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Payer Name Payer ID 1199 National Benefit Fund 13162 A & I Benefit Plan Administrators 93044 AAG Benefit Plan Administrators 75240 AARP United Healthcare Insurance 36273 ABC Health Plan of New York 48185 ABMA Medical Corp. (Hnet Sr. & Secure Horizons ONLY) IP079 Abrazo Advantage Health Plan 03443 Abri Health Plan ABRI1 Access Administrators (Texas) AHS01 Acclaim 64071 Acclaim IPA MHIPA Acclaim IPA (MHCAC) MHIPA Acclaim Repricing 21356 Accountable IPA AHIPA ACS Benefit & Consulting Services, Inc. 72467 Adaptis Healthplan 91173 Administration Systems Research Corporation (ASR) 38265 Administrative Concepts, Inc. 22384 Advanced Benefit Solutions/Tribal Health Partners ADVTH Advanced Data Solutions, Inc. 58202 Advanced Medical Management AMM01 Advantage by Bridgeway Health Solutions 68056 Advantage by Buckeye Community Health Plan 68056 Advantage by Managed Health Services 68056 Advantage by Superior HealthPlan 68056 Advantage Health Solutions 35209 Advantage Medical Group (CA) NMM01 Advantage Preferred Plus 77070 Advantica Benefits 59374 Advica - Northeast Georgia Health System 13376 AdvoCare Incorporated (Ohio BWC) 31147 Advocate Health Centers 36320 Advocate Health Partners (PHO's) 65093 Aetna / US Healthcare (All Plans) 60054 Aetna Affordable Health Choices 57604 Aetna Better Health Connecticut Medicaid 23225 Aetna Better Health Illinois Medicaid 26337 Aetna Better Health Pennsylvania Medicaid 23228 Aetna Texas Medicaid and CHIP 38692 Affiliated Doctors of Orange County ADOCS Exchange EDI Claims Payer List
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Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

May 07, 2020

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Page 1: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Payer Name Payer ID

1199 National Benefit Fund 13162

A & I Benefit Plan Administrators 93044

AAG Benefit Plan Administrators 75240

AARP United Healthcare Insurance 36273

ABC Health Plan of New York 48185

ABMA Medical Corp. (Hnet Sr. & Secure Horizons ONLY) IP079

Abrazo Advantage Health Plan 03443

Abri Health Plan ABRI1

Access Administrators (Texas) AHS01

Acclaim 64071

Acclaim IPA MHIPA

Acclaim IPA (MHCAC) MHIPA

Acclaim Repricing 21356

Accountable IPA AHIPA

ACS Benefit & Consulting Services, Inc. 72467

Adaptis Healthplan 91173

Administration Systems Research Corporation (ASR) 38265

Administrative Concepts, Inc. 22384

Advanced Benefit Solutions/Tribal Health Partners ADVTH

Advanced Data Solutions, Inc. 58202

Advanced Medical Management AMM01

Advantage by Bridgeway Health Solutions 68056

Advantage by Buckeye Community Health Plan 68056

Advantage by Managed Health Services 68056

Advantage by Superior HealthPlan 68056

Advantage Health Solutions 35209

Advantage Medical Group (CA) NMM01

Advantage Preferred Plus 77070

Advantica Benefits 59374

Advica - Northeast Georgia Health System 13376

AdvoCare Incorporated (Ohio BWC) 31147

Advocate Health Centers 36320

Advocate Health Partners (PHO's) 65093

Aetna / US Healthcare (All Plans) 60054

Aetna Affordable Health Choices 57604

Aetna Better Health Connecticut Medicaid 23225

Aetna Better Health Illinois Medicaid 26337

Aetna Better Health Pennsylvania Medicaid 23228

Aetna Texas Medicaid and CHIP 38692

Affiliated Doctors of Orange County ADOCS

Exchange EDI Claims Payer List

Page 2: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Affinity Health Plan 13334

Affinity Medical Group 46594

Affinity Medicare Advantage 13333

Affordable Benefit Administrators 95426

AFL- CIO Food & Beverage Dealer's Trust Fund - Toledo, Ohio 34444

AFTRA Health Fund 13346

Agate Resources/LIPA/Trillium 20048

AGIA, Inc. 95241

AKM Medical Group (Cap Management Systems) CAPMN

Alabama Medical Surgical, LLC 06311

Alameda Alliance for Health 95327

Alaska Children's Services, Inc. 91136

Alaska Electrical Health & Welfare Fund 92600

Alaska Laborers Construction Industry Trust 91136

Alaska Pipe Trades Local 375 91136

Alaska State Employee Association (ASEA) Local 52 PAPER

Alaska United Food & Commercial Workers Health & Welfare

Trust 91136

Alignis 58213

All Saints/Covenant - Milwaukee, Wisconsin 39160

Allcare AC101

Allegiance Benefit Plan Management Inc 81040

Alliance - Alpha Care Gold ADSL1

Alliance IPA (California) HCP01

Alliance PPO, Inc. (Maryland) 52149

Alliant Health Plans of Georgia 58234

Allied Administrators - San Francisco, California 94177

Allied Benefit Systems 37308

Allied Physicians Medical Group (CA) NMM01

AlohaCare ALOHA

AlohaCare - Medicare Advantage ALOHA

AlohaCare - Quest ALOHA

Alpha Care Medical Group SYMED

ALPS CompCare (Ohio BWC) 31147

Alta Bates Medical Group A0701

Alta Senior Care (Hnet Sr. & Secure Horizons ONLY) IP079

AMA Insurance Agency AMAIA

Amalgamated Life Insurance Company (ALICARE) 13550

AMCO 62176

AmeriBen Solutions, Inc. 75137

Americaid Community Care (Maryland) 27517

Americaid Community Care (New Jersey) 27516

American Administrative Group (AAG) 37283

Page 3: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

American Administrative Group (AAG) - Gallagher Benefit

Administrators 37283

American Administrative Group (formerly known as ICON

Benefit Admin) 75185

American Behavioral 63106

American Benefit Plan Administrators (ABPA) 95170

American Benefits Management - North Canton, Ohio 34187

American Community Mutual Insurance (OH) 60305

American Family Health Providers (Cap Management Systems) CAPMN

American Family Insurance Company AMF11

American Family Medicare Supplement and PPO Policies 56071

American General 62030

American Healthcare Alliance 01066

American Heritage 77083

American Imaging Management, Inc. 36369

American Insurance Company of Texas 81949

American International Group, Inc. (AIG) 87726

American Lifecare 72099

American Medical and Life Insurance 23212

American Medical Security (AMS) 81400

American National Insurance Company 74048

American Republic Insurance Company 42011

American Specialty Health ASHP1

American Worker Health Plan 37322

America's 1st Choice Health Plans of South Carolina 20553

America's PPO 16120

America's TPA 41178

AmeriChoice of FL 87726

AmeriChoice of IL 87726

AmeriChoice of MD 04567

AmeriChoice of NE UFNEP

AmeriChoice of New Jersey (New Jersey Medicaid) 86047

AmeriChoice of New Jersey Personal Care Plus (New Jersey

Medicare) 86001

AmeriChoice of New York (New York Medicaid) 86048

AmeriChoice of New York Personal Care Plus (New York

Medicare) 86002

AmeriChoice of Pennsylvania Medicaid/CHIP 86049

AmeriChoice of Pennsylvania Personal Care Plus (Pennsylvania

Medicare) 25175

AmeriChoice of RI 87726

Americhoice San Diego County - Co Medical Svcs (CMS) AMCH1

Americhoice San Diego County - Coverage Initiative AMCH7

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Americhoice San Diego County - Low Income Health Plan (LIHP) AMCH7

Americhoice San Diego County - Physicians Emergency Svcs

(PES) AMCH2

Americhoice San Diego County - Ryan Care Act AMCH3

Americhoice San Diego County - SD Co Sheriff's Dept AMCH5

Americhoice San Diego County - SD Primary Care Services AMCH4

AmeriChoice Tennessee 95378

Amerigroup Community Care Network 27514

Amerigroup Florida 27514

Amerigroup Georgia 27514

Amerigroup Louisiana 27514

Amerigroup Maryland 27514

Amerigroup Nevada 27514

Amerigroup New Jersey 27514

Amerigroup New Mexico 27514

Amerigroup New York 27514

Amerigroup Ohio 27514

Amerigroup Tennessee 27514

Amerigroup Texas 27514

Amerigroup Virginia 27514

AmeriHealth Administrators 54763

AmeriHealth Delware, Non-HMO 93688

AmeriHealth HMO (New Jersey, Delware) 23037

AmeriHealth Mercy Health Plan 22248

AmeriHealth New Jersey, Non-HMO 60061

Amerihealth NJ, DE & PA HMO 95044

Amida Care 24818

AMVI (Cap Management Systems) CAPMN

AMVI/Prospect Health Network (Prospect Medical Group) PROSP

Anaheim Memorial IPA (MHCAN) MHIPA

Anchor Benefit Consulting, Inc. 53085

Ancillary Benefit Systems / Arizona Foundation for Medical

Care 86062

Ancillary Care Management - ACM 03172

Angeles IPA (SynerMed) SYMED

Antares Management Solutions 34192

APAC (Pinnacle Health Resources) (Prospect Medical Group) PROSP

Apex Benefit Services 34196

Apollo Healthcare IPA (MedPOINT) (CA) MPM11

AppleCare Medical Management APP01

APS Healthcare, Inc. 54160

Page 5: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Arcadian Community Care (CA) (LA) AMS11

Arcadian Health Plan (OK) AMS11

Arcadian Management Services AMS11

Arizona Physicians IPA (APIPA) 03432

Arkansas Best Corporation 75278

Arkansas Community Care (AR) AMS11

Arnett Health Plans 87726

Arroyo Vista Family Health Center (CA) NMM01

Asian Community Medical Group HSM01

ASRM Corp ASRM1

Associated Benefits 50266

Associated Third Party Administration (ATPA) ATPA1

Associates for Health Care, Inc (AHC) 36326

Assurant Health 98514

Assurant Health (fka Fortis) 39065

Assurant Self-Funded - Ft. Mill, South Carolina 37313

Assurecare of Minnesota ARM Group 88035

Assured Benefits Administrators 74240

Asuris Northwest Health SX179

Athens Area Health Plan Select 95691

Atlantic Medical Insurance 22285

Atlanticare 22304

Atlantis Health Plan 13853

Atlas Administrators TH004

Atlas Life Insurance Company 90956

AultComp Managed Care Organization (Ohio BWC) 31147

Aultra Administrative Group 37242

Austin Regional Clinic Employee Benefit Plan CMSEB

Automated Benefit Services (ABS) 38259

Automated Group Administration, Inc. (AGA) 37280

Avalon IPA (Cap Management Systems) CAPMN

Avalon Medical Group (Cap Management Systems) CAPMN

Avatar Comp (Ohio BWC) 31147

Avera - John Morrell and Curley 38310

Avera Health Plans 46045

Avesis Third Party Administrators - Phoenix, Arizona 87098

AvMed, Inc. 59274

AXA Assistance USA 65101

Bakersfield Family Medical Center (California) BKRFM

Banner Health Co - Antero Greeley SX145

Banner Health Co - Antero High Plains SX145

Banner Health Co - Antero Mountain Shadows SX145

Banner Health Co - Choice Plus SX145

Banner Health Co - HMO Greeley SX145

Page 6: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Banner Health Co - HMO High Plains SX145

Banner Health Co - HMO Mountain Shadows SX145

Banner Health Co - Pacificare Greeley SX145

Banner Health Co - Pacificare High Plains SX145

Banner Health Co - Pacificare Mountain Shadows SX145

Banner Health Co - Rocky Mountain HMO Greeley SX145

Banner Health Co - Rocky Mountain HMO High Plains SX145

Banner Health Co - Secure Horizons Greeley SX145

Banner Health Co - Secure Horizons High Plains SX145

Banner Health Co - Secure Horizons Mountain Shadows SX145

Banner Health Company SX145

Banner Medisun 77078

Bass Administrators, Inc. 37248

BCBS - Alabama ALBLU

BCBS - Arizona AZBLU

BCBS - Arkansas ARBLU

BCBS - Colorado, Anthem COBLU

BCBS - Colorado, Anthem COBLU

BCBS - Connecticut, Anthem East CTBLU

BCBS - Delaware SB570

BCBS - District of Columbia, CareFirst SB580

BCBS - District of Columbia, CareFirst 12000

BCBS - Florida 00590

BCBS - Georgia GABLU

BCBS - Hawaii, HMSA HIBLU

BCBS - Illinois (HCSC) ILBLU

BCBS - Indiana, Anthem Midwest INXBC

BCBS - Iowa IABLU

BCBS - Kansas, ASK 47163

BCBS - Kentucky, Anthem Midwest KYXBC

BCBS - Kentucky, Anthem Midwest KYXBC

BCBS - Louisiana LABLU

BCBS - Maine MEBLU

BCBS - Maryland, CareFirst SB690

BCBS - Maryland, CareFirst 12011

BCBS - Massachusetts SB700

BCBS - Michigan 00710

BCBS - Michigan, Medicare Plus Blue 710MA

BCBS - Minnesota MNBLU

BCBS - Mississippi MSBLU

BCBS - Mississippi (State Employees/Teachers Health Plan MSBTH

BCBS - Missouri MOBLU

BCBS - Missouri MOBLU

Page 7: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

BCBS - Montana SB751

BCBS - Nebraska 00760

BCBS - Nevada, Anthem NVBLU

BCBS - New Hampshire NHBLU

BCBS - New Jersey, Horizon 22099

BCBS - New Mexico (HCSC) NMBLU

BCBS - New York, Empire SB803

BCBS - New York, Excellus, Central SB805

BCBS - New York, Excellus, Rochester SB804

BCBS - New York, Excellus, Utica-Watertown SB806

BCBS - New York, Northeastern, ASK 00800

BCBS - New York, Western, ASK 00301

BCBS - North Carolina NCBLU

BCBS - Ohio, Anthem Midwest OHBLU

BCBS - Ohio, Anthem Midwest Dental OHBLU

BCBS - Oklahoma (HCSC) OKBLU

BCBS - Oregon, Regence ORBLU

BCBS - Pennsylvania, Highmark 54771

BCBS - Rhode Island RIBLU

BCBS - South Carolina 401

BCBS - South Carolina SCBLU

BCBS - South Carolina Federal 402

BCBS - South Carolina, Carolina Benefit Administrators 498

BCBS - South Carolina, Companion Health Care 922

BCBS - South Carolina, Consolidated Benefits, Inc. C16

BCBS - South Carolina, Employer's Life Insurance Company 130

BCBS - South Carolina, Medical Claims Management

Corporation 781

BCBS - South Carolina, Planned Administrators 886

BCBS - South Carolina, Preferred Blue 481

BCBS - South Carolina, Preferred Health System (HMO Blue) 403

BCBS - South Carolina, State Employees Health Plan 400

BCBS - South Carolina, State Teachers 400

BCBS - South Carolina, Thomas Cooper Agency 315

BCBS - South Dakota SDBLU

BCBS - Tennessee, Includes TennCare Select & BlueCare TNXBC

BCBS - Texas (HCSC) TXBLU

BCBS - US Virgin Islands VIBLU

BCBS - Utah UTBLU

BCBS - Vermont VTBLU

BCBS - Virginia, Anthem VABLU

BCBS - Virginia, Anthem VABLU

Page 8: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

BCBS - West Virginia, Highmark 54828

BCBS - Wisconsin WIBLU

BCI Administrators, Inc. 49153

Beacon Health Strategies 43324

Beech Street Corporation 95377

Behavioral Health Systems 63100

Bella Vista Medical Group IPA (MedPOINT) (CA) MPM10

Bellflower Medical Center (SynerMed) SYMED

Benecorp National Corporation 33192

Benefit & Risk Management Services 99320

Benefit Administrative Systems 36149

Benefit Coordinators Corporation - Pittsburgh, Pennsylvania 25145

Benefit Management Administrators Inc (TX) 74266

Benefit Management Group, Inc. 20018

Benefit Management Services (BMSSIG) 00999

Benefit Management Systems, Inc. 37212

Benefit Plan Administrators (BPA) 88027

Benefit Plan Administrators, Inc. - Fargo, North Dakota 37286

Benefit Plan Administrators, Inc. - Roanoke, Virginia 37118

Benefit Plan AdministratorsCompany - Eau Claire, Winconsin 39081

Benefit Plan Management, Inc. 44273

Benefit Planners, Inc. 74223

Benefit Systems & Services, Inc (BSSI) 36342

Benesight 87265

Benesys, Inc. 37248

Berrien Health Plan 38338

Best Life & Health Insurance Company (Irvine, CA) 95604

Better Health Plans of South Carolina 32006

Big Lots Associate Benefit Plan (EBMC) 31074

Block Vision BV001

Blue Bell Benefit Trust ECIBB

Blue Benefit Administrators of MA 03036

Blue Choice HealthPlan of South Carolina Medicaid SCBCH

Blue Cross - Alaska, Premera AKBLU

Blue Cross - California CABLC

Blue Cross - California CABLC

Blue Cross - California CMSP claims CMSPI

Blue Cross - Idaho IDBLC

Blue Cross - North Dakota, Noridian NDBLC

Blue Cross - Pennsylvania, Capital PABLC

Blue Cross - Washington, Premera WABLU

Blue Cross - Wyoming, Noridian WYBLC

Page 9: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Blue Plus Medical Assistance MNCARE MNADV

Blue Shield - California CABLS

Blue Shield - Idaho, Regence IDBLS

Blue Shield - New York, Northeastern, ASK 00800

Blue Shield - North Dakota, Noridian NDBLS

Blue Shield - Puerto Rico Triple-S PRBLS

Blue Shield - Puerto Rico Triple-S PRBLS

Blue Shield - Washington, Regence WABLS

Blue Shield - Wyoming, Noridian WYBLS

Bluegrass Family Health 61124

Boilermakers National Health & Welfare 36609

Boon-Chapman Benefit Administrators 74238

Boston Medical Center Health Plan, Inc. (BMC HealthNet Plan) 13337

Bravo Health 52192

Breathco/CSL Pulmonary 65005

Bridge Benefits 41170

Bridgestone/Firestone 88033

Bridgeway Arizona 68054

Brodart 35182

Brokerage Concepts, Inc. 51037

Brown & Toland Medical Group 94316

Bryan Independent School District BRISD

Buckeye Community Health - Ohio 32004

Butler Benefit 42150

C&O Employees Hospital Association 23708

Cal Care IPA PPM01

California Alcohol & Drug Program CAADP25

California Alcohol & Drug Program CAADP20

California Department of Mental Health CADMH

California Pacific Physicians Medical Group HSM01

Cannon Cochran Management Services, Inc. 37105

Cap Management Systems CAPMN

Cap Management Systems 95399

Cape Health Plan 38245

Capital Advantage Insurance Company (CAIC) 23045

Capital Community Health Plan 87726

Capital District Physicians Health Plan (CDPHP)-Professional

Claims 95491

Capital Health Plan 95112

Capitol Administrators 68011

Caprock Health Plan CAPHP

Care 1st Health Plan (AZ) 57116

Care 1st Health Plan (CA) 57115

Page 10: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Care Improvement Plus 77082

Care Network AMM01

Care to Care 41222

Care Wisconsin 27004

CareCore - Wellcare NY 14188

CareCore National - Healthnet 14184

CareCore National, LLC - Health Net New Jersey 14185

CareCore National, LLC (Aetna Radiology Claims) 14179

CareCore National, LLC (Oxford Radiology Claims) 14180

CareMore IPA CARMO

CareOregon 93975

CarePlus Cardiology - New Century Health NCH04

CarePlus Dermatology - New Century Health NCH01

CarePlus Health Plans, Inc. 65031

CarePlus Urology - New Century Health NCH03

CareSource IN 37311

CareSource MI - Community Choice Michigan 38338

Caresource MI - Community Choice Michigan 38325

CareSource OH 31114

Careworks 10010

CareWorks (Ohio BWC) 31147

Cariten Healthcare 62073

Cariten Senior Health 62072

Carolina Care Plan 57105

Carolina Crescent Health Plan Inc. SX191

Carolina Summit Healthcare, Inc. 56195

Carpenter's Health & Welfare Trust Fund of St. Louis 25125

Cascade East Health Plans 93040

Caterpillar Inc. 37060

CBCA Administrators 55438

CBH Sunshine State Health Plan 68058

CBSA (Corporate Benefit Services of America) 41124

CDS Group Health 88022

Cedars-Sinai Medical Network Services 95166

Cedars-Sinai Medical Network Services 95167

Celtic Insurance 68063

Celticare 68060

Cement Masons & Plasterers Health & Welfare Trust 91136

CenCal Health SBRHA

Cenpatico Behavioral Health - South Carolina 68059

Cenpatico Behavioral Health - Texas 68053

Cenpatico Behavioral Health - Arizona 68048

Cenpatico Behavioral Health - Georgia 68050

Cenpatico Behavioral Health - Indiana 68052

Page 11: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Cenpatico Behavioral Health - Kansas 68047

Cenpatico Behavioral Health - Massachusetts 68061

Cenpatico Behavioral Health - Ohio 68051

Cenpatico Kentucky 06868

Centene Advantage Plans 68056

CenterCare 13357

Centinela Valley IPA (MedPOINT) (CA) MPM03

Centra Benefits (Dallas) 75243

Central Benefits Life 31118

Central Benefits Mutual 31118

Central Benefits National 31118

Central California Alliance for Health - CCAH 95311

Central Mass Health Care (CMHC) 02041

Central Reserve Life 34097

Central States Health & Welfare Funds 36215

Century Health Solutions 48120

CHA - Commonwealth Health Alliance 23171

CHAMPVA - HAC 84146

Chautauqua County Healthcare Plan - Mayville, New York 16600

Chesapeake Life Insurance Company 59223

Chesterfield Resources CRI01

Chicago Health Systems 36334

Childhealth Plus by Healthfirst (CHP) 80141

Children First Medical Group 94321

Children of Women Vietnam Veterans-VA HAC 84146

Children's Physician Medical Group CPMG1

Childrens Treatment Unit (CTU) AMM01

CHIP - Community First COMMF

CHIP - Teens to Tots/Texas University Health TTPCH

CHOC Health Alliance 33065

Choice One/UTMB CHIP Healthcare Systems 76049

Choice Plus Joint Offering and Options Joint Offering PPO Plans 04271

Christian Brothers Services 38308

Christus Spohn Health Network SPOHN

CIGNA 62308

CIGNA - Behavioral Health MCCBV

Cigna - Great West Health 62308

Cigna Medicare Access 86033

Cigna Medicare Select Advantage 86033

Citrus Health TH130

Citrus Health Care 10207

City of Amarillo COA01

City of San Antonio TTCEC

Page 12: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

City of Visalia TKFMC

CL Frates and Company/OSMA Health 73071

Claims Change of Vendor Request

Claimsbridge West 11752

ClaimsWare, Inc. DBA ManageMed 57080

Clarendon Kids CHIP Program SHP11

CM Administrators, Inc. 56211

CNIC Health Solutions - InterCare Health Plans 37227

Cofinity (HMS Healthcare, PPOM, Sloans Lake & Flora Health

Networks 38335

Colorado Access Behavioral Health COACC

Colorado Access CHP + COACC

Colorado Access HMO COACC

Colorado Choice Health Plans H0657

Columbia Community Care (WA) AMS11

Columbia United Providers 91162

Combined Benefits Administrators 88059

Come Care de Puerto Rico 20231

Commerce Benefits Group 34181

Commonwealth Care Alliance 14315

Community Behavioral Health Network of Pennsylvania 65391

Community Care BHO 23282

Community Care Managed Health Care Plans of OK 73143

Community Care Organization 39126

Community Care Plus 71079

Community Family Care and CFC San Fernando Valley

(SynerMed) SYMED

Community First - Star Health Plan COMMF

Community Health Alliance 35193

Community Health Center Network - CHCN CHCN1

Community Health Choice 48145

Community Health Electronic Claims (CHEC - webTPA) 75261

Community Health Group CHGRP

Community Health Network of Connecticut 62149

Community Health Plan of Washington (CHPW) CHPWA

Community Health Solutions of Louisiana CLA11

Community Medical Group of the West Valley CMGWV

Comp - Ohio - Austintown, Ohio 34177

Comp One (Ohio BWC) 31147

CompManagement Health Systems, Inc. (Ohio BWC) 31147

Comprehensive Behavioral Care 59314

Comprehensive Benefits Administrator, Inc. (CBA) 03036

Comprehensive Medical Care (Ohio BWC) 31147

Compusys of Colorado COMPU

Page 13: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Concert Health Plan 36434

Confed Admin Services, Inc. 80667

Connecticare - Medicare 78375

ConnectiCare, Inc. 06105

Connecticut Carpenters Health Fund 37307

Connecticut General, Cigna 62308

Consociate Group - Decatur, Illinois 37135

Consolidated Associates Railroad 75284

Consolidated Group/HPS 04274

Consolidated Health Plans 87843

Continental General Insurance Company 71404

Continuum ABC MSO 13397

Contra Costa Health Plan CCHP

Contractors Laborers Teamsters & Engineers 47046

Cook Children's Health Plan CCHP1

Cook Children's Star Plan CCHP9

Cooperative Benefit Administrators (CBA) 52132

Cooperative Managed Care Services 35199

Co-Ordinated Benefit Plans 14829

Coordinated Medical Specialists 58204

Core Management Resources Group 58231

CoreSource Arizona, Minnesota 35182

CoreSource Little Rock, Arkansas 75136

CoreSource Maryland, Pennsylvania, Illinois 35182

CoreSource North Carolina, Indiana 35182

CoreSource Ohio 35183

Cornerstone Benefit Administrators 35202

Corporate Benefit Services of America (CBSA) 41124

Corporate Benefits Service, Inc. - North Carolina 56116

CorrectCare - California Prison Health Care Services CCIH1

Correctional Medical Services 43160

CorSolutions 48146

Corvel Corporation (Ohio BWC) 31147

Cosvi 31517

Country Life Insurance Company 62553

Covenant Administrators, Inc. - Atlanta, Georgia 58102

Covenant Management Systems Employee Benefit Plan CMSEB

Coventry - Advantra (Texas, New Mexico & Arizona) 25133

Coventry - Advantra Freedom/Advantra Savings 25133

Coventry - Altius 25133

Coventry - American Postal Workers Union Health Plan (APWU) 44444

Coventry - Association Benefit Plan 25133

Coventry - Carelink 25133

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Coventry - Carelink Medicaid 25133

Coventry - Carenet 25133

Coventry - CHCcares - South Carolina 25151

Coventry - First Health Network 73159

Coventry - Foreign Service Benefit Plan 25133

Coventry - Health America/Health Assurance 25133

Coventry - Healthcare USA 25133

Coventry - Mail Handlers Benefit Plan 25133

Coventry - Missouri Dept of Transportation/MODOT & St. Louis

University 25133

Coventry Cares of Kentucky 25133

Coventry Diamond Plan 25133

Coventry Health & Life - Tennessee 25133

Coventry Health Care National Network 25133

Coventry Health Care National Network 25133

Coventry Health Care of Delaware 25133

Coventry Health Care of Georgia 25133

Coventry Health Care of Iowa 25133

Coventry Health Care of Louisiana 25133

Coventry Health Care of Nebraska 25133

Coventry Health Care of Nevada 25133

Coventry Health Plan of Florida 25133

Cover Colorado - InterCare Health Plans 37227

CRA Managed Care (Ohio BWC) 31147

Crawford & Company (Ohio BWC) 31147

Creative Medical Systems 64068

Creative Plan Administrators 37320

Crown City Medical Group IPA PPM01

Croy-Hall Management, Inc. 37266

CTI Administrators 42141

Culinary Health Fund 59140

Custody Medical Services (CMS) AMM01

CWIBENEFITS 57080

DakotaCare DAK01

Dean Health Plan 39113

Definity Services 87726

Definity Services 87726

Delano IPA 77124

Delaware Health Plan Consortium 63081

Delaware Physicians Care, Inc. 27009

DelawareCare 25137

Delta Health Systems DHS01

Delta Health Systems 94235

Denver Health - Indigent 84134

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Denver Health and Hospital Authority 84133

Denver Health Medicaid Choice (DHMC) 84133

Denver Health Medical Plan 84135

Denver Health Medical Plan, Inc. - Medicare Choice 84131

Deseret Mutual SX105

Desert Canyon Community Care (AZ) AMS11

Desert Medical Group (California) DESRT

Destiny Health 36436

Detroit Medical Center 56240

Devon Health Services 68423

Directors Guild of America - Producer Health Plan 23706

DirigoChoice PPO 44273

Diversified Administration 06102

Diversified Group Administration 25160

DME Jurisdiction A, CEDI 16003

DME Jurisdiction B, CEDI 17003

DME Jurisdiction C, CEDI 18003

DME Jurisdiction D, CEDI 19003

Doctors Hospital of Montclair - San Bernadino (SynerMed) SYMED

Driscoll Children's Health Plan (CHIP) (Texas) 74284

Dunn & Associates Benefit Administrators 35186

Early Intervention Central Billing 36434

East LA Doctors Hospital SYMED

East LA Doctors Hospital (MedPOINT) (CA) MPM13

Eastland Medical Group IPA EMG11

EBA - City of San Antonio TTCEC

EBA & M - Employee Benefits Admin and Mngmt Corp 22262

EBC, Inc. 37257

EBS of Louisiana 41198

EBS of Ohio 34166

EDS Administrative Services 22521

Eighth District Electrical Benefit Fund 74234

El Paso First - CHIP EPF03

El Paso First Group Health EPF08

El Proyecto del Barrio (MedPOINT) (CA) MPM04

ElderPlan, Inc. 31625

Ellis Consultants Inc. ECISF

Elmco Insurance 37253

Emerald Health Network Inc (all PPO) 34167

Emergency Medical Service Fund (EMSF) AMM01

EMI-KP Ambulance Claims 59299

Empire Physicians MG EMP01

Employee Benefit Concepts - Farmington Hills, Michigan 38241

Page 16: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Employee Benefit Consultants 37257

Employee Benefit Corporation 37215

Employee Benefit Management Corporation (Ohio) (EBMC) 31074

Employee Benefit Management Services, Inc. (EBMS) SX182

Employee Benefit Management Services, Inc. (EBMS) 12X44

Employee Benefit Services - Ft. Mill, South Carolina 37216

Employee Benefit Services of Louisiana, Inc. (EBS) 41198

Employee Benefit Systems 42149

Employee Benefits Plan Administration, Inc (EBPA) 03036

Employee Health Systems SYMED

Employee Plans, LLC 35112

Employee Security, Inc. 54098

Employer Plan Services 74212

Employers Coalition on Health (ECOH) 27008

Employers Direct Health 75232

Employers Direct Health (Employee Plan) 75236

Employers Direct Health (Fully Insured) 75235

Employers Direct Health (Self-Funded Plan) 75233

Employers Health Cooperative (EHC) MIDSC

Employers Health Insurance (EHI) 61101

Employers Mutual, Inc - Jacksonville, Florida 59298

Employers Mutual, Inc - Stuart, Florida 59331

Encircle PPO 35206

Encompass 37110

Encore Health Networks 35206

ENH Medical Group IPA 36364

Enstar Natural Gas 91136

Entrust Inc 36878

Equitable Plan Services - Oklahoma City, Oklahoma 73126

ERA Change of Vendor Request

Erin Group Administrators 23250

Essence Healthcare 20818

E-V Benefits Management, Inc. 34159

EverCare Star Plus (all states) 87726

Evergreen Health Plan 58233

Excel MSO EXC01

Exceptional Care Medical (Cap Management Systems) CAPMN

ExclusiCare (UCCI) 71412

EyeMed Vision Care 58177

FABOH (CHP/RPU) Call

Facey Medical Foundation 95432

FACS Group 37300

Fallon Community Health 22254

Page 17: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Family Care Specialists FCS01

Family Choice Medical CAPMN

Family Health Alliance (Cap Management Systems) CAPMN

Family Health Center (CA) NMM01

Family Health Partners - Health Wave of Kansas 31472

Family Health Partners/MC+ Missouri 43173

Family Health Plan (Ohio BWC) 31147

Family Practice Associates HPN11

Family Seniors Medical Group AMM01

Farm Family 14140

FCE Benefit Administrators, Inc. 33033

Federated Benefits 37300

Federated Human Resource Services 37300

Federated Mutual Insurance 41041

Fidelis Care New York 11315

Fidelis Secure Care 77054

First Administrators FAMR1

First Carolina Care 56196

First Choice Health Network 91131

First Choice of Midwest (PPO) 75138

First Priority Health 23241

First Seniority Freedom 87726

First Service Admin - Limited Medical 20807

First Service Administrators, Inc. 59276

FirstCare Star Medicaid 94999

Fitzharris & Company, Inc. - Farmingdale, New York 11244

Florida Hospital Healthcare Systems 59321

Florida Hospital Waterman 48116

Florida Netpass 65063

FMH Benefit Services, Inc. 48117

Ford Meter Box Company Inc. 37305

Formax, Inc. 87066

Foundation Benefit Administrators BOONG

Foundation for Medical Care of Tulare & Kings County TKFMC

Fox Valley Medicine Site 199 FVMCH

Fox Valley Medicine Site 451 FVMC1

Fox-Everett, Inc. 64069

Freedom First 31313

Freedom Health Plan 41212

Freedom Life Insurance Company of America 62324

Fresenius Medical Care Health Plan 23130

Friant Water Users TKFMC

Fringe Benefit Management 59069

Fringe Benefits Coordinators 59204

Page 18: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

FrontPath Health Coalition 34171

Galveston County Indigent Health Care 30005

Garfield Medical Center (SynerMed) SYMED

Gates McDonald Health Plus, Inc. (Ohio BWC) 31147

Gateway Health Plan - Medicare Assured 60550

Gateway Health Plan Medicaid Pennsylvania 25169

Gateway Health Plan Ohio - Medicare Assured 91741

Gateway IPA (Pinnacle Health Resources) (Prospect Medical

Group) PROSP

GEHA (Government Employees Hospital Assoc) 57254

GEHA (Government Employees Hospital Association) 44054

Geisinger Health Plan 75273

Gemcare Health Plan 20376

Genesis Healthcare AMM01

GENEX Care of Ohio (Ohio BWC) 31147

Gettysburg Health 23274

GHI - Group Health Inc 25531

GHI - Medicare Private Fee for Service 55247

GI Innovative Management 58204

Gilsbar, Inc. 07205

Glendale Physicians Alliance AMM02

Global Care 07689

Global Care Medical Group IPA (MedPOINT) (CA) MPM05

Golden Rule Insurance Company 37602

Golden State Physicians Medical Group MBADM

Golden Triangle Physician Alliance (GTPA) Selectcare TX 72189

Good Samaritan Medical Practice Assn AMM01

Grant Physicians Practice Association 37234

Great Lakes Health Plan 95467

Great West Healthcare 63665

Great West Healthcare 80705

Greater LA Health (Cap Management Systems) CAPMN

Greater Orange Medical Group (CA) NMM01

Greater San Gabriel Medical Group (CA) NMM01

Greater San Gabriel Valley Physicians (Cap Management

Systems) CAPMN

Greater TriCities IPA PDT01

Greater Valley (California) HCP01

Group Administrators Ltd. 36338

Group and Pension Administrators 48143

Group Health Coop South Central (Wisconsin-Claims) 39167

Group Health Coop South Central (Wisconsin-Encounters) 39168

Group Health Cooperative - West 91051

Page 19: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Group Health Cooperative of Eau Claire 95192

Group Health Inc. - New York (GHI) 13551

Group Insurance Service Center, Inc. 37276

Group Practice Affiliates 68046

Guardian Life Insurance Company of America 64246

H.E.R.E.I.U Welfare Pension Funds 37114

HAA Preferred Partners Miami 65101

HAP/AHL/Curanet (Health Alliance Plan of MI) 38224

Harmony Health Plan of Illinois 36406

Harmony Health Plan of Indiana 36405

Harrimon Jones (California) HCP01

Harrington Benefit Services, Inc. 59142

Harrington Health - Kansas (Formerly known as Fiserv Health) 62061

Harrington Health Non-EPO 59143

Harvard Pilgrim Best Buy HMO NetOption Plan 04271

Harvard Pilgrim Best Buy HMO Plan 04271

Harvard Pilgrim Best Buy HSA PPO 04271

Harvard Pilgrim Best Buy POS Plan 04271

Harvard Pilgrim Best Buy PPO Plan 04271

Harvard Pilgrim Core Coverage HMO Plan 04271

Harvard Pilgrim Health Care 04271

Harvard Pilgrim HMO Plan 04271

Harvard Pilgrim Independence Plan Tiered Copayment PPO

Plan 04271

Harvard Pilgrim Medicare Enhanced Plan 04271

Harvard Pilgrim NetOption HMO Plan 04271

Harvard Pilgrim Non-Group HMO Plan 04271

Harvard Pilgrim Plus Plan HMO Plan 04271

Harvard Pilgrim POS Plan 04271

Harvard Pilgrim PPO Plan 04271

Harvard Pilgrim Tiered Copay HMO 04271

HCH Administration - Illinois 37111

HCH Administrators, Inc. 37215

HCHA Albq - Self Funded 37329

HCS - Health Claims Service - Boise, Idaho 82018

HDM Benefit Solutions HDMCO

HDPC-Premier Healthcare 90023

Health Administration Service, Inc. 34185

Health Alliance Exclusive & Plus 23172

Health Alliance Medical Plans, Inc. 77950

Health Alliance Plan of Michigan 38224

Health Care District Palm Beach County HCDPB

Health Care District Palm Beach County 95828

Page 20: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Health Care LA, IPA (MedPOINT) (CA) MPM06

Health Care Network of Wisconsin (HCN) 42102

Health Care Payer's Coalition - Toledo, Ohio 34193

Health Choice Generations (AZ) 62180

Health Choice of Arizona 62179

Health Choice Utah 45399

Health Cost Solutions 62111

Health Designs Plus - Hudson, Ohio 34158

Health EOS 34080

Health EZ 41178

Health First (FL) 95019

Health First of Austin 75289

Health Management Solutions (Ohio BWC) 31147

Health Net of Arizona 38309

Health Net of California & Oregon 95567

Health Net of California (Encounters) 95570

Health Net of the Northeast, Inc. 06108

Health New England 04286

Health Partners - Jackson, Tennessee 62157

Health Partners - Minnesota 07003

Health Partners - Pennsylvania 80142

Health Payment Systems, Inc. 20270

Health Plan of Michigan 83253

Health Plan of Nevada (Claims) 76342

Health Plan of San Joaquin/San Joaquin Health Administrators 68035

Health Plan of San Mateo HPSM1

Health Plans Inc. 44273

Health Plus of Louisiana 95009

Health Plus PHSP - Brooklyn, New York 11324

Health Risk Management 41170

Health Safety Net - Massachusetts Medicaid MAHSN

Health Services for Children with Special Needs 37290

Health Services Preferred (HSP) – Emerald Health 34167

Healthcare Management Administrator (HMA) HMA01

HealthCare Partners (CA) HCP01

HealthCare Partners, IPA (NY) 11328

Healthcare Solutions Group 73147

Healthcare's Finest Network (HFN) 36335

HealthChoice of Connecticut/Yale Preferred Health 95376

HealthComp (CA) 85729

HealthEase/WellCare of Florida 59608

Healthfirst TPA - Tyler, Texas 75234

Healthfirst 65 Plus 80141

Page 21: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Healthfirst Health Plan of New Jersey 80141

Healthfirst Inc. (New York) 80141

HealthHelp Network, Inc (HHNI) 59087

Healthlink HMO 96475

Healthlink PPO 90001

HealthNet Cal Care (SynerMed) SYMED

HealthNow New York 55204

HealthPlan Services (Tampa) 59140

HealthPlus of Michigan 38216

HealthSCOPE Benefits, Inc. (formerly known as CNA Health

Partners) 71063

HealthSmart Management Services Organization HSM01

HealthSmart Preferred Care (HSPC) 75250

Healthsource - Arkansas 71074

Healthsource - Arkansas Medicare HMO , Cigna 71075

Healthsource - Georgia, Cigna 58210

Healthsource - Kentucky 61127

Healthsource - Maine 01041

Healthsource - Massachusetts (CMHC) 02041

Healthsource - N. Texas, Cigna 75255

Healthsource - New Hampshire 02038

Healthsource - North Carolina, Cigna 56147

Healthsource - Ohio 31141

Healthsource - South Carolina 06119

Healthsource - Tennessee, Cigna 62129

Healthsource Provident, Cigna 68195

HealthSpring HMO Medicare + Choice 63092

HealthStar, Inc 36332

HealthSun HESUN

Healthy Palm Beaches 95827

Healthy Texas 68064

Healthy Way LA (Los Angeles), Primary Care (HWLA) MAP01

Heritage Consultants 59230

Heritage Physician Network (HPN) (Houston) HPN11

HHIC Freedom Blue PPO - Medicare Advantage (West Virginia) 71768

High Desert Primary Care 33069

Highmark-Key Family 35145

Hill Physicians Medical Group 00046

HIP Healthy Indiana Plan - Anthem INXBC

HIP-Health Insurance Plan of Greater New York 55247

HMA - Healthcare Management Administration HMA01

HMA Hawaii 86066

HMO of Colorado COHMO

Page 22: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Hollywood Presbyterian Medical Group (SynerMed) SYMED

Hometown Health Plan - Nevada 88023

Horizon HealthCare Administration (HHA) 22304

Horizon Healthcare of New York 22099

Horizon New Jersey Health 22326

Hotel Employees & Restaurant Employees Health & Trust 91136

HPS Paradigm, Inc. 58227

HRM Claim Management 41170

Hudson Health Plan 13335

Humana 61101

Humana (Encounters) 61102

Humana Health Plans of Ohio 95348

Humana Veterans Health Care Services HERO

Humboldt-Del Norte Foundation for Medical Care 94154

Huntington Park Mission Medical Group (Cap Management

Systems) CAPMN

I.E. Shaffer - West Trenton, New Jersey 22175

ICARE (Independent Care Health Plan (WI) 11695

Idaho Physicians Network PRIME

ILCBH (IL Community Behavioral Healthcare) 68065

IlliniCare Health Plan 68066

IMcare 41600

INDECS Corporation 40585

Independence Administrators TA720

Independence Blue Cross (IBC) Highmark 54704

Independence Medical Group - Kern County IMG01

Independence Medical Group - Tulare County IMG02

Independent Health SX073

Indiana Comprehensive Health Insurance Assoc ICHIA INXBC

Indiana Hoosier Healthwise HHW - Anthem INXBC

Indiana ProHealth Network 35161

Indiana Teamsters Health Benefit Funds 35107

Individual Health Insurance Companies 31053

Inetico 43471

Informed UHC Compass Rose Health Plan 50946

Informed, LLC 52196

Ingalls Provider Group 36348

Inland Empire Health Plan IEHP1

Innovante Benefit Administrators aka HealthTrans 31172

Innovative Healthware Solutions 04320

Instil Health HMO C60

Instil Health PPO C61

Insurance Administrators of America, Inc. (IAA) 37279

Insurance Design Administrators 13315

Page 23: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Insurance Management Services - Amarillo 15688

Insurance Management Services of Texas (IMS) IMSMS

Insurance Services of Lubbock ISL11

Integra Administrative Group -Seaford, Delaware 51020

Integra BMS 56139

Integra Group 31127

Integra Group-CHA 31129

Integrated Care Network by Emerald 34167

InterCare Health Plans, Inc. 37227

Interface EAP 60280

Intergroup Service Corporation 23287

International Brotherhood of Boilermakers 36609

International Brotherhood of Boilermakers Employee Health

Care 48603

International Educational Exchange Services (IEES) 16158

International Funding, LTD 39182

International Medical Card 37624

International Medical Group IMGIN

Iowa Benefits, Inc. (IBI) 41124

ISOL ISL11

IU Medical Group IUMED

J. F. Molloy and Associates, Inc. 61271

Jackson Memorial Health Plan 59171

Jackson Memorial Health Plan (Forida) 05014

John Alden Life Insurance Company 41099

Johns Hopkins Healthcare - Priority Partners 52189

Johns Hopkins Medical Center 52123

Joplin Claims 43178

Joy Medical Group AMM01

JP Farley Corporation 34136

JP Farley Corporation - County Health Plans (MI) 63719

JSL Administrators 37272

Kaiser Foundation Health Plan of Colorado 91617

Kaiser Foundation Health Plan of Georgia 21313

Kaiser Foundation Health Plan of Northern California 94135

Kaiser Foundation Health Plan of Ohio 34092

Kaiser Foundation Health Plan of Southern California 94134

Kaiser Foundation Health Plan of the Mid-Atlantic States 52095

Kaiser Foundation of the Northwest 93079

Kanawha Insurance Company 57038

Kansas City Blue Cross Blue Shield, ASK 47171

Kansas Health Solutions for Medicaid Mental Health 98601

Karing Physicians Medical Group HSM01

Kaweah Delta TKFMC

Page 24: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Kentucky Health Administrators 27215

Kentucky Health Select 63077

Kentucky Spirit Health Plan 68067

Kern County CDCR 28021

Kern Health Systems 77039

Key Benefit Administrators 37217

Key Medical Group IP082

Key Select 37321

Keystone Health Plan East 95056

Keystone Mercy Health Plan 23284

Kitsap Physician Services (KPS) KPS01

Klais & Company 34145

Klais & Company (Ohio BWC) 31147

Korean American Medical Group KAMG1

LA Care Health Plan (Los Angeles) LACAR

La Vida IPA LVIPA

LaCare Louisiana 27357

Lake Forest Mangaed Care Associates 37112

Lakeside Health Services 95415

Lakeside IPA 95416

Lakeside Medical Group LMG11

Lakeside Medical Group aka Regal Lakeside LMG01

Landmark Healthcare LNDMK

Lane Individual Practice Assoc (LIPA) LIPA2

LaneCare LCMMH

LaSalle Medical Associates (MedPOINT) (CA) MPM14

Lawndale Christian Health Plan 36333

Leon Medical Center Plan - Miami, Florida 37316

Liberty Union 37281

Life and Health Insurance Company of America 98205

Life Assurance Company 37281

Life Investors Insurance Company of America LIIC3

Life Investors Insurance Company of America LIICA

Life Investors Insurance Company of America LIIC2

Life Trac 41136

Lifeprint LIFE1

LifeWise Health Plan of Arizona 91155

LifeWise Health Plan of Oregon 93093

LifeWise Health Plan of Washington 91049

LIPA/Agate Resources LIPA1

Local 135 Health Benefits Fund - Indianapolis, Indiana 35107

Loma Linda University Healthcare - Managed Care Claims 33036

Loma Linda University/Adventist Health System 37267

London Health Administrators PAPER

Page 25: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Long Beach Memorial IPA (MHCLB) MHIPA

Los Angeles Medical Center IPA PPM01

Louisiana Healthcare Connections 68069

Lovelace Health Plan 90328

Lovelace Sandia Health Plan 90328

Mabuhay Medical Group (Cap Management Systems) CAPMN

Magellan Health Services 01260

MagnaCare 11303

Magnolia Health Plan 68062

Maine Employer's Mutual Insurance Co (MEMIC) 01047

Maksin Management Corporation 22195

MAMSI Life and Health Insurance Company (MLH) 87726

Managed Care Services, LLC 35162

Managed Care Systems (Delano Regional Medical Group) MCS02

Managed Care Systems (Gemcare) MCS01

Managed Health Networks (MHN) 22771

Managed Health Services - Indiana (Medicaid HMO) 39186

Managed Health Services - Wisconsin 39187

MAPCO, Inc. 75258

MAPFRE/MAPFRE Medicare 02309

March Vision Care 52461

Marin IPA IP097

Maryland Individual Practice Association, Inc. (MD IPA) -

Maryland 87726

Maryland Physician Care 22348

Mashantucket Pequot Tribal Nation 37121

Massachusetts Mutual 65935

Masters, Mates and Pilots Plan MMPHB

Matthew Thornton Health Plan 02030

MaxiMed IPA 26394

Mayo Management Services, Inc. (MMSI) Mayo Clinic Health

Solutions 41154

MBA of Wyoming (Worland, WY) 87065

MBS (MedCost Benefit Services) 56205

McKinley Medical Group (California) MHM02

McLaren Health Plan 38338

MCS Advantage (MCS Classicare) 96197

MD – Individual Practice Association 87726

MDwise Healthy Indiana Plan (HIP) MDWIS

MDwise Healthy Indiana Plan (HIP) SX172

MDwise Hoosier Alliance 20475

MDwise Hoosier Alliance - Family Planning Claims SX172

MDwise Methodist IUMED

MDwise Select Health (Family Planning claims only) IUMED

Page 26: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

MDwise St. Catherine (Family Planning claims only) IUMED

MDwise St. Margaret Mercy (Family Planning claims only) IUMED

MDwise St. Vincent (Family Planning claims only) IUMED

MDwise Total Health IUMED

MDwise Wishard IUMED

Med Partners 35205

Med Pay 88058

MedAdmin Solutions 58204

MedCom 59231

MedCost, Inc. 56162

MedDirect 38353

Medfocus 95321

Medica Choice (ALLINA) 94265

Medica Health Care Plan 78857

Medicaid - Alabama ALMCD

Medicaid - Alaska AKMCD

Medicaid - Arizona (AHCCCS) AZMCD

Medicaid - Arkansas ARMCD

Medicaid - California Medi-Cal CAMCD

Medicaid - California Medi-Cal (FPACT - Family PACT) CAMCF

Medicaid - Colorado COMCD

Medicaid - Connecticut CTMCD

Medicaid - Delaware DEMCD

Medicaid - District of Columbia DCMCD

Medicaid - Florida FLMCD

Medicaid - Georgia, HP GAMCD

Medicaid - Hawaii HIMCD

Medicaid - Idaho IDMCD

Medicaid - Illinois, IDHFS ILMCD

Medicaid - Indiana INMCD

Medicaid - Iowa, Noridian IAMCD

Medicaid - Iowa, Noridian IAMCD

Medicaid - Iowa, Noridian IAMCD

Medicaid - Kansas, HP KSMCD

Medicaid - Kentucky KYMCD

Medicaid - Louisiana KidMed LAMCK

Medicaid - Louisiana, Unisys LAMCD

Medicaid - Maryland, DHMH MDMCD

Medicaid - Massachusetts, MassHealth MAMCD

Medicaid - Michigan MIMCD

Medicaid - Michigan, BCCCP (Breast Cancer Cervical Cancer

Prevention) MIBCC

Medicaid - Minnesota MNMCD

Page 27: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Medicaid - Mississippi MSMCD

Medicaid - Missouri MOMCD

Medicaid - Montana MTMCD

Medicaid - Nebraska NEMCD

Medicaid - Nevada, Magellan Medicaid DHCFP

Medicaid - New Jersey, Molina NJMCD

Medicaid - New Mexico NMMAD

Medicaid - New York NYMCD

Medicaid - North Carolina DNC00

Medicaid - North Carolina Health Choice DNC00

Medicaid - North Dakota NDMCD

Medicaid - Ohio OHMCD

Medicaid - Oklahoma OKMCD

Medicaid - Oregon, DHS ORMCD

Medicaid - Pennsylvania PAMCD

Medicaid - Rhode Island RIMCD

Medicaid - South Carolina SCXIX

Medicaid - South Dakota SDMCD

Medicaid - Tennessee for TennCare Select and BlueCare

Medicaid TNXBC

Medicaid - Texas, TMHP TXMCD

Medicaid - Utah, UHIN UTMCD

Medicaid - Vermont VTMCD

Medicaid - Virginia, ACS VAMCD

Medicaid - Washington WAMCD

Medicaid - West Virginia, Molina WVMCD

Medicaid - Wisconsin WIMCD

Medicaid - Wisconsin Chronic Disease Program (WCDP) WICDP

Medicaid - Wisconsin Well Woman Program (WWWP) WIWWP

Medicaid - Wyoming WYMCD

Medical Administrators, Inc. (Ohio BWC) 31147

Medical Benefits Administration MBADM

Medical Benefits Administrators, Inc. - Newark, OH 74323

Medical Benefits Companies - Newark, OH 74323

Medical Benefits Mutual - Newark, Ohio 74323

Medical Benefits Mutual Life Insurance Company 74323

Medical Development International 52181

Medical Mutual of Ohio 29076

Medical Network of Colorado Springs CSMED

Medical Resource Management 58203

Medical Services Initiative 12057

Medical Value Plan (MVP) Health Plan of Ohio 38224

Medicare - Alabama, Part A, Cahaba ALMCR

Medicare - Alabama, Part B, Cahaba ALMCR

Page 28: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Medicare - Alaska, Part A, Noridian AKMCR

Medicare - Alaska, Part B, Noridian AKMCR

Medicare - Arizona, Part A, Noridian AZMCR

Medicare - Arizona, Part B, Noridian AZMCR

Medicare - Arkansas, Part B, Novitas ARMCR

Medicare - California, Northern, Part A, Palmetto CAMCN

Medicare - California, Northern, Part B, Palmetto CAMCN

Medicare - California, Southern, Part A, Palmetto CAMCS

Medicare - California, Southern, Part B, Palmetto CAMCS

Medicare - Colorado, Part A, TrailBlazer COMCR

Medicare - Colorado, Part B, TrailBlazer COMCR

Medicare - Connecticut, Part B, NGS CTMCR

Medicare - Delaware, Novitas Solutions DEMCR

Medicare - District of Columbia, Novitas Solutions DCMCR

Medicare - DME Jurisdiction A, CEDI 16003

Medicare - DME Jurisdiction B, CEDI 17003

Medicare - DME Jurisdiction C, CEDI 18003

Medicare - DME Jurisdiction D, CEDI 19003

Medicare - Florida, Part A, First Coast Service Options (FCSO) FLMCR

Medicare - Florida, Part B, First Coast Service Options (FCSO) FLMCR

Medicare - Georgia, Part A, Cahaba GAMCR

Medicare - Georgia, Part B, Cahaba GAMCR

Medicare - Hawaii, Part A, Palmetto HIMCR

Medicare - Hawaii, Part B, Palmetto HIMCR

Medicare - Idaho, Part A, Noridian IDMCR

Medicare - Idaho, Part B, Noridian IDMCR

Medicare - Illinois, Part A, NGS ILMCR

Medicare - Illinois, Part B, WPS ILMCR

Medicare - Indiana, Part A, WPS INMCR

Medicare - Indiana, Part B, WPS INMCR

Medicare - Iowa, Part B, WPS IAMCR

Medicare - Kansas, Part B, WPS KSMCR

Medicare - Kentucky, Part B, CGS KYMCR

Medicare - Louisiana, Part B, Novitas LAMCR

Medicare - Maine, Part B, NHIC MEMCR

Medicare - Maryland, Part A, Novitas Solutions MDMCR

Medicare - Maryland, Part B, Novitas Solutions MDMCR

Medicare - Massachusetts, Part A, NHIC MAMCR

Medicare - Massachusetts, Part B, NHIC MAMCR

Medicare - Michigan, Part A, WPS MIMCR

Medicare - Michigan, Part B, WPS MIMCR

Medicare - Minnesota, Part A, Noridian MNMCR

Page 29: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Medicare - Minnesota, Part B, WPS MNMCR

Medicare - Mississippi, Part B, Cahaba MSMCR

Medicare - Missouri Eastern, Part B, WPS MOMRE

Medicare - Missouri Western, Part B, WPS MOMRW

Medicare - Montana, Part A, Noridian MTMCR

Medicare - Montana, Part B, Noridian MTMCR

Medicare - Nebraska, Part B, WPS NEMCR

Medicare - Nevada, Part A, Palmetto NVMCR

Medicare - Nevada, Part B, Palmetto NVMCR

Medicare - New Hampshire, Part B, NHIC NHMCR

Medicare - New Jersey, Part B, Novitas Solutions NJMCR

Medicare - New Mexico, Part A, TrailBlazer NMMCR

Medicare - New Mexico, Part B, TrailBlazer NMMCR

Medicare - New York, Empire Downstate, Part B, NGS NYMRE

Medicare - New York, Part A, NGS NYMCR

Medicare - New York, Queens, Part B, NGS NYMRQ

Medicare - New York, Upstate, Part B, NGS NYMRU

Medicare - North Carolina, Part B, Palmetto NCMCR

Medicare - North Dakota, Part A, Noridian NDMCR

Medicare - North Dakota, Part B, Noridian NDMCR

Medicare - Ohio, Part A, CGS OHMCR

Medicare - Ohio, Part B, CGS OHMCR

Medicare - Oklahoma, Part A, TrailBlazer OKMCR

Medicare - Oklahoma, Part B, TrailBlazer OKMCR

Medicare - Oregon, Part A, Noridian ORMCR

Medicare - Oregon, Part B, Noridian ORMCR

Medicare - Pennsylvania, Part A, Novitas Solutions PAMCR

Medicare - Pennsylvania, Part B, Novitas Solutions PAMCR

Medicare - Puerto Rico, Part B, First Coast Service Options PRMCR

Medicare - Puerto Rico, Part B, First Coast Service Options PRMCR

Medicare - Railroad, Palmetto RRMCR

Medicare - Rhode Island, Part B, NHIC RIMCR

Medicare - South Carolina, Part B, Palmetto SCMCR

Medicare - South Dakota, Part A, Noridian SDMCR

Medicare - South Dakota, Part B, Noridian SDMCR

Medicare - Tennessee, Part A, Cahaba TNMCR

Medicare - Tennessee, Part B, Cahaba TNMCR

Medicare - Texas, Part A, TrailBlazer TXMCR

Medicare - Texas, Part B, TrailBlazer TXMCR

Medicare - Utah, Part A, Noridian UTMCR

Medicare - Utah, Part B, Noridian UTMCR

Medicare - Vermont, Part B, NHIC VTMCR

Page 30: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Medicare - Virginia, Part B, Palmetto VAMCR

Medicare - Washington, Part A, Noridian WAMCR

Medicare - Washington, Part B, Noridian WAMCR

Medicare - West Virginia, Part B, Palmetto WVMCR

Medicare - Wisconsin, Part A & (FQHC), NGS 00450

Medicare - Wisconsin, Part B, WPS WIMCR

Medicare - Wyoming, Part A, Noridian WYMCR

Medicare - Wyoming, Part B, Noridian WYMCR

Medicare Y Mucho Mas (MMM) MCMMM

Medicina Familiar Medical Group (Cap Management Systems) CAPMN

Medico Insurance Co HDM04

Medigold or Mt. Carmel Health Plan 95655

MedSolutions, Inc. 62160

MedStar Physician Partners 00243

Megan Medical Clinic (California) HCP01

Memorial Clinical Associates MCA11

Memorial Healthcare IPA MHIPA

Memorial Hermann Health Network MHHNP

Memorial Hospital of Gardena (MedPOINT) (CA) MPM12

Memorial Medical Group (California) HCP01

Mercy Care Plan (AHCCCS) 86052

Mercy Care Plus 71079

Mercy Health Plans 43166

Mercy Physicians Medical Group (NAMM Southern CA) IP079

Meridian Health Plan 13189

Meritain Health 38232

Meritain Health 34159

Meritain Health MN 41124

Meritain Health/Agency Services Inc. 64158

Meritain Health/North American Administrators 64157

Mesa Mental Health 85035

Methodist First Choice 23550

Metro Alliance 82135

MetroPlus Health Plan 13265

Metropolitan Health Plan 10850

Metrowest Health Plan - Preferred Care MWP01

Metrowest Star Medicaid MWS01

MFPP New PE MNCAD

MFPP Ongoing MNCAD

MHNet 74289

Mid Atlantic Psychiatric Services, Inc. (MAPSI) 52149

Mid-America Associates, Inc. 37281

MidCities IPA (Cap Management Systems) CAPMN

Page 31: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

MidCoast Care IPA - California 77012

Mid-County Physicians Medical Group - San Diego (SynerMed) SYMED

Midland National Insurance Company 90956

Midlands Choice, Inc. 47080

MidSouth Administrative Group 62168

Midwest Health Plan MHP77

Mid-West National Life Insurance Company of Tennessee -

Insurance Center 59224

MIPS 05018

Mission Community IPA Medical Group (MedPOINT) (CA) MPM07

Mississippi Physicians Care Network (MPCN) 64084

Mississippi Public Entity Employee Benefit Trust (MPEEBT) 37233

Mississippi Select Healthcare 64088

Missoula County Medical Benefits Plan 37275

Missouri Care 43179

MLink 37265

MMAC (Managed Medical Assurance Company, Ltd.) (Ohio

BWC) 31147

Molina Healthcare (Encounters) 43174

Molina Healthcare of California 38333

Molina Healthcare of Florida 51062

Molina Healthcare of Michigan 38334

Molina Healthcare of Nevada 20676

Molina Healthcare of New Mexico 09824

Molina Healthcare of Ohio 20149

Molina Healthcare of Texas 20554

Molina Healthcare of Washington 38336

Molina Healthcare Utah (American Family Care) SX109

Momentum Health Services 72135

Monarch Healthcare IPA IP095

Mondial Assistance 50749

Montefiore Contract Management Organization 13174

Monumental Life Insurance Company MMLIC

Monumental Life Insurance Company MMLI3

Mosiac IPA Medical Group IP083

Motion Picture Health Plan MPI01

Motorola 36111

Mountain States Administrative Services, Inc. 86040

MPA Custom Provider Network 80900

MPE Services, Inc. 37233

MPLAN, Inc. / HealthCare Group, LLC 95444

Page 32: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Multicultural Primary Care Medical Group - San Diego

(SynerMed) SYMED

Multiplan Wisconsin Preferred Provider Network (MWPPN) 34080

Municipal Health Benefit Plan 81883

Mutual Assurance Administrators 37256

Mutual Group (US) 59140

Mutual of Omaha Insurance Co 71412

Mutually Preferred 71412

MVP Health Care 14165

N.W. Ironworkers Health & Security Trust Fund 91136

N.W. Roofers & Employers Health & Security Trust Fund 91136

N.W. Textile Processors 91136

NAA (North America Administrator, L.P.) - Nashville, Tennessee 65085

Naperville Health Care Associates NHCA1

NaphCare 58182

National Association of Letter Carriers / NALC 53011

National Benefit Administrators - New Jersey 56175

National Benefit Administrators - North Carolina 56176

National Capital Preferred Provider Organization (NCPPO) 90001

National Claim Administration, Inc. 37126

National Finance Insurance Company 90956

National Foundation Life Insurance Company 98205

National Imaging Association SX190

National Rural Electric Coop (NRECA) 52132

National Telecommunications Cooperative Association (NTCA) 52103

National Telecommunications Cooperative Association

(NTCA/SMC) 52120

National Telecommunications Cooperative Association Staff

(NTCA- Staff) 52104

Nationwide Health Plans 31417

NCAS - Charlotte, North Carolina 75191

NCAS - Fairfax, Virginia 75190

Neighborhood Health Partnership 95123

Neighborhood Health Partnership of FL 96107

Neighborhood Health Plan - Boston, Massachusetts 04293

Neighborhood Health Plan of Rhode Island 05047

Neighborhood Health Providers & Suffolk Health Plan 11325

Nesika Health Group 37255

Netcare Life and Health Insurance - Hagatna, Guam 66055

Network Health (Massachusetts) 04332

Network Health Plan of Wisconsin 39144

Network Medical Management (CA) NMM01

Page 33: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Nevada Care 86067

New Century Health - Humana Dermatology NCH02

New Era Life Insurance Company 75281

New Life Medical Group dba Healthy New Life Medical Corp HSM01

New Market Dimensions 65056

New York Life - LTC NYL11

New York Network Management 11334

New York Presbyterian System Select Health 24819

NGS American Inc. 38225

Nippon Life Insurance Company of America 81264

NJ Carpenters Health Fund 22603

Noble AMA Select IPA PDT01

Noble Community Medical Associates LA CAPMN

Noble Mid Orange - HealthSmart (California) HMS01

North American Administrators, Inc. 64157

North American Benefits Network (NABN) 34159

North American Health Plan 64157

North Broward Hospital District 37314

North Texas Healthcare Network 35212

North Texas Healthcare Network (NTHN) NTX11

North West Life PH018

North West Orange County Medical Group PROSP

Northeast Community Care (ME) (NH) (NY) AMS11

Northern CA Advantage Medical Group HSM01

Northern California Sheet Metal Workers Insurance Plan 38238

Northern Illinois Health Plan 36347

Northern Nevada Trust Fund - Reno, Nevada 88027

Northridge Medical Group (California) NMG01

Northshore Physician Associates IPA 48026

Northwest Community Health Partners (NAMM) 36234

Northwest Diag. Clinic/Selectcare of Texas (NWDC) 62119

Northwest Suburban IPA (Illinois) 36346

Nova Casualty Company 16114

Nova Healthcare Administrators, Inc. - Grand Island, New York 16644

NovaSys Health Network 71080

Nuestra Familia Medical Group (Prospect Medical Group) PROSP

Nyhart 37299

NYS DOH UCP (New York ADAP) 14142

Occupational Health Management, Inc. (HealthManage) (Ohio

BWC) 31147

ODS Healthcare 13350

Office of Group Benefits 72087

Page 34: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Ohana Health Plan 14163

Ohio Bureau of Workers Compensation (Ohio BWC) 31147

Ohio Comp Choice, Inc. - HMS (Ohio BWC) 31147

Ohio Employee Health Partnership (Ohio BWC) 31147

Ohio Health Choice, PPO 34189

Ohio Health Group 95435

Olympic Health Management Systems, Inc. 91151

Omni/Medcore HP MDCOR

Omnicare, A Coventry Health Plan 25133

One Call Medical 22321

One Health Plan of California, Inc. 95379

One Health Plan of Georgia, Inc. 95569

One Health Plan of Illinois, Inc. 95388

OneNet PPO 52149

Operating Engineers Locals 302 & 612 Health & Security Fund 91136

OptiCare Eye Health Network 56190

Optima Health Plan 54154

Optima Insurance Company 54154

Optimum Choice of the Carolinas (OCCI) 52152

Optimum Choice, Inc (OCI) 87726

Optimum Healthcare, Inc. 20133

OptumHealth Behavior Solutions 87726

OptumHealth Behavioral Solutions (formerly PacifiCare

Behavioral Health) 87726

OptumHealth Behavioral Solutions (formerly United Behavioral

Health) 87726

OptumHealth Behavioral Solutions New Mexico 87726

OptumHealth Care Solutions - all plans 41161

Orange Coast Memorial IPA MHIPA

Orange County Advantage Medical Group, Inc HSM01

Orange County Physicians IPA Medical Group, Inc dba Noble

Community Medical Assoc of Mid-Orange County HSM01

Orthonet - Aetna 13383

Orthonet (Uniformed Services Family Health Plan) 13382

OrthoNet Corporation - Cigna 13381

Orthonet-Healthnet - White Plains, New York 25681

OSF Care Advantage OSFMC

OSF Health Plans - Peoria, Illinois 62171

OSG - St. Therese Physicians Association 37116

Oxford Health Plan Medicare Advantage 06111

Oxford Health Plan Medicare Advantage 87726

Oxford Health Plans Commercial 06111

Ozark Health Plan (MO) AMS11

Page 35: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

P5 Health Plan Solutions of Utah 87068

Pacific Alliance Medical Group and Hospital (SynerMed) SYMED

Pacific HealthCare IPA HSM01

Pacific Hospital of Long Beach HSM01

Pacific IPA (California) PCFCI

PacifiCare (HMO, EPO, Medicare + Choice) 87726

PacificSource Health Plans 93029

PacificSource Medicare 20377

Panamerican Life Insurance Co of Puerto Rico (PALIC) 81240

Paper claims PAPER

Paragon Benefits, Inc. 58174

Paramount Healthcare PHCAR

Paramount Preferred Network (Ohio BWC) 31147

Parity Healthcare, LLC. 58204

Parkland Community Health Plan 66917

Partners National Health Plans of North Carolina, Inc. 56152

Partnership Health Plan of California PHPCA

Pasadena Primary Care Physicians (Cap Management Systems) CAPMN

Passport Advantage 76569

Passport Health Plan 61129

Patient Advocates, Inc. 10525

PAYNET, INC. 37210

PCA Health Plan of Florida 65018

Peach State Health Plan 68049

Ped-I-Care Title 19 M3FL8

Ped-I-Care Title 21 M3FL6

Pennsylvania's Preferred Health Networks (PPHN) 06161

Peoples Benefit Life Insurance PBLIC

Peoples Health Network - Kenner, Louisiana 72126

Performax, Inc. 41124

Personal Choice (IBC) Highmark 54704

Personal Insurance Administrators (Agoura Hills, CA) 95397

PersonalCare 25133

PHA Insurance Services - Orlando, Florida 95183

PHCS Network 54210

PHCS Savility Payers 13306

Phoenix Health Plan 03440

PHP - Physicians Health Plan of Northern Indiana 12399

PHP of Mid-Michigan - Behavioral Health 87726

PHP of South Michigan - Behavioral Health 87726

PHP of Southwest Michigan - Behavioral Health 87726

PHP of West Michigan - Behavioral Health 87726

PHP/Physicians Health Plan Mid-Michigan 37330

Page 36: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Physician Associates of Louisiana 58204

Physicians Assoc of Greater San Gabriel Valley PA513

Physicians Care Network 36345

Physician's Data Trust PDT01

Physicians Health Association of Illinois 37136

Physicians Health Choice (Claims) PHCS1

Physicians Health Choice (Encounters) PHCEN

Physicians Health Collaborative 20398

Physician's Health Plan- SC 09173

Physicians Health Plan South Carolina 87726

Physicians' Healthways IPA PHIPA

Physicians Mutual Insurance Company 47027

Physicians Plus Insurance Corporation 39156

Physicians United Plan TH131

Pinnacle Claims Management, Inc. 24735

Pinnacle Health Resources (Prospect Medical Group) PROSP

Pinnacol Assurance 84109

Pittman & Associates 37224

Plan de Bienestar UTM-PRSSA 02379

Plan de Salud Hospital Menonita 36242

Plan de Socios Auxilio Mutuo 78704

Planned Administrators, Inc. (PAI) 37287

Podi Care Managed Care 58204

POMCO 16111

PPO Plus, LLC 72148

PPP (Public Private Partnership) American Insurance

Administrators - AIA, Primary Care MAP01

Practicare, Inc. 04334

Prairie Medical Group (La Vida) LVIPA

Prairie States Enterprises, Inc. 36373

Preferred Benefits Administrator 61665

Preferred Care Partners - Miami, Florida 65088

Preferred Community Choice / PCCSelect / CompMed 73145

Preferred Health Plan - Louisville, Kentucky 61106

Preferred Health Professionals (PHP)(ASK) 00023

Preferred Health Systems Insurance Company (PHSIC) 60110

Preferred IPA (CA) PFIPA

Preferred Medical Plan 31899

Preferred Medicare Choice 92131

Preferred Network Access, Inc. - Darien, Illinois 36401

Preferred Plus of Kansas (PPK) 60110

PreferredOne - Minnesota 41147

Premier Benefits, Inc. 43166

Premier Comp of Hometown Health Network (Ohio BWC) 31147

Page 37: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Premier Eye Care of FL 65054

Premier Health Plan 43166

Premier Health Systems 90440

Premier Managed Care, Inc. (Ohio BWC) 31147

Premier Physicians Network & Valley Division (PPN) CAPMN

Presbyterian Health Plan (Commercial) PREHP

Presbyterian Salud! PRESA

Prestige Health Choice 45056

Prevea Health Insurance Plan 39185

Primary Care & Pediatrics IPA (PCPIPA) CAPMN

Primary Care Associates (NAMM) IP079

Primary Health Plan PRIME

Primary PhysicianCare, Inc. 56144

Primary Provider Management Company PPM01

Prime Care Health Plan UH015

Prime Vision Health 56190

PrimeCare Medical Network (NAMM) Chino IP079

PrimeCare Medical Network (NAMM) Citrus Valley IP079

PrimeCare Medical Network (NAMM) Coachella Valley IP079

PrimeCare Medical Network (NAMM) Corona IP079

PrimeCare Medical Network (NAMM) Hemet IP079

PrimeCare Medical Network (NAMM) Inland Valley IP079

PrimeCare Medical Network (NAMM) Moreno Valley IP079

PrimeCare Medical Network (NAMM) North American Medical

Management (CA) IP079

PrimeCare Medical Network (NAMM) Redlands IP079

PrimeCare Medical Network (NAMM) Riverside IP079

PrimeCare Medical Network (NAMM) San Bernardino IP079

PrimeCare Medical Network (NAMM) Sun City IP079

PrimeCare Medical Network (NAMM) Temecula IP079

PrimeSource Health Network 04320

PrimeWest Health Plan 61604

Principal Financial Group 61271

Principal Life Insurance Company 61271

Priority Health 38217

Prism - First Health 37303

Prism - Univera 37315

Prism Network, Inc. 37268

ProCare (Prospect Medical Group) PROSP

ProCare Health Plan - ABW (Detroit, Michigan) 38329

ProCare Health Plan - Health Choice (Detroit, Michigan) 38329

ProCare Health Plan - Medicaid (Detroit, MI) 70259

Professional Benefit Administrators 59296

Page 38: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Professional Benefit Administrators, Inc. - Oak Brook, Illinois 36331

Professional Claims Management PAPER

Professional Risk Management 34134

ProMed HealthCare Administrators (California) IP057

Promina 58226

Prospect Health Network PROSP

Prospect Medical Group PROSP

Prospect Sherman Oaks Medical Group PROSP

PROSSAM Asociacion de Maestros 94027

Protegrity Services (Ohio BWC) 31147

Providence Choice Option PHP01

Providence Good Health Plan PHP01

Providence of Oregon Health Plan SX133

Provident Life & Accident Insurance Company of America 68195

Provident Preferred of Washington 91131

ProviDRs Care Network 48100

Prudent Care Medical Group (SynerMed) SYMED

PSN - Florida Medicaid (JMH) 09822

Psychcare 51052

Puget Sound Benefits Trust 91136

Puget Sound Electrical Workers Trust 91136

Puget Sound Health Partners, Inc 42172

Quad Med (Pewaukee, WI) 39197

Qual Choice of Arkansas 35174

Qual Choice of Virginia 35171

QualCare, Inc. 23342

Qual-Med Colorado EPO QMDCE

Qual-Med New Mexico QUANM

Qual-Med Portland (PO) QMDPO

R & N Market TKFMC

RBMS, LLC 91176

Redlands IPA (San Bernardino) SYMED

Regal Medical Group (California) REGAL

Regency Employee Benefits 38221

Regent Medical Group HSM01

Regional Care, Inc. 47076

Reserve National Insurance 73066

ResourceOne Administrators 37278

Resurrection Health Care Preferred 36396

Right Choice Benefit Administrators 37331

River City Medical Group RCMG1

Riverside Family Health Medical Group (MedPOINT) (CA) MPM08

RMSCO, INC. - Liverpool, New York 16117

Page 39: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Rocky Mountain Health Plan - Grand Junction 84065

Rocky Mountain Health Plan - Grand Junction SX141

Rooney Life Inc 37602

Rosemont of Des Plaines, Illinois 36215

Rush Prudential Health Plans (HMO Only) 36389

S & S Healthcare Strategies 31441

SafeGuard SFG99

Sagamore Health Network 35164

Saigon Medical Group HSM01

Samaritan Health Plans CP001

SAMBA (Special Agents Mutual Benefit Association) 62308

San Francisco Health Plan, encounters SFHP1

San Luis Obispo Select 33072

Sanford Health Plan 91184

Santa Barbara Regional Health Authority SBRHA

Santa Clara County IPA (SCCIPA) 10378

Santa Clara Family Health Plan 24077

Sante Health System and Affiliates 77038

SCAN (Senior Care Action Network) SCAN Health Plan (AZ

Medicare) 73172

SCAN Health Plan (AZ AHCCCS) 20460

SCAN Health Plan (CA) 72261

SCHC Total Care Inc. (Acceptius Gateway Payer) 16146

SCINET - Claims - OSNA United Health Care SX195

Scott & White Healthcare 88030

Screen Actors Guild 99289

Seaview IPA SVIPA

Secure Health Plans of Georgia, LLC 28530

Security Health Plan 39045

Select Administrative Services (SAS) 64088

Select Benefit Administrators - Des Moines, Iowa 42137

Select Benefit Administrators of America - Ashland, Winconsin 37282

Select Health of South Carolina 23285

Selectcare 00014

SelectCare of Texas (Houston) HPN11

SelectCare of Texas (HPN) Heritage Physicians Network 76045

SelectCare of Texas (Kelsey-Sebold) aka TexanPlus 61225

SelectHealth SX107

Self Insured Benefit Administrators - Clearwater, Florida 59111

Self Insured Plans 36404

Self-Funded Plans (Illinois, Pennsylvania, Ohio) 34131

Sendero Health Plan 36426

Senior Care Partners 36390

Page 40: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Senior Health Partners (SHP) 80141

Senior Whole Health 83035

Sentara Family Care 54154

Sentara Health Management 54154

Sentinel Management Services 23249

Sentry Insurance a Mutual Company 39033

Seoul Medical Group (Cap Management Systems) CAPMN

Sequoia Beverage TKFMC

Seton Employee Plan SHEBP

Seton Health Plan - CHIP SHPCH

Seton Health Plan - Exclusive Provider Network EPNSH

Seton Health Plan - Map Program SHMAP

Share Health Plan - Illinois/HMO UH005

Share Health Plan - Illinois/PPO UH006

Sharp Community Medical Group SCMG1

Shasta Administrative Services 75280

Sheakley UNICOMP (Ohio BWC) 31147

Sheffield, Olson & McQueen, Inc. 41143

Sierra Health Services (Claims) 76342

Sierra Nevada IPA MBADM

Signature Health Alliance 62159

Simply Healthcare 27094

Sinclair Health Plan 84076

Sloans Lake Managed Care 84096

Smith Administrators 02057

Solidarity Managed Care Organization (Ohio BWC) 31147

Sonoma County Primary Care IPA (SCPCI) SCPCI

South Indiana Health Options (HMO) SX142

South Point Hotel & Casino 35227

SouthCare/Healthcare Preferred 25147

Southeast Community Care (GA) (NC) (SC) (VA) AMS11

Southeast Texas Gov't Employees Benefit Pool STGEB

Southern Benefit Services 37318

Southern CA Children's Healthcare Network (Synermed) SYMED

Southern California Physicians Managed Care SCP01

Southern Health Services 25133

Southland Advantage Medical Group HSM01

Southland San Gabriel Valley Medical Group HSM01

Southwest Administrators SWADM

Southwest Service Life 37266

Special Risk International 52190

Spokane Community Care (WA) AMS11

St. Barnabas System Health Plan 22240

St. John's Claims Administration 37264

Page 41: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

St. Joseph Health Foundation of Northern California 68033

St. Joseph Heritage Healthcare STJOE

St. Jude (St. Joseph Heritage Healthcare) STJOE

St. Mary's Health Plans 88029

St. Peter Medical Group HSM01

St. Therese Physician Association 37116

St. Thomas Medical Network (Gulfquest) STM01

St. Vincent Catholic Medical Centers 13407

St. Vincent IPA PDT01

State Auto Insurance Companies 46450

State Employees Group Benefits 72087

State Farm Insurance Companies 31053

States General Life Insurance 75087

Staywell Health Plan 14163

Sterling Medicare Advantage Life Ins 67829

Sterling Option 1 91151

Stirling Benefits STL01

Stoner and Associates - Cincinnati, OH 31121

Student Insurance 74227

SummaCare Health Plans 95202

Summit America Insurance Services, Inc. 37301

SummitCorp (Ohio BWC) 31147

Sun Health SX186

Sunamerica Life Insurance Company 90956

Sunshine State Health Plan 68057

Superior Administrators, Inc. - Santa Ana, California 23218

Superior Choice Medical Group, Inc HSM01

Superior Health Plan SHP11

Superior Health Plan CHIPS EPO SHP11

Superior Health Plan of Texas 39188

Sutter Connect - California 09157

Synermed SYMED

Talbert Medical Group TALMG

Tall Tree Administrators 88067

Tarrant County Texas First TOPA1

Tarrant Health Services 37228

TASEBA TKFMC

TBG Administrative Services 39157

Teachers Health Trust 88019

Team Choice - Alpha Care Gold ADSL1

Team Choice - Gold 75139

Team Choice PNS 75133

Team Choice UMC 75134

Teamcare 36215

Page 42: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Texan Plus (Houston) HPN11

Texan Plus (Kelsey-Sebold) 61225

Texarkana Community Care (AR) AMS11

Texas Association of School Boards TTASB

Texas Children Star Medicaid TXCSM

Texas Children’s Health Plan 76048

Texas Childrens Health Plan STAR (Medicaid) 75228

Texas Children's Star TH077

Texas Christus 45210

Texas Community Care (TX) AMS11

Texas HealthSpring 33104

Texas Municipal League Group 74214

Texas Premier Plan TH089

Texas True Choice TTCEC

Texas University Plan - UPG Commercial UPGUT

The Care Network/The Savannah Business Group 68423

The City of Odessa 75600

The Empire Plan 87726

The Health Exchange (Cerner Corp) 20356

The Health Plan - Massillon, Ohio and St. Clairsville, Ohio ONLY 34150

The Health Plan (Ohio BWC) 31147

The Health Plan of the Upper Ohio Valley 34150

The Healthcare Group 35206

The Integrity Benefit Group 58200

The Loomis Co - TPA Wyomissing, PA (HIS Gateway PA) 23223

The Mega Life & Health Insurance Company 59221

The Mega Life & Health Insurance Company - Starbridge

StarHRG 59225

The Mega Life OKC 59227

The Perfect Health Insurance Company 13522

The Preferred Healthcare System (PPO) 04320

The Public Health Program AMM01

The TPA (Benesight) 87265

The Wellness Plan 38200

Theraphysics THERA

Theraphysics (Colorado ONLY) COTHE

Therapy Network of Puerto Rico TNPR1

Three Rivers Health Admnistrators, Inc. - Monroeville,

Pennsylvania 25175

Time Insurance Company (Assurant Health) 39065

TML Intergovernmental Employee Benefit Pool 74214

Today's Health WITH1

Today's Health Wisconsin 20081

Page 43: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

Today's Options (American Progressive and Pyramid Life) 48055

Tongass Timber Trust 92620

Tooling & Manufacturing Assn 61425

Torrance Hospital IPA THIPA

Total Carolina Care 68055

Total Community Care 31182

Total Health Care Michigan 38201

Total Health Choice Florida 38202

Total Health Management - PBM (Ohio BWC) 31147

Touchpoint 87726

Touchpoint Health Plan HMO 97910

Touchstone Health PSO 23856

Touchstone Health/ Health Net Smart Choice 13402

Tower Life Insurance Company 69493

Town & Country TKFMC

TR Paul, Inc. 37230

TransAmerica Life Financial Insurance Company TFLIC

TransAmerica Life Insurance Company TSAA2

TransAmerica Life Insurance Company TLINS

TransAmerica Life Insurance Company TLIN2

TransAmerica Life Insurance Company 59222

TransAmerica Occidental Life Insurance Company TOLI2

TransChoice - Key Benefit Administrators 37284

Transwestern Insurance Adminstrators, Inc. TRAN1

Tricare For Life, WPS TDDIR

Tricare, North - Health Net Federal Services, PGBA 38520

Tricare, North & South, PGBA 38520

Tricare, South - Humana Military, PGBA 38520

Tricare, West (TriWest), WPS WESTR

Trilogy Health Network 62777

Trilogy Health/CareVu 98514

True Choice USA TCUSA

True Choice USA - Christus Health Plan TCUCH

Trusted Plans Service Corporation - Tacoma, Washington 91078

Trustmark Insurance Company 61425

TTPA Comm 76054

Tufts Health Plan 04298

TXEN AltPros 75206

UBH - United Behavioral Health (Health Plan HMO) 87726

UBH - United Behavioral Health –Employer division UBHRI

UBH RIOS 87726

Ucare of Minnesota 52629

UCI - University Physicians and Surgeons HSM01

UCSF/CSL Pulmonary 65006

Page 44: Exchange EDI Claims Payer List · Exchange EDI Claims Payer List. Affinity Health Plan 13334 Affinity Medical Group 46594 Affinity Medicare Advantage 13333 ... South Carolina, Preferred

UFCW California (Blue Shield) CABLS

UHA University Health Alliance 99026

UICI Administrators - State of Nevada 74223

Ultra Benefits Inc 41206

UMR - Cincinnati, fka United Medical Resources 31107

UMR - Harrington Benefit Services (Columbus, Ohio) 95266

UMR - Harrington, fka Harrington Benefit Services-Westerville 75196

UMR - Lexington, fka CommonWealth Administrative Group 37237

UMR - Onalaska, fka Midwest Security 79480

UMR - Wausau/UHIS, fka Fiserv Health - Wausau Benefits,

Benesight, Employers Insurance of Wisconsin 39026

UMWA Health & Retirement Funds 52180

UniCare 80314

Unified Group Services 35198

Unified Health Services 62170

Unified IPA (California) HCP01

Unified IPA (Illinois) 01691

Uniform Medical Plan/Harrington Benefit Services 75243

Uniformed Service Family Health Plan 13407

Union Pacific Railroad Employees 87042

Union Security Insurance Company (Assurant Health) 70408

Unison Health Plan/Better Health 62183

Unison Health Plan/Three Rivers 25175

United Agriculture Benefit Trust UAGBT

United Care Medical Network (formerly United St. Joseph

Mission) CAPMN

United Food & Commercial Workers Unions and Food

Employers Benefit SCUFW

United Healthcare 87726

United Healthcare of Louisiana 87726

United Healthcare Plan of River Valley 95378

United Healthcare West (formerly known as PacifiCare) 87726

United Healthcare West (formerly known as PacifiCare)

(Encounters) 95958

United of Omaha 71412

United Physicians of North Colorado 84132

United Resource Network 41194

United Security Life & Health 81108

United Security Life Ins Co PAPER

Unity Health Insurance Corp 66705

Univera - Healthcare Plan/ChoiceCare Buffalo SX087

Univera - Pre Paid Health Plan of New York SX086

Univera - Univera Health Southern Tier SX088

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Univera Healthcare CNY 12X17

Univera Healthcare SSA ENY 12X20

Univera Healthcare SSA WNY, PPO, Traditional 12X19

Univera Healthcare WNY 12X18

Univera SSA ENY SX090

Univera SSA WNY SX091

Universal Care - California 33001

Universal Care - Tennessee 33002

Universal Health Care Group - St. Petersburg, Florida 50528

University Comp Care (Ohio BWC) 31147

University Family Care 09830

University Family Care - Healthcare Group 07503

University Family Care - Maricopa Health Plan 09908

University Health Alliance UHA01

University of Missouri 25133

University of Washington Students & Graduate Students 91136

Upland Medical Group (California) IPO56

UPMC Health Plan (Commercial) 23281

Upper Peninsula Health Plan 38337

US Benefits 93092

US Department of Labor - OWCP 77044

US Family Health Texas & Louisiana USFHP

US/Healthcare (HMO) 23222

USAA (United States Automobile Association) 74095

USFHP-St. Vincent Catholic Medical Center 13407

Utah Public Employees Health Plan (PEHP) SX106

Valley Baptist Health Plan (TX) TH022

Valley Health Plan - CHDP VHPCH

Valley Health Plan - Commercial VHPCO

Valley Health Plan - Managed Care VHPMC

Valley Preferred - PPO Allentown, Pennsylvania (HIS Gateway

Payer) 23253

Value Options - Commercial VOCOM

Value Options - Medicaid Colorado VOMCO

Value Options - Medicaid Kansas VOMKS

Value Options - Medicaid Maryland VOMMD

Value Options - Medicaid Massachusetts VOMMA

Value Options - Medicaid Pennsylvania VOMPA

Value Options - Medicaid Texas VOMTX

Vanguard Health Systems (SynerMed) SYMED

Vantage Health Plan, Inc. (Louisiana) 72128

Vantage Health Plan, Inc. (Ohio BWC) 31147

Vantage Medical Group (California) IPA PPM01

Verdugo Hills Medical Group VHMG1

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Verity National Group 75256

Veterans Administration (VA) Fee Basis Programs 12115

Victor Valley IPA VVIPA

Village Family Health 73743

Virginia Premier Health Plan 54176

Vision Care Incorporated 37297

Vista Health Plan 55248

Viva Health Inc 63114

VNS Choice Medicare 77073

Vytra Healthcare 22264

Washington (State of) Labor & Industry SX063

Waterloo Municipal Employees Health Plan OBALB

Waterstone Benefit Administrators 73155

Watts Healthcare Corp (MedPOINT) (CA) MPM09

WEA Insurance Group (Wisconsin Education Assoc) 39151

WEB-TPA / Community Health Electronic Claims / CHEC 75261

Wellcare Health Plan, Inc. (Encounters) 59354

Wellcare HMO, Inc. 14163

Wellcare of Florida 14163

Wellcare of Georgia 14163

Wellcare of Illinois 14163

Wellcare of Kentucky 14163

Wellcare of Louisiana 14163

Wellcare of New York 14163

Wellcare of Ohio 14163

WellMed (Claims) WELM2

WellMed (Encounters) WELMD

WellMed/Secure Horizons WELM2

WellPath 25133

Wells Fargo Third Party Administrators, Inc. 87815

Wels Benefit Plan Office 22925

Wenatchee Valley Medical Center 91064

West Coast Stationary Engineers Health & Security Trust Fund 91136

West Virginia Workers Compensation - Brickstreet 77025

Western Growers Assurance Trust 24735

Western Growers Insurance Company 24735

Western Health Advantage 68039

Western Health Inc. 37306

Western Mutual Insurance / WMI-TPA 37247

Western Southern Financial Group - Cincinnati, Ohio 31048

Westlake Financial Group WESTL

Weyco Inc 38232

William C. Earhart Company, Inc. 93050

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William J. Sutton & Company 98010

Windsor Medicare Extra 62153

Winhealth Partners - Wyoming WNHLT

Wisconsin Auto & Truck Dealers Insurance Plan 39200

Woodman Accident and Life Company 81949

Worker's Compensation - Texas TWCCP

Worksite Benefit Services, LLC 20333

World Insurance Company 75276

WPS Commercial WPS00

Writer's Guild Industry Health Plan 23710

Yale New Haven Health - MSO INC. 06121

Yavapai County 09829

Yorba Park (St. Joseph Heritage Healthcare) STJOE