ID(s) to identify the
Underwriters Safety and Claims TP108 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Union Insurance Company of Providence 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 152
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
United Dominion Realty Trust TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
United States Cold Storage TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Unitrin Direct Property & Casualty Company 16063 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Utica Mutual Insurance Company 25976 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Utica National Insurance Co of Texas 43478 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 153
Page 155
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Vanliners Insurance Company 21172 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Vicorp Restaurants Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
WC Solutions J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
Wal-Mart J1004 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX claims Only. You and/or
your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 154
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Weatherford I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Weimer ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
White Deer I.S.D J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Whiteface C.I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 155
Page 157
eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Wyman-Gordon Companies TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Xl Environmental Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
Yorkstown ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the
State of Texas Only. You
and/or your vendor must be
contracted for the Workers
Compensation transaction
service (Emdeon Office
customers excluded). Please
visit
http://transact.emdeon.com/
for contac
Znat Insurance (Zenith National Insurance) 30120 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com
for info.
Zurich Farmers J1015 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 156
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eClaims Medical Payer List
March 2012
Payer ID State Model Enroll Additional Information
Zurich Insurance NA 16535 WORKERS COMPENSATION N
Payer id is for Workers Comp
TX MN claims Only. You
and/or your vendor must be
contracted for this
transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com
for info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 157