Important Information: In a medical emergency, call 9-1-1 or go to the nearest emergency facility. EDI Payor ID: 56071 Mail Claims to: American Family Mutual Insurance Company PO Box 21801 Eagan, MN 55121-0801 Box 21341 Eagan, MN 55121 If a customer's ID card still references the El Paso, TX address, please reference the address above when submitting paper claims. Search claims by patient I.D., DOB, name, and more. . Claims mailing address remains the same: Alliance Coal Health Plan. Planstin Administration Inc 2022 Or contact us by telephone (Voice/TDD): Toll free: 800.279.4000 Local: 608.276.4000 Fax: 608.276.9119 . InnovAge's Program of All-inclusive Care for the Elderly (PACE) is an alternative to nursing facilities. Contact Us - Blackhawk Claims Service GA, Inc. About Blackhawk Products Providers Brokers Employers Members Contact Us CONTACT US Do you have a question about getting a quote or filing a claim? NOVO Health Procedures List; . P.O. Billing Address and Payer ID Numbers Denver Health Medical Plan, Inc. Medical Care/Point of Service P.O. Provider Relations Department Phone: 303-602-2100 Fax: 303-602-2516. P.O. PO Box 21342 Eagan, MN 55121-0342. Box 211502 Eagan, MN 55121. Payor ID - 76498 Phone: 1-866-506-2830. <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Avoid delays in claims handling and processing. PO Box 893 Portland, ME 04104. usAt Phm$C|M/TcPtO:nD 9@?CXYhh{|abEOk>~"]#%4\y4W(``@CQY7(C B.q:Gu/5e0$%xT81n PO Box 211577. Payer id provider number reference professional rev. Eagan, MN 55121 (BCBSAZ providers in AZ submit to EDI #53589) Florida 88090 (PHX) Zelis/Medica PO Box 2839 . Hy cN0oXW@M3[b. See the Notice to Residents on page 2 of the claim form. endobj Premium Payments Mailing Address: PO Box 14998, Oklahoma City, OK 73113 Agent Services Phone: (888) 524-3629 Mailing Address: PO Box 14498, Oklahoma City, OK 73113 Claims Phone: (888) 524-3629 Fax: (385) 207-7883 Mailing Address: Medicare Supplement Claims PO Box 211635 Eagan, MN 55121 Box 211184 Eagan, MN 55121 Valid and registered NPI is required. Group ID remains the same: 2008ALC. %?}n ,HUp$}`,w?MTO8)h:`*'N/} ^O|NgLL&A xE%*x'c:1SMO#Dz:clI7UWkK^=MoiV(~_|sjolI(k2@kcn N@< }K4^KR}d0I(eO Gd@@VdKq6f$5`t( PcT(LJluIv8 @S;7L`+0e:TCje3C9{S, Electronic (837I) Loop 2010AA . Box 21538 Eagan, MN 55121. Each PACE participant has a team of medical experts dedicated to providing personalized healthcare and support to help them age at home. If you experience issues with your account, call support at (855) 297-4436. t8\+upi+8t{`V eTKt_T98/P Box 211473, Eagan, MN 55121 Note: Your participation in SOMOS IPA does not affect your relationship with EmblemHealth for patients with other lines of business, such as Customer Service: 1-800-884-4901 (TTY/TDD . Box 21800 Eagan, MN 55121-0800 Service: 877-874-6385 Sales: 212-300-0739 Fax: 212-214-0892 Box 24992 Seattle, WA 98124-0992 Electronic Payer ID: 84-135 . Effective 1/1/2022, the new Payer ID for all Bright HealthCare plans (excluding California Medicare Advantage) is BRGHT. Effective February 25, 2019, FirstCare Health Plans will no longer accept P.O. 2021 ID Card Example (AZ) 2022 ID Card Example (FL) . Box 21155 Eagan, MN 55121. For paper claims, please submit to Vivida at the following address: Vivida Health PO Box 211290 . . P.O. Aither Health is a healthcare solutions company offering a full suite of innovative products and services for third-party administrators and risk bearing entities such as self-funded employers, health plans and providers. Attach the spreadsheet to a copy of the request form. gL>:E/0c7GUEV">OlE: ,),5#` %&\&a:|E|$q|A-9Y0<6'wuaqMxWo3E/S'| 3FTe\d?M$'c=b'ct&KlDk0>*)x*` Centivo electronic payer ID: 45564 Submit all claims to the following address: Centivo P.O. UT, and VA: (2022 services effective 1/1) Bright HealthCare Claims P.O. Important Phone Numbers NM108 = XX NM109 = NPI # Paper (UB-04) NPI # - Box 56 . Eagan, MN 55121. Member Services Our MoreCare customer service agents are available to help you with your membership concerns Monday - Friday, 8 a.m. to 8 p.m CST Box 211342 Eagan, MN 55121 If a claim is deemed deficient or an unclean claim to the point of unpayable, FirstCare will notify the . stream All dental claims should be mailed to GEHA at the appropriate address below: Box 211221, Eagan, MN 55121 Also note Paper claim submissions that have multiple pages to a claim should only have the total of the claim submitted on the last page Quartz requires diagnosis codes on dental claims % All medical claims should be mailed to the addresses listed below for each network. american republic insurance company n po box 21670 eagan, mn 55121 (800) 247-2190 americas tpa y po box 398220 minniapolis, mn 55439 (800) 948-3253 medical claims department 1 0 obj Offering employee benefit services including third party administrators, TPAs, employee bridge plans and self funded plans. Member Services: (855) 979-5192. We are licensed and bonded and we represent only top-rated insurance companies. P.O. Box 5080 . Bright HealthCare does not accept faxed claims. 312-864-8200, 711 (TTY/TDD) PO Box 211197 Eagan, MN 55121 Electronic Payor ID #43185 (918) 615-7972 . Find out More. 250 Barrow Street Houma, LA 70360. Box 211747 Eagan, MN 55121 Provider Filing Claims Must Include Itemized Bill or HCFA Form Copy of Primary Carrier EOB For a complete list of claims submission addresses, refer to the professional and facility payer ID grids at www.amerihealth.com/edi.There . P.O. Electronic claim submission is available to all providers. Access program guidance. WELCOME TO BAY BRIDGE ADMINISTRATORS Bay Bridge Administrators is a full-service, nationally recognized, third party administrator of fully-insured employee benefit plans. Online Member Portal Through eHealthChoices, you can get a summary of your benefits, access claims, eligibility, EOB statements, forms and more. Get in touch 100 Decker Ct, Suite 250 866-910-6166 Outreach@blackhawktpa.com Name (required) Email (required) Message Claims Tel: 1-888-888-2519 Click to Email. The information was current at the time of publication. Box 21146 Eagan, MN 55121 Visit In-Person: Syracuse. Please refer to our Receiver and Payer ID codes document. Acceptance of this card should indicate acceptance of the Plan's benefits as payment in Main Tel: 1-800-800-1397 Click to Email. Submit claims electronically using the SOMOS Payer ID: 81336 through Change Healthcare or another approved EDI vendor, or mail paper claims to: SOMOS IPA, LLC, P.O. Payer ID: 94265 + Product Fact Sheets Altru & You With Medica Clear Value With Medica Essentia Choice Care with Medica Medica Choice Passport Medica CompleteHealth Medica Elect and Medica Essential Medica Focus Park Nicollet First with Medica Select the appropriate Payer ID below to view Medica claim submission and product guidelines for each plan. x=rS5G25+U#*scB}%H{*sN7hIEggzMW7,(OfS=-WeYU MQW_~Ty. 2017 Provider Benefits Summary . Add the Bind Benefits, Inc., payer ID number into your systems. 3 0 obj Call us Monday 8am to 6pm EST | Tues-Friday 8am to 5pm EST. %PDF-1.5 Eagan, MN 55121. We hope you enjoy our new look! Group benefit services claim department p.o. . Mail Claims and Other Correspondence to: Excellus BlueCross BlueShield P.O. You may submit claims to Surest (365-day timely filing) electronically at Surest payer ID 25463 or by mail to: PO Box 211758 Eagan, MN 55121 After a claim has been submitted, quickly check claims status on UHSS.UMR.comor call 1-844-368-6661 to speak with a specially trained UnitedHealthcare Shared Services Provider Service Representative. At 90 Degree Benefits we know your patients are your priority and we know the importance of providing comprehensive health plan information 24/7 so you can find what you need quickly and get back to what you do best care for our patients. Please find resources for our Ohio provider network below. endobj Mail your redetermination or request for adjustment to: Baylor Scott & White Health Plan ATTN: Claims Review Dept. For details on submitting claims, updating rosters, and other tips, please check our additional provider resources. Medical Directors. SSI Payer ID & Sub ID 99999-0648 (314) 209-2700 or (866) 597-9560 Option 5, then Option 2 IBEW Local 309 Collinsville, Illinois Meritain Health PO Box 853921 . Vivida's Electronic Payer ID: A0102. Login to eHealthChoices Flexible Spending MyFlex Online allows you to view your FSA, HSA or HRA account balance, submit eligible claims on qualified expenses and access forms. Contact HealthEZ for reimbursement rates for any facility based care. Y(W^PuPuX< Sutter Health PlusP.O. Box 21099 Eagan, MN 55121. EDI# 19753. For Medica members with Payer ID #71890, 53589 or 88090, send the Claim Adjustment/Appeal Request Form with supporting documentation to: . Po Box 211282 Eagan Mn. Box 21974 Eagan, MN 55121 1-800-778-2119 Verify eligibility and benefits at 1-888-356-7899 www.pearprovider.com Independence Blue Cross Federal Employee Below is the process for interim billing for inpatient hospital stays that exceed one hundred (100) consecutive days. 317 -210 -2010 service@pointcomfort.com . To get provider specific information and service, call 844-732-3415. <> Receive fair and prompt payment along with an Explanation of Benefits. Contact Varipro with any questions or comments. Box 21546 Eagan, MN 55121. We've got answers. Our senior management staff has over 90 years of combined experience. Payer List. Billing Address: ArchCare Advantage c/o Peak TPA. Contact ClearChain Health with any questions. Claims and Benefits. Login to MyFlexOnline Payer ID provider number reference Facility Use this guide as a reference tool when submitting facility claims. Box 211681 Eagan, MN 55121 For pharmacy support: Contact MedImpact Provider phone line: 8444012055 Fax: 8587907100 Review claims payment history. Box 211592 Eagan, MN 55121-2892 Payer ID 06541 CountyCare Provider Quick Reference Guide January 2021 Page 1 of 2 Provider Services CountyCare Website Visit for documents, forms, important health plan information, and provider and member resources. Important Telephone Numbers. Click anywhere to close. Box 211758, Eagan, MN 55121. Electronic payer ID remains the same: 93658. P.O. . To join our Ohio provider network, just complete this form. Your ID Card. P.O. P.O. Sutter Health Plus includes the PPG and claims submission address on the member's identification (ID) card. <>>> Website: Claims.pointcomfort.com Phone: 317 -210 -2010 . Box 211597 Eagan, MN 55121 Wisconsin Family Care c/o WPS Health Insurance P.O. Phone: 888-920-7526 Email: member@planstin.com. Claims Status ameriban y po box 7186 boise, id 83707 (800) 786-7930-a-medical claims department . Box 211595 Eagan, MN 55121 What is the Payer ID? Claims address: Bind, P.O. Mail claims to: ClearChain Health. Maddy Virtual Care; WEA Trust + INTERLINK CancerCARE; NOVO Health. Seniors receive customized healthcare and social support at a nearby PACE center. P.O. Box 21631. Providers should submit all claims within ninety (90) days of the date of service for prompt adjudication and payment. To learn more about benefits, visit our educational resources page. P.O. Eagan, MN 55121. MWG Administrators : (888) 888-2519 Submit Electronic Claims To: Change Healthcare Payer ID: 64090 www.changehealthcare.com SoftCare Payer ID: 01757 www.softcare.com US Mail Claims Submissions AmFirst Insurance Company P.O. Claim Status. Until 6/13/21, pre-2021 dates of service (DOS) paper claims can be mailed to: Maryland Physicians Care P.O. Payer ID; Emdeon/ Change Healthcare: 13360: MDOnline/ Ability Network: 13360: . Box 21994 Eagan, MN 55121 Questions? All facilities and non PHCS providers please send all claims to: Group Benefit Services Claim Department P.O. Box 4368 Lutherville, MD 21094. Box 211592 Eagan, MN 55121-2892: Payer ID: 06541: Claims Timely Filing Requirement : Submit claims 180 calendar days from date of . P.O. Interim Billing for Inpatient Hospital Stays. Payer ID: 71890 ID: 1234567891 Name: Mayo Medical Plan Page Fact Sheet 2 of 4 . P.O. Here are some ways to get in touch. bjrplbp&d$u PO Box 211290 Eagan, MN 55121 . . To place an order, contact Integrated Home Care Services directly: Phone 1-844-215-4264. Simply log in to your Smart Data Solutions account to process policyholders' claims easily and efficiently 24 hours per day, 7 days a week, at no cost to you. If there are multiple claims in question, you may provide an Excel spreadsheet that contains the additional information. Box 21524 Eagan, MN 55121 Electronic Payer ID: 65-456. Sutter Health Plus acknowledges paper claims within 15 business days following receipt. EDI Payer ID: 58379 EDI Payer Name: Hometown Health Plan MA HMO (P3 Health Partners Nevada) Professional, Institutional and Hospital Claims CLAIMS STATUS . Contact Us. PO Box 211342 Eagan, MN 55121 Prior Authorization: 1-800-884-4905 Card Issue Date: 12/01/2019 FOR MEMBERS This card is for identification only and does not guarantee current membership or coverage. Save search results to a spreadsheet. Or if you're in Illinois or Texas, call us directly at 1-800-338-6833 (TTY 711) 2 0 obj Farmington Hills, MI 48333 . Non-participating providers must submit all other claims to the member's participating provider group (PPG). To help answer your questions promptly and accurately, please have individual policy numbers or group ID numbers ready. 985-868-7070. payer information* Paper claim mailing address Billing provider ISA-08 GS-03 AmeriHealth HMO AmeriHealth Q3A AmeriHealth PA - ERISA POS 54704 95044 23037 Claims Receipt Center P.O. https://www.countycare.com Varipro is a TPA (Third Party Administrator) with the look and feel of a fully insured plan. Electronic (837P) Loop 2010AA NM108 = XX NM109 = NPI # Paper (CMS-1500) NPI # - Box 33A We've used 2 TPAs over my 20 years here. Eagan, MN 55121 Claims Appeals (844) 865-8033 Fax: (888) 345-9110 Claims Appeals Mailing Address MoreCare Attn: Appeals Department P.O. Author: schmdm Created Date: For any questions regarding claims status, please call Provider Services at 1-800-761-5602, Monday through Friday . Important Information: In a medical emergency, call 9-1-1 or go to the nearest emergency facility. PO Box 211435 . SGIC Payer ID: 11789; Electronic Services Available (EDI) Professional/1500 Claims: YES: Institutional/UB Claims: YES: Need to submit transactions to this insurance carrier? The Claim Adjustment/Appeal Request Form and documentation will be reviewed. . Submit Claims to: Payer ID # 41178 HealthEZ: PO Box 211186, Eagan, MN 55121 FACILITIES MEDICAL NETWORK: None -All claims paid at the Allowable Charge, generally 150% for facilities. Reserve National Insurance Claim Form Should be filled out completely and submitted with the physician and/or hospital bill. Submit all claims to: EDI Payer ID: 66701 Group Marketing Services, Inc. PO Box 21044 Eagan, MN 55121 Please submit Cofinity, First Health Network, Lakeland Care, American Health Alliance, Dental and Vision claims electronically to Smart Data Solutions (SDS) claims clearinghouse: EDI Payer ID: 66701 Don't Have A Provider Portal Account with SDS? <> Provider Services: (855) 979-5194. Please review, complete, and submit our online form. 4 0 obj Fax 1-844-215-4265. Claims mailing addresses. Active Providers: log in to the PCU Provider Claims Portal , where medical and dental professionals can: Access claims status 24/7. Providers currently enrolled in EFT prior to 07/01/20 will not have to re-register with Change Healthcare. EDI Payer ID: PCU02 . P.O. Schedule Demo. Select your Provider Network located on your IHP ID Card. If you have questions just give us a call at 1-877-762-3515, 8am to 5pm. Claims should be submitted to PO Box 211681, Eagan, MN 55121 or electronically using payer ID 45564. Box 211184 : Eagan, MN 55121 . PO Box 21051 Eagan, MN 55121-0051 Electronic pay ID: 12422 Medica Behavioral Health claims should be submitted to: Medica PO Box 30757 Salt Lake City, UT 84130 Electronic pay ID: 87726 Medica Chiropractic claims should be submitted to: Medica PO Box 212 Minneapolis, MN 55440-0212 Electronic pay ID: 41161 Inspire by Medica
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