WORKERS' COMPENSATION / AUTO PAYER LIST 09/10/2021 …

[Pages:50]WORKERS' COMPENSATION / AUTO PAYER LIST 04/28/2023

* Provider must be contracted with Carisk *Carisk Imaging to Allstate Insurance - Auto Only *Carisk Imaging to Geico (Auto Only) *Carisk Imaging to Nationwide (Auto Only) *Carisk Imaging to New York City Law Department *Carisk Imaging to NJ-PLIGA *Carisk Imaging to North Dakota WSI *Carisk Imaging to NYSIF *Carisk Imaging to Progressive Insurance (Auto Only) *Carisk Imaging to Pure (Auto Only) *Carisk Imaging to Safeco Insurance (Auto Only) *Carisk Imaging to SafeTPA, LLC (NY Only) *Carisk Imaging to Selective Insurance (Auto Only) *Carisk Imaging to USAA (Auto Only) 1st Auto & Casualty 21st Century Insurance 22125 Roscoe Corp. AAA Minnesota/Iowa AAA Northern California, Nevada & Utah Insurance Exchange ABC Const. Company ABF Freight System, Inc. (Arkbest) Accd Accident Fund Insurance Co of America Accuride Corporation Ace Property & Casualty Ins Co ACIG Insurance Company Active Care, Inc. ACTS Retirement - Life Communities Acuity, A Mutual Insurance Company AD-COMP Adelanto Correctional Facility (CA) Administaff Administrative Claim Service, Inc Adminsure Admiral Linen & Uniform Service Advance America Cash Advance Centers Advance Services, Inc. Advanced Auto Parts - All states EXCEPT TX MN Advanced Auto Parts - TX MN

Adventist Health System (Bunch CareSolutions) (also includes CO, FL, GA, KS, KY) Advocare MCO, Inc Affiliated Foods, Inc. AG Facilities Operations, LLC Agri Beef Co. AIG-Chartis Alarm Contractors (WC Only)

Payer ID E1069 GEICO A0002

NYCL001 E3926 NDWSI

NYSIF1510 E1139 PURE01 E0602 SAFE01 E1077 A0001 J1585 41556 41556 11983 41556 41556 J3789 J3729 J1790 J1024 41556 J1578 J3840 J2163 J1240 J1667 J1798 J1241 J1005 J2292 J2144 J1843 J1608 J2162 J2161 J1973 J1896 J1977 41556 41556 19402 J3859

All TX MN CA IL LA NJ NY OR WI NC NM OK TN VA States

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837P x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

837I x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

WORK COMP

x x

x

x

x

x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

AUTO x x x

x x x x x

x

835 Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only

Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only

x Rejects Only Rejects Only

x Rejects Only Rejects Only

x x x x Rejects Only x x x Rejects Only x x x Rejects Only Rejects Only Rejects Only x x x x x x

Rejects Only Rejects Only Rejects Only

x

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WORKERS' COMPENSATION / AUTO PAYER LIST 04/28/2023

* Provider must be contracted with Carisk Alaska National Insurance Albertsons, Inc. Alcoa Fasteners Systems Alex Lee, Inc. Align Networks (One Call Physical Therapy) Allen Canning Allergan W.C. Holding, INC. Alliant Energy Allianz Global Corporate & Specialty (AGCS) - dates of injury on or after 1/1/2018 Allianz Resolution Management (ARM) - dates of injury on or before 12/31/2012 Allied Claims Administration, Inc. Allied Construction (via EMC Risk Services) (Except CA, NM, NV) Allied Insurance Companies Allied Property and Casualty Ins Co Allmerica Financial Benefits Insurance Company Allstate - Except New Jersey Allstate - NJ Only (Auto Only) Alta Healthcare Alternative Service Concepts (ASC) Alvey Systems (AON Risk) AMCO Ins Co America First American Airlines - DOI after 9/1/2014 ONLY American Alternative Insurance Corporation American Apparel, LLC (DOI after 7/14/16) American Claims Management (ACM) American Coin Merchandising, Inc American Country (Auto Only) American Country (WC Only) American Cyanamid American Family Home Insurance Company American Family Mutual Insurance Company American Furniture Warehouse American Home Craft American Liberty Insurance Company American Millennium American Mining Insurance Group, LLC American Modern Home Insurance Company American Select American Specialty Companies American Specialty Ins. / MIB American Standard Insurance Company of Ohio (AUTO ONLY) American Standard Insurance Company of Wisconsin (AUTO ONLY) Amerihealth Casualty Services Ameriprise (Auto Only) Amerisafe Risk Services

Payer ID J1577 J2376 J1244 J2166 J1716 J1740 J2341 J1619 J2332 J2326 J1733 J1118 J1550 J1550 J1589 C1037 C1089 41556 J2149 J1025 J1550 J1427 J2000 J4030 J2189 J1236 J1026 C1075 J1249 J1027 J4031 J2134 41556 J1250 41556 J4021 J1524 J4032 J3317 J1028 J1029 C1055 C1055 J3969 C1097 J1447

TX MN CA IL x

xx xxx xxx

xxxx

LA NJ NY OR WI NC NM OK TN VA

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x x

All States

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x x

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x x x x x x x x

x

837P x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

837I x x

x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

WORK COMP

x x x x x x x x x x x x x x x x

x x x x x x x x x x

x x x x x x x x x x x x x

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AUTO

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x x x

x x x x x

Page 2 of 50

835 x x

Rejects Only x

Rejects Only x

Rejects Only x x x x x x x x x

Rejects Only Rejects Only Rejects Only

x x Rejects Only x x x Rejects Only x x x x x Rejects Only Rejects Only Rejects Only Rejects Only x x x x x x x x Rejects Only Rejects Only x

WORKERS' COMPENSATION / AUTO PAYER LIST 04/28/2023

* Provider must be contracted with Carisk Amerisure Insurance Amerisure Mutual Insurance AmFed Companies LLC (Amfed National Insurance) AmGuard Insurance Company - Guard DBA Amica Insurance Company (Auto Only) Amtrust North America ANACO ANAIC Cibus Anchor Glass Container Corporation Anheuser Busch Antelope Valley Community Hospital Antelope Valley Ret. Antelope Valley Union High School District APM Terminals Applied Materials Applied Underwriters (Except AZ) Archer Daniels Midland Company Ardagh Group Areas USA, Inc. Argent (Subsidiary of West Bend but this route is Argent only) Argonaut Insurance Company(ARGO) Argus Claims Arizona & 21st Corp. DBA Berkley East Conv. Hospital Arkansas Best Arrowpoint Association Casualty Insurance Company Association County Commissioners of Georgia (ACCG). Athens Athens - ABF Freight Systems, Inc Athens - Alemeda Health Systems Athens - American Apparel, Inc (DOI prior to 7/14/16) Athens - American Brass & Iron Foundry Athens - Angelus Block Athens - Bay Area Housing Authority Risk Management Athens - Central County Fire Department Athens - Children's Hospital Los Angeles Athens - City of Beverly Hills Athens - City of Mountain View Athens - City of San Jose Athens - City of Vernon Athens - County of Solano Athens - Crum Athens - East Bay Municipal Utility District Athens - East Bay Regional Parks District Athens - Fairmont Hotel Athens - FASIS

Payer ID J1206 J1205 J3735 J1453 C1098 J1868 41556 41556 J2136 J1620 J2197 41556 J2185 J3788 J2160 J1775 J1735 J2344 J1944 J1420 19801 J3307 41556 J2142 J1564 J1254 J1869 J1914 J2096 J2097 J2098 J2099 J2100 J2101 J2102 J2103 J2104 J2105 J2106 J2107 J2108 J3728 J2109 J2110 J2111 J2112

TX MN CA IL xxxx

x

LA NJ NY OR WI NC NM OK TN VA

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x

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x

All States

x x x x

x x x x x x

x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

837P x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

837I x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

WORK COMP

x x x x

x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

AUTO x x

x

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835 Rejects Only Rejects Only

x x Rejects Only x Rejects Only Rejects Only x x x Rejects Only x x x Rejects Only x Rejects Only x x x Rejects Only Rejects Only Rejects Only x x Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only x Rejects Only Rejects Only Rejects Only Rejects Only

WORKERS' COMPENSATION / AUTO PAYER LIST 04/28/2023

* Provider must be contracted with Carisk Athens - Golden Gate Bridge Highway & Transportation Athens - Goodwill Industries (San Francisco, San Mateo, Marin Counties) Athens - H&S Venture Athens - Household Industries Self Insured Group Athens - Kings Seafood Company Athens - KPC Healthcare Athens - Long Beach Public Transportation Company Athens - McKesson Corporation Athens - Orora North American Athens - Placentia-Yorba Linda Unified School District Athens - Presbyterian Intercommunity Hospital PIH Athens - San Francisco Unified School District Athens - Sony Corporation of America Athens - Sunsweet Growers, Inc. Athens - Temecula Valley Unified School District Athens - The Conco Companies - ARCH WC Athens - The Conco Companies - Zurich Athens - The Permanente Medical Group, Inc. Athens - Vintage Senior Living Atlantic PPO to Atlantic Imaging Group Atlantic PPO to Hartford Insurance Atlantic PPO to Merchants Mutual Atlantic PPO to NY City Transit Atlantic PPO to NYC Dept. of Sanitation Atlantic PPO TO QBE Insurance Atlantic PPO to Sedgwick WC Insurance Atlantic PPO to Sentry Insurance Atlantic PPO to Travelers Atlantic PPO to US DOL NJ claims Atlantic PPO to US DOL NY claims Aureon HR Solutions (via EMC Risk Services) (Except CA, NM, NV) Austin Mutual Ins Auto Club Group Auto Club Group Insurance Company Auto Club Insurance (ACIA) Auto Club Insurance Association Auto Club Property-Casualty Insurance Company Auto One Insurance (Auto Only) Automobile Dealers Insurance Company Inc Auto-Owners \ Home-Owners Insurance Company Auto-Owners \ Owners Insurance Company Auto-Owners \ Property-Owners Insurance Co Auto-Owners \ Southern-Owners Company Auto-Owners Insurance Company Auto-Owners Life Insurance Company AVIR Inc.

Payer ID J2113 J2114 J2335 J2115 J2116 J2117 J2118 J2119 J2120 J2121 J2122 J2124 J2126 J2127 J2128 J2129 J2130 J2131 J2132 J2013 J2035 J2046 J2055 J2056 J2067 J2071 J2074 J2079 J2083 J2084 J1118 J1682 11983 11983 11983 11983 11983 C1082 J1861 J1580 J1583 J1699 J1688 J1556 J1596 41556

TX MN CA IL

x x x x x

LA NJ NY OR WI NC NM OK TN VA x

All States

x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

x x x x x x x x

837P x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

837I x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

WORK COMP

x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

x x x x x x x x

AUTO x

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835 Rejects Only Rejects Only

x Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only

x x x x x x x Rejects Only Rejects Only x x x x x x Rejects Only

WORKERS' COMPENSATION / AUTO PAYER LIST 04/28/2023

* Provider must be contracted with Carisk Avizent Ayers Trucking Azz Inc. Baker Tanks, Inc. Balance Staffing Workforce Baldwin County Bank of America Banner Health Baptist Healthcare Systems, Inc (KY ONLY) Bardavon Health Innovations Barker Claim Services Barnes Barrett Business Services Inc (BBSI) BART - San Francisco Bay Area Rapid Transit Bashas Corporate Offices Basic Resources, Inc. Bass Pro Group, LLC Bauman Workers' Compensation Loss Fund Account Bb&T Corporation (Branch Banking & Trust) Beacon Insurance Company Of America Beacon Mutual Beall's Inc / Midwest Employers Bed Bath & Beyond Beeville ISD Belfor USA LTD INC Belk, Inc. Benchmark Insurance Bergen Risk Berkley Agribusiness Risk Specialists

Berkley Entertainment and Environmental (formerly Berkley Specialty Underwriters) Berkley Mid-Atlantic Group Berkley National Insurance Company Berkley Net Underwriters, LLC Berkley Regional Insurance Company Berkley Risk Administrators Company, LLC Berkley Southeast Insurance Group (BSIG) Berkley Valley Conv Hospital Berkshire Hathaway Direct Insurance Company Berkshire Hathaway Homestate Companies (BHHC) Bernardo H. Co. Club Berwind Corporation Beverly Hills Carmel Big 5 Corp Bighorn Construction BI-Mart

Payer ID J1415 J1018 J3773 41556 J3844 J4022 J1729 J3811 J2164 J2334 J3818 J1503 J1686 J1770 J3732 41556 J1958 J3305 J1995 J3318 J1234 J1030 J2167 41556 J4023 J2168 J1257 J3997 J2190

TP019 J3863 J2192 J1523 J2194 J1526 J2145 41556 J1975 20044 41556 J1031 41556 J1738 41556 J2349

TX MN CA IL

LA NJ NY OR WI NC NM OK TN VA x

All States

x x x x x x x x

x x x x x x x x x x x x x x x x x x

x

837P x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

837I x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

WORK COMP

x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

AUTO

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835 Rejects Only

x x Rejects Only Rejects Only x x x x Rejects Only Rejects Only x x x x Rejects Only x x x x x x x Rejects Only

x Rejects Only Rejects Only

x

x x x x x x Rejects Only Rejects Only x x Rejects Only x Rejects Only x Rejects Only Rejects Only

WORKERS' COMPENSATION / AUTO PAYER LIST 04/28/2023

* Provider must be contracted with Carisk Bituminous Fire and Marine Bituminous Insurance Company Bloomin' Brands Inc Bloomingdale's BMICO BMW North America

Bobrick Washroom Boeing Company Boeing Company - WC ONLY Boise Cascade Company Boler Company Boulder Community Hospital Bremco Construction Briad Restaurant Group, LLC Brickstreet (EXCEPT PA) Bridgefield Casualty Bridgefield Employers Bristol West Broadspire, a Crawford Company Brotherhood Mutual Insurance Broward County Board of Commissioners (Fl) Brownsville Independent School District Brownyard Group Inc. (Arch Insurance) Brunswick Corporation Buffett, Granny's Buffett) Builders Group of MN Builders Insurance Group (Georgia Only) (Work Comp and Auto) Builders Mutual Insurance Bunch and Associates Burke Williams Burlington Coat Factory Wareho Burton Way Carmel Business First Butler America Holdings, INC.- Corvel - CORVEL (WC Only) Bycor Gen Contract C+A2:R1155ity Of New Orleans (LA) Cadet Uniform Supply Caliber Holdings Corporation California Fair Services Authority California Restaurant Mutual Benefit Corporation - Sig California Schools Risk Management California Water Service Company Callahan, McCune CalPortland Company Cambridge Healthcare Services, LLC

Payer ID J1691 J1579 J3725 J1347 C1073 J1259

41556 J1964 J1964 J1801 J1870 41556 41556 J2169 J1761 J1437 J1437 J1764 TP021 J1445 J3843 41556 11150 J1032 J1501 J1391 J3975 J1968 J1435 J4037 J1033 41556 J1437 J3860 41556 J2309 41556 J1979 J1535 J4033 J3326 41556 41556 J3758 J2182

TX MN CA IL

LA NJ NY OR WI NC NM OK TN VA

All States

x x x x x x

837P x x x x x x

837I x x x x x

WORK COMP

x x x x x x

AUTO

xxxxx xxxxx

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Page 6 of 50

835 x x x x

Rejects Only Rejects Only

Rejects Only x x x x

Rejects Only Rejects Only

x x x x x x x x Rejects Only x x x Rejects Only Rejects Only x x x x Rejects Only x x Rejects Only x Rejects Only x x x x Rejects Only Rejects Only x x

WORKERS' COMPENSATION / AUTO PAYER LIST 04/28/2023

* Provider must be contracted with Carisk Cambridge Integrated Services Campbell Union School District Capistrano Unified School District (CA) Capital Insurance Group Wc Capitol Indemnity Capitol Insurance Companies CAPS-SIG Captain D'S LLC Cardenas Markets (Carl Warren) Care Logic (WC Only) Carewest CareWorks Consultants, Inc. (aka CareWorks USA and CCI) Carhartt Carolina Healthcare Systems (Chs) Casitas Municipal Water District (CA) Caterpillar Catholic Diocese of San Diego Catholic Mutual - Preferred Professional Insurance Company Catholic Mutual - Virginia Surety Company, Inc. CC-Development Group, Inc. CCMSI - Claims serviced by Conduent Only Cedars-Sinai Health System Cendant Corporation Centennial Insurance Company Central Contra Costa Transit Authority Central Florida Health Central Garden & Pet Company Central Hockey League Central Mutual Insurance Central Texas Iron Works Chaffey Joint Union H. S. District (CA) Chandler's P. Verdes Chapman Convalescent Charming Shoppes, Inc. Cherokee Insurance Chesapeake Insurance Chesterfield Services, Inc.** Chico's Fas Inc Children's Hospital Colorado Children's Hospital of Orange County - First Aid Chireno ISD CHS Chubb (legacy Chubb & Son) - WC Chula Vista Elementary School District Church Mutual Insurance Company (WC ONLY)

Payer ID J1819 41556 J1637 J1980 J1262 J1809 41556 J4024 J1516 J3868 J2258 J1866 J1931 J3320 J1630 J3799 41556 41556 41556 J1900 J1010 41556 J1034 19895 J1605 J3909 J3737 J1035 J4011 J2293 J1646 41556 41556 J1036 J1970 J1908 J1479 J2315 41556 41556 J3874 J3820 J1554 41556 J1265

TX MN CA IL

xx

x

xx

LA NJ NY OR WI NC NM OK TN VA

xx

x

xx

xx

All States

x x x x x x x x x x x x x x x x x x x x x x x

x x x x x x x x x x

x x x x x x x x x x

837P x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

837I x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

WORK COMP

x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

AUTO x x

x

835 Rejects Only Rejects Only

x x Rejects Only x Rejects Only x x x x x x x x x Rejects Only Rejects Only Rejects Only x Rejects Only Rejects Only x x x Rejects Only x x x Rejects Only x Rejects Only Rejects Only x x Rejects Only x x Rejects Only Rejects Only Rejects Only Rejects Only x Rejects Only x

Page 7 of 50

WORKERS' COMPENSATION / AUTO PAYER LIST 04/28/2023

* Provider must be contracted with Carisk CIGA Cincinnati Insurance Citizens Insurance Company of America Citizens of Humanity Citrus Memorial Health Foundation Inc. (WC Only) Citrus Valley Health Partners Citrus World, Inc. City And County Of Denver City and County of San Francisco (CCSF) City of Adelanto City of Ames (via EMC Risk Services) (Except CA, NM, NV) City of Arlington City of Ashland City Of Bakersfield City of Baltimore City of Banning (CA) City of Barstow (CA) City of Beaverton City of Belmont (Self Insured) City of Blythe (CA) City of Brea City of Cambridge City of Campbell City of Carlsbad City of Carmel By The Sea City of Carson City of Charlotte City Of Chino City of Colton City of Coronado City of Costa Mesa City of Dallas City of Del Mar City of Des Moines (via EMC Risk Services) (Except CA, NM, NV) City of Desert Hot Springs (CA) City Of Durham City of Edinburg, Texas City of El Paso City Of El Selgundo City of Encinitas City of Escondido City Of Everett (Wa) City of Fort Worth (TX) City of Fountain Valley (CA) City of Fresno FPOA ADR1

Payer ID J1532 J1562 J1582 J3759 J3908 J1613 J1945 J3340 J1885 J3867 J1118 A0033 41556 J3336 J4043 J1792 J1793 41556 41556 J1794 J1880 J3905 41556 41556 41556 41556 J1928 J2306 41556 41556 J2343 J1441 41556 J1118 J1799 J3821 41556 A0046 J4027 41556 41556 J3332 J1680 J1632 J2337

TX MN CA IL x x

x

LA NJ NY OR WI NC NM OK TN VA

All States

x x x x x x x

x x x x x x x x x x x x x x x x x x x x x x x x x

x x x x x x x x x x

837P x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

837I x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

WORK COMP

x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

AUTO x

835 Rejects Only Rejects Only

x x Rejects Only x x Rejects Only x x x x Rejects Only Rejects Only x x x Rejects Only Rejects Only x Rejects Only x Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only Rejects Only x x Rejects Only Rejects Only x x Rejects Only Rejects Only x x x Rejects Only

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