ELIGIBILITY, CLAIMS STATUS, REFERRALS, …

1 eligibility , CLAIMS status , REFERRALS, AUTHORIZATIONS, NOTICE OF ADMISSION PAYER LIST. claim status - Submit View View Notice of State Name of Payer eligibility claim status Authorizations Pre-Certs Batch File Referrals Referrals Pre-Cert Admission NAT'L AARP X X X*. SC Absolute Total Care X X X X. NAT'L ACS Benefit Services X X. OH Accountable Care Management Group X X. FL Administrative Services Inc X. AZ Advantage (Bridgeway Health Solutions) X. OH Advantage (Buckeye Community Health Plan) X. WI Advantage (Managed Health Services) X.

2 TX Advantage (Superior HealthPlan) X. MULTI Advantage Health (MI, LA) X. CA Advantek Benefit Administrators X*. MULTI Advantra (AZ, NM, TX) X X. NAT'L Advantra Freedom Medicare X X. NAT'L Aetna X X X X X X X. IL Aetna Better Health (IL) X X. FL Aetna Better Health (FL) X X. KY Aetna Better Health (KY) X. LA Aetna Better Health (LA) X X. MI Aetna Better Health (MI) X X. MO Aetna Better Health (MO) X X. NJ Aetna Better Health (NJ) X X. NV Aetna Better Health (NV) X X. NY Aetna Better Health (NY) X X. OH Aetna Better Health(OH) X X.

3 PA Aetna Better Health (PA) X X. TX Aetna Better Health (TX) CHIP X X. TX Aetna Better Health (TX) X X. VA Aetna Better Health (VA) X. WV Aetna Better Health (WV) X. NAT'L Aetna Enhanced X*. NAT'L Aetna Long Term Care X X. NAT'L Aetna Retiree Medical Plan X X. NAT'L Aetna Senior Supplemental X X. WI Affinity Health X X. NAT'L Affinity Health Plan Essential X*. NY Affinity Health Plan Exchange X*. NAT'L Affinity Health Plan Medicare X X. NAT'L AFLAC X X. NAT'L AFLAC Medicare Supplement X X. Last Updated 2/13/2018 * Indicates a payer that requires additional enrollment information.

4 1. eligibility , CLAIMS status , REFERRALS, AUTHORIZATIONS, NOTICE OF ADMISSION PAYER LIST. claim status - Submit View View Notice of State Name of Payer eligibility claim status Authorizations Pre-Certs Batch File Referrals Referrals Pre-Cert Admission NY Agewell New York X*. AL Alabama Medicaid X* X. CA Alameda Alliance for Health X* X*. AK Alaska Medicaid (Batch) X*. AK Alaska Medicaid X*. NAT'L All Savers X X. GA Alliant Health Plans X. NAT'L Allegiance X X. NAT'L Allied Benefit Systems X X. HI AlohaCare X. NAT'L AltaMed X*. AL Alternative Insurance Resources X X.

5 MULTI Altius Health Plans (WY, UT, ID) X X. AR Ambetter of Arkansas X X X. IL Ambetter of Illinois X X. MI Ameraplan X X. MULTI AmeriBen X X. MULTI American Family Insurance Group X X. PR American Health Medicare eligibility X. NAT'L American Income Life Insurance Company X. NAT'L American National Life Insurance Company X X. TX American National Life Insurance Company of Texas X X. NAT'L American Network Ins. Medicare Supplement X X. NAT'L American Postal Workers Union (APWU) X X. NAT'L American Republic Insurance Company X X. NAT'L American Retirement Life Insurance Company X X.

6 NJ AmeriChoice of NJ Medicaid X. MULTI Amerigroup X X X* X X. MULTI Amerigroup Medicare X. MULTI Amerihealth Administrators X*. LA Amerihealth Caritas (LA) X. MULTI Amerihealth Caritas (PA) X* X X X. IA Amerihealth Caritas (IA) X X. MI Amerihealth Caritas VIP Care Plus Medicaid X. MI AmeriHealth Caritas VIP Care Plus Medicare X. NAT'L AmeriHealth DC X. MULTI Amerihealth Commercial (DE, NJ, PA) X* X X*. PA Amerihealth Northeast PA X. PA Amerihealth PA New West X. Last Updated 2/13/2018 * Indicates a payer that requires additional enrollment information.

7 2. eligibility , CLAIMS status , REFERRALS, AUTHORIZATIONS, NOTICE OF ADMISSION PAYER LIST. claim status - Submit View View Notice of State Name of Payer eligibility claim status Authorizations Pre-Certs Batch File Referrals Referrals Pre-Cert Admission PA Amerihealth VIP Care X. NAT'L Ameritas Life Insurance Company X X. OH Antares X. CO Anthem (CO) X*. MULTI Anthem Blue Cross Blue Shield (CO, CT, IN, KY, ME, NH, NV, OH, VA) X X X* (CT & KY) X X. GA Anthem Blue Cross Blue Shield of GA X X X X. IN Apex Benefit Services X. WI Arise Health Plan X*.

8 WI Arise Health Plan Medicare Select Policy X X. AZ Arizona Medicaid X. AZ Arizona Physicians IPA X. AR Arkansas Medicaid X* X. NAT'L Aspire (CHOMP) X*. CA Aspire Health Advantage X*. NAT'L ASR Health Benefits X. WA Asuris Northwest Health Plan X X. OH AultCare X. NAT'L Automated Benefit Services X X. NAT'L Auxiant X. MULTI Avera Health Plans X X. FL AvMed Health Plans X. NAT'L Bankers Life and Casualty X. NAT'L Banner Health X X. KY Baptist Health Plan X*. KY Baptist Health Plan Medicare Advantage X. TX BaylorScott and White Health Plan X.

9 NY BCBS of Central New York X. NY BCBS of Western New York X. NAT'L Beacon Health Options/Value Options X* X*. NAT'L Beacon Health Strategies X*. NAT'L Benefit Administrative Systems X*. NE Benefit Management Inc X X. OH Benovation X X. OK Best Choice Plus - Broward Health (FL) X. NAT'L Best Life and Health X X. FL Better Health Plans of Florida X. MULTI Better Health Plan Medicaid (PA, SC, TN) known as Unison Health Plan X X. MA Blue Benefit Administrators X*. AL Blue Cross Blue Shield of Alabama X X. Last Updated 2/13/2018 * Indicates a payer that requires additional enrollment information.

10 3. eligibility , CLAIMS status , REFERRALS, AUTHORIZATIONS, NOTICE OF ADMISSION PAYER LIST. claim status - Submit View View Notice of State Name of Payer eligibility claim status Authorizations Pre-Certs Batch File Referrals Referrals Pre-Cert Admission AK Blue Cross Blue Shield of Alaska (Premera) X X. AZ Blue Cross Blue Shield of Arizona X X. AZ Blue Cross Blue Shield of Arizona Advantage X X. AR Blue Cross Blue Shield of Arkansas X* X. FL Blue Cross Blue Shield of Florida X X X X X X X. GA Blue Cross Blue Shield of Georgia X X X* X X.