Health Plan/Payer List Availity Clearinghouse and Web Portal

Health Plan/Payer List Availity Clearinghouse and Web Portal

Updated 10/07/2014

Availity P.O. Box 550857 Jacksonville, FL 32255-0857

Table of Contents

Health Plan/Payer List Availity Clearinghouse and Web Portal

Navigating the EDI Clearinghouse Health Plan Partners Section.............................................................................3 Availity's NPI Options....................................................................................................................................4 Availity's Electronic Data Interchange (EDI) Health Plans Partners....................................................................5 ? 32 Availity's Electronic Remittance Advice (ERA) Health Plan Partners................................................................33 - 49 Availity's Business to Business (B2B) Health Plan Partners.................................................................................50 Availity's Web Portal Health Plan Partners.................................................................................................51 ? 54 Workers' Compensation Payer List.........................................................................................................55 - 138

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Health Plan/Payer List Availity Clearinghouse and Web Portal

Navigating the EDI Clearinghouse Health Plan Partners Section

Claim Enrollment Required: Denotes payers that require enrollment for EDI claims submission (837P/I). See EDI Requirements for enrollment details.

Government Payer: Denotes Government payers. May not be a direct connection to the government entity.

Remit (835): Electronic remittance advice sent by payers to communicate adjudication results and payment information for submitted claims. Receiving remits generally requires additional enrollment. Please enroll with Availity first. Please see the Electronic Remittance Advice (ERA) Health Plan Partners section of the list for registration details.

NPI Option: The NPI is a unique identification number for covered health care providers. Availity is making every effort to confirm and communicate the status of our connected payers. For a detailed explanation of our NPI options please see page 4 of this document.

(EDI) Electronic Data Interchange: Customers create batch transactions in their own practice management system (PMS) or hospital information system (HIS) and upload them to Availity. This functionality can be transparent to the end user if their system vendor offers a seamless solution. Availity also offers end users the ability to log onto the portal to upload batches directly. A list of vendor partners is available on the Availity web site.

(B2B) Business to Business: Customers submit transactions in real-time or near real-time using their own practice management system (PMS) or hospital information system (HIS), often using the vendor's user interface. A list of vendors that support this level of integration is available on the Availity web site. Please see Availity's B2B specification document for additional information.

Premium ($): The "$" in the Premium column indicates that the payer requires enrollment in Availity Advanced Clearinghouse if the provider is based in Texas. Please click the link for more information:

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Health Plan/Payer List Availity Clearinghouse and Web Portal

Availity's NPI Options

Option 1 Option 2

Legacy ID Required Dual ID

NPI allowed Legacy identifier required

Allows all of the following scenarios: NPI only Legacy identifier only NPI and Legacy identifiers

Option 3 Option 4

NPI per Mandate

NPI required as Primary Identifier. Tax ID required as a secondary identifier on claims in 2010AA or 2010AB. Only specific non-Legacy qualifiers allowed as secondary identifiers in certain

provider loops.

NPI per Mandate. Legacy ID also allowed.

4 = Option 3 plus: Any other secondary identifiers as allowed in the Implementation Guide will also be

accepted.

4* = Option 3 plus: Tax IDs (EI, SY, TJ) as allowed in the Implementation Guide will also be accepted

as secondary identifiers.

4# = Option 3 plus: Location Numbers (LU) as allowed in the Implementation Guide will also be

accepted as secondary identifiers.

*A legacy identifier is any identifier that payers used to identify a provider as a health care provider before the NPI mandate. Legacy identifiers include OSCAR, NSC, PINs, UPINs, Blue Cross provider numbers, and other payer-designated identifiers.

(+) Indicates the payer has requested a front-end taxonomy code edit.

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Availity's Electronic Data Interchange (EDI) Health Plan Partners

Government Payer* Claim Enroll Required

Remit (835) NPI Option

Premium Payer ID

Payer Name

Professional Claim (837)

Institutional Claim (837)

Eligibility & Benefits (270)

Claim Status (276)

Auth & Referral

(278)

Additional Information

13162 93044 48185 68069 AHS01 64071 37118 87815 72467 38254 75678 22384 59141 38265 37278 58202 51909 35209 77070 59374 25133 95340 65093 36320 65093

1199 NATIONAL BENEFIT FUND A & I BENEFIT PLAN ADMINISTRATORS ABC HEALTH PLAN ABSOLUTE TOTAL CARE ACCESS ADMINISTRATOR ACCLAIM ACMG ACORDIA NATIONAL ACS CONSULTING SERVICES, INC ACTIVA BENEFIT SERVICES, LLC ACTIVE CARE (UCS) ADMINISTRATIVE CONCEPTS, INC ADMINISTRATIVE SERVICES ADMINISTRATIVE SYSTEMS RESEARCH CORPORATION - ASR ADMINONE ADVANCED DATA SOLUTIONS, INC ADVANCED PHYSICIAN ASSN. (CHICAGO) ADVANTAGE HEALTH SOLUTION ADVANTAGE PREFERRED PLUS ADVANTICA ADVANTRA/HLTH AMERICA INC ADVENTIST HEALTH SYSTEM WEST - ROSEVILLE, CA ADVOCATE HEALTH PARTNERS ADVOCATE MEDICAL GROUP ADVOCATE PHYSICIAN PARTNERS

$

26337

AETNA - ILLINOIS MEDICAID

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$

60054

AETNA AFFORDABLE HEALTH CHOICES (SM) - SRC

2

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x

$

23225

AETNA BETTER HEALTH CONNECTICUT MEDICAID

50023

AETNA BETTER HEALTH OF OHIO

$

60054

AETNA INSURANCE COMPANY

2

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2

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2

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$

38692

AETNA TX MEDICAID & CHIP

x

2

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x

13334

AFFINITY HEALTH PLAN

2

x

x

13346

AFTRA HEALTH FUND

2

x

x

64158

AGENCY SERVICES, INC.

2

x

x

95327

ALAMEDA ALLIANCE FOR HEALTH

x

4

x

91136

ALASKA CHILDREN'S SERVICES, INC.

2

x

x

92600

ALASKA ELECTRICAL HEALTH & WELFARE FUND

2

x

x

91136

ALASKA LABORERS CONSTRUCTION INDUSTRY TRUST

2

x

x

91136

ALASKA PIPE TRADERS LOCAL 375

2

x

x

91136

ALASKA UNITED FOOD & COMMERCIAL WORKERS HEALTH & WELFARE TRUST

2

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x

13550

ALICARE

2

x

x

PRINT

ALL HEALTH PLAN PRINT (PRINT TO PAPER)

x

2

x

x

MRIPA 81040 ADSL1 88461 52149 58234 94177 37308 75261 A0701 25133 AMAIA 13550 68069 68069 68069

ALLCARE HEALTH PLAN ALLEGIANCE BENEFIT PLAN ALLIANCE - ALPHA CARE GOLD ALLIANCE HEALTHPLANS OF WISCONSIN ALLIANCE PPO, INC. ALLIANT HEALTH PLANS (GEORGIA) ALLIED ADMINISTRATORS (S.F., CA) ALLIED BENEFITS SYSTEMS ALPHA DATA SYSTEMS ALTA BATES MEDICAL GROUP ALTA HEALTH STRATEGIES AMA INSURANCE AGENCY AMALGAMATED LIFE AMBETTER FROM BUCKEYE COMMUNITY HEALTH PLAN AMBETTER FROM COORDINATED CARE AMBETTER FROM CELTICARE HEALTH PLAN

x

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payer ID 68055 may also be used

formerly Advocate Health Centers EDI submitters located in the IL, NM, OK, OR, TX, and WA regions require Advanced Clearinghouse enrollment for this payer. Please contact your practice management vendor or advancedclearinghouse@ for further details. EDI submitters located in the IL, NM, OK, OR, TX, and WA regions require Advanced Clearinghouse enrollment for this payer. Please contact your practice management vendor or advancedclearinghouse@ for further details. EDI submitters located in the IL, NM, OK, OR, TX, and WA regions require Advanced Clearinghouse enrollment for this payer. Please contact your practice management vendor or advancedclearinghouse@ for further details. EDI submitters located in the IL, NM, OK, OR, TX, and WA regions require Advanced Clearinghouse enrollment for this payer. Please contact your practice management vendor or advancedclearinghouse@ for further details. EDI submitters located in the IL, NM, OK, OR, TX, and WA regions require Advanced Clearinghouse enrollment for this payer. Please contact your practice management vendor or advancedclearinghouse@ for further details. When submitting to this payer ID please ensure the following: The claim is for a Medicaid, Child Health Plus, or Family Health Plus member and the subscriber ID is as printed on Member's ID Card

Please contact Anet Quiambao at 510.747.6153 to join Alameda Alliance's EDI network

To enroll for All Health Plan Print (Print To Paper), please complete and submit the APP Submitter Information and Enrollment Packet. Please note that claims cannot be converted to paper for payers with the state code of SC or MN. APP Submitter Information and Enrollment Packet Effective 8/1/2012, formerly known as Mid Rogue Oregon Health Plan

Availity's Electronic Data Interchange (EDI) Health Plan Partners

Premium Payer ID

Payer Name

68069 68069 68069 68069 68069 68069 75137 75185

37283

63103 95170 ACN01 41161 41160 87726 AMF11 60801 98205 62030 01066 36369 81949 72099 60739 44444 56071 42011 37322 20553 20029 16120 86047 86001 86048 86002 86049 86003 26375 54763 23037 22248 79966 53085

86062

AMBETTER FROM MAGNOLIA HEALTH AMBETTER FROM MANAGED HEALTH SERVICES AMBETTER FROM PEACH STATE HEALTH PLAN AMBETTER FROM SUNSHINE HEALTH AMBETTER FROM SUPERIOR HEALTH AMBETTER OF ARKANSAS AMERIBEN SOLUTIONS, INC. AMERICAN ADMINISTRATIVE GROUP - AAG AMERICAN ADMINISTRATIVE GROUP - AAG (FORMERLY GALLAGHER BENEFITS) AMERICAN BEHAVIORAL AMERICAN BENEFIT PLAN ADMINISTRATORS AMERICAN CHIROPRACTIC NETWORK AMERICAN CHIROPRACTIC NETWORK (PAN) AMERICAN CHIROPRACTIC NETWORK IPA OF N.Y. AMERICAN COMMERCIAL BARGE LINES AMERICAN FAMILY INSURANCE CO. AMERICAN FIDELITY ASSURANCE COMPANY AMERICAN FOUNDERS LIFE INSURANCE CO. AMERICAN GENERAL AMERICAN HEALTHCARE ALLIANCE AMERICAN IMAGING MANAGEMENT AMERICAN INSURANCE COMPANY OF TEXAS AMERICAN LIFECARE AMERICAN NATIONAL INSURANCE CO AMERICAN POSTAL WORKERS UNION AMERICAN REPUBLIC AMERICAN REPUBLIC INSURANCE AMERICAN WORKER HEALTH PLUS AMERICA'S 1ST CHOICE - SOUTH CAROLINA AMERICA'S CHOICE HEALTHPLANS/NMA AMERICA'S PPO (ARAZ) AMERICHOICE OF NEW JERSEY (MEDICAID NJ) AMERICHOICE OF NEW JERSEY PERSONAL CARE PLUS (MEDICARE) AMERICHOICE OF NEW YORK (MEDICAID NY) AMERICHOICE OF NEW YORK PERSONAL CARE PLUS (MEDICARE) AMERICHOICE OF PENNSYLVANIA MEDICAID/CHIP AMERICHOICE OF PENNSYLVANIA PERSONAL CARE PLUS (MEDICARE) AMERIGROUP AMERIHEALTH ADMINISTRATORS AMERIHEALTH HMO NEW JERSEY AND DELAWARE AMERIHEALTH MERCY HEALTH PLAN AMIDA CARE ANCHOR BENEFIT CONSULTING, INC

ANCILLARY BENEFIT SYSTEMS/ARIZONA FOUNDATION FOR MEDICAL CARE

47198

ANTHEM CA

00050

ANTHEM CO

00060

ANTHEM CT

00130

ANTHEM IN

00630

ANTHEM IN

00160

ANTHEM KY

00660

ANTHEM KY

Government Payer* Claim Enroll Required

Remit (835) NPI Option

Professional Claim (837)

Institutional Claim (837)

Eligibility & Benefits (270)

Claim Status (276)

Auth & Referral

(278)

Additional Information

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This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal (), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal (), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal (), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal (), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal (), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal (), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal (), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or contact Availity Client Services (1.800.282.4548).

Availity's Electronic Data Interchange (EDI) Health Plan Partners

Premium Payer ID

Payer Name

00180

ANTHEM ME

00680

ANTHEM ME

00241

ANTHEM MO

00270

ANTHEM NH

00770

ANTHEM NH

00265

ANTHEM NV

00332

ANTHEM OH

00834

ANTHEM OH

00423

ANTHEM VA

00450

ANTHEM WI

00950

34196 54160 61101 AZFMC 03432 27154 75278 62176 87726 ASRM1 ATPA1 36326 39065

ASNTH

74240 93221 95691 13853 90956 ATRIO CMSEB 38259 37280 91136 46045 59275 59274 65026 SX145

ANTHEM WI

APEX BENEFIT SERVICES APS HEALTHCARE, INC. ARCADIAN MGMT SERVICES ARIZONA FOUNDATION FOR MEDICAL CARE ARIZONA PHYSICIANS IPA ARIZONA PRIORITY CARE PLUS ARKANSAS BEST CORPORATION - CHOICE BENEFITS ARKANSAS MANAGED CARE ORG (AMCO) ARNETT HEALTH PLANS ASRM CORP (NJ) ASSOCIATED THIRD PARTY ADMINISTRATION ASSOCIATES FOR HEALTH CARE, INC ASSURANT HEALTH

ASSURANT HEALTH RE-PRICING VIA HEALTHSPAN

ASSURED BENEFITS ADMINISTRATORS ASURIS NORTHWEST HEALTH ATHENS AREA HEALTH PLAN ATLANTIS HEALTH PLAN ATLAS LIFE INSURANCE COMPANY ATRIO HEALTH PLAN AUSTIN REGIONAL CLINIC EMPLOYEE BENEFIT PLAN AUTOMATED BENEFIT SERVICES (ABS) AUTOMATED GROUP ADMINISTRATION, INC. AUTOMOTIVE MACHINISTS LOCAL 289 HEALTH & WELFARE FUND AVERA HEALTH AVMED ENCOUNTERS AVMED, INC. BAPTIST HEALTH SOUTH FLORIDA BANNER HEALTH PLAN

Government Payer* Claim Enroll Required

Remit (835) NPI Option

Professional Claim (837)

Institutional Claim (837)

Eligibility & Benefits (270)

Claim Status (276)

Auth & Referral

(278)

Additional Information

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This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal

x

(), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or

contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal

(), and then click EDI File Management | Send and Receive EDI Files. After selecting

your organization, click SendFiles. For further assistance, click Help at the top of the portal page or

contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal

x

(), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or

contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal

x

(), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or

contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal

(), and then click EDI File Management | Send and Receive EDI Files. After selecting

your organization, click SendFiles. For further assistance, click Help at the top of the portal page or

contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal

x

(), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or

contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal

x

(), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or

contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal

(), and then click EDI File Management | Send and Receive EDI Files. After selecting

your organization, click SendFiles. For further assistance, click Help at the top of the portal page or

contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal

x

(), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or

contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal

x

(), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or

contact Availity Client Services (1.800.282.4548).

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal

(), and then click EDI File Management | Send and Receive EDI Files. After selecting

your organization, click SendFiles. For further assistance, click Help at the top of the portal page or

contact Availity Client Services (1.800.282.4548).

x

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Effective 8/20/12, payer ID 95440 will no longer be valid. Please use payer ID 87726.

x

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Use payer ID ASNTH to submit professional or institutional Assurant Health claims to be routed for

x

HealthSpan Re-Pricing. Use existing Payer IDs for claims for Assurant Health lines of business without

re-pricing.

x

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x x

Availity's Electronic Data Interchange (EDI) Health Plan Partners

Premium Payer ID

Payer Name

41204 06941 49153 43324 95377

BASIC PLUS BAY BRIDGE ADMINISTRATORS LLC BCI ADMINISTRATORS, INC. BEACON HEALTH STRATEGIES BEECH STREET CORPORATION

$

60054

BELL ATLANTIC

41205 36149 51037 25145 00999 37212 37118 39081 74223 36342 61425 95604 01508 62183 BSHS1 CX025 BV001 BV001 37308

BENEFIT ADMINISTRATIVE SERVICES (BAS) BENEFIT ADMINISTRATIVE SYSTEMS BENEFIT CONCEPTS BENEFIT COORDINATORS CORPORATION (PITTSBURGH, PA) BENEFIT MANAGEMENT SERVICES (BMS) BENEFIT MANAGEMENT SYSTEMS,INC BENEFIT PLAN ADMINISTRATORS (ROANOKE, VA) BENEFIT PLAN ADMINISTRATORS, CO (EAU CLAIRE, WI) BENEFIT PLANNERS, INC. BENEFIT SYSTEMS & SERVICES, INC (BSSI) BENEFIT TRUST LIFE BEST LIFE & HEALTH INSURANCE CO. BETTER HEALTH OF FLORIDA BETTER HEALTH PLANS, INC. BIENVIVIR SENIOR HEALTH PLAN BIG LOTS ASSOCIATES BENEFIT PLANS BLOCK VISION OF TEXAS BLOCK VISION, INC BLUE BELL BENEFITS TRUST

00610

BLUECROSS (BC) ID

$

00520

BLUECROSS BLUESHIELD (BCBS) AR

53589 00101

BLUECROSS BLUESHIELD (BCBS) AZ BLUECROSS BLUESHIELD (BCBS) GA

00601

BLUECROSS BLUESHIELD (BCBS) GA

00621

BLUECROSS BLUESHIELD (BCBS) IL HCSC

$

53120

BLUECROSS BLUESHIELD (BCBS) LA

12B14 SB700

220

BLUECROSS BLUESHIELD (BCBS) MA BLUECROSS BLUESHIELD (BCBS) MA

BLUECROSS BLUESHIELD (BCBS) MN

00220

BLUECROSS BLUESHIELD (BCBS) MN

00222

BLUECROSS BLUESHIELD (BCBS) MN

222

BLUECROSS BLUESHIELD (BCBS) MN

720

BLUECROSS BLUESHIELD (BCBS) MN

00720

BLUECROSS BLUESHIELD (BCBS) MN

00722

BLUECROSS BLUESHIELD (BCBS) MN

722

BCBS 22099 00790 00840 84980 61124 94036 BS001

BLUECROSS BLUESHIELD (BCBS) MN

BLUECROSS BLUESHIELD (BCBS) MT BLUECROSS BLUESHIELD (BCBS) NJ HORIZON BLUECROSS BLUESHIELD (BCBS) NM HCSC BLUECROSS BLUESHIELD (BCBS) OK HCSC BLUECROSS BLUESHIELD (BCBS) TX HCSC BLUEGRASS FAMILY HEALTH BLUESHIELD (BS) CALIFORNIA BLUESHIELD (BS) CALIFORNIA

Government Payer* Claim Enroll Required

Remit (835) NPI Option

Professional Claim (837)

Institutional Claim (837)

Eligibility & Benefits (270)

Claim Status (276)

Auth & Referral

(278)

Additional Information

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EDI submitters located in the IL, NM, OK, OR, TX, and WA regions require Advanced Clearinghouse enrollment for this payer. Please contact your practice management vendor or advancedclearinghouse@ for further details.

Enrollment required. Please go to to enroll. Availity's submitter id = 000000611 EDI submitters located in the IL, NM, OK, OR, TX, and WA regions require Advanced Clearinghouse enrollment for this payer. Please contact your practice management vendor or advancedclearinghouse@ for further details. All providers and facilities must first register to create a login and password. The link for provider or facilities to enroll is . Availity Assigned Submitter ID - E0079.

This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal (), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or contact Availity Client Services (1.800.282.4548). This payer accepts EDI batch claims via the Availity portal only. To do so, log in to the Availity portal (), and then click EDI File Management | Send and Receive EDI Files. After selecting your organization, click SendFiles. For further assistance, click Help at the top of the portal page or contact Availity Client Services (1.800.282.4548).

EDI submitters located in the IL, NM, OK, OR, TX, and WA regions require Advanced Clearinghouse enrollment for this payer. Please contact your practice management vendor or advancedclearinghouse@ for further details.

BCBSMN requires atypical providers to submit their payer assigned provider id in the REF01 with a G2 qualifier. Patient's ID card will denote which payer id to use electronically. BCBSMN requires atypical providers to submit their payer assigned provider id in the REF01 with a G2 qualifier. Patient's ID card will denote which payer id to use electronically. BCBSMN requires atypical providers to submit their payer assigned provider id in the REF01 with a G2 qualifier. Patient's ID card will denote which payer id to use electronically. BCBSMN requires atypical providers to submit their payer assigned provider id in the REF01 with a G2 qualifier. Patient's ID card will denote which payer id to use electronically. BCBSMN requires atypical providers to submit their payer assigned provider id in the REF01 with a G2 qualifier. Patient's ID card will denote which payer id to use electronically. BCBSMN requires atypical providers to submit their payer assigned provider id in the REF01 with a G2 qualifier. Patient's ID card will denote which payer id to use electronically. BCBSMN requires atypical providers to submit their payer assigned provider id in the REF01 with a G2 qualifier. Patient's ID card will denote which payer id to use electronically. BCBSMN requires atypical providers to submit their payer assigned provider id in the REF01 with a G2 qualifier. Patient's ID card will denote which payer id to use electronically.

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