OptumInsight Medical Payer List (01/27/2020)

OptumInsight Medical Payer List

1 of 41

(07/17/2023)

Payer Name

Payer ID

Claim Office Number

State

Reports

Entered As

Secondary**

Enrollment

Payer Type

(UCS) Masonry Industry Trust 1199 SEIU National Benefit Fund 21st Century Insurance and Financial Services 2020 Eyecare 360 Alliance PPO Gilsbar 3P ADMIN 8th Distric Electrical A.G. Administrators A & I Benefit Plan Administrators AARP Hospital Indemnity Plans insured by UnitedHealthcare Insurance Company AARP Medicare Supplement Plans insured by UnitedHealthcare Insurance Company

60230 13162 51028 2020E 07205 20413 74234 11370 93044

36273

36273

NOCD ALL NOCD ALL NOCD MN NOCD ALL NOCD ALL NOCD ALL NOCD UT NOCD ALL NOCD ALL

NOCD ALL

NOCD ALL

AARP MedicareComplete insured through UnitedHealthcare /

Oxford Mosaic Network / Oxford Medicare Network

87726

NOCD ALL

AARP MedicareComplete insured through UnitedHealthcare (formerly AARP MedicareComplete from SecureHorizons) ABMG Abrazo Advantage Health Plan Abri Healthplan Access Administrators Access Behavioral Care Access Medical Group ACCLAIM Acclaim IPA Acclaim IPA (MHCAC) Accountable HC IPA (Customer Service (562) 435-3333 for claims with DOS prior to 5/1/15) Healthsmart Benefit Solutions (Wells Fargo TPA, formerly Acordia National) ACS Benefit Services, inc. ACS Benefits Payer Compass

87726 NOCD ALL A0701 NOCD CA 03443 NOCD ALL ABRI1 NOCD ALL AHS01 NOCD ALL COACC NOCD CO AMG02 NOCD All 64071 NOCD All MHIPA NOCD CA MHIPA NOCD CA

AHIPA NOCD ALL

87815 72467 PA331

MCSI ALL NOCD ALL NOCD ALL

Activa Benefits Services, LLC (Formerly Amway Corporation) ActivHealthcare Administrative Services, Inc. Adminstrative Concepts, Inc. Advance Benefit Mgmt Systems USA Incorp Advanced Data Solutions Advanstaff, Inc. Advantage Care IPA Advantage Health Network IPA Advantage Health Solutions, Inc. Advantek Benefit Administrators Advantica Benefits Advanzeon Solutions AdventHealth Advantage Plans Adventist Health System Advocate Health Centers (AHC) Advocate Health Partners (PHO) Aegis Administrative Services Aetna Affordable Health Choices (SM) SRC Aetna Better Health - PA Medicaid Aetna Better Health Medicaid IL Aetna Better Health Nevada Aetna Better Health NY Aetna Better Health Kansas Aetna Better Health of California

Aetna Better Health of Illinois Inc

Aetna Better Health of Kentucky Aetna Better Health of Louisiana Aetna Better Health of Maryland Aetna Better Health of Michigan Aetna Better Health of New Jersey Aetna Better Health of Ohio Aetna Better Health of Virginia Aetna Better Health of West Virginia Aetna Health Plan - PPO Aetna Life & Casualty Company Aetna Life & Casualty Company

38254 AHC01 59141 22384 66457 58202 74234 ACIPA NMM01 35209 83077 59374 59314 RP039 95340 36320 65093 CB637 57604 23228 26337 128NV 34734 128KS

128CA

68024 128KY 128LA 128MD 128MI 46320 50023 128VA 128WV 60054 60054 60054

NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD CA NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD PA NOCD IL NOCD NV NOCD ALL NOCD KS

NOCD CA

NOCD IL NOCD KY NOCD LA NOCD MD NOCD MI NOCD NJ NOCD ALL NOCD VA NOCD WV NOCD ALL NOCD ALL NOCD ALL

Y UCS MASONRY IND T Y 1199 NATIONAL BEN Y 21ST CENTURY INS N 2020 EYECARE Y 360 ALLIANCE PPOG Y 3P ADMIN N 8TH DIST ELECTRIC N AG ADMIN N A AND I BENEFIT P

Y AARP MEDICARE SUP

Y AARP MEDICARE SUP

Y OXFORD MEDICARE N

Y AARP MEDICARECOMP Y ABMG Y ABRAZO ADV HEALTH N ABRI HEALTHPLAN N ACCESS ADMINISTRA S ACCESS BEHAVIORAL Y ALLIED MED GROUP N ACCLAIM N MEMORIAL HC IPA N MEMORIAL HC IPA

Y ACCOUNTABLE HC IP

Y ACORDIA NATIONAL Y ACS BENEFIT SERVI Y ACS BENE PAYER CO

Y ACTIVA BENE SVCS Y ACTIVHEALTHCARE Y ADMIN SVCS INC N ADMIN CONCEPTS IN N ADV BENE MGMT USA Y ADVANCED DATA SOL N ADVANSTAFF INC N ADVANTAGE CARE IP Y ADVANTAGE HLTH IP N ADVANTAGE HEALTH N ADVANTEK BENEFIT A ADVANTICA BENEFIT Y ADVANZEON SOLUTIO Y ADVENT HLTH N ADVENTIST HLTH SY Y ADVOCATE HEALTH Y ADVOCATE HLTH PAR Y AEGIS ADMIN SVCS Y AETNA AFFORDABLE Y AETNA BH PA MEDIC N AETNA BH MCAID IL N AETNA NV N AETNA BET HLTH NY N AETNA BET HLTH KS

N AETNA CA AETNA BETTER HEALTH OF

Y ILLINOIS INC Y AETNA BET HLTH KY Y AETNA BH LOUISIAN Y AETNA MD Y AETNA BH MICHIGAN Y AETNA BH NEW JERS Y AETNA BTTR HLTH O Y AETNA BH VA Y AETNA BTR HLTH WV Y AETNA HEALTH PLAN Y AETNA Y AETNA LIFE

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE C

Y

FALSE C

Y

FALSE C

Y

FALSE C

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

For up-to-date payer information, please access the payer list from the OptumInsight website at: or contact OptumInsight Customer Service and Support at1-866-678-8646 (1-866-OPTUMGO)

OptumInsight Medical Payer List

2 of 41

(07/17/2023)

Payer Name

Payer ID

Claim Office Number

State

Reports

Entered As

Aetna Life & Casualty Company

60054 NOCD ALL

Aetna Life & Casualty Company

60054 NOCD ALL

Aetna OHIORISE

45221 NOCD ALL

Affiliated Doctors of Orange County

ADOCS NOCD CA

Affiliated Physicians IPA

POP06 NOCD ALL

Affinity Essentials

23334 NOCD ALL

Affinity Health Plans (Contact Affinity EDI Coordinator before

submitting claims electronically at EDI@ or call

718-794-7592.)

13334 NOCD ALL

AFFINITY MEDICAL GROUP

46594 NOCD ALL

Affordable Benefit Administrators, Inc. (Claims with the

following address should only be sent to this payerID: ABA, PO

BOX 10787, Burbank, CA 91510-0787)

95426 NOCD ALL

Ageright Advantage

ARA01 NOCD ALL

Agewell New York

AWNY6 NOCD ALL

Agua Caliente

AGUA1 NOCD ALL

AHPO (Cleveland, OH)

31138 NOCD OH

AIG Chartis

19402 NOCD ALL

AIG Educational Markets (Formerly Maksin Management

Corporation)

22195 NOCD ALL

Aither Health

64884 NOCD ALL

AKM Medical Group

IP080 NOCD CA

Alameda Alliance for Health (Provider must contact payer to be

approved. Contact at Alameda is Anet Quiambao at 510-747-

6153 or aquiambao@)

95327 NOCD ALL

Alamitos IPA (Customer Service 562-602-1563)

AIPAZ NOCD CA

Alaska Childrens Services, Inc

91136 NOCD AK

Alaska Laborers Construction Industry Trust

91136 NOCD AK

Alaska Pipe Trades Local 375

91136 NOCD AK

Alaska United Food & Commercial Workers Health & Welfare

Trust

91136 NOCD AK

Albuquerque Public Schools

85600 NOCD ALL

Alexian Brothers Community Services of Tennessee

44423 NOCD ALL

AliCare

13550 NOCD ALL

Alignment Healthcare

CCHPC NOCD ALL

All Savers Insurance / UnitedHealthcare

81400 NOCD ALL

AllCare (Must contact AllCare, 800-564-6901 for setup and

payerID.)

CALL CALL ALL

AllCare PEBB

26158 NOCD ALL

Alivi Health

ALIVI NOCD ALL

Allegiance Benefit Plan Management, Inc.

81040 NOCD ALL

Alliance Coal Health Plan

93658 NOCD ALL

Alliance Physicians High Desert

22417 NOCD ALL

Alliant Health Plans of Georgia

58234 NOCD GA

Allied Benefit Systems

37308 NOCD ALL

Allied Physicians of California IPA

NMM01 NOCD ALL

AlohaCare

ALOHA NOCD HI

AlphaCare

ALPHA NOCD ALL

Alphacare Medical Group

MPM32 NOCD ALL

Alta Bates Medical Group

A0701 NOCD CA

AltaMed

ALTAM NOCD ALL

Alternative Opportunities

16089 NOCD ALL

Amalgamated Life - PA/Alicare

13343 NOCD ALL

Amalgamated Transit Union Division 1001 Health & Welfare

Fund

COMPU NOCD CO

Ambetter of Arkansas

68069 NOCD ALL

AmeraPlan

38219 NOCD ALL

Ameriben - IEC Group

97661 NOCD ALL

Ameriben Solutions

75137 NOCD ALL

Americaid Community Care (Houston)

27515 NOCD TX

American Administrative Group - AAG (Formerly known as

UICI Administrators

75240 NOCD ALL

American Administrative Group (formerly Gallagher Benefit) American Behavioral American Benefits Plan Administrators (Las Vegas, NV) American Family (administered by American Republic) American Family Health Providers American Family Insurance American Fidelity Assurance Company American General American Health Advantage of Utah American Health Advantage of Texas American Healthcare Alliance

37283 63103 59140 56071 IP080 TH095 60801 62030 31145 31155 01066

NOCD ALL NOCD ALL NOCD NV NOCD ALL NOCD CA NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL

Y AETNA LIFE INSUR Y AETNA LIFE INSURA Y AETNA OHIORISE Y AFFIL DOCS OF OC Y AFF PHYSICIANS IP Y AFFINITY ESSENTIA

Y AFFINITY HEALTH O N AFFINITY MED GROU

N AFFORDABLE BENE A N AGERIGHT Y AGEWELL NEW YORK Y AGUA CALIENTE Y AHPO CLEVELAND OH Y AIG CHARTIS

Y AIG EDUC MARKETS N AITHER N AKM MEDICAL GROUP

Y ALAMEDA ALLIANCE N ALAMITOS IPA Y ALASKA CHILD SVCS Y AK LABORERS TRUST Y AK PIPE LOCAL 375

Y AK UNITED FOOD TR A ALBUQUERQUE PS Y ALEXIAN BROTHERS Y ALICARE Y ALIGNMENT HCARE N UNITEDHEALTHONE

N CONTACT SUPPORT Y ALLCARE PEBB N ALIVI HEALTH Y ALLEGIANCE BENEFI N ALLIANCE COAL Y ALL PHYS HIGH DES Y ALLIANT GEORGIA Y ALLIED BENEFIT Y ALLIED PHYS OF CA N ALOHACARE N ALPHACARE N ALPHACARE MEDICAL Y ABMG N ALTAMED Y ALTERNATIVE OPPOR Y AMALGAMATED LIFE

N AMALG TRANSIT UNI Y AMBETTER Y AMERAPLAN Y AMERIBEN IEC GROU Y AMERIBEN SOLUTION Y AMERICAID HOUSTON

Y AAG

A AMERICAN ADMINIST N AMERICAN BEHAVIOR A AM BENEFITS PLAN N AM FAMILY INSURAN N AM FAMILY HLTH PR Y AMERICAN FAMILY I Y AMERICAN FIDELITY N AMERICAN GENERAL N AHA OF UTAH N AHA OF TX N AM HEALTHCARE ALL

For up-to-date payer information, please access the payer list from the OptumInsight website at: or contact OptumInsight Customer Service and Support at1-866-678-8646 (1-866-OPTUMGO)

Secondary**

Enrollment

Payer Type

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

TRUE

T

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE C

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

TRUE

N

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE T

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

TRUE

N

Y

FALSE G

Y

FALSE G

OptumInsight Medical Payer List

3 of 41

(07/17/2023)

Payer Name

Payer ID

Claim Office Number

State

Reports

Entered As

American Insurance Company of TX American LIFECARE (Group Number required. Valid only for claims with a billing address of 1100 Poydras ST. #2600, New Orleans, LA 70163) American National Insurance Co American Plan Administrators American Postal Workers Union Health Plan American Postal Workers Union Health Plan American Republic Insurance Company American Specialty Health American Therapy Administrators ATA Wisconsin American Worker Health Plan Americas 1st Choice Health Plans of South Carolina Americas 1st Choice of South Carolina, Inc. America's Choice NMA America's Health Choice America's PPO (Formerly known as ARAZ.) America's PPO / America's TPA AmeriChoice NJ, Medicaid, NJ Family Care (UnitedHealthcare Community Plan) Amerigroup - Illlinois Amerigroup - Maryland and District of Columbia Amerigroup - New Jersey Amerigroup of Iowa Amerigroup / Americaid - Houston Amerigroup Houston (Claims and Encounters) Amerigroup Illinois (Claims and Encounters Amerigroup Multiple States (Claims and Encounters) Amerigroup of Florida Amerigroup Ohio (Claims and Encounters AmeriHealth - New Jersey (Non-HMO Claims) AmeriHealth Administrators

81949

72099 74048 95606 44444 44444 42011 ASH01 ATHAL 37322 20553 55349 20029 21810 16120 41178

86047 28804 28807 28806 26375 28805 26374 27518 26378 28809 27518 SX075 54763

NOCD ALL

NOCD ALL NOCD ALL NOCD ALL NOCD All NOCD All NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL

NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD

NJ ALL MD,DC NJ ALL TX TX IL ALL FL OH ALL ALL

AmeriHealth Caritas Louisiana (Formerly known as LA Care) Amerihealth Caritas Next FL Amerihealth Caritas Next NC Amerihealth Caritas North Carolina AmeriHealth Caritas Ohio Inc AmeriHealth Caritas Healthplan New Hampshire AmeriHealth Caritas VIP Care AmeriHealth Caritus VIP Care Plus (Michigan) Amerihealth Delaware Amerihealth District of Columbia (For EDI Support, please email edi.dc@ or call 1-888-656-2383) AmeriHealth HMO New Jersey and Delaware (Must complete enrollment form under payer ID 95044) Amerihealth HMO NJ and Delaware

AmeriHealth Mercy Health Plan (Name has changed to AmeriHealth Caritas Pennsylvania. Claims containing Dates of Service on or after Jan. 1, 2021 will need to be sent under this payer ID).

27357 45408 83148 81671 35374 87716 77062 77013 77799

77002

23037 95044

22248

NOCD LA NOCD FL NOCD NC NOCD NC NOCD OH NOCD NH NOCD ALL NOCD MI NOCD ALL

NOCD ALL

NOCD NJ,DE NOCD NJ DE

NOCD All

AmeriHealth NorthEast (Dates of Service on or before Dec. 31,

2020, may continue to use the following until Dec. 31, 2021.

For dates of service 01/01/21 or after use payer ID 22248}

77001 NOCD ALL

Amerikids-Dallas/Ft. Worth

26374 NOCD TX

Amerivantage

26375 NOCD ALL

Amfirst Insurance Company

64090 NOCD ALL

AM-First Insurance Morgan White

01757 NOCD ALL

Amida Care (Formerly Vida Care.)

24818 NOCD ALL

Amida Care Medicare

79966 NOCD ALL

Amtrust North America

J1868 NOCD ALL

AMVI

IP080 NOCD CA

Amway Corporation

38254 NOCD All

Anaheim Memorial IPA (MHCAN)

MHIPA NOCD CA

Anchor Benefit Consulting

53085 NOCD ALL

Anerican Founders Life Ins Co (NFL Plans only)

98205 NOCD ALL

Angeles IPA (SynerMed)

75299 NOCD ALL

Angle Insurance Company of Utah

39856 NOCD ALL

Antares Management Solutions

34192 NOCD ALL

Anthem BCBS Indiana

00630 NOCD IN

Anthem BCBS Virginia

00423 NOCD VA

Anthem Blue Cross of California

BC001 NOCD CA

Anthem Blue Cross Blue Shield

0002937 NOCD OH

N AMER INS OF TEXAS

Y AMERICAN LIFECARE Y AMER NAT INSURANC N AMERICAN PLAN Y AMERICAN POSTAL W Y APWU N ARIC Y AM SPECIALTY HLTH Y ATA WISCONSIN N AMERICAN WORKER H R AMERICAS FIRST CH Y AM FIRST CHOICE S Y AMERICAS CHOICE N Y AMERICAS HEALTH C Y AMERICAS PPO ARAZ Y AMERICAS PPO

Y UHC COMMUNITY NJ Y AMERIGROUP N AMERIGROUP MD N AMERIGROUP NJ Y AMERIGROUP IOWA Y AMERIGROUP HOUSTO Y AMERIGROUP HOUST Y AMERIGROUP ILLINO Y AMERIGROUP MULTI Y AMERIGROUP OF FL Y AMERIGROUP OHIO Y AMERIHEALTH NJ Y AMERIHEALTH ADMIN

Y LA CARE N FL NEXT N NC NEXT N NC CARITAS N OH CARITAS Y NH CARITAS N AMERIHLTH CARITAS Y AH CARITUS VIP CA N AMERIHEALTH DE

Y AMERIHEALTH DC

Y AMERIHEALTH HMO Y AHLTH HMO NJ & DE

Y AMERIHEALTH MERCY

Y AMERIHEALTH NE Y AMERIKIDS DALLAS Y AMERIGROUP IOWA Y AMFIRST INS CO Y AM FIRST INS MORG N AMIDA CARE Y AMIDA CARE MEDICA N AMTRUST N AMVI Y AMWAY N MEMORIAL HC IPA A ANCHOR BENEFIT CO N AMERICAN FOUNDERS Y ANGELES IPA SYNER N ANGLE Y ANTARES MGMT SOLN Y ANTHEM BCBS IN Y ANTHEM BCBS VA Y CA BLUE CROSS N ANTHEM BCBS

For up-to-date payer information, please access the payer list from the OptumInsight website at: or contact OptumInsight Customer Service and Support at1-866-678-8646 (1-866-OPTUMGO)

Secondary**

Enrollment

Payer Type

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE C

N

FALSE G

N

FALSE T

N

FALSE G

N

FALSE G

N

FALSE T

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE T

N

FALSE G

Y

TRUE

N

N

TRUE

N

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

TRUE

G

Y

TRUE

N

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

OptumInsight Medical Payer List

4 of 41

(07/17/2023)

Payer Name

Payer ID

Claim Office Number

State

Reports

Entered As

Anthem Medicaid (WI) (Formerly BadgerCare)

WIBLS NOCD WI

Anthem of Colorado

COBLS BCBS CO

Anthem of Nevada

NVBLS NOCD NV

Apex Benefit Services (Claims must contain the rendering

provider ID or the claim will reject.)

34196 NOCD ALL

Apex Health

83112 NOCD ALL

APEX Healthcare (Now knows as Access Community Health

Network)

ACCOM NOCD ALL

Apostrophe

81312 NOCD ALL

ARAZ (Now known as America's PPO.)

16120 NOCD ALL

Arbor Health

52312 NOCD ALL

Arcadia Healthcare Solutions IPG

11081 NOCD ALL

Arcadia Healthcare Solutions NPA

36364 NOCD ALL

Arcadia Insurance Company

37105 NOCD ALL

Arcadian Management Services, Inc (Group number should be

entered if available. )

61101 NOCD ALL

Argus Dental and Vision

ARGUS NOCD ALL

Arise Health Plan (Formerly Prevea Health)

39185 NOCD ALL

Arizona Medicaid (AHCCCS)

AZMCD NOCD AZ

Arizona Pipe Trades Health and Welfare Trust Fund Local

Union Nos. 469 & 741 Metal Trades Health Plan

74234 NOCD AZ

Arizona Pipe Trades Health and Welfare Trust Fund Local

Union Nos. 469 & 741 Pipe Trades Health Plan

74234 NOCD AZ

Arizona Priority Care Plus

27154 NOCD ALL

Arkansas Best Corporation (previous payer ID 75278, new

payer ID is effective for claims submitted December 15, 2017

and after).

62308 NOCD ALL

Arkansas Managed Care Organization (AMCO)

62176 NOCD AR

Arkansas Total Care

68069 NOCD AR

Arnett Health Plan - former payer id 95440

87726 NOCD ALL

Arroyo Viata Family Health Center

NMM01 NOCD ALL

Arta Health Network

OCN01 NOCD CA

ASAGEHA

06603 NOCD ALL

Asian American Medical Group

AAMG1 NOCD CA

Aspire Health Plan

46156 NOCD ALL

ASR Corporation

38265 NOCD ALL

ASRM

ASRM1 NOCD ALL

Associated Hispanic Physicians Southern California

MPM44 NOCD ALL

Associates for Healthcare

36326 NOCD ALL

Assurant Health Self Funded (MUST VERIFY ALL CLAIMS SHOULD GO TO ALLIED BENEFIT for Assurant Health Self Funded groups with Plan effective dates after 5/1/2013) Assured Benefits Administrators

75068 74240

NOCD ALL NOCD ALL

Asuris Northwest/MedAdvantage (REF*1B*Provider ID in Billing

and Rendering required even when NPI is submitted.)

SX179 NOCD ALL

Asuris NW Health

93221 NOCD ALL

Atlantic Coast Life Insurance

87020 NOCD ALL

Atlantic Medical

22285 NOCD ALL

Atlantis Eye Care

AEC01 NOCD ALL

Atlas Life Ins Co (NFIC Plan only)

90956 NOCD ALL

Atrio Health Plan (Formerly known as Marion Polk Health Plan

Advantage)

MPCHA NOCD ALL

Aultcare

MNAUL NOCD OH

Author by Humana

61108 NOCD SC

Automated Benefit Services (ABS)

38259 NOCD ALL

Automated Group Administration, Inc.

37280 NOCD ALL

Automotive Machinists Local 289 Health & Welfare Trust -

Grp#F32

91136 NOCD ALL

Avalon Healthcare Solutions (Must contact the payer directly at

Provider Services @ 855-895-1676 prior to sending claims.) AVA01 NOCD ALL

Avalon Healthcare Solutions North Carolina

AVA02 NOCD NC

Avalon IPA

IP080 NOCD CA

Avante Health (Customer Service 559-261-9060)

AH001 NOCD ALL

Avectus Healthcare Solutions (Call 855-AVECTUS)

MP001 NOCD ALL

Avera Health Plans

46045 NOCD ALL

Avesis Third Part Administrators

87098 NOCD ALL

AVMED

59274 NOCD FL

Axminister Medical Group

AXM01 NOCD ALL

AZ Integrated Physicians

NCHON NOCD ALL

Bakersfield Family Medical Center

BKRFM NOCD ALL

N ANTHEM WI MEDICAI Y CO ANTHEM N NV ANTHEM

N APEX BENE SERVICE N APEX

Y APEX HEALTHCARE N APOSTROPHE Y ARAZ N ARBOR HEALTH N ARCADIA N ARCADIA NPA Y ARCADIA IPG

Y ARCADIAN MGMT SVS N ARGUS Y ARISE HEALTH PLAN Y AZ MEDICAID

N AZ METAL TRADES

N AZ PIPE TRADES N AZ PRIORITY CARE

Y ARKANSAS BEST COR Y AR MCO Y AK TOTAL CARE Y ARNETT HEALTH PLA Y ARROYO VISTA FAM N ARTA HLTH NETWORK Y ASAGEHA N ASIAN AMERICAN MG N ASPIRE HEALTH PLA Y ASR CORPORATION Y ASRM CORP N ASSOC HISP PHYS Y ASSOC HEALTHCARE

N ASSURANT HLTH SLF Y ASSURED BENEFITS

Y ASURIS NW MEDADVA Y ASURIS NW HEALTH N ATLANTIC COAST N ATLANTIC MEDICAL Y ATLANTIS EYE CARE N ATLAS LIFE INS CO

Y MARION POLK HP AD N AULTCARE Y AAUTHOR HUMANA Y AUTOMATED BEN SVC N AUTOMATED GROUP A

Y AUTO GRP F32

Y AVALON HC SOLUTIO N AVALON HEALTHCARE N AVALON IPA N AVANTE HEALTH N MEDPAY FIRST ONE Y AVERA HEALTH PLAN Y AVESIS TPA Y AVMED N AXMINISTER MED GR N AZ INTEGRATED PHY N BAKERSFIELD FAMIL

Secondary**

Enrollment

Payer Type

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE T

Y

FALSE N

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE C

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

TRUE

N

Y

FALSE G

Y

FALSE G

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE N

Y

FALSE G

N

FALSE G

Y

FALSE G

For up-to-date payer information, please access the payer list from the OptumInsight website at: or contact OptumInsight Customer Service and Support at1-866-678-8646 (1-866-OPTUMGO)

OptumInsight Medical Payer List (07/17/2023)

Payer Name

5 of 41

Payer ID

Claim Office Number

State

Reports

Entered As

Bakery & Confectionery Union and Industry International Health BCTF1 NOCD ALL

Banner Health

12X42 NOCD ALL

Banner Health & Aetna Health Insurance Company

67895 NOCD ALL

Banner Medicare Advantage Plus (PPO)

16663 NOCD ALL

Banner Medicare Advantage Plus (HMO)

16664 NOCD ALL

Banner University Family Care (University of Arizona Health

Plans)

66901 NOCD ALL

Baptist Health South Florida

65026 NOCD ALL

Baycare Select Health Plans Incorp

81079 NOCD ALL

BCBS Of Vermont

SB915 NOCD VA

BCBS Of Michigan (Dental Claims Only)

BBMDQ NOCD MI

N BAKERY UNION Y BANNER HEALTH Y AETNA BANNER HLTH N BANNER PPO N HMO BANNER

A BANNER UNIV OF AZ N BAPTIST HLTH S FL Y BAYCARE SELECT N BCBS VA N BCBS MI DENTAL

BCBS of Texas Medicaid (Plan effective December 1, 2015) 66001 NOCD TX

BCBS Western NY Medicaid

WNYMD NOCD NY

Beacon Health Options

BHOVO NOCD ALL

Beacon of Life

65432 NOCD ALL

Beaver Medical Group

45967 NOCD ALL

Behavioral Health Systems

63100 NOCD ALL

Bella Vista Med Grp IPA

MPM10 NOCD CA

Benefit & Risk Management Services (Commercial Medicare

under Med3000)

99320 NOCD ALL

Benefit Administrative Systems

36149 NOCD ALL

Benefit Concepts

51037 NOCD ALL

Benefit Coordinators Corporation

25145 NOCD ALL

Benefit Management LLC/VBA

88092 NOCD ALL

Benefit Management Services

56139 NOCD ALL

Benefit Management Systems, Inc of Mississippi

37212 NOCD MS

Benefit Management, Inc. of KS (Only accepts claims for these

groups

BMI187,BMI219,BMI234,BMI236,BMI214,BMI241,BMI617

BMI246,BMI246.)

48611 NOCD ALL

Benefit Plan Administrators Co. (Payer ID valid only for claims

with a billing submission address of PO Box 1128, Eau Claire,

WI 54702-1128)

39081 NOCD WI

Benefit Systems and Services, Inc.

36342 NOCD All

Benefit Trust Life Insurance Company

61425 NOCD All

Y BCBS TEXAS MEDICA Y BCBS W NY MEDICAI N BEACON HLTH OPTIO Y BEACON LIFE N BEAVER N BEHAVIORAL HS N BELLA VISTA MED G

N BENE RISK MGMT SV Y BENE ADMIN SYSTEM Y BENEFIT CONCEPTS N BENEFIT COOR CORP Y BENE MGMT LLC VBA N BENE MGMT SVCS Y BMS OF MS

N BENEFIT MGMT KS

Y BENEFIT PLAN WI Y BENEFIT SYSTEMS Y BENEFIT TRUST LIF

BeneSys, Inc. (Now known as Sheet Metal Workers Local 104) 38238

Benmark

BNMK1

Berkshire Health Partners

23243

Berkshire Intergroup

10956

Best Life & Health Insurance Co.

95604

NOCD ALL NOCD ALL NOCD ALL NOCD ALL NOCD ALL

N BENESYS INC MI N BENMARK N BERKSHIRE HLTH PA Y BERKSHIRE INTERGR N BEST LIFE AND HEA

Better Health Plan of Florida (For claims rejections, contact payer at 800-514-4561 and select provider services option.) Beverly Hospital BHSF International Big Lots Associates Benefit Plans BIND (UHC Choice Plus Multiplan) Block Vision of Texas Block Vision, Inc. Blue Advantage of Arkansas Blue Care PPO Blue Chip of Rhode Island Blue Choice Medicaid Blue Choice of Rochester NY Blue Choice of South Carolina Blue Cross Blue Shield Michigan Medicare Blue Cross Blue Shield of Florida Blue Cross Blue Shield Of Western New York Blue Cross Community Solutions (Effective 12-14-14. Payer was previously known as IL BCBS ICP with a payerID of 00621) Blue Cross Complete Blue Cross IA COB Blue Cross Medicare Advantage (For DOS after 01-01-2017 and for MemberID starting with YDL, YDJ, XOD, XOJ, ZGD,ZGI, ID,YIJ, YUX and UYB only) Blue Cross MI Blue Care Complete Blue Cross of California Blue Cross of Idaho Blue Grass Family Health (SRRIPA) Blue Lake Rancheria

20488 NOCD ALL

N

MPM42 NOCD ALL

N

67668 NOCD ALL

Y

CX025 NOCD ALL

N

25463 NOCD ALL

N

BVTX1 NOCD TX

Y

BV001 NOCD ALL

Y

ARBLS NOCD AR

Y

VABLS BCBS VA

Y

RICHP NOCD RI

Y

00403 NOCD SC

Y

N6BLS NOCD NY

Y

00922 NOCD SC

N

MIMCR NOCD MI

Y

FLBLS BCBS FL

Y

N1BLS NOCD ALL

N

MCDIL NOCD ALL

Y

32002 NOCD ALL

Y

SB645 NOCD MT,IL,TX,O N

66006 NOCD MT,IL,TX,O N

MIBCN NOCD MI

N

BC001 NOCD CA

Y

IDBLC BCBS ID

Y

15754 NOCD ALL

N

IP061 NOCD CA

N

BETER HP OF FL BEV HOSP BHSF INTERNATIONA BIG LOTS ASSOC BE BIND BLOCK VISION TX BLOCK VISION INC AR BLUE ADVANTAGE BLUECARE PPO RI BLUE CHIP BLUE CHOICE MCAID ROCHESTER BLUE CH BLUE CHOICE OF SC BCBS MI MEDICARE FL BLUE SHIELD BCBS OF WEST NY

ILLINOIS BCBS ICP BLUE CROSS COMPLE BLUE CROSS IA

BC MCARE ADV MIT MI BLUE CARE CA BLUE CROSS ID BLUE CROSS BLUE GRASS FAMILY BLUE LAKE RANCHER

For up-to-date payer information, please access the payer list from the OptumInsight website at: or contact OptumInsight Customer Service and Support at1-866-678-8646 (1-866-OPTUMGO)

Secondary**

Enrollment

Payer Type

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE N

N

FALSE G

N

FALSE G

Y

FALSE N

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE N

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

TRUE

N

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

FALSE N

N

FALSE G

Y

TRUE

N

Y

FALSE N

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE N

Y

TRUE

N

Y

FALSE G

Y

TRUE

N

Y

FALSE G

Y

FALSE G

OptumInsight Medical Payer List

6 of 41

(07/17/2023)

Payer Name

Payer ID

Claim Office Number

State

Reports

Entered As

Blue Medicare of North Carolina (Contracted providers only.

Call 888-296-9790)

CALL NOCD NC

Y CALL SUPPORT

Blue Shield of Alabama

ALBLS NOCD AL

Y AL BLUE SHIELD

Blue Shield of Alaska

AKBLS NOCD AK

N AK BLUE SHIELD

Blue Shield of Arizona

AZBLS NOCD AZ

Y AZ BLUESHIELD

Blue Shield of Arkansas

ARBLS NOCD AR

Y AR BLUE SHIELD

Blue Shield of California

BS001 NOCD CA

Y CA BLUE SHIELD

Blue Shield of Central NY HMO/PPO

N2BLS NOCD NY

Y CE NY BLUE SHIELD

Blue Shield of Colorado

COBLS BCBS CO

Y CO BLUE SHIELD

Blue Shield of Connecticut

CTBLS NOCD CT

Y CT BLUE SHIELD

Blue Shield of Delaware

DEBLS BCBS DE

Y DE BLUE SHIELD

Blue Shield of Georgia (State Health of GA)

GABLS BCBS GA

Y GA BLUE SHIELD

Blue Shield of Hawaii

HIBLS NOCD HI

N HI BLUE SHIELD

Blue Shield of Idaho (Per Provider Testing)

IDBLS BCBS ID

Y ID BLUE SHIELD

Blue Shield of Illinois

ILBLS BCBS IL

Y IL BLUESHIELD

Blue Shield of Indiana

INBLS NOCD IN

Y IN BLUE SHIELD

Blue Shield of Iowa

IABLS BCBS IA

N IA BLUE SHIELD

Blue Shield of Iowa (For Secondary claims only where

Medicare is primary) (Provider must be enrolled with IABLS

prior to sending to this payer. )

IABLM NOCD IA

N IA BLUE SHIELD CO

Blue Shield of Kansas

KSBLS BCBS KS

Y KS BLUE SHIELD

Blue Shield of Kansas City

KCBLS NOCD KS,MS

Y KC BLUE SHIELD

Blue Shield of Kentucky

KYBLS NOCD KY

Y KY BLUE SHIELD

Blue Shield of Louisiana

LABLS NOCD LA

N LA BLUE SHIELD

Blue Shield of Maine

MEBLS NOCD ME

Y ME BLUE SHIELD

Blue Shield of Maryland

MDBLS BCBS MD

Y MD BLUE SHIELD

Blue Shield of Massachusetts

MABLS NOCD MA

Y MA BLUE SHIELD

Blue Shield of Michigan

MIBLS NOCD MI

Y MI BLUE SHIELD

Blue Shield of Minnesota

MNBLS NOCD MN

N MN BLUE SHIELD

Blue Shield of Mississippi

MSBLS NOCD MS

Y MS BLUE SHIELD

Blue Shield of Missouri

MOBLS NOCD MO

Y MO BLUE SHIELD

Blue Shield of Montana

MTBLS BCBS MT

Y MT BLUE SHIELD

Blue Shield of National Capital Area

NCABS NOCD DC VA MD Y NCA

Blue Shield of Nebraska

NEBLS BCBS NE

Y NE BLUE SHIELD

Blue Shield of Nevada

NVBLS NOCD NV

Y NV BLUE SHIELD

Blue Shield of New Hampshire

NHBLS NOCD NH

Y NH BLUE SHIELD

Blue Shield of New Jersey

22099 NOCD NJ

Y NJ BLUESHIELD

Blue Shield of New Mexico

NMBLS NOCD NM

Y NM BLUE SHIELD

Blue Shield of New York (Empire)

NYBLS NOCD NY

N NY BLUE SHIELD

Blue Shield of North Carolina

NCBLS NOCD NC

Y NC BLUE SHIELD

Blue Shield of North Dakota

NDBLS BCBS ND

N ND BLUE SHIELD

Blue Shield of Northeast NY

N5BLS NOCD NY

Y NE NY BLUE SHIELD

Blue Shield of Ohio

OHBLS NOCD OH

Y OH BLUE SHIELD

Blue Shield of Oklahoma

OKBLS BCBS OK

Y OK BLUE SHIELD

Blue Shield of Oregon

ORBLS NOCD OR

Y OR BLUE SHIELD

Blue Shield of Pennsylvania

PABLS NOCD PA

Y PA BLUE SHIELD

Blue Shield of Rhode Island

RIBLS NOCD RI

Y RI BLUE SHIELD

Blue Shield of Rochester NY

N7BLS NOCD NY

Y ROCHESTER BLUE SH

Blue Shield of South Carolina

SCBLS NOCD SC

Y SC BLUE SHIELD

Blue Shield of South Dakota

SDBLS BCBS SD

N SD BLUE SHIELD

Blue Shield of Tennessee

TNBLS BCBS TN

Y TN BLUE SHIELD

Blue Shield of Texas

TXBLS NOCD TX

Y TX BLUE SHIELD

Blue Shield of Utah

UTBLS NOCD UT

Y UT BLUE SHIELD

Blue Shield of Utica NY

N4BLS NOCD NY

Y UTICA BLUE SHIELD

Blue Shield of Vermont

VTBLS NOCD VT

N VT BLUE SHIELD

Blue Shield of Virginia

VABLS BCBS VA

Y VA BLUE SHIELD

Blue Shield of West Virginia

WVBLS NOCD WV

Y WV BLUE SHIELD

Blue Shield of Wisconsin

WIBLS NOCD WI

N WI BLUE SHIELD

Blue Shield of Wyoming

WYBLS BCBS WY

Y WY BLUE SHIELD

Bluebonnet Administrators

37121 NOCD LA

N BLUEBONNET ADMINI

Boilermakers national Health & Welfare Fund

36609 NOCD ALL

Y BOILERMAKERS NATL

Bollinger, INC.

BOLL1 NOCD ALL

N BOLLINGER INC

Boncura Health (Dupage Medical Group)

DMG01 NOCD ALL

N BONCURA HEALTH

Boon-Chapman Benefit Administrators, Inc.

74238 NOCD ALL

Y BOON CHAPMAN BENE

Boston Medical Center Healthnet

13337 NOCD MA

N BOSTON MED CENTER

BPS Inc

48964 NOCD ALL

Y BPS INC

Brand New Day (Encounters)

UC002 NOCD ALL

N BRAND NEW ENC

Brand New Day (FFS)

UC001 NOCD ALL

N BRAND NEW FFS

Braven Health

84367 NOCD ALL

N BRAVEN

Bravo Health (Now CIGNA HealthSprings.)

52192 NOCD ALL

Y BRAVO HEALTH

Breckpoint

BRKPN NOCD ALL

N BRECKPT

BridgeSpan

BRIDG NOCD ALL

N BRIDGESPAN

Bridgeway Arizona

68069 NOCD AZ

Y BRIDGEWAY ARIZONA

Bright Health (for DOS after 01/01/2022)

BRGHT NOCD ALL

Y BRGHT HEALTH

For up-to-date payer information, please access the payer list from the OptumInsight website at: or contact OptumInsight Customer Service and Support at1-866-678-8646 (1-866-OPTUMGO)

Secondary**

Enrollment

Payer Type

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

TRUE

N

Y

FALSE G

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

TRUE

N

Y

FALSE N

Y

TRUE

N

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

FALSE G

Y

TRUE

N

N

FALSE N

N

FALSE N

Y

FALSE N

Y

TRUE

N

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

TRUE

N

Y

FALSE N

Y

TRUE

N

Y

FALSE N

Y

FALSE N

N

FALSE N

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

TRUE

N

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

FALSE N

Y

TRUE

N

Y

FALSE N

Y

FALSE N

Y

FALSE N

N

FALSE G

Y

TRUE

N

Y

FALSE G

Y

FALSE N

Y

FALSE N

N

FALSE N

Y

FALSE N

Y

TRUE

N

Y

FALSE N

Y

FALSE N

Y

FALSE G

Y

FALSE G

Y

FALSE N

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

TRUE

N

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

OptumInsight Medical Payer List

7 of 41

(07/17/2023)

Payer Name

Payer ID

Claim Office Number

State

Reports

Entered As

Bright Health Physicians Bright Health Plan (for DOS prior to 01/01/2022)

BHP01 NOCD CA CB186 NOCD ALL

Brighton Health Plan Solutions (for DOS prior to 01/01/2022) BritCay Brockerage Concepts, Inc (Benefit Concepts) Brown & Toland Medical Group Brown & Toland Sutter Brown & Toland SutterSelect Buckeye Community Health Buckeye Ohio Medicaid Butler Benefits C & O Employees Hospital Association C3 Health (fka Access Health Inc.) California Anthem Blue Cross California Blue Cross California Health and Wellness California IPA California Pacific Medical Center California Water Services Cal-Optima Direct Cannon Cochran Management Services, Inc. LA (Claims for Payer address of Metairie, LA only.) CAP Management Cap Management Systems Capital Advantage Insurance Company (CAIC) PROFESSIONAL (BCBS ProviderID and Performing ProviderID required. Call 800-874-8433) Capital Blue Cross PROFESSIONAL (BCBS ProviderID and Performing ProviderID required. Call 800-874-8433) Capital District PHP Capital Health Plan Capital International Management Services Capitol Administrators (Lucent Health) CapRock HealthPlans Cardiovascular Care Providers Care4Kids (WI Medicaid) Care 1st Health Plan of Arizona Care 1st Health Plan of CA Care Access PSN Care Around the Clock Care Choices HMO Care Core National Care N' Care Care Plus Care to Care Care Wisconsin Health Plan (Trizetto) CareCentrix Carecore National Wellcare CareCore National, LLC (Aetna Radiology Claims) CareCore National, LLC (Radiology charges for Oxford) CareFirst BCBS - DC, National Capital Area Carelink Medicaid Caremore Caremore IPA CareMore Value Plus (CVP) Carenet of Virginia (Prepare to use consolidated Coventry payerID of 25133.) CareOregon, Inc. CarePlus Cardiology - New Century Health CarePlus Health Plan (Call payer for PayerID) Caresource Health Plan of Oregon Caresource AR Caresource IN CareSource KY CareSource of Georgia CareSource OH CareSource Ohio Medicaid Caresource West Virginia Careworks of Ohio Carolina Behavioral Health Alliance Carolina Care Plan (Part of the Medical Mutual Family of companies. Former payerID was 57105.) Carolina Crescent

11303 NOCD ALL 22286 NOCD ALL 51037 NOCD ALL 94316 NOCD ALL BTSS1 NOCD ALL BTSS1 NOCD ALL 68069 NOCD IA 0004202 NOCD OH 42150 NOCD ALL 23708 NOCD ALL A1680 NOCD MI BC001 NOCD CA BC001 NOCD CA 68069 NOCD CA AMM14 NOCD CA 94056 NOCD ALL CWS99 NOCD CA CALOP NOCD ALL

71057 95399 IP080

NOCD LA NOCD ALL NOCD CA

23045 NOCD PA

23045 SX065 95112 65067 68011 CAPHP GCVCP 39113 57116 57115 65063 57721 HM037 14182 66010 65031 41222 27004 11345 14188 14179 14180 SB580 25140 CM001 CARMO CARMO

NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD NOCD

PA ALL All ALL ALL ALL ALL ALL AZ CA ALL ALL ALL ALL ALL ALL ALL ALL ALL ALL ALL NY, NJ MD,DC ALL ALL ALL ALL

25142 NOCD VA 93975 NOCD OR NCH04 NOCD ALL CALL CALL ALL MRCHP NOCD ALL ARCS1 NOCD AR INCS1 NOCD IN KYCS1 NOCD KY GACS1 NOCD ALL 31114 NOCD OH 0003150 NOCD OH WVCS1 NOCD ALL 10010 NOCD OH 56215 NOCD NC

29076 68069

NOCD SC NOCD ALL

Y BRIGHT HEALTH PHY Y BRIGHT HEALTH PLA

N MAGNACARE Y BRITCAY Y BROCKERAGE CONCEP Y BROWN TOLAND N BROWN TOLAND SUTT Y BROWN TOLAND SUT Y BUCKEYE COMM HLTH N BUCKEYE MCD Y BUTLER BENEFITS Y C AND 0 EMP HOSP N ACCESS HEALTH PLA Y CA BLUE CROSS Y CA BLUE CROSS Y CA HEALTH WELLNES N CALIFORNIA IPA Y CA PACIFIC MED CE Y CA WATER SERVICES Y CALOPTIMA DIRECT

N CANNON COCHRAN LA N CAP MANAGEMENT N CAP MGMT SYSTEMS

Y CAPITAL ADV INS

Y CAPITAL BLUE CROS A CAPITAL DIST PHP Y CAPITAL HEALTH PL Y CAP INTL MGMT SVC Y CAPITOL ADMINISTR N CAPROCK HEALTH PL N CARDIOVASCULAR CA N CARE4KIDS Y AZ CARE FIRST HP N CARE 1ST HP OF CA N CARE ACCESS PSN Y CARE AROUND CLOCK N CARE CHOICES HMO Y CARE CORE NATIONA N CARE N CARE A CARE PLUS N CARE TO CARE N CARE WI HEALTH PL Y CARECENTRIX N CARECORE NAT WELL N CARECORE NATIONAL Y CARECORE OXFORD Y CAREFIRST NCA Y CARELINK MEDICAID Y CAREMORE N CAREMORE IPA N CAREMORE IPA

Y CARENET VIRGINIA Y CAREOREGON INC N CAREPLUS CARDIO N CALL PAYER N CARESOURCEHPOR Y CARESOURCE AR Y CARESOURCE IN N CARESOURCE KY N CARESOURCE OF GA R CARESOURCE OH N CS OH MCD Y CARESOURCE WV N CAREWORKS OF OHIO N CAROLINA BEHAV HL

Y CAROLINA CARE PLA Y CAROLINA CRESCENT

For up-to-date payer information, please access the payer list from the OptumInsight website at: or contact OptumInsight Customer Service and Support at1-866-678-8646 (1-866-OPTUMGO)

Secondary**

Enrollment

Payer Type

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE N

Y

FALSE N

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE N

Y

FALSE G

N

FALSE G

N

FALSE N

Y

FALSE G

Y

FALSE T

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE N

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE N

N

FALSE N

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

OptumInsight Medical Payer List

8 of 41

(07/17/2023)

Payer Name

Payer ID

Claim Office Number

State

Reports

Entered As

Carolina Summit Healthcare, Inc

56195 NOCD

Carpenters' and Millwrights' Health Benefit Trust Fund

COMPU NOCD

Carpenters Health and Welfare Fund of Philadelphia

CX101 NOCD

Carpet, Linoleum and Resilient Tile Layers Health and Welfare

Fund

COMPU NOCD

CBA Blue

03036 NOCD

CBHA Carolina Behavioral Health Alliance

56215 NOCD

CBNHP Health Choices

65391 NOCD

CBSA (Corporation Benefit Services of America)

41124 MCSI

CCMC - Comprehensive Care Management Corp

CCMC1 NOCD

CCS (aka Comprehensive Care Systems)

MNBLS NOCD

CDO Technologies

63028 NOCD

Cedar Valley Community Health Plan

SISCO NOCD

Cedars-Sinai Medical Network Services Claims

95166 NOCD

Cedars-Sinai Medical Network Services Encounters

95167 NOCD

Celtic Insurance

CELTC NOCD

CeltiCare

68069 NOCD

Cement Masons & Plasterers Health & Welfare Trust -

Grp#F16

91136 NOCD

CenCal Health

95386 NOCD

Cenpatico - Georgia

68069 NOCD

Cenpatico - Kansas (Prior to submitting claims please call

Provider Relations Dept at 866-896-7293 to verify your provider

info is on file in the claim system.)

68068 NOCD

Cenpatico (For multiple states)

68068 NOCD

Cenpatico Behavioral Health - Wisconsin (Call 800-225-2573

ext 25525 prior to submitting claims.)

68068 NOCD

Cenpatico Behavioral Health AZ (Prior to submission, contact

866-495-6748 to verify provider ID.)

68068 NOCD

Cenpatico Florida Behavioral Health

68068 NOCD

Cenpatico Indiana

68068 NOCD

Cenpatico Massachusetts

68068 NOCD

Cenpatico Ohio

68068 NOCD

Centene Advantage Plans (claims for former payer ID 95567

with DOS on or after 1/1/18)

68069 NOCD

Center for Elders Independence

94312 NOCD

Center for Healthy Living

CPHL1 NOCD

Center IPA

POP01 NOCD

CenterCare

13357 NOCD

CenterLight Healthcare

13360 NOCD

Centinela IPA

IP080 NOCD

Centivo

45564 NOCD

CentraCare

66698 NOCD

ALL CO ALL

CO ALL ALL ALL ALL NY MN WY,UT ALL ALL ALL ALL ALL

ALL CA GA

ALL ALL

ALL

AZ FL ALL MA OH

ALL ALL ALL ALL ALL ALL ALL CA ALL

Central Benefit National (Now known as Tribute Health Plan.) 61184

Central California Alliance for Health (Alliance EDI Support Unit

831-430-5510)

SX169

Central California Women's Health

WH001

Central Health Medicare

CHCPI

Central Ohio Primary Care Senior Care Advantage

AGL02

Central Reserve Life

13193

Central Reserve Life Ins.Co. (Formertly Loyal American Life

(Medicare Supplement) )

13193

Central States Southeast and Southwest Areas Health and

Welfare and Pensions Funds

36215

Centurion of Tennessee

42140

Century PHO

36393

CHA - Commonwealth Health Alliance

23171

Chaffey Medical Group

49533

NOCD ALL

NOCD CA NOCD CA NOCD ALL NOCD ALL NOCD ALL

NOCD ALL

NOCD All NOCD ALL NOCD ALL NOCD ALL NOCD ALL

CHAMPVA-HAC (CHAMPVA-HAC is not associated with and

does not process claims for TRICARE (formerly CHAMPUS.) 84146 NOCD ALL

Chautauqua County Health Plan (Mayville,NY)

16600 NOCD NY

Children First Medical Group (For questions regarding claim

status, providers will need to contact payer: CFMG Provider

Customer Service 510-428-3154)

94321 NOCD ALL

Children's Community Health Plan Wisconsin

251CC NOCD ALL

Children's Specialists of San Diego

CSSD2 NOCD CA

Chinese Community Health Plan (Unique Provider ID must be

on claim.)

94302 NOCD ALL

Chirometrics Inc.

33070 NOCD ALL

Chiropractic Association of South Dakota

CASD1 NOCD SD

Chiropractic Care of Minnesota, Inc. (For Dates of service

before 1-01-08, continue to use payerID of ACN01.)

LNDMK NOCD MN

Y CAROLINA SUMMIT N CARPENTERS HBTF N CARPENTERS HW FUN

N CARPET TILE HWF Y CBA BLUE Y CBHA Y CBHNP HEALTH CHOI Y CBSA Y CCMC Y CCS COMPREHENSIVE Y MBA OF WYOMING N SISCO Y CEDARS SINAI CLAI Y CEDARS SINAI ENCO N CELTIC INS Y CELTICARE

Y CEMENT GRP F16 N CENCAL HEALTH Y CENPATICO GA

Y CENPATICO KANSAS Y CENPATICO

Y CENPATICO BHAV WI

Y CENPATICO BH AZ Y CENPATICO FL BHV Y CENPATICO INDIANA Y CENPATICO MASSACH Y CENPATICO OHIO

Y CENTENE ADVANTAGE N CENTER ELDERS IND N CTR HLTH LIVING Y CENTER IPA Y CENTERCARE N CENTERLIGHT HC N CENTINELA IPA N CENTIVO Y CENTRACARE

Y CENTRAL BENEFITS

N CEN CAL ALLIANCE Y CENT CA WOMENS HE N CENTRAL HLTH MEDI Y CENTRAL OHIO Y CENTRAL RESERVE L

Y LOYAL AMERICAN L

Y CENTRAL STATES SO N CENTURION TENNESS N CENTURY PHO Y CHA N CHAFFEY

N CHAMPVA HAC Y CHAUTAUQUA HEALTH

N CHILDREN FIRST MG Y CHILD COMM HP WI Y CHILD SPEC OF SD

Y CHINESE COMM HP Y CHIROMETRICS INC R CHIRO ASSOC SD

Y CHIRO CARE MN

For up-to-date payer information, please access the payer list from the OptumInsight website at: or contact OptumInsight Customer Service and Support at1-866-678-8646 (1-866-OPTUMGO)

Secondary**

Enrollment

Payer Type

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE N

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

TRUE

N

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

N

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE G

Y

FALSE P

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download