Clearance EDI Eligibility Payer List

1 Clearance EDI Eligibility Payer List To request a connection to a Payer not on the list below, please submit a New Payer Connection Request. Reference the CAQH web site for CORE Certified payers. See Legend for explanation of Payer List. Payer Name Change Healthcare Payer -assigned Payer Connectivity Authorization Payer ID ID Type Available Required 1199 National Benefit Fund 1199NB 13162 Both Portal A & I Benefit Plan AIBPL1 93044 Portal Portal AARP AARP 36273 Both Portal Absolute Total Care CNTENE 68069 X12 No Acclaim ACCLA1 64071 Portal Portal ACS Benefit Services ACSBE1 72467 Portal Portal Administrative Services ADMIN 59141 X12 No Advantage by Bridgeway CNTENE 68069 X12 No Advantage by Buckeye (Bridgeway Advantage CNTENE 68069 X12 No Plan). Advantage by Managed health Services CNTENE 68069 X12 No Advantage by Superior health Plan CNTENE 68069 X12 No Advantra Freedom CHCADF 25152 X12 No Adventist ADVEN1 95340 Portal Portal AdviCare WELLCR 45423 Portal Portal AETNA AETNA 60054 Both Portal Aetna Better health of Florida ABHFL 128FL Both Portal Aetna Better health of Illinois ABHILL 26337 Both Portal Aetna Better health of Kentucky COVCKY 128KY Both ABHKY1 No Aetna Better health of Louisiana ABHLA1 128LA Portal Portal Aetna Better health of Michigan ABHMI 128MI X12 No Aetna Better health of New York ABHNY 34734 X12 No Aetna Better health of Ohio ABHOH 50023 Portal Portal Aetna Better health of Pennsylvania ABHPA 23228 Both Portal Aetna Better health of Texas ABHTX 00364 X12 No Aetna Better health of

2 Virginia CHCCN 128VA Both Portal ABHVA1. Aetna Better health of West Virginia ABHWV1 128WV Portal Portal AETNA Long Term Care AETLTC 60054 X12 No Aetna SSI ATNSSI 62118 Both Portal Affinity Essentials AFFNY1 23334 Portal Portal Affinity health Plan AFFIN 13334 Both Portal Affinity health Plan Medicare Advantage AHPMCR 13333 X12 Portal AFLAC (Dental only) AFLAC X12 No AgeWell New York AWNY1 AWNY6 Portal Portal Alabama Blue Cross Blue Shield ALBCSI 00010BC Both Portal ALBCSP 00510. Alabama Medicaid ALCAID 752548221 Both Portal Alaska Medicaid AKMCD1 AKMEDICAID Both FHSC Portal Alameda Alliance for health ALAHP1 95327 Portal Portal Alignment health Care ALHC1 CCHPC Portal Portal All Savers health Plan ALLSA1 Portal Portal Allegiance Benefit Plan Management, Inc ALGNC1 81040 Portal Portal Alliant health Plans ALLNT1 58234 Both Portal Allied Benefit ALBENS 37308 Both Portal Alohacare ALOHA 990309519 Both Portal Allwell from Absolute Total Care CNTENE 68069 X12 No Allwell from Arkansas health & Wellness CNTENE 68069 X12 No Allwell from Buckeye health Plan CNTENE 68069 X12 No Allwell from health Net CNTENE 68069 X12 No Allwell from Home State health CNTENE 68069 X12 No Allwell from Louisiana Healthcare Connections CNTENE 68069 X12 No Allwell from Managed health Services CNTENE 68069 X12 No Allwell from Managed health Services health CNTENE 68069 X12 No Wisconsin Allwell from Magnolia health CNTENE 68069 X12 No Allwell from PA health & Wellness CNTENE 68069 X12 No Allwell from Peach State health Plan CNTENE 68069 X12

3 No Allwell from Sunflower health Plan CNTENE 68069 X12 No Allwell from Sunshine health CNTENE 68069 X12 No Allwell from Superior HealthPlan CNTENE 68069 X12 No Altius ALTIUS SX113 X12 No AMA Insurance AMAIA1 AMAIA X12 Portal Amalgamated Life AMGMT1 13550 Portal Portal Ambetter from Buckeye Community health Plan CNTENE 68069 X12 No Ambetter from CeltiCare health Plan CNTENE 68069 X12 No Ambetter from health Net CNTENE 68069 X12 No Ambetter from Homestate health CNTENE 68069 X12 No Ambetter from Magnolia health CNTENE 68069 X12 No Ambetter from Managed health Services CNTENE 68069 X12 No Ambetter from Peach State health Plan CNTENE 68069 X12 No Ambetter from Sunshine health CNTENE 68069 X12 No Ambetter from Superior health CNTENE 68069 X12 No Ambetter Illinicare health CNTENE 68069 X12 No Ambetter New Hampshire Healthy Families CNTENE 68069 X12 No Ambetter of Arkansas CNTENE 68069 X12 No Ameriben Solutions AMERBN 75137 Both Portal American health Medicare AMHMED 660650587 X12 No American Medical Security (AMS) AMMEDS 81400 X12 No American National Insurance Company AMNIC 74048 X12 No American National Life Insurance Company of ANLITX 10596 X12 No Texas American Postal Workers Union AMPWU 44444 X12 No American Republic Insurance (MAP)

4 AMRRP1 42011 Both Portal American Retirement Life Insurance Company ARLIMS 10538 X12 No Medicare Supplement America's Choice health Plans AMRCH1 20029 Portal Portal AmericasHealth Plan AMRHP1 Portal Portal AmeriChoice AMCHO1 UFNEP Portal Portal AmeriGroup AMRGRP 27514 Both Portal AmeriHealth Administrators TPA AMHADM 54763 X12 No AmeriHealth Caritas Delaware AHCDE 77799 X12 No AmeriHealth Caritas District of Columbia AHCDC1 77002 Portal Portal AmeriHealth Caritas Iowa AHCIA 77075 Both Portal AmeriHealth Caritas Louisiana LACAR 27357 Both Portal AmeriHealth Caritas Pennsylvania AMHLTH 22248 Both Portal AmeriHealth Caritas VIP Care Michigan ACVMI1 77013 Portal Portal AmeriHealth Caritas VIP Care Pennsylvania AMCVC 77062 X12 No Amerihealth Mercy health Plan - Medicaid HMO AMHLTH 22248 X12 No Amerihealth New Jersey/Delaware - HMO PAIBCE 95044 Both Portal Ameritas Life Insurance Company AMRTAS 00425 X12 No Amida Care Medicare AMICM1 79966 Portal Portal Antares Management Solutions ANTAR 34192 X12 No Anthem Blue Cross (fka CA Blue Cross) CABC2 47198 Portal Portal Arise health Plan Medicare Select Policy AHPMSP 39158 X12 No Arizona Blue Cross Blue Shield AZBCBS 53589 Both Portal Arizona Foundation AZFND1 860629899 Portal Portal Arizona Medicaid AZCAID 866004791 Both Portal Arizona Physicians IPA AZPIPA 03432 X12 No Arizona Physicians IPA Healthcare Group AZPIPA 03432 X12 No Arkansas Blue Cross Blue Shield ARBCBS 00520 Both Portal X12.

5 Arkansas Medicaid ARCAID 716007869 Both Portal ASI Corporation ASICR1 Portal Portal ASR health Benefits ASRHL1 Portal Portal Asuris Northwest ASURNH 93221 Both Portal Atrio health Plans ATRIO1 MP-AD/ Portal MP_ADVANTAGE Portal AultCare AULTCR 341488123 X12 No Aultra Administrative Group ALTRA1 Portal Portal Automated Benefit Services ABSERV 383269272 Both Portal Automated Group Administration AUGRP1 37280 Portal Portal Auxiant health AUXHE1 Portal Portal Avera health Plans AVERA1 46045 Portal Portal Avesis TPA AVSIS1 87098 Portal Portal AVSIS2. AVMed AVMED 59274 Both Portal Bankers Fidelity BKFID1 Portal Portal Bankers Life and Casualty Company BNKLIF Both Portal Banner health Network MDSUN 12X42 X12 No Banner University Family Care BUFCR 66901 X12 No BAS health BASHL1 36149 Portal Portal Beacon BCNHL1 43324 Portal Portal Bell County Indigent health Care BCIHC1 Portal Portal Benefit Administration Services, Ltd (BAS LTD)

6 BNADM1 41205 Portal Portal Benefit Plan Administrators BPAM1 37118 Portal Portal Benefits Management Inc BNMGT1 48611 Portal Portal BeneSys Administration BENESY1 Portal Portal Best Choice health Plan BCHP X12 No Best Life and health BSTLFE 95604 X12 No Better health Plan of Florida FLBTHE 20488 Both Portal Block Vision SUPVS1 Block Vision Portal Portal Blue Choice health Plan of South Carolina BLCHHP 922 X12 No Blue Cross Blue Shield Arizona Advantage MDSUN 77078 X12 No Blue Cross Blue Shield of National Capital Area - DCBCBS 00080 Both Portal CareFirst 00580. Blue Cross Blue Shield of Western New York BWNYMC 00246 X12 No Medicaid MCO. Blue Cross Community health Plans BCCOM MCDIL X12 No Blue Cross Medicare Advantage PPO/HMO BLMADV X12 No Bluegrass Family health dba Baptist health Plan BLGRSS 611241101 Both Portal Boon-Chapman Benefit Administrators, Inc.

7 BNCHAP 74238 X12 No Boon Group (The) BOONGR BOONG X12 No Boston Medical Center health Plan BMCHLT 13337 Both Portal Boulder Administration Services BASRV1 Portal Portal Bravo health BRAVO1 52192 Portal Portal Bridgespan BDSPH1 BRIDG Portal Portal Bridgeway health Solutions CNTENE 68069 X12 No Buckeye Community health CNTENE 68069 X12 X12. Cal Optima Direct CALOP CALOP Both Portal California Blue Cross CABC 47198 X12 No California Blue Cross CABC2 47198 Portal Portal California Blue Shield CABS 94036 Both Portal California health and Wellness CNTENE 68069 X12 No California Medicaid (Medi-Cal) CACAID 610442 Both Portal X12. Capital Blue Cross of Pennsylvania PACAPB 23045 X12 No Capital District Physicians health Plan CDPHP 95491 Both Portal Capital health Plan CAPTAL 95112 X12 No Capitol Administrators CPADM1 68011 Portal Portal CapRock health Plans CAPRO1 CAPHP Portal Portal Care 1st health Plan of Arizona CRFRAZ 57116 X12 No Care Improvements Plus CRIMPL 77082 Both Portal Care N Care CAREN1 Portal Portal Care Wisconsin health Plan CAREW1 27004 Portal Portal Care1st health Plan CAFRS1 57115 Portal Portal CareFirst Federal Employee Program CARFEP X12 No CareMore IPA CRMRE CARMO Both Portal CareOregon CAREO1 93975 Portal Portal CarePlus health Plans, Inc.

8 CRPLUS 95092 X12 No 65031. CareSsource HMO CRSRC1 31114 Portal Portal CareSource of Indiana CSRCIN INCS1 X12 No CareSource of Ohio CRSROH 31114 X12 No CareSource of West Virginia CSRCWV WVCS1 X12 No Carpenters health and Welfare Trust Fund of St. CARHLT X12. Louis No CBA Blue CBABL1 03036 Portal Portal CDS Group health CDSGP1 88022 Portal Portal Celtic Insurance CNTENE 68069 X12 No CeltiCare Massachusetts Behavioral health CENPAT 68068 X12 No (CBH). Celticare Massachusetts Medical CNTENE 68069 X12 No CenCal health CENCL1 000000953865941 Portal CACAID Portal Cenpatico Behavioral health - Arizona CENPAT 68068 X12 No Cenpatico Behavioral health - Florida CENPAT 68068 X12 No Cenpatico Behavioral health - Georgia CENPAT 68068 X12 No Cenpatico Behavioral health - Illinois CENPAT 68068 X12 No Cenpatico Behavioral health - Indiana CENPAT 68068 X12 No Cenpatico Behavioral health - Kansas CENPAT 68068 X12 No Cenpatico Behavioral health - Mississippi CENPAT 68068 X12 No Cenpatico Behavioral health - Missouri CENPAT 68068 X12 No Cenpatico Behavioral health - New Hampshire CENPAT 68068 X12 No Cenpatico Behavioral health - Ohio CENPAT 68068 X12 No Cenpatico Behavioral health - South Carolina CENPAT 68068 X12 No

9 Cenpatico Behavioral health - Texas CENPAT 68068 X12 No Cenpatico Behavioral health - Wisconsin CENPAT 68068 X12 No Centerlight Healthcare CTRLT1 13360 Portal Portal Centinela Valley IPA Medical CENTI1 MPM03 Portal Portal Central California Alliance for health CCALL1 CCA01 Portal Portal Central health Medicare Plan HMO CNHLT1 CHCPI Portal Portal Central Reserve Life Insurance Company CRLIMS X12 No Medicare Supplement Central States Fund CSTFND X12 No Central States Indemnity CTLST1 Portal Portal CHAMPVA / Spina Bifida / Children of Women CHMPVA 84146 X12 No Vietnam Veterans Chinese Community health Plan CCHP1 94302 Portal Portal Christian Brothers Services CBSER1 38308 Both Portal Christian Care Ministries CCMIN1 59355 Portal Portal Chronic Renal Program RENAL1 Portal Portal CIGNA CIGNA 62308 Both Portal Cigna HealthSpring Tennessee Alabama HSPRNG HSTN Both Portal Cincinnati Financial CINFN1 46871 Portal Portal Cincinnati health Plan CRSROH 31114 X12 No Citrus health CITRS1 10207 Portal Portal City of Austin MAP SHMAP1 SHMAP Portal Portal Claims Management Service Incorporated CLMSMS X12 No Clover health CLOVE1 77023 Portal Portal CMO The Care Management Company CMOCO1 Portal Portal CMS Medicare CMSMED / CMSHSP X12 X12.

10 Colonial Penn Life Insurance Company CPLIC Both Portal Colorado Access COACCS COACC Both Portal Colorado Blue Cross Blue Shield COBCBS 00050 Both Portal Colorado Medicaid COCAID 77016 X12 No Columbus health Plan CRSROH 31114 X12 No Commonwealth Care Alliance CWCAL1 14315 Portal Portal Community C