ESolutions Interactive Payerlist



Multi-Payer Set UpProvider Name FORMTEXT ?????Tax ID FORMTEXT ?????Billing NPI FORMTEXT ?????Address FORMTEXT ????City FORMTEXT ????State FORMTEXT ?????Zip FORMTEXT ?????Contact FORMTEXT ?????Phone FORMTEXT ????? Fax FORMTEXT ?????Email FORMTEXT ?????Date FORMTEXT ?????Check the box next to each payer ID for EDI set up. Submit completed form to eSolutions Inc. by attaching to an email addressed to ESH@. In the subject line, enter your provider name followed by “Payer Setup”.ERA Enrollment Payers FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 131621199 National Benefit Fund FORMCHECKBOX MAHC1Medical Assoc. Health Plan/Health Choices FORMCHECKBOX 65093Advocate Health Partners (PHO) FORMCHECKBOX 74323Medical Benefits Mutual FORMCHECKBOX 36320Advocate Medical Group FORMCHECKBOX 29076Medical Mutual of Ohio FORMCHECKBOX AWNY6AgeWell New York FORMCHECKBOX CB833Medical Mutual of Ohio( Dental) FORMCHECKBOX 62030American General FORMCHECKBOX MCMMMMedicare Y Mucho Mas Institutional FORMCHECKBOX 26119American Ins. Administrators FORMCHECKBOX (Enroll with L0210) FORMCHECKBOX 11983Auto Club Insurance Association FORMCHECKBOX 62160MedSolutions, Inc. - eviCore FORMCHECKBOX 59274AvMed–EFT setup Required prior to ERA Setup FORMCHECKBOX 39190MedStar Family Choice FORMCHECKBOX Enroll at: Change Healthcare EFT Enrollment FORMCHECKBOX 13265MetroPlus Health Plan FORMCHECKBOX 81079BayCare Select Health Plans FORMCHECKBOX 10850Metropolitan Health Plan FORMCHECKBOX SB580BCBS – DC, CareFirst (Both SB580 and 12000) FORMCHECKBOX 13174Montefiore Contract Management Org. FORMCHECKBOX SB690BCBS – MD, CareFirst FORMCHECKBOX 34009MyNEXUS, Anthem FORMCHECKBOX BOONGGGGBoon Admin. Services-Foundation Benefit Admin. FORMCHECKBOX 34010MyNEXUS, Aetna Medicare Adv Texas FORMCHECKBOX 52192Bravo Health & Texas Healthspring FORMCHECKBOX 39144Network Health Plan of Wisconsin FORMCHECKBOX 06607Cardinal Innovations Healthcare FORMCHECKBOX 76112North American Ins Co dba Oxford Life FORMCHECKBOX 66010Care N Care FORMCHECKBOX NWADMNorthwest Admin. (Enroll with ID 91068) FORMCHECKBOX 27004Care Wisconsin Health FORMCHECKBOX 48026Northshore Physician Associates IPA FORMCHECKBOX 75190CareFirst Administrators / NCAS FORMCHECKBOX 14142NYS DOH UCP (New York ADAP) FORMCHECKBOX 65031CarePlus Health Plans, Inc. *EFT is required FORMCHECKBOX 54154Optima Health / Sentara Health*EFT Required FORMCHECKBOX 23626Central PA Teamsters Fund FORMCHECKBOX 13383Orthonet Corporation - Aetna FORMCHECKBOX 80214ChampVA-HAC Medicare Crossover (84146) FORMCHECKBOX 86711PACE Southeast Michigan FORMCHECKBOX 84146ChampVA-HAC (Also enroll with 80214) FORMCHECKBOX 93029PacificSource66917Parkland Community Health Plan61129Passport Health Plan72126Peoples Health Network251PDPiedmont WellStar Health Plan37224Pittman & Associates37287Planned Administrations, Inc.16111POMCO65088Preferred Care Partners60110Preferred Health Systems Insurance65054Premier Eye Care87716Prestige Health ChoicePacificSource (Includes Payer ID 20416) FORMCHECKBOX 84147ChampVA FORMCHECKBOX FORMCHECKBOX 20416Pacific Source Comm.(Enroll w/ID 93029) FORMCHECKBOX 52106Christus Health Plan of TX and LA FORMCHECKBOX 66008Passport Advantage FORMCHECKBOX 77023Clover Health fka CarePoint Health Plans FORMCHECKBOX 72126Peoples Health Network FORMCHECKBOX 13285Clover Health Network FORMCHECKBOX 83276Physicians Health Plan of MI Medicare FORMCHECKBOX COACCColorado Access (Enroll with 84129) FORMCHECKBOX 21524Preferred Medical Claims Services FORMCHECKBOX 39126Community Care Inc. (WI) - Also enroll 60995 FORMCHECKBOX 65054Premier Eye Care FORMCHECKBOX FORMCHECKBOX 60995Community Care Inc Family Care – Also enroll 39126 FORMCHECKBOX 13027Primaria VillageMD of Central Indiana FORMCHECKBOX 73143Community Care Managed Health Care of OK FORMCHECKBOX 61604PrimeWest Health Plan FORMCHECKBOX 37363Compsych FORMCHECKBOX SX133Providence of Oregon Health Plan FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 39113Dean Health Plan FORMCHECKBOX FORMCHECKBOX 07035DeCare Dental Health Insurance FORMCHECKBOX 23342QualCare, Inc. FORMCHECKBOX 39069Delta Dental of Wisconsin FORMCHECKBOX 22312QualCare, Inc. (dba QANI Admin.) FORMCHECKBOX 64246Dental Guard Preferred FORMCHECKBOX 76066Renaissance Physicians (Enroll with 52192) FORMCHECKBOX CX093Dental Select FORMCHECKBOX 74205Right Care from Scott & White FORMCHECKBOX 74284Driscoll Children’s Health Plan FORMCHECKBOX CP001Samaritan Health Plans FORMCHECKBOX 31625Elder Plan FORMCHECKBOX 37259SAMBA – ERA Only FORMCHECKBOX 03964Elderwood Health FORMCHECKBOX 91184Sanford Health Plan FORMCHECKBOX 37216Employee Benefit Services – EFT is required FORMCHECKBOX 77038Sante Health System and Affiliates FORMCHECKBOX 84517Esse Health ACO, LLC (ERA Only) FORMCHECKBOX 93742Securian Dental Plan FORMCHECKBOX 20818Essence Healthcare FORMCHECKBOX SCS17Sendero Idealcare FORMCHECKBOX 77009First Choice VIP Care Plus – South Carolina FORMCHECKBOX 15682Senior Network Health FORMCHECKBOX 25169Gateway Health Plan Medicaid PA FORMCHECKBOX SWHNYSenior Whole Health (Enroll with 20149) FORMCHECKBOX 95192Group Health Cooperative Eau Claire FORMCHECKBOX 38242Southern Benefit Admin. EFT Required FORMCHECKBOX 39167Group Health Cooperative of South Central WI FORMCHECKBOX 84146Spina Bifida - VA HAC (Also enroll 80214) FORMCHECKBOX 64246Guardian Life Insurance FORMCHECKBOX 31053State Farm Insurance Co. EFT Required FORMCHECKBOX 47738Hamaspik Choice FORMCHECKBOX 62179Steward Health Choice of Arizona FORMCHECKBOX 38224HAP/AHL/Curanet (Health Alliance Plan of MI) FORMCHECKBOX 62180Steward Health Choice Generations (AZ) FORMCHECKBOX 77950Health Alliance FORMCHECKBOX 45399Steward Health Choice Utah - Medicaid FORMCHECKBOX 95019Health First Health Plan (Enroll with 15064) FORMCHECKBOX 46221Steward Health Choice Insurance Co. FORMCHECKBOX *EFT is required for Health First FORMCHECKBOX 22100Steward Health Choice Integrated Care FORMCHECKBOX 95567Health Net of California & Oregon FORMCHECKBOX 13054Steward Health Choice Generations Utah FORMCHECKBOX 04286Health New England* FORMCHECKBOX 67814Sun Life and Health Insurance Co. FORMCHECKBOX *Note:Provider must also enroll at payer’s website: FORMCHECKBOX 43619Teamsters Local 688 Ins. & Welfare FORMCHECKBOX FORMCHECKBOX 76048Texas Children’s Health Plan FORMCHECKBOX SectionB:Vendor Name: Emdeon, Vendor Tax ID: 133052274 FORMCHECKBOX 75228Texas Children’s Health Plan (Medicaid) FORMCHECKBOX Vendor Contact Phone: 866-924-4634 FORMCHECKBOX 82694The Macaluso Group FORMCHECKBOX Vendor Name (Appointed): Emdeon FORMCHECKBOX 14163Today’s Options (Enroll with ID 48055) FORMCHECKBOX CX009HealthPartners of Minnesota FORMCHECKBOX 23856Touchstone Health PSO (Enroll with ID 11328) FORMCHECKBOX CX010Health Partners of Minnesota (Medicaid) FORMCHECKBOX TRP1ETransamerica Life Insurance Company FORMCHECKBOX 80141HealthFirst Inc.* - EFT Required to receive ERA FORMCHECKBOX 31118Provider Partners Health Plan of MD FORMCHECKBOX *Note:Provider must contact HealthFirst to complete FORMCHECKBOX L0230Trusted Health Plan * FORMCHECKBOX ERA/EFT Setup at 888-801-1660. FORMCHECKBOX *Note:Provider must contact Trusted Health to FORMCHECKBOX FORMCHECKBOX Complete ERA Setup at 910-715-8131. FORMCHECKBOX 37290Health Services for Children Special Needs FORMCHECKBOX 04298Tufts Health Public Plans (Enroll with ID 04332) FORMCHECKBOX 96475Healthlink HMO FORMCHECKBOX 77022Ultimate Health Plan FORMCHECKBOX 87815HealthSmart Benefit Solutions FORMCHECKBOX 34638Unified Physicians Network (Chicago IPA) FORMCHECKBOX 52192HealthSpring - Star + FORMCHECKBOX 45282University of Maryland Health Advantage FORMCHECKBOX 63092HealthSpring HMO Medicare + Choice (Also 52192) FORMCHECKBOX 23281UPMC Health Plans Advantage Dental only FORMCHECKBOX 47181Highmark Health Options (Also enroll 25169, 91741) FORMCHECKBOX 38337Upper Peninsula Health Plan FORMCHECKBOX 86066HMA Hawaii FORMCHECKBOX 13407USFHP-St. Vincent Catholic Medical Center FORMCHECKBOX 84555HMO Louisiana – Blue Medicare Advantage FORMCHECKBOX 12115Veterans Administration (VA) Fee Basis Pgm. FORMCHECKBOX 66003Hopkins Health Advantage FORMCHECKBOX 12116Veterans Administration (VA) Fee Basis Dental FORMCHECKBOX 22326Horizon New Jersey Health FORMCHECKBOX 26545VillageCareMAX FORMCHECKBOX 33884iCircle of New York FORMCHECKBOX 63114Viva Health Plan FORMCHECKBOX 35161Indiana Prohealth Network FORMCHECKBOX 91136Welfare and Pension Admin. Service FORMCHECKBOX 95444Indiana University Health Plans FORMCHECKBOX WVS01West Virginia Senior Advantage FORMCHECKBOX FORMCHECKBOX 31048Western Southern Financial Group FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 52123Johns Hopkins Healthcare (Also Enroll 52189) FORMCHECKBOX FORMCHECKBOX 71066Kansas Superior Select – KS Health Advantage FORMCHECKBOX FORMCHECKBOX 37316Leon Medical Center (Enroll with ID LMCHP) FORMCHECKBOX FORMCHECKBOX 25181LIFE Pittsburgh FORMCHECKBOX FORMCHECKBOX 37175Loyola Physician Partners FORMCHECKBOX FORMCHECKBOX 36334MacNeal Health Providers-Chicago Health Sys. FORMCHECKBOX FORMCHECKBOX MCC01Magellan Complete Care AZ FORMCHECKBOX FORMCHECKBOX 22771Managed Health Networks FORMCHECKBOX FORMCHECKBOX 53275Martin’s Point Health Care FORMCHECKBOX FORMCHECKBOX 83269Mary Washington Health Plan FORMCHECKBOX FORMCHECKBOX 41154Mayo Management Services (MMIS) FORMCHECKBOX FORMCHECKBOX 56205MedCost Benefit Services (MBS) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Claim Enrollment Payers FORMCHECKBOX HIMCDHawaii Medicaid (Enroll with SKHI0) FORMCHECKBOX Claim and ERA Enrollment PayersPRBLSPuerto Rico Blue Shield and 835 FORMCHECKBOX 22099Horizon Healthcare of New Jersey and 835 FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX ................
................

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

Google Online Preview   Download