All States Payer List - OfficeAlly

1 All States Payer List Professional Claims (HCFA 1500). ALL States **Requires Pre-Enrollment Payer ID Name Claims Type State 1199 Local Benefit Fund 13162 (Provider should submit claims with assigned Plan Provider ID, as 2 digit suffix is no longer required. Call Renaud Dufr Comm esne at (646) 473-6960 for a list of Network ID's.). 59069 21st Century Health and Benefits Comm 51028 21st Century Insurance and Financial Services (For Minnesota only) Comm MN. 20413 3P Admin Comm 74234 8th District Elec Comm UT. 93044 A & I Benefit Plan Administrators Comm 37283 AAG - American Administrative Group (Formerly Gallagher Benefit Admin) Comm 75185 AAG - American Administrative Group (Formerly Icon Benefit Admin) Comm 75240 AAG Benefit Plan Administrators, Inc. Comm 87726 AARP - Payer ID valid only for claims with a billing submission address of PO Box 30968 Salt Lake City, UT 84130 Comm 87726 AARP - Payer ID valid only for claims with a billing submission address of PO Box 31361 Salt Lake City, UT 84161 Comm 87726 AARP - Payer ID valid only for claims with a billing submission address of PO Box 31362 Salt Lake City, UT 84161 Comm IP079 ABMA Medical Corporation Comm CA.

2 03443 ABRAZO Advantage Health Plan Comm AHS01 Access Administrators Comm COACC Access Behavioral Care Comm CO. 64071 Acclaim Comm 21356 Acclaim Repricing Comm AHP01 Accountable Health Plan - Wisconsin & Iowa Comm ** AHIPA Accountable IPA (California) Comm HPSVC ACEC Comm NV. 72467 ACS Benefit Services, Inc. Comm 36112 ACS Rewards Administration Center Comm AHC01 ActivHealthCare Comm 22384 Administration Concepts, Inc. Comm 38265 Administration Systems Research Corp Comm 59141 Administrative Services, Inc. Comm 37278 AdminOne Comm Advanced Medical Associates (Testing of each provider is required by Payer and done automatically by office ally TMG01 Comm once you start submitting claims for this Payer .). AMM01 Advanced Medical Management Comm & HMO CA. AMM02 Advanced Medical Management MSI Comm & HMO CA. 74234 Advanstaff, Inc. Comm 68056 Advantage by Bridgeway Health Solutions Comm 68056 Advantage by Buckeye Community Health Plan Comm 68056 Advantage by Managed Health Services Comm 68056 Advantage by Superior HealthPlan Comm NMM01 Advantage Medical Group Comm ADVTK Advantek Benefit Administrators Comm 25133 Advantra - Health Assurance - Health America, Inc.

3 Comm 25133 Advantra - Kansas City Medicare - Coventry Comm 25133 Advantra Freedom Comm 95340 Adventist Health System West - Roseville, California Comm 36320 Advocate Health Centers Comm IL. 65093 Advocate Health Partners Comm IL. 33898 Aegis Security Insurance Company Comm PA. 60054 Aetna Comm 57604 Aetna Affordable Health Choices (SM) - SRC Comm 23225 Aetna Better Health Comm 23225 Aetna Better Health - Connecticut Medicaid Comm 60054 Aetna Student Health Comm 38692 Aetna TX Medicaid Comm TX. ADOCS Affiliated Doctor's of Orange County (ADOC) Comm & HMO CA. APG01 Affiliated Physicians Group (APG) Comm IL. ** 13334 Affinity Health Plan Please contact before sending claims or 718-794-7592 Comm 46594 Affinity Medical - Claim Status reports available at Comm CA. 13333 Affinity Medicare Advantage for Medicare claims with DOS after 1-1-10 Comm 95426 Affordable Benefit Administrators, Inc. Comm 34444 AFL - CIO Food & Beverage Dealer's Trust Fund Comm OH. 13346 AFTRA Health Fund Comm NY.

4 37280 AGA Comm 64158 Agency Services Inc. (Now known as Meritain Health) Comm MAP01 AIA- American Insurance Administrators (PO Box 2501 Bassett, CA and City of Industry addresses only) Comm CA. CAPMN AKM Medical Group (Cap Managements Systems) Comm CA. 06311 Alabama Medical Surgical Associates Comm 91136 Alaska Children's Services, Inc. Group #P68 Comm 92600 Alaska Electrical Health & Welfare Fund Comm AK. 91136 Alaska Laborers Construction Industry Trust Group # F23 Comm ** Indicates Pre-Enrollment - Approval from office ally and Payer Required Prior to Claim Submission Revised 05/12/2010 Payer List subject to change without notice Page 1 of 31. Payer ID Name Claims Type State 91136 Alaska Pipe Trades Local 375 Group # F24 Comm 91136 Alaska UFCW Health & Welfare Trust Group # F45 Comm 13550 ALICARE Comm 58213 Alignis Comm 37602 All Savers Insurance Company Comm 81040 Allegiance Benefit Plan Management, Inc. 13079 Alliance Healthcare - Stones River Regional IPA Comm HCP01 Alliance IPA Comm & HMO CA.

5 23172 Alliance Partners Comm OH. 20257 Alliance Physicians (High Desert Primary Care Alliance) Hesperia, CA Comm CA. 52149 Alliance PPO Comm 88461 Alliance, The (A Wisconsin provider network) (Call Dave Sell at 608-210-6656 to pre-enroll) Comm 91131 Alliant Health Plan (FCHN) Comm WA. 58234 Alliant Health Plans of Georgia Comm GA. 94177 Allied Administrators - San Francisco, California Comm CA. 37308 Allied Benefit Systems, Inc. Comm NMM01 Allied Physicians Medical Group Comm SYMED Alpha Care Medical Group Comm & HMO CA. 80705 ALTA Health & Life Insurance Comm IP079 Alta Senior Care Comm CA. 25133 Altius Health Plan Comm 25133 Altius Health Plan- Coventry Comm UT. AMAIA Ama Insurance Agency, Inc. Comm 13550 Amalgamated Life Comm CO. 13343 Amalgamated Life IPA Alicare Comm COMPU Amalgamated Transit Union Division 1001 Health & Welfare Fund Comm 75137 Ameriben Solutions, Inc. Comm 20029 America's Choice Comm 27517 Americaid Community Care - Maryland Comm MD. 27516 Americaid Community Care - New Jersey Comm NJ.

6 75240 American Administrative Group Comm 37283 American Administrative Group (AAG) - Formerly Gallagher Benefit Admin Comm 42112 American Administrators - West Des Moines, Iowa Comm 63103 American Behavioral Comm HPSVC American Benefit Plan Administrators - HealthPlan Services, Inc. Comm & HMO. 34187 American Benefits Management - North Canton, Ohio Comm OH. 37128 American Commercial Barge Lines Comm 60305 American Community Mutual Insurance Comm ACN01 American Complimentary Care Network Comm CAPMN American Family Health Providers - Cap Managements Systems Comm CA. AMF11 American Family Insurance Comm 62030 American General Life & Accident Comm 01066 American Healthcare Alliance Comm 36369 American Imaging Management, Inc. Comm 81949 American Insurance Company of Texas Comm TX. 87726 American International Group, Inc. (AIG) Comm 72099 American Life Care Comm 81400 American Medical Security Comm 74048 American National Insurance Company (ANICO) Comm APSFL American Pioneer - South Florida Comm FL.

7 APBPN American Pioneer Brevard PHY Net Comm 62308 American Postal Workers Union (Claims with DOS prior to 1/1/10 should use Payer ID 44444) Comm 14190 American PPO Comm 48055 American Progressive Life and Health Insurance Company Comm 42011 American Republic Insurance Company (ARIC) Comm 17965 American Sentinel Insurance Company Comm PA. ASHP1 American Specialty Health Plan Comm 37322 American Worker Health Plan Comm 41161 American Chiropractic Network (ACN) Comm 41160 American Chiropractic Network IPA of New York (ACNIPA) Comm NY. 20029 Americas Health Choice Comm 95378 AmeriChoice - Tenncare Comm TN. 87726 AmeriChoice of Connecticut Comm CT. 87726 AmeriChoice of Florida Comm FL. 87726 AmeriChoice of Illinois Comm IL. 87726 AmeriChoice of Maryland Comm MD. 87726 AmeriChoice of New England Comm NE. 86047 AmeriChoice of New Jersey Medicaid Comm NJ. AmeriChoice of New Jersey Personal Care Plus (Medicare) (All claims require AmeriChoice provider id - call 888-362- 86001 Comm NJ.)

8 3368 to obtain.). 86048 AmeriChoice of New York Medicaid and Child Health Plus Comm NY. AmeriChoice of New York Personal Care Plus (Medicare) (All claims require AmeriChoice provider id - call 888-362- 86002 Comm NY. 3368 to obtain.). 86049 AmeriChoice of Pennsylvania Medicaid Comm PA. AmeriChoice of Pennsylvania Personal Care Plus (Medicare) (All claims require AmeriChoice provider id - call 888-345- 86003 Comm PA. 3627 to obtain.). 87726 AmeriChoice of Rhode Island Comm RI. ** Indicates Pre-Enrollment - Approval from office ally and Payer Required Prior to Claim Submission Revised 05/12/2010 Payer List subject to change without notice Page 2 of 31. Payer ID Name Claims Type State 95378 AmeriChoice of Tennessee Comm TN. ASRM1 AmeriCorp Comm 28804 Amerigroup Community Care of New Mexico Comm NM. 28804 Amerigroup Community Care Comm 28804 Amerigroup Corporation - Fort Worth, Texas Comm TX. 28805 Amerigroup Corporation - Houston, Texas Comm TX. 28809 Amerigroup Florida Healthy Kid Comm FL.

9 28804 Amerigroup Georgia Comm GA. 28808 Amerigroup Illinois Comm IL. 28808 Amerigroup Ohio Comm OH. ** 54763 AmeriHealth Administrator *Must also be a Highmark provider* Comm ** 93688 Amerihealth Delaware Non-HMO (Highmark) *Must also be a Highmark provider* Comm DE. ** 95044 Amerihealth Delware - New Jersey HMO (Highmark) *Must also be a Highmark provider* Comm DE/NJ. 22248 Amerihealth Mercy Health Plan Comm ** 60061 Amerihealth New Jersey Non-HMO (Highmark) *Must also be a Highmark provider* Comm NJ. PPM01 Ameri-West Health Associates Comm AMILR AMIL - ARIA - Via Mediview Comm TX. PROSP AMVI - Prospect Health Network (Prospect Medical Group) Comm & HMO CA. CAPMN AMVI (Cap Managements Systems) Comm CA. 53085 Anchor Benefit Consulting Inc. Comm 86062 Ancillary Benefit Systems - Arizona Foundation for Medical Care Comm AZ. HSM01 Angel Medical Group DBA Superior Choice Medical Group Comm SYMED Angeles IPA Comm & HMO CA. 34192 Antares Management Solutions Comm HDMDG Antelope Valley Medical Associates Comm & HMO CA.

10 80705 Anthem Health & Life Insurance Company of New Jersey Comm & HMO NJ. 16140 APA Partners, Inc. Comm PROSP APAC (Pinnacle Health Resources) (Prospect Medical Group) Comm & HMO CA. 34196 Apex Benefit Services Comm APP01 AppleCare Medical Management Comm & HMO CA. 54160 APS Healthcare Inc. Comm 44444 APWU - Affordable Network Comm 16120 ARAZ Comm AZ. AMS11 Arcadian Community Care Comm LA. AMS11 Arcadian Health Plan Comm OK. AMS11 Arcadian Management Services Comm CA. AMS11 Arcadian of Washington (Arcadian Mgmt Serv) Comm WA. 36356 Argus Health Systems Comm 86062 Arizona Foundation for Medical Care Comm & HMO AZ. 03432 Arizona Physicians IPA (APIPA) Comm 74234 Arizona pipe Trades Health & Welfare Trust Fund Local Unions #469 & 741 Pipe Trades Health Plan Comm AZ. 75278 Arkansas Best Corporation Comm AMS11 Arkansas Community Care Comm AR. 95440 Arnett Health Plans Comm NMM01 Arroyo Vista Family Health Center Comm HSM01 Asian Community Medical Group, Inc. Comm ASRM1 ASRM Corp Comm ASRM1 ASRM Corp.