CLAIMS & ERA PAYER LIST March 13, 2020
[Pages:134]CLAIMS & ERA PAYER LIST March 04, 2022
LEGEND: I = Institutional, P = Professional, D = Dental COB = Coordination of Benefits
Transaction Column: 837 = Claims, 835 = ERA Available Column: A Check-mark indicates that the transaction type is available. Enrollment Column: A Check-mark indicates that enrollment is required for the transaction type. COB Column: A Check-mark Indicates that the payer accepts secondary claims electronically for the transaction type. Attachments: A Check-mark indicates that the payer accepts medical attachments electronically for the transaction type.
Payer Name 1199 National Benefit Fund 1199 National Benefit Fund 1st Medical Network - Atlanta GA 1st Medical Network - Atlanta GA 1st MN--Atlanta GA 1st MN--Atlanta GA 21st Century Health and Benefits 6 Degrees Health A & I Benefit Plan Administrators A.G.I.A. Inc. AAG Benefit Plan Administrators Inc. AAG-American Administravie Group ( Formerly Icon Benefit Admin)
AARP - UnitedHealthcare Insurance Company AARP - UnitedHealthcare Insurance Company AARP Dental Insurance Plan AARP Dental Insurance Plan AARP MedicareComplete through UnitedHealthcare/AARP MedicareComplete
AARP MedicareComplete through UnitedHealthcare/AARP MedicareComplete
AblePay Health
Payer Code
13162 13162 29076 29076 29076 29076 59069 20446 93044 95241 75240
75185
36273 36273 AARP1 AARP1 87726
Transaction
837 835 837 835 837 835 837 837 837 837 837
837
837 835 837 835
Available I PD
Enrollment I PD
COB I PD
Attachments I PD
Notes
Effective immediately, please send all claims for Payer 75185 to HealthSmart Benefit Solutions (EDI Payer ID #37283). Claims submitted under payer ID 75185 will be subject to claim rejection effective Q1 2019.
837
87726 ABLPY
835
837
Experian Health Payer List
Page 1 of 134
Payer Name
AblePay Health Abrazo Advantage Health Plan Absolute Total Care Absolute Total Care
Accelerated Claims Inc. Access Administrators Access Community Health Network Access IPA Access IPA Access Medical Group Access Medical Group Access Medicare Acclaim Acclaim Acclaim IPA Accountable Care Management Group, LLC Accountable Healthcare IPA (AHCIPA) ACMG ACS Benefit Services Inc. ACS Benefit Services Inc. ACTIN Care Groups Activa Benefit Services LLC Administration Systems Research Corporation Administration Systems Research Corporation Administrative Concepts Inc. Administrative Concepts Inc. Administrative Services Inc. ADVANCED DATA SOLUTIONS Advantage by Bridgeway Health Solutions Advantage by Bridgeway Health Solutions
Advantage by Buckeye Community Health Plan Advantage by Buckeye Community Health Plan
Advantage by Managed Health Services
Experian Health Payer List
Payer Code
ABLPY 03443 68069
68069
99999-0748 AHS01 ACCOM ACC01 ACC01 AMG02 AMG02 19305 64071 64071 IP095 45328 AHIPA 37118 72467 72467 24585 38254 38265 TLU02 22384 22384 59141 58202 68069
68069
68069
68069
68069
Transaction
835 837 837
835
837 837 837 837 835 837 835 837 837 835 837 837 837 837 837 835 837 837 837 835 837 835 837 837 837
835
837
835
837
Available I PD
Enrollment I PD
COB I PD
Attachments I PD
Notes
Also known as Phoenix Advantage
ERA Payer Code 68069; ERA requires EFT enrollment
Also known as Clifton Health Systems ERA Payer Code TLU02
ERA Payer Code 68069; ERA requires EFT enrollment ERA Payer Code 68069; ERA requires EFT enrollment
Page 2 of 134
Payer Name
Advantage by Managed Health Services
Advantage by Peach State Advantage by Peach State
Advantage by Sunshine State Advantage by Sunshine State
Advantage by Superior HealthPlan Advantage by Superior HealthPlan
Advantage Care IPA Advantek Benefit Administrators Advantek Benefit Administrators ADVANTICA BENEFITS ADVANTICA BENEFITS Advanzeon Solutions Adventist Hanford Adventist Health Care Network Adventist Health Plan (AHP) Adventist Health System West - Roseville CA Adventist Health System West - Roseville CA Adventist White Memorial - Crown City Medical Group Adventist White Memorial - Southland Gabriel Valley Advisory Health Administrators Advocate Medical Group - AMG (Legacy AHC) Advocate Medical Group - AMG (Legacy AHC) Advocate Physician Partners Advocate Physician Partners Aegis Administrative Services Aetna Aetna Aetna (Professional Encounter Claims - Not BULK) Aetna Affordable Health Choices (SM) - SRC Aetna Affordable Health Choices (SM) - SRC Aetna Better Health of California Aetna Better Health of California
Experian Health Payer List
Payer Code
68069
68069
68069
68069
68069
68069
68069
ACIPA 83077 83077 59374 59374 59314 MPM36 MPM51 MPM37 95340 95340 MPM33 MPM34 CB159 36320 36320 65093 65093 CB637 60054 60054 60054 60054 60054 128CA 128CA
Transaction
835
837
835
837
835
837
835
837 837 835 837 835 837 837 837 837 837 835 837 837 837 837 835 837 835 837 837 835 837 837 835 837 835
Available I PD
Enrollment I PD
COB I PD
Attachments I PD
Notes
ERA Payer Code 68069; ERA requires EFT
enrollment
ERA Payer Code 68069; ERA requires EFT enrollment
ERA Payer Code 68069; ERA requires EFT enrollment
ERA Payer Code 68069; ERA requires EFT enrollment
Page 3 of 134
Payer Name
Aetna Better Health of Florida Aetna Better Health of Florida Aetna Better Health of Illinois Aetna Better Health of Illinois Aetna Better Health of Kansas Aetna Better Health of Kansas Aetna Better Health of Kentucky Aetna Better Health of Kentucky Aetna Better Health of Louisiana Aetna Better Health of Louisiana Aetna Better Health of Maryland Aetna Better Health of Maryland Aetna Better Health of Michigan Aetna Better Health of Michigan Aetna Better Health of Nebraska (for claims with DOS prior to 1/1/17) Aetna Better Health of Nebraska (for claims with DOS prior to 1/1/17) Aetna Better Health of New Jersey Aetna Better Health of New Jersey Aetna Better Health of New York Aetna Better Health of New York Aetna Better Health of Ohio Aetna Better Health of Ohio Aetna Better Health of Pennsylvania Aetna Better Health of Pennsylvania Aetna Better Health of Texas (Medicaid & CHIP) Aetna Better Health of Texas (Medicaid & CHIP) Aetna Better Health of Virginia Aetna Better Health of Virginia Aetna Better Health of West Virginia Aetna Better Health of West Virginia Aetna Better Health Premier Plan (JVHL) Aetna Better Health Premier Plan (JVHL) Aetna Better Health Premier Plan MMAI Aetna Better Health Premier Plan MMAI Aetna Medicare
Experian Health Payer List
Payer Code
25133 128FL 68024 68024 128KS 128KS 128KY 128KY 128LA 128LA 128MD 128MD 128MI 128MI 25133 42130 46320 46320 34734 34734 50023 50023 23228 23228 38692 38692 128VA 128VA 128WV 128WV M5JVH M5JVH 26337 26337 60054
Transaction
835 837 837 835 837 835 837 835 837 835 837 835 837 835 835 837 837 835 837 835 837 835 837 835 837 835 837 835 837 835 837 835 837 835 837
Available I PD
Enrollment I PD
COB
Attachments
I PD I PD
Notes
ERA Payer Code 25133 Formerly IlliniCare
ERA Payer Code 25133
Provider must be an approved JVHL lab
Page 4 of 134
Payer Name
Aetna Medicare Aetna Senior Supplement/American Continental Aetna U.S. Healthcare (JVHL) Aetna U.S. Healthcare (JVHL) Affiliated Doctor's of Orange County Affiliated Partners IPA Affiliated Physicians IPA Affinity by Molina Healthcare Affinity by Molina Healthcare Affinity Health Plan Affinity Health Plan AFFINITY MEDICAL GROUP Affordable Benefit Administrators Inc. Affordable Benefit Administrators Inc. AFLAC (ERA Only) AFTRA Health Fund (claims with DOS on or after 1/1/2015) AFTRA Health Fund (claims with DOS on or after 1/1/2015) A-G Administrators LLC AGA Agate Resources Inc. (LIPA) Agency Services Inc AgeRight Advantage AgeRight Advantage Agewell New York Agewell New York AHP Provider Network AHPO (Cleveland OH) Aither Health Aither Health AKM Medical Group Alabama Medicaid Alabama Medicaid Alabama Medicaid Alabama Medicaid Alabama Medicare
Experian Health Payer List
Payer Code
60054 62118 J1JVH J1JVH ADOCS POP09 POP06 16146 16146 13334 13334 46594 95426 95426 52080 62308 62308 11370 37280 20048 64158 ARA01 ARA01 AWNY6 AWNY6 MPM38 31138 64884 64884 CAPMN 12K01 12K01 SKAL0 SKAL0 10112
Transaction
835 835 837 835 837 837 837 837 835 837 835 837 837 835 835 837 835 837 837 837 837 837 835 837 835 837 837 837 835 837 837 835 837 835 837
Available I PD
Enrollment I PD
COB
Attachments
I PD I PD
Notes
Provider must be an approved JVHL lab
Formerly known as TotalCare NY Formerly known as TotalCare NY For claims with DOS prior to 11/01/21
Page 5 of 134
Alabama Medicare Alameda Alliance for Health Alameda Alliance for Health
Alamitos IPA
Payer Name
Alamitos IPA Alan Sturm & Associates Dental Alaska Carpenters Trust Alaska Children's Services Inc. Alaska Children's Services Inc. Alaska Electrical Trust Funds Alaska Electrical Trust Funds Alaska Laborers Construction Industry Trust Alaska Medicaid Alaska Medicaid Alaska Medicare Alaska Medicare Alaska Pipe Trades Local 375 Alaska United Food & Commercial Workers Health & Welfare Trust Albuquerque Public Schools Albuquerque Public Schools Alexian Brothers Community Services of TN ALICARE ALICARE Align Senior Care (CA)
Align Senior Care (CA)
Align Senior Care (FL)
Align Senior Care (FL)
Align Senior Care (MI)
Align Senior Care (MI)
Experian Health Payer List
Payer Code
10112 95327 95327
AIPAZ
CAPMN R7003 91136 91136 91136 60054 60054 91136 77200 77200 SMAK0 SMAK0 91136 91136 85600 85600 44423 13550 13550 ASCA1
ASCA1
ASFL1
ASFL1
ASMI1
ASMI1
Transaction
835 837 835
837
837 837 837 837 835 837 835 837 837 835 837 835 837 837 837 835 837 837 835 837
835
837
835
837
835
Available I PD
Enrollment I PD
COB I PD
Attachments I PD
Notes
Payer returns ERA's automatically once electronic claim submission begins. For DOS Prior to 5/1/2020. Claims with DOS
5/1/20 and after use payer code CAPMN.
Payer returns ERA's automatically once electronic claim submission begins. Payer returns ERA's automatically once electronic claim submission begins. Payer returns ERA's automatically once electronic claim submission begins Payer returns ERA's automatically once electronic claim submission begins Payer returns ERA's automatically once electronic claim submission begins. Payer returns ERA's automatically once electronic claim submission begins.
Page 6 of 134
Payer Name
Align Senior Care (VA)
Align Senior Care (VA)
Alignment Health Plan Alignment Health Plan Alignment Healthcare Alignment Healthcare All Savers/UHC All Savers/UHC AllCare Advantage Allcare Health CCO Allcare Health CCO AllCare IPA AllCare IPA Allegiance Benefit Plan Management Inc. Allegiance Benefit Plan Management Inc. Alliance Behavioral Health Alliance Behavioral Health Alliance Coal Health Plan Alliance Coal Health Plan Alliance IPA
Alliance Physicians High Desert Alliance Physicians High Desert
Alliance Physicians Medical Group Alliance Physicians Medical Group Alliant Health Plans of Georgia Alliant Health Plans of Georgia Allianz Global Assistance Allied Benefit Systems Allied Benefit Systems Allied Healthcare
Allied Healthcare
Experian Health Payer List
Payer Code
ASVA1
ASVA1 CCHPC CCHPC AHCA1 AHCA1 81400 81400 MRCHP MRIPA MRIPA AC101 AC101 81040 81040 23071 23071 93658 93658
HCP01
22417 22417 APP01 APP01 58234 58234 50749 37308 37308 ALLCA
ALLCA
Transaction
837
835 837 835 837 835 837 835 837 837 835 837 835 837 835 837 835 837 835
837
837 835
Available I PD
Enrollment I PD
COB I PD
Attachments I PD
Notes
Payer returns ERA's automatically once electronic
claim submission begins.
Payer returns ERA's automatically once electronic
claim submission begins
Former payer ID 26160
This payer is now part of OptumCare Network. Please submit claims using payer code OCN01. EFT enrollment is required in order to obtain ERA's
837
835
837
835
837
837
835
837
835
Payer Returns ERA Automatically
Payer returns ERA's automatically once electronic claim submission begins. Payer returns ERA's automatically once electronic claim submission begins.
Page 7 of 134
Allied Pacific of California Allied Pacific of California Allied Physicians Medical Group Allied Physicians Medical Group Allina Health Aetna Allina Health Aetna AllWays Health Partners
Payer Name
AllWays Health Partners Allwell of Arkansas Health & Wellness Allwell of Arkansas Health & Wellness
Alpha Care Medical Group Alpha Care Medical Group Alta Bates Medical Group ALTA Health Strategies AltaMed
AltaMed Alterwood Advantage Altius Health Plans Altius Health Plans Alvarado IPA Always Care Vision AMA Insurance Agency AMA Insurance Agency AMA Insurance Agency AMA Insurance Agency Amalgamated Life Amalgamated Life Amalgamated Life - PA / Alicare Ambay Health Network I & P Ambetter of Illinois Ambetter of Illinois
AMCO AmeriBen Solutions Inc.
Experian Health Payer List
Payer Code
NMM01 NMM01 NMM01 NMM01 54398 54398
04293
04293 68069
68069
NMM04 NMM04 A0701 25133
ALTAM
ALTAM RP016 25133 25133 SYMED ATR01 AMAIA AMAIA TH071 TH071 13550 13550 13343 AMBHN 68069
68069
62176 75137
Transaction
837 835 837 835 837 835 837
Available I PD
Enrollment I PD
COB
Attachments
I PD I PD
Notes
Formerly known as Neighborhood Health Plan
835
837
835
837
835
837
837
837
ERA Payer Code 68069; ERA requires EFT enrollment Former payer code MPM32.
Effective 3/27/19, the new payer ID is ALTAM
835
837
837
835
837
837
837
835
837
835
837
835
837
837
837
835
837
837
Effective 1/1/22 ERA Payer Code 25133
ERA Payer Code 68069; ERA requires EFT enrollment
Page 8 of 134
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