Prompt Solutions 2009 Payor List · AMERICAN BENEFITS MANAGEMENT CNE--AMEBEMA-01 34187 34187 Billing Submission Address only: P.O. Box 35008 North Canton, ... Pacificare High Plains,

Prompt Solutions 2009 Payor List

Payor Name Internal Pay Number PSI 5 Digit NAIC Special Instructions

1199 NATIONAL BENEFIT FUND CNE--NATBEFU-01 13162 13162 Provider should submit claims with assigned plan

1ST MN CNE--FIRSTMN-01 58203 58203 Atlanta, GA 1st MEDICAL NETWORK CNE--FIRSTMN-01 58203 58203 Atlanta, GA 21st CENTURY HEALTH & BENEFITS CNE--CENHEBE-01 59069 59069 3P ADMIN CNE--3PADMIN-01 20413 20413 360 ALLIANCE - GILSBAR CNE--GILSBAR-02 88053 88053 A & I BENEFIT PLAN ADMINISTRATORS CNE--AIBEPLA-01 93044 93044

A.G.I.A., INC. CNE--AGIAINC-01 95241 95241 Claims are printed and mailed to payor

AAG BENEFIT PLAN ADMINISTRATORS CNE--AAGBEPL-01 75240 75240 AAG AMERICAN ADMINIS GROUP CNE--AAGAMAD-01 37283 37283 Formerly Gallagher Benefit Admin AAG AMERICAN ADMINIS GROUP CNE--AAGAMAD-02 75185 75185 Formerly Icon Benefit Admin

ABMA MEDICAL CORP CNE--ABMAMEC-01 E3510 E3510

Alta Bates Med Assoc (Hnet Sr & Secure Horizon Only Claims from California Providers

ABRAZO ADVANTAGE HEALTH PLAN CNE--ABRADHE-01 03443 03443 ABSOLUTE TOTAL CARE CNE--ABSTOCA-01 68055 68055 ACCLAIM CNE--ACCLAIM-01 64071 64071 ACCLAIM REPRICING CNE--ACCLARE-01 21356 21356 ACCORDIA NATIONAL CNE--ACCONAT-01 87815 87815 ACS BENEFIT SERVICES CNE--ACSBESE-01 72467 72467 ACS CONSULTING SVS, INC CNE--ACSCOSE-01 72467 72467 Only ACS Benefit Svs Claims ACS REWARDS ADMINISTRATION CTR CNE--ACSREAD-01 36112 36112 ADMINISTRATION SYSTEMS RESEARCH CORPORATION CNE--ADMSYRE-01 38265 38265 ADMINISTRATIVE CONCEPTS INC CNE--ADMICON-01 22384 22384

ADMINISTRATIVE SERVICE CONSULTANTS

CALL PROMPT FOR ASSISTANCE WITH THIS PAYOR

ADMINISTRATIVE SERVICES INC CNE--ADMISER-01 59141 59141 AdminOne CNE--ADMINON-01 37278 37278 ADVANCED DATA SOLUTIONS CNE--ADVDASO-01 58202 58202

ADVANTAGE BY BRIDGEWAY HEALTH SOLUTIONS CNE--ADVANTA-01 68056 68056 ADVANTAGE BY MANAGED HEALTH SERVICES CNE--ADVANTA-01 68056 68056

ADVANTAGE BY SUPERIOR HEALTHPLAN CNE--ADVANTA-01 68056 68056 ADVANTAGE HEALTH SOLUTIONS CNE--ADVHESO-01 35209 35209 ADVANTAGE PREFERRED PLUS CNE--ADVPRPL-01 77070 77070 ADVANTRA FREEDOM CNE--ADVAFRE-01 25152 25152 ADVANTRA SAVINGS CNE--ADVASAV-01 25152 25152 ADVANTRA/HEALTH AMERICA, INC. CNE--ADVHEAM-01 25126 25126 ADVENTIST HEALTH SYSTEM WEST CNE--ADVHESY-01 95340 95340 ROSEVILLE, CA

ADVOCATE HEALTH CENTERS CNE--ADVHECE-01 36320 36320 CLAIM OFFICE NO LONGER REQUIRED

ADVOCATE PHYSICIAN PARTNERS CNE--ADVOCPP-01 65093 65093 CLAIM OFFICE NO LONGER REQUIRED

AETNA H.P. - SELECT CHOICE CNE--AETSECH-01 60054 60054 (Former Prudential to 60054) AETNA H.P. - SR. CHOICE- NY/NJ CNE--AETSRNY-01 60054 60054 AETNA H.P.-SEL. CHOICE-NY/NJ CNE--AETSENY-01 60054 60054 AETNA HEALTH PLANS-ELECT CHOIC CNE--AETELCH-01 60054 60054 AETNA HEALTH PLANS-MANAGED CHO CNE--AETMACH-01 60054 60054

AETNA HEALTH PLN PTNRS PPO CNEP-AETHEPL-01 60054 60054 AETNA LIFE AND CASUALTY CO CNE--AETLICA-01 60054 60054

AETNA MEDICAL ENCOUNTERS CNE--AETMEEN-01 60055 60055 NEW NAIC NUMBER 12/2004 Encounters only

AETNA ROSTERS CNE--AETROST-01 60054 60054 Rosters only Clm Of 000+E26506 AETNA/US HEALTHCARE CNE--USHEACA-01 60054 60054

AETNA AFFORDABLE HEALTH CHOICES CNE--AETAFHE-01 57604 57604 Affordable Health Choices (SM) - SRC

AFFINITY HEALTH PLAN CNE--AFFHEPL-01 13334 13334 Call payor before sending AFTRA HEALTH FUND CNE--AFTHEFU-02 13346 13346 AGA CNE--AGAINSU-01 37280 37280 Automated Group Administration

AGATE RESOURCES INC (LIPA) CNE--AGATRES-01 20048 20048 Contact Denise Watts at 541-762-2172 for assistance from Payor

AGENCY SERVICES CNE--AGENCSE-01 64158 64158 Now known as Meritain Health AH & L CNE--ANTHELI-02 80705 80705 Great West Healthcare AHC CNE--ASCFOHE-01 36326 36326 HealthEOS AHPO (CLEVELAND, OH) CNE--AHPOCOH-01 31138 31138 ALASKA CARPENTERS TRUST CNE--ALACATR-01 91136 91136 Group Number (F40) req'd ALASKA CHILDREN'S SERVICES,INC CNE--ALACHSE-01 91136 91136 Group Number (P68) req'd ALASKA ELECTRICAL H&W FUND CNE--ALAELHE-01 92600 92600 ALASKA LABORERS CONSTRUCTION CNE--ALALACO-01 91136 91136 Group Number (F23) req'd ALASKA PIPE TRADES LOCAL 375 CNE--ALAPITR-01 91136 91136 Group Number (F24) req'd ALASKA UNITED FOOD & COMM. CNE--ALAUNFO-01 91136 91136 Group Number (F45) req'd ALICARE(AKA AMALGAMATED LIFE) CNE--ALICARE-01 13550 13550 ALICARE - PA CNE--ALICARE-02 13343 13343 (AKA AMALGAMATED LIFE) ALIGNIS CNE--ALIGNIS-01 58213 58213 ALLEGIANCE BENEFIT PLAN MGMT INC CNE--ALLBEPL-01 81040 81040 ALLIANCE HEALTHCARE CNE--ALLSTRI-01 13079 13079 STONES RIVER REGIONAL IPA

ALLIANCE, THE PPO - WISCONSIN CNE--ALLIAWI-01 88461 88461

The Alliance PPO in Wisconsin - Only WI Providers Only Mailing address: PO Box 44365, Madison, WI 53744

ALLIANCE PPO, INC. (Maryland) CNE--ALLPPIN-01 52149 52149 KNA OneNet PPO, LLC ALLIANT HEALTH PLANS CNE--ALLHEPL-01 58234 58234 of Georgia ALLIED ADMINISTRATORS CNE--ALLIEAD-01 94177 94177 San Francisco, CA ALLIED BENEFIT SYSTEMS CNE--ALLBESY-01 37308 37308 ALTA HEALTH & LIFE INSURANCE CNE--ALTHELI-01 80705 80705 Great West Healthcare

ALTA HEALTH STRATEGIES CNE--ALTHEST-01 87043 87043 FKA First Health - NKA Coventry Healthcare National Network

ALTA SENIOR CARE CNE--ALTSECA-01 E3510 E3510

Hnet Sr and Secure horizons only - Providers in Northern California only.

AMALGAMATED LIFE CNE--AMALLIF-01 13550 13550 AKA ALICARE AMALGAMATED LIFE - PA CNE--AMALIPA-01 13343 13343 AKA ALICARE AMERIBEN SOLUTIONS, INC CNE--AMERSOL-01 75137 75137 AMERICAID COMMUNITY CARE - NJ CNE--AMECOCA-04 27516 27516 New Jersey AMERICAID COMMUNITY CARE- MD. CNE--AMECOCA-03 27517 27517 Maryland AMERICAN ADMINISTRATIVE GROUP CNE--AMEADGR-01 75240 75240

AMERICAN ADMINISTRATORS CNE--AMERADM-01 42112 42112 West Des Moines, Iowa PAYOR id on all cards

AMERICAN ADMINISTRATORS DBA SELECT BENEFIT ADMINISTRATORS CNE--AMERADM-02 42137 42137

West Des Moines, Iowa PAYOR id on all cards

AMERICAN BEHAVIORAL CNE--AMERBEH-01 63103 63103

AMERICAN BENEFIT PLAN ADMINISTRATORS CNE--AMEBEPL-01 95170 95170

AMERICAN BENEFITS MANAGEMENT CNE--AMEBEMA-01 34187 34187

Billing Submission Address only: P.O. Box 35008 North Canton, Ohio 44735

AMERICAN CHIROPRACTIC NETWORK CNE--AMECHNE-01 41161 41161 Also Known As - ACN AMERICAN CHIROPRACTIC NWK NY CNE--AMECHNY-01 41160 41160 IPA of NY (ACNIPA) AMERICAN COMMUNITY MUTUAL INS CNE--AMECOMU-01 60305 60305 AMERICAN GENERAL CNE--AMERGEN-01 62030 62030 AMERICAN HEALTHCARE ALLIANCE CNE--AMEHEAL-01 01066 01066

AMERICAN IMAGING MANAGEMENT CNE--AMEIMMA-01 36369 36369 Assigned Grp Policy Plan ID req'd

AMERICAN INTERNATIONAL GROUP CNE--AMEINGR-01 87726 87726 old naic 13311 - send to UHC 87726 Dec 04 AIG

AMERICAN LIFECARE CNE--AMERLIF-01 72099 72099

Group # req'd - Only 1100 Poydras Street, Suite 2600, New Orleans, LA 70163-2602

AMERICAN MEDICAL SECURITY, INC CNE--AMEMESE-01 81400 81400 AMERICAN NATIONAL INS CO CNE--AMENAIN-01 74048 74048 (ANICO) AMERICAN POSTAL WKRS UN HTH CNE--AMEPOWO-01 44444 44444 Not including State of Maine APWU - CONVERSION PLAN CNE--APWUPLA-01 55544 55544 AMERICAN PROGRESSIVE LIFE & HLTH CNE--AMEPRLI-01 48055 48055 AMERICAN REPUBLIC INS CO CNE--AMEREIN-01 42011 42011 AMERICAN WORKER HEALTH PLAN CNE--AMEWOHE-01 37322 37322 AMERICAS PPO CNE--AMERPPO-01 16120 16120 AMERICAS TPA CNE--AMERTPA-01 41178 41178 AMERICHOICE OF NEW JERSEY MCR CNE--AMENJMR-01 86001 86001 Provider Network ID Req'd AMERICHOICE OF NEW YORK MCR CNE--AMENYMR-01 86002 86002 Provider Network ID Req'd AMERICHOICE OF NJ MEDICAID CNE--AMENJME-01 86047 86047 Provider Network ID Req'd AMERICHOICE OF NY MEDICAID CNE--AMENYME-01 86048 86048 Provider Network ID Req'd

AMERICHOICE OF PERSONAL CARE PLUS CNE--AMEPAME-01 86003 86003 Provider Network ID Req'd Medicare

AMERICHOICE OF PENNSYLVANIA CNE--AMECHPA-01 86049 86049 Provider Network ID Req'd Medicaid

AMERIGROUP CORPORATION CNE--AMEGRCO-01 27514 27514 FORT WORTH FKA Americaid Community Care

AMERIGROUP GEORGIA CNE--AMEGRGA-01 27514 27514

AMERIGROUP CORPORATION CNE--AMEGRCO-02 27515 27515 Houston FKA Americaid Community Care

AMERIGROUP COMMUNITY CARE OF NEW MEXICO CNE--AMECOCA-05 27514 27514 AMERIGROUP FLORIDA CNE--AMERIFL-01 27519 27519 AMERIGROUP ILLINOIS & OHIO CNE--AMERIIL-01 27518 27518 AMERIHEALTH ADMINISTRATORS CNE--AMEHEAD-01 54763 54763 AMERIHEALTH HMO (NJ & DE) CNE--AMENJDE-01 23037 23037 AMERIHEALTH MERCY HEALTH PLAN CNE--AMEMEHE-01 22248 22248 Medicaid managed care ANCHOR BENEFIT CONSULTING INC CNE--ANCBEC0-01 53085 53085

ANCILLARY BENEFIT SYSTEMS CNE--ANCBESY-01 86062 86062 Arizona Foundation for Medical Care

ANCILLARY CARE MANAGEMENT CNE--ANCCAMA-01 03172 03172 ACM ANTARES MANAGEMENT SOLUTIONS CNE--ANTMASO-01 34192 34192 ANTHEM HEALTH & LIFE INS OF NJ CNE--ANTHELI-01 80705 80705 Great West Healthcare APA PARTNERS LATHAM,NY CNE--APAPART-01 16140 16140 APEX BENEFIT SERVICES CNE--APEBESE-01 34196 34196 APS HEALTHCARE INC CNE--APSHECA-01 54160 54160

APS PAPER CLAIM CNE--APSPAPC-01 54100 54100 CLAIMS ARE PRINTED AND MAILED TO APS PAPER CLAIM

ARAZ BLOOMINGTON, MN CNE-----ARAZ-01 16120 16120 HEALTH EZ ARCADIAN MANAGEMENT SERVICES CNE--ARCMASE-01 77045 77045 ARGUS HEALTH SYSTEMS CNE--ARGHESY-01 36356 36356

ARIZONA FOUNDATION FOR MEDICAL CARE CNE--AZFOUMC-01 86062 86062 AFMC

ARIZONA PHYSICIANS IPA CNE--ARIPHIP-01 03432 03432 ARKANSAS BEST CORP CNE--ARKBEST-01 75278 75278 CHOICE BENEFITS

ARKANSAS MANGED CARE ORGANIZATION INC CNE--ARMANCA-01 62176 62176 ARKANSAS MUNICIPAL LEAGUE CNE--ARMUNLE-01 71603 71603

ARNETT HEALTH PLANS CNE--ARNHEPL-01 95440 95440

Call payor before sending Provider id for rendering or referring provider req'd

ASC OF OHIO CALL PROMPT SOLUTIONS FOR SETUP

ASR / ASR CORP / ASR HEALTH BENEFITS CNE--ASRHEBE-01 38265 38265 ASSOCIATES FOR HEALTHCARE CNE--ASCFOHE-01 36326 36326 AHC ASSURANT HEALTH CNE--ASSUHEA-01 39065 39065 ASSURANT HEALTH SELF-FUNDED CNE--ASSUHEA-02 37313 37313 Ft. Mill, SC ASSURANT MINIMED-KEY FAMILY CNE--ASSMIKE-01 37323 37323 AssureCare Inc CNE--ASSUREC-01 88035 88035 ASSURED BENEFITS ADMINISTRATORS CNE--ASSBEAD-01 74240 74240 ASW / LIFEWISE CNE--ASWLIFE-01 37294 37294 ATHENS AREA HEALTH PLAN SELECT CNE--ATHARHE-01 95691 95691

ATLANTICARE ADMINISTRATORS CNE--ATLANAD-01 22304 22304 AkA Horizon Healthcare Admin - HHA

ATLANTIS HEALTH PLAN CNE--ATLHEPL-01 13853 13853 Provider Network ID Req'd

AULTRA ADMINISTRATIVE GROUP CNE--AULADGR-01 37242 37242

Billing submission address: P.O. Box 35276 Canton, OH 44735-5276

AUTOMATED BENEFIT SERVICES CNE--AUTBESE-01 38259 38259

AUTOMATED GROUP ADMINISTRATION CNE--AUTGRAD-01 37280 37280

Please send these EDI claims to the Payer ID of the PPO shown on the Members ID card.

AUTOMOTIVE MACHINISTS LOCAL289 CNE--AUTMALO-01 91136 91136 Group Number (F32) req'd AVERA HEALTH PLANS CNE--AVEHEPL-01 46045 46045 AveraAdvantage CNE--AVERADV-01 48055 48055

AvMed, Inc. CNE--AVMEDIN-01 59274 59274 Insured ID must be 11 digit Member ID

BANNER HEALTH CNE--BANNHEA-01 SX145 SX145

Enrollment is required. Arizona, Rocky Mountain HMO Greeley, Antero Greeley, Antero High Plains, Antero Mountain Shadows, Choice Plus, HMO Greeley, HMO High Plains, HMO Mountain Shadows, Pacificare Greeley, Pacificare High Plains, Pacificare Mountain Shadows, Rocky Mountain HMO High Plains, Secure Horizons Greeley, Secure Horizons High Plains & Secure Horizons Mountain Shadows

BASS ADMINISTRATORS, INC CNE--BASADIN-01 37248 37248 BC INDIGENT CNE--BCINDIG-01 74230 74230 BCI ADMINISTRATORS CNE--BCIADIN-01 49153 49153

BEACON HEALTH STRATEGIES CNE--BEAHEST-01 43324 43324

Please use the following Plan IDs for block 11 on the 1500 form. Neighborhood Health Plan of MA=001; Hudson Health Plan=004;FallonCommunity Plan=005; Neighborhood Health Plan of RI=006; Affinity Health Plan=009; DC Chartered Health Plan=013

BEECH STREET CORP CNE--BEESTCO-01 95377 95377

Also Claims Repricing mailed to: Beech Street Corp PO Box 57015 Irvine, CA 92619

BEHAVIORAL HEALTH SYSTEMS CNE--BEHHESY-01 63100 63100 BENCOMP NATIONAL CORP CNE--BENNACO-01 33192 33192 BENEFIT ADMINISTRATIVE SYSTEMS CNE--BENADSY-01 36149 36149

BENEFIT COORDINATORS CORP CNE--BENCOCO-01 25145 25145 Only: 111 Ryan Ct. # 300, Pitsburg, PA 15205

BENEFIT MANAGEMENT SERVICES Call Prompt for Assistance

BENEFIT MANAGEMENT SERVICES INC CNE--BENMASE-01 00999 00999

D0-20-Billing Provider Blue Cross Blue Shield ID is required. Must be either 5 or 10 alphanumeric characters in length.

BENEFIT MANAGEMENT SYSTEMS CNE--BENMASY-01 37212 37212 BENEFIT PLAN ADMINISTRATORS CNE--BENPLND-01 37286 37286 North Dakota - BPA BENEFIT PLAN ADMINISTRATORS INC CNE--BENPLAD-01 37118 37118 Roanoke, VA

BENEFIT PLAN ADMINISTRATORS CO CNE--BENPLCO-01 39081 39081 Only: PO Box 1128, Eau Claire, WI 54702

BENEFIT PLANNERS, INC. CNE--BENPLIN-01 74223 74223 BENEFIT SOURCE INC CNE--BENESOU-01 38257 38257 BENEFIT SYSTEMS & SVCS INC CNE--BESYSVC-01 36342 36342 BSSI BENESIGHT CNE--BENSIGT-01 87265 87265 (formerly known as The TPA) BENESYS INC CNE--BENESYS-02 37248 37248 BENESYS LHP CLAIMS UNIT CNE--BENLHCL-01 37248 37248

BERKSHIRE HEALTH PARTNERS - PPO

CALL PROMPT SOLUTIONS FOR SETUP Wyomissing, PA (IHS Gateway Payer)

BEST LIFE & HEALTH INS CO CNE--BESLIHE-01 95604 95604 BETTER HEALTH PLANS OF S. CAROLIN CNE--BETHEPL-02 32006 32006 South Carolina BETTER HEALTH PLANS, INC CNE--BETHEPL-01 62183 62183

BLUE CARE NETWORK CMI--BLUCANE-01 BLUEC EDI ENROLLMENT REQ'D - PROVIDER NUMBER REQ'D

BLUE SHIELD CALIFORNIA CNE--BLUSHCA-01 94036 94036 EDI ENROLLMENT REQ'D - PROVIDER NUMBER REQ'D

BLUE SHIELD DC / Northern Virginia CNE--CAREFST-01 SB580 SB580

EDI ENROLLMENT REQ'D - PROVIDER NUMBER REQ'D CAREFIRST BLUE

BLUE SHIELD ILLINOIS BIL--ILLINOI-01 ILBCS EDI ENROLLMENT REQ'D - PROVIDER NUMBER REQ'D

BLUE SHIELD INDIANA BAD--INDIANA-01 INBCS EDI ENROLLMENT REQ'D - PROVIDER NUMBER REQ'D

BLUE SHIELD KENTUCKY B----KENTUCK-01 KYBCS EDI ENROLLMENT REQ'D - PROVIDER NUMBER REQ'D

BLUE SHIELD MARYLAND CNE--CAREFST-02 SB690 SB690

EDI ENROLLMENT REQ'D - PROVIDER NUMBER REQ'D CAREFIRST BLUE

BLUE SHIELD MICHIGAN BMI--MICHIGA-01 MIBCS EDI ENROLLMENT REQ'D - PROVIDER NUMBER REQ'D

BLUE SHIELD MINNESOTA B----MINNESO-01 MNBCS

EDI ENROLLMENT REQ'D - CALL PROMPT FOR ASSISTANCE

BLUE SHIELD NEW JERSEY CNE--BLUSHNJ-01 22099 22099 EDI ENROLLMENT REQ'D - PROVIDER NUMBER REQ'D

BLUE SHIELD OHIO B----OHIO----01 OHBCS EDI ENROLLMENT REQ'D - PROVIDER NUMBER REQ'D

BLUE SHIELD WISCONSIN BWI--WISCONS-01 WIBCS EDI ENROLLMENT REQ'D - PROVIDER NUMBER REQ'D

BLUEGRASS FAMILY HEALTH CNE--BLUFAHE-01 61124 61124

BMC HEALTHNET PLAN CNE--BMCHEPL-01 13337 13337 12 DIGIT PROVIDER NUMBER REQUIRED

BMGI BENEFIT MANAGEMENT GROUP CNE--BENMAGR-01 20018 20018 BOILERMAKERS NATIONAL HEALTH CNE--BOINAHE-01 36609 36609 and Welfare Fund BOON-CHAPMAN ADMINISTRATORS CNE--BOOCHAD-01 74238 74238

BOSTON MEDICAL CENTER HEALTHNE CNE--BOSMECE-01 13337 13337 Provider Nwk ID Req'd - 12 Digits BPS INC CNE--BPSINC--01 13310 13310

BRAVO HEALTH CNE--BRAVHEA-01 52192 52192

FKA Elder Health, Inc. serving members in Pennsylvania, Maryland, Delaware, Texas and Washington D.C. - not to be confused with ElderPlan in NY

BRIDGESTONE CLAIMS SERVICES CNE--BRICLSE-01 37285 37285 BRIDGEWAY ARIZONA CNE--BRIDGAZ-01 68054 68054 BROKERAGE CONCEPTS CNE--BROKCON-01 51037 51037 BRODART CO. CNE--BRODART-01 35182 35182 NEW NAIC

BROKERAGE SERVICE INC CALL PROMPT SOLUTIONS FOR SETUP

BROWARD HEALTH 37314 37314 BROWN AND TOLAND MEDICAL GROUP CNE--BROTOME-01 94316 94316

BUCKEYE COMMUNITY HEALTH CNE--BUCCOHE-01 32004 32004 Enrollment is required. Call 800-225-2573 ext.25525

BUTLER BENEFIT CNE--BUTLBEN-01 42150 42150 C & O EMPLOYEES' HOSPITAL ASSO CNE--C&OEMHO-01 23708 23708 C. L. FRATES & CO - OSMA HEALTH CNE--OSMAHEA-01 73071 73071 CADENT ADMINISTRATORS CNE--CADEADM-01 33192 33192 CADENT UNDERWRITERS CNE--CADEUND-01 33192 33192 CANNON COCHRAN MANAGEMENT SVC CNE--CANCOMA-02 37105 37105 CANNON COCHRAN MANAGEMENT SVC CNE--CANCOMA-03 71057 71057 Metairie, LA CAPE HEALTH PLAN CNE--CAPHEPL-01 38245 38245 CAPITAL COMMUNITY HLTH PLN CNE--CAPCOHE-01 87726 87726

CAPITAL HEALTH PLAN CNE--CAPHEPL-01 95112 95112

Call Payor prior to sending - provider must register NPI - Rendering NPI or UPIN is req'd

CAPITOL ADMINISTRATORS CNE--CAPITAD-01 68011 68011 CARE 1st HEALTH PLAN OF ARIZONA CNE--CARE1ST-01 57116 57116 CARE IMPROVEMENT PLUS CNE--CARIMPL-01 77082 77082 CARE TO CARE CNE--CARTOCA-01 41222 41222 CareCentrix CNE--CARECEN-01 11345 11345

CARECHOICES MICHIGAN CNE--CARCHMI-01 38269 38269 Mercy Healthplans Enrollment Req'd call Payor

CareCore National CNE--CARENAT-01 14182 14182

CareCore National - Healthnet CNE--CARNAHE-01 14184 14184

Provider network and Rend prov'd id - facility and facility id also required

CareCore National LLC CNE--CARNAAE-01 14179 14179 Aetna Radiology Claims CareCore National LLC CNE--CARNAOX-01 14180 14180 Oxford Radiology Claims CareCore National LLC CNE--CARECOR-01 14185 14185 Health Net New Jersey CareGuide CNE--CAREGUI-01 16147 16147 CARELINK ADVANTRA/OH W VA CNE--CAREADV-01 25139 25139 Commercial Claims Only CARELINK HEALTH PLAN/OH W VA CNE--CARHEPL-01 25139 25139 Commercial Claims Only CARELINK MEDICAID CNE--CAREMED-01 25140 25140 Medicaid Claims Only CARENET CNE--CARENET-01 25142 25142 CareOregon INC CNE--CAREORE-01 93975 93975

CarePlus Health Plans, Inc CNE--CARPLHE-01 65031 65031 Formerly Physicians Healthcare Plans Inc

CARESOURCE OH CNE--CARESOU-01 31114 31114 Ohio CAREWORKS CNE--CAREWOR-01 10010 10010 NOT WORK COMP CLAIMS CARITEN HEALTHCARE CNE--CARHECA-01 62073 62073 CARITEN SENIOR HEALTH CNE--CARSEHE-01 62072 62072 CAROLINA CARE PLAN INC CNE--CARCAPL-01 57105 57105

CAROLINA CRESCENT HEALTH PLAN CNE--CARCRHE-01 SX191 SX191 Enrollment is required. See payors website.

CAROLINA SUMMIT HEALTHCARE CNE--CARSUHE-01 56195 56195

CARPENTER'S HEALTH & WELFARE TRUST FUND OF ST. LOUIS CNE--CARHEWE-01 25125 25125

Utilizes CMR Network - Claims printed and mailed to the payor

CATHOLIC HEALTHCARE WEST CNE--CATHEWE-01 SX183 SX183 CBCA ADMINISTRATORS CNE--CBCAADM-01 55438 55438

CBCA ADMINISTRATORS (HRM) CNE--CBCAADM-02 41170 41170 Formerly Health Risk Management (HRM)

CBSA CNE-----CBSA-01 41124 41124 CORPORATE BENEFIT SERVICES OF AMERICA

CDO TECHNOLOGIES CNE--CDOTECH-01 87065 87065

CDS GROUP HEALTH CNE--CDSGRHE-01 88022 88022

CEDARS-SINAI MEDICAL NETWORK SVS CNE--CEDSIME-02 95166 95166

CEMENT MASONS & PLASTERERS H&W CNE--CEMMAPL-01 91136 91136 Group Number (F16) req'd on claim

CENPATICO BEHAVIORAL HEALTH CNE--CENBEHE-01 68047 68047 KANSAS Enrollment is required. Call 800-225-2573 ext.25525

CENPATICO BEHAVIORAL HEALTH CNE--CENBEHE-02 68048 68048 Arizona Enrollment is required. Call 800-225-2573 ext.25525

CENPATICO FLORIDA CNE--CENPAFL-01 68058 68058

CENPATICO GEORGIA CNE--CENPGEO-01 68050 68050 Enrollment is required. Call 800-225-2573 ext.25525

CENPATICO INDIANA CNE--CENPIND-01 68052 68052

Call Provider Relations Dept at Prior to submitting claims, please call Provider Relations Dept at 1-877-647-4848 to verify your provider info is on file in the claim system

CENPATICO KANSAS CNE--CENPAKS-01 68047 68047

Call Provider Relations Dept at 1-866-896-7293 to verify your provider info is on file in the claim system

CENPATICO OHIO CNE--CENPAOH-01 68051 68051

CENTENE ADVANTAGE PLANS CNE--CENADPL-01 68056 68056 CENTERCARE CNE--CENTCAR-01 13357 13357 CENTRAL BENEFITS LIFE CNE--CENBELI-01 31118 31118 CENTRAL BENEFITS MUTUAL CNE--CENBEMU-01 31118 31118 CENTRAL BENEFITS NATIONAL CNE--CENBENA-01 31118 31118 CENTRAL RESERVE LIFE CNE--CENRELI-01 34097 34097 CENTRAL SeniorCare CNE--CENTSEN-01 62218 62218 CENTRAL STATES H & W FUNDS CNE--CENSTHE-01 36215 36215

CENTRAL VALLEY MEDICAL GROUP CNE--CENVAME-01 E3510 E3510

ONLY CLAIMS FROM NORTHERN CALIFORNIA PROVIDERS

CENTURY HEALTH SOLUTIONS CNE--CENHESO-01 48120 48120 CHA HEALTH CNE--CHAHEAL-01 23171 23171 Commonwealth Health Alliance

CHAMPVA - HAC CNE--CHAMPVA-01 84146 84146 This payor does not process Tricare Claims

CHAUTAUQUA COUNTY HEALTHCARE P CNE--CHACOHE-01 16600 16600 Mayville, NY CHCcares of South Carolina CNE--CHCSOCA-01 25151 25151

CHESAPEAK LIFE INS CO CNE--CHELIIN-01 59223 59223 ONLY: PO Box 982017, North Richland Hills, TX 76182

CHESTERFIELD RESOURCES INC CNE--CHESRES-01 34154 34154 CHILDREN FIRST MEDICAL GROUP CNE--CHIFIMG-01 94321 94321 CHILDREN OF WOMEN VIETNAM VETERANS - VA HAC CNE--CHIWOVI-01 84146 84146

Claims are printed and mailed to payor

CHILDREN'S MEDICAL SERVICES CNE--CHIMESE-01 37314 37314 North Broward Hospital District

(Florida)

CHINESE COMMUNITY HEALTH PLAN CNE--CHICOHE-01 94302 94302 CCHP Provider ID req'd. Call payor prior to sending

CHOC CHILDRENS HOSPITAL OF ORANGE COUNTY HEALTH ALLIANCE CNE--CHIHOOR-01 33065 33065

CHOICE ONE UTMB CHIP HEALTH PLAN CNE--CHOIONE-01 76049 76049 CALL PAYOR PRIOR TO SENDING

CHP/RPU (FABOH) CNE--CHPRPUF-01 39112 39112

Commonwealth Health Plan Repricing Unit. Rendering Provider and location number req'd

CHRISTIAN BROTHERS SERVICES CNE--CHRBRSE-01 61271 61271 CIGNA CNE--CIGNA---01 62308 62308 CIGNA BEHAVIORAL HEALTH CNE--CIGBEHE-01 SX071 SX071 BEHAVIORAL HEALTH ONLY CIGNA HEALTH PLAN HMO CNEH-CIGHEPL-01 62308 62308 CIGNA PPO CNEP-CIGNAPP-01 62308 62308

CIGNA MEDICARE ADVANTAGE CNE--CIGHESE-01 86033 86033 CIGNA HEALTHCARE FOR SENIORS

CLAIMS MANAGEMENT SERVICES BWI--WISCONS-01 BLUE SHIELD PROVIDER NUMBERS REQ'D

ClaimsWare, INC. CNE--CLAWAIN-01 57080 57080 DBA ManageMed

CLARENDON'S HEALTHY KIDS CNE--CLAHEKI-01 33192 33192 CLEARCHOICE HEALTH PLAN CNE--CLEHEPL-01 77201 77201 COIHS CM ADMINISTRATORS, INC CNE--CMADMIN-01 56211 56211 Coastal Administrative Services CNE--COAADSE-01 77052 77052 COFINITY CNE--COFINIT-01 38335 38335 COLORADO ACCESS CNE--COLOACC-01 84129 84129 COLUMBIA UNITED PROVIDERS CNE--COLUNPR-01 91162 91162 COMMERCE BENEFITS GROUP CNE--COMBEGR-01 34181 34181 COMMONWEALTH CARE ALLIANCE CNE--COMCAAL-01 14315 14315 COMMUNITY CARE BHO CNE--COMCBHO-01 23282 23282

COMMUNITY CARE MANAGED CARE OK CNE--COMCAMA-01 73143 73143 Managed Health Care Plans of Oklahoma

COMMUNITY CARE ORGANIZATION CNE--COMCAOR-01 39126 39126 COMMUNITY CARE PLUS CNE--COMCAPL-01 71079 71079 COMMUNITY CHOICE OF MICHIGAN CNE--COMCHMI-01 38325 38325 Community Claims Administration CNE--COMCLAD-01 26231 26231 COMMUNITY HEALTH ALLIANCE CNE--COMHEAL-01 35193 35193 COMMUNITY HEALTH CHOICE CNE--COMHECH-01 48145 48145 COMMUNITY HEALTH ELE. PLANS CNE--COMHEEL-01 75261 75261 CHEC

COMMUNITY HEALTH NETWORK CT CNE--COMHECT-01 62149 62149 Anesthesia claims must go paper

COMMUNITY HLTH PLN - MO CNE--COMMHEP-01 90010 90010

Located in St. Joseph, MO. Service area inc: NW Missouri, NE Kansas, SW Iowa & SE Nebr

COMMUNITY MEDICAL GROUP OF THE WEST VALLEY, INC

CNE--COMMEGR-01 66121 66121 COMPMED CNE--COMPMED-01 73145 73145 AKA Preferred Community Choice COMP - OHIO CNE--COMPOHI-01 34177 34177 Austintown, OH CompBenefits CORPORATION CNE--COMPCOR-01 37297 37297 COMPREHENSIVE BEHAVIORAL CARE CNE--COMBECA-01 59314 59314 COMPREHENSIVE BENEFITS ADMIN CNE--COMBEAD-01 03036 03036 ConnectiCare, INC. CNE--CONNECT-01 06105 06105 ConnectiCare - MEDICARE CNE--CONNMCR-01 78375 78375

CONNECTICUT CARPENTERS HEALTH FUND CNE--CONCAHE-01 37307 37307 CONNECTICUT GENERAL LIFE INS CNE--CONGELI-01 62308 62308 CONSOCIATE GROUP CNE--CONGROU-01 37135 37135 CONSOLIDATED ASSOC RAILROAD CNE--CONASRR-01 75284 75284 CONTINENTAL GENERAL INS CO CNE--CONGEIN-01 71404 71404 COOK GROUP HEALTH PLAN CNE--COOGRHE-01 35149 35149 COOPERATIVE BENEFIT ADMIN CNE--COOBEAD-01 52132 52132 CBA

COOPERATIVE MANAGED CARE SERVICES CNE--COOMACA-01 35199 35199

EDI Enrollment Req'd Call Payor ST ANTHONY MEMORIAL, ST CATHERINE HOSPITAL, ST FRANCIS & ST MARGARET MERCY CMCS CUST SERV 800-352-7502

COORDINATED MEDICAL SPECIALISTS CNE--COOMESP-01 58204 58204 CORE ADMINISTRATIVE SERVICES CNE--CORADSE-01 58231 58231 CORE MANAGEMENT RESOURCES GRP CNE--CORMARE-01 58231 58231

CORESOURCE AZ MN CNE--CORAZMN-01 41045 41045 NEW NAIC ONLY Arizona & Minnesota Addresses

CORESOURCE LITTLE ROCK CNE--CORLITT-01 75136 75136 Little Rock, Arkansas only

CORESOURCE OF NC IN CNE--COROFNC-01 35180 35180 Claims mailing address in NorthCarolina or Indiana

CORESOURCE PA MD IL CNE--CORPAMD-01 35182 35182 Claims mailing address in Maryland, Penn or Illinois

CORESOURCE OHIO CNE--COROFOH-01 35183 35183 Claims mailing address in Ohio only

CORESOURCE - INTERNAL CNE--CORSOUR-01 35187 35187 CORNERSTONE BENEFIT ADMINISTRATO CNE--CORBEAD-01 35202 35202

CORPORATE BENEFIT SRV. OF AMER CNE--CORBESE-01 41124 41124 Only: PO Box 27267, Minneapolis, MN 55427

CORPORATE BENEFITS SVCS., INC CNE--CORBESE-02 56116 56116 Only: PO Box 12953, Charlotte, NC 28220

CORPORATE SYSTEMS ADMINI CNE--CORSYAD-01 37246 37246 CORRECTIONAL MEDICAL SERVICES CNE--CORMESE-01 43160 43160 COUNTRY LIFE INSURANCE CNE--COULIIN-01 62553 62553 COVENANT ADMINISTRATORS INC CNE--COVADGA-01 58102 58102 Atlanta, GA COVENTRY ADVANTRA CNE--COVADVA-01 25152 25152 Texas, New Mexico, Arizona COVENTRY HLTH AND LIFE INS CNE--COVHELI-01 25133 25133 Oklahoma COVENTRY HLTH AND LIFE INS CNE--COVHETN-01 25141 25141 TENNESSEE COVENTRY HLTH CARE DE CNE--COVHEDE-01 25130 25130 Delaware COVENTRY HLTH CARE GA CNE--COVHEGA-01 25127 25127 Georgia COVENTRY HLTH CARE IA CNE--COVEHIA-01 25132 25132 Iowa COVENTRY HLTH CARE KS CNE--COVHEKS-01 25133 25133 Kansas COVENTRY HLTH CARE LA CNE--COVHELA-01 25135 25135 Lousiana COVENTRY HLTH CARE NE CNE--COVHENE-01 25136 25136 Nebraska COVENTRY HLTH CARE Nevada CNE--COVHLNV-01 25149 25149 Nevada

COVENTRY HLTH CARE NATIONAL NETWORK CNE--COVHENA-01 87043 87043 FKA FIRST HEALTH DIRECT COVENTRY MISSOURI CNE--COVENMO-01 87043 87043 CREATIVE MEDICAL SYSTEMS CNE--CREMESY-01 64068 64068 CREATIVE PLAN ADMINISTRATORS CNE--CREPLAD-01 37320 37320

CROY-HALL MGMT INC CNE--CROHAMG-01 37266 37266

Billing Submission address only: PO Box 982005, Ft. Workth, TX 76182 - Unique Policy Number or ID Card Number Req'd

CUSTOM BENEFIT ADMINISTRATORS CNE--CUSBEAD-01 39170 39170 CWIBENEFITS INC CNE--CWIBEIN-01 57080 57080

CUSTOM DESIGN BENEFITS INC CNE--CUSDEBE-01 82056 82056

D. H. EVANS & ASSOC CALL PROMPT FOR ASSISTANCE

DART MANAGEMENT CORP CNE--DARTMAN-01 06172 06172 DAVITA HEALTH CNE--DAVIHEA-01 33066 33066 DC CHARTERED HEALTH PLAN INC CNE--DCCHAHE-01 95748 95748 Medicaid & Alliance

DEANCARE HMO C--H-DEANCAR-01 EDI enrollment req'd - PROVIDER NUMBERS REQ'D

DEFINITY SERVICES CNE--DEFINSE-01 64159 64159 AKA Definity Health DELAWARE PHYSICIANS CARE INC CNE--DELPHCA-01 27009 27009 DELTA HEALTH SYSTEMS CNE--DELHESY-01 94235 94235

DENVER HEALTH MEDICAID CHOICE CNE--DENHEMC-01 84133 84133 AKA Denver Health & Hospital Authority

DENVER HEALTH - INDIGENT CNE--DENHEIN-01 84134 84134 DENVER HEALTH MEDICAL PLAN CNE--DENHEME-01 84135 84135

DENVER HEALTH MEDICAL PLAN - MEDICARE CHOICE CNE--DENHEME-02 84131 84131 MEDICARE CHOICE DESTINY HEALTH CNE--DESTHEA-01 36436 36436 DETROIT MEDICAL CENTER CNE--DETMECE-01 56240 56240

DEVON HEALTH CALL PROMPT FOR ASSISTANCE

DIAMOND PLAN CNE--DIAMPLA-01 25131 25131 DIRECT ASSIGNMENT BENEFIT PLANS CNE--DIRASBE-01 33192 33192 DIRECTORS GUILD OF AMERICA CNE--DIRGUAM-01 23706 23706 Producer Health Plan

DIVERSIFIED GROUP BROKERAGE CNE--DIVGRBR-01 06102 06102

AKA Diversified Administration Corp Payor ID should be on Members card - 06102

DME REGION B M----DMEREGB-01 DMERB

Call Prompt Prior to Sending; Provider Enrollment Req'd Durable Medical Equipment - Region B IL, IN, KY, MI, MN, OH, and WI

DRISCOLL CHILDRENS HEALTH PLAN CNE--DRICHHE-01 74284 74284 DUNN AND ASSOCIATES BENEFITS ADM CNE--DUNASBE-01 35186 35186

E-V BENEFITS MANAGEMENT, INC CNE--EVBENMA-01 34159 34159

Only: PO Box 94928 or PO Box 89476 Cleveland, OH 44101 KNA Meritain Health

EASTLAND MEDICAL GROUP CNE--EASMEGR-01 66122 66122 EBC MID-AMERICA CALL PROMPT TO ENROLL EBMC CNE--EBMC----01 31074 31074

EBS OF OHIO CNE--EBSOHIO-01 34166 34166 Claims mailed to: PO Box 2568, Mansfield, OH 44906

EHI CNE--EHI-----01 61101 61101 12/1/02 claims go to Humana ELDER HEALTH PLAN CNE--ELDHEIN-01 52192 52192 Pennsylvania & Maryland HMO ElderPlan INC CNE--ELDPLIN-01 31625 31625 Provider ID req'd Elmcare LLC CNE--ELMCALL-01 36399 36399 ELMCO CNE--ELMCO---01 37253 37253 EMERALD HEALTH NETWORK CNE--EMEHENE-01 34167 34167 All PPO Business EMI-KP AMBULANCE CLAIMS CNE--EMIAMCL-01 59299 59299 EMPHESYS CNE--EMPHEIN-01 61101 61101 12/1/02 claims go to Humana EMPLOYEE BENEFIT CLAIMS OF MID-AMERICA CALL PROMPT TO ENROLL

EMPLOYEE BENEFIT CLAIMS OF WISCONSIN CNE--EBCTPA1-01 37257 37257 www.ebctpa.com (440) 262-1160.

EMPLOYEE BENEFIT CONCEPTS, INC CNE--EMPBECO-01 38241 38241 Farmington Hills, MI

EMPLOYEE BENEFIT CONSULTANTS CNE--EBCTPA1-01 37257 37257 www.ebctpa.com (440) 262-1160.

EMPLOYEE BENEFIT CORPORATION CNE--EMPBECO-02 37215 37215

EMPLOYEE BENEFIT MGMT CORP CNE--EMPBEMA-02 31074 31074 EBMC - AKA BIG LOTS ASSOC BENEFIT PLAN

EMPLOYEE BENEFIT SERVICES CNE--EMPBESE-01 37216 37216 MAILING ADDRESS: FT. MILLS, SC

EMPLOYEE BENEFIT SVS OF LOUISIANA CNE--EMPBESE-02 41198 41198 EBS OF LOUISIANA

EMPLOYEE BENEFITS PLAN ADMINISTRATION, INC CNE--EMPBEPL-01 03036 03036 E.B.P.A. EMPLOYEE CLAIM ADJ CNE--EMCLADJ-01 75184 75184 EMPLOYEE PLANS, LLC CNE--EMPPLLL-01 35112 35112 EMPLOYER PLAN SERVICES CNE--EMPPLSE-01 74212 74212 EMPLOYERS DIRECT HEALTH CNE--EMPDIHE-01 75232 75232 EMPLOYERS DIRECT HEALTH CNE--EMPDIHE-02 75236 75236 Employee Plan EMPLOYERS DIRECT HEALTH - FI CNE--EMPDIFI-01 75235 75235 EMPLOYERS DIRECT HEALTH - SF CNE--EMPDISF-01 75233 75233 EMPLOYERS HEALTH (EMPHESYS) CNE--EMPHEIN-01 61101 61101 12/1/02 claims go to Humana EMPLOYERS HEALTH NETWORK LLC CNE--EMPHENE-01 20508 20508 EMPLOYERS INS OF WAUSAU CNE--EMPINWA-01 39026 39026 EMPLOYERS MUTUAL INC/ FL ONLY CNE--EMPMUIN-01 59298 59298 Jacksonville, Florida

EMPLOYERS MUTUAL INC CNE--EMPMUIN-02 59331 59331 Stuart, Florida Call payor for filing requirements

ENCIRCLE PPO CNE--ENCIRCL-01 35206 35206 ENCOMPASS CNE--ENCOMPA-01 37110 37110 ENCORE HEALTH NETWORK CNE--ENCHENE-01 35206 35206 ENH MEDICAL GROUP IPA EVANSTON CNE--ENHMEGR-01 36364 36364

ENSTAR NATURAL GAS CNE--ENSNAGA-01 91136 91136 Group Number (P61) req'd on claims

ENTRUST CNE--ENTRUST-01 36878 36878 EQUICOR PPO CNEP-EQUICOR-01 62308 62308 EQUICOR/EQUITABLE CNE--EQUEQUI-01 62308 62308 EQUITABLE(CIGNA) CNE--EQUITAB-01 62308 62308

EQUITABLE PLAN SERVICES CNE--EQUPLSE-01 73126 73126 ONLY: PO Box 720460, Oklahoma City, OK 73172

ERIN GROUP ADMINISTRATORS CNE--ERIGRAD-01 23250 23250 ES BEVERIDGE AND ASSOCIATES CNE--ESBEVAS-01 34108 34108 ESSENCE HEALTHCARE CNE--ESSEHEA-01 20818 20818 EVERGREEN HEALTH PLAN CNE--EVEHEPL-01 58233 58233

EVOLUTIONS HEALTHCARE SYSTEMS CNE--EVOHEFL-01 59313 59313

Claims billing address only: PO Box 5001, Newport Richey, FL 34656

ExclusiCare CNE--EXCLUSI-01 71412 71412 F.A. RICHARD & ASSOCIATES INC CNE--FARICAS-01 37289 37289

FABOH (CHP/RPU) CNE--FABOHWI-01 39112 39112 Rendering provider and location number req'd

FACEY MEDICAL FOUNDATION CNE--FACMEFO-01 95432 95432 FACS GROUP CNE--FACSGRP-01 37300 37300

FALLON COMMUNITY HEALTH CNE--FALCOHE-01 22254 22254 SX072 OLD # - PLEASE USE 22254

FAMILY CARE CNE--FAMICAR-01 60995 60995 FAMILY HEALTH PARTNERS CNE--FAMHEKS-01 31472 31472 HEALTHWAVE OF KANSAS FAMILY HEALTH PARTNERS MC, MO CNE--FAMHEPA-01 43173 43173 MC + MISSOURI FAMILY MEDICAL NETWORK CNE--FAMMENE-01 36396 36396 Call payor prior to sending

FARA BENEFIT SERVICES CNE--FARBESE-01 37289 37289 AKA FARA - No Workmens Comp Claims

FARM FAMILY LIFE CNE--FARFALI-01 14140 14140 FCE BENEFIT ADMINISTRATORS CNE--FCEBEAD-01 33033 33033

FEDERATED BENEFITS CNE--FEDEBEN-01 37300 37300 AKA FEDERATED HR SERVICES

FEDERATED MUTUAL HLTH INS CO CNE--FEDMUHE-01 41041 41041 FIDELIS CARE NEW YORK CNE--FIDCANY-01 11315 11315 FIDELIS SECURE CARE CNE--FIDSECA-01 77054 77054

FIRST CAROLINA CARE CNE--FIRCACA-01 56196 56196

FIRST CHOICE HEALTHPLANS (CT) CNE--FIRCHCT-01 14162 14162 Provider Ntwk ID Req'd 5-8 digits Connecticut

FIRST CHOICE HEALTH NETWORK CNE--FIRCHHE-01 91131 91131 AKA First Choice Health Administrators

FIRST CHOICE OF MIDWEST - PPO CNE--FIRCHMI-01 75138 75138 FIRST GREAT-WEST LIFE CNE--FIRGRWE-01 80705 80705

FIRST HEALTH NETWORK CNE--FIRHENE-01 73159 73159 FKA CCN MANAGED CARE INC & PPO OKLAHOMA

FIRST HEALTH STRATEGIES CNE--FIRHEST-01 87043 87043 SEE COVENTRY HEALTH CARE NATIONAL NETWORK

FIRST MEDICAL NETWORK CNE--FIRMENE-01 58203 58203 FMN - Atlanta, GA FIRST SERVICE ADMINISTRATORS INC CNE--FIRSEAD-01 59276 59276 Also known as Florida 1st

FISERV HEALTH - KANSAS/TENNESSEE CNE--FISERHE-01 62061 62061 Formerly Willis Admin Services Corp

FISERV HEALTH - WAUSAU BENEFITS/BENESIGHT CNE--FISHEWA-01 39026 39026 FITZHARRIS & COMPANY CNE--FITZCOM-01 11244 11244 FLORIDA 1st CNE--FLORFIR-01 59276 59276 AKA First Service Administrators FLORIDA HEALTH CARE PLAN CNE--FLORHCP-01 59322 59322

FLORIDA HOSPITAL HEALTHCARE SYS CNE--FLOHOHE-01 59321 59321

Provider network ID req'd - out of network must call payor prior to sending

FLORIDA HOSP WATERMAN EMP BEN CNE--FLOHOWA-01 48116 48116 FLORIDA LEAGUE OF CITIES INC CNE--FLOLECI-01 59698 59698 FMH BENEFIT SERVICES, INC. CNE--FMHBESE-01 48117 48117 FORMAX INC CNE--FORMINC-01 87066 87066

FORTIS BENEFITS INC CNE--FORBEIN-01 70408 70408 KNA Union Security Insurance Company

FORTIS INS COMPANY/TIME CNE--FORINCO-01 39065 39065

FOUNDATION BENEFIT ADMINISTRATORS CNE--FOUBEAD-01 BOONG BOONG CONTRACTOR EMPLOYEE BENEFITS ADMIN

FOX-EVERETT, INC. CNE--FOXEVIN-01 64069 64069 FREEDOM HEALTH PLAN CNE--FREHEPL-01 41212 41212 FRESENIUS MEDICAL CARE CNE--FREMECA-01 23130 23130 FRINGE BENEFIT MANAGEMENT CNE--FRIBEMA-01 59069 59069 FRINGE BENEFITS COORDINATORS CNE--FRIBECO-01 59204 59204 FrontPath HEALTH COALITION CNE--FROHECO-01 34171 34171

GALLAGHER BENEFITS ADMIN CNE--GALBEAD-01 37283 37283 GBA KNA American Administrative Group

GALVESTON COUNTY INDIGENT HEALTH CARE CNE--GALCOIN-01 30005 30005

GATEWAY HEALTH PLAN - MEDICARE ASSURED CNE--GATHEPL-02 60550 60550

Medicare Assured - check ID card for payor # 60550 - (yellow card)

GATEWAY HEALTH PLAN CNE--GATHEPL-01 25169 25169 Medicaid PA. Check ID card for payor # 25169 - (green card)

GATEWAY HEALTH PLAN OF OHIO CNE--GATHEPL-03 76028 76028 OHIO - Check ID card for payor # 76028 - (white card)

GATEWAY HEALTH PLAN OH - MEDICARE ASSURED CNE--GATHEPL-04 91741 91741

Ohio - Check ID card for payor # 91741

GBA CNE--GALBEAD-01 37283 37283 GBA KNA American Administrative Group

GE GROUP LIFE ASSURANCE CO CNE--GEGLIAS-01 67815 67815 KNA Genworth Life & Health

GEISINGER HEALTH PLAN CNE--GEIHEPL-01 75273 75273 EDI ENROLLMENT REQ'D - Call payor

GE VOLUNTARY BENEFITS PROFESSIONAL INSURANCE COMPAN CNE--GEVOLBE-01 59041 59041 GEVB - PIC Gettysburg Health CNE--GETTHEA-01 23212 23212 Cinergy Health Plan

GH BASIC HEALTH PLAN CNE--GHBASIC-01 91051 91051 Western Washington State. Payor setup req'd call payor 1st

GH INDIVIDUAL AND FAMILY PLAN CNE--GHINDFA-01 91051 91051 Western Washington State. Payor setup req'd call payor 1st

GHC COMMERCIAL CNE--CHCCOMM-01 91051 91051 Western Washington State. Payor setup req'd call payor 1st

GHC MEDICARE & CHOICE CNE--GHCMECH-01 91051 91051 Western Washington State. Payor setup req'd call payor 1st

GHI - MEDICARE PRIVATE FEE FOR SERV CNE--GHIMCRP-01 22937 22937 GHI - NEW YORK CNE--GHINY---01 13551 13551 Group Health Inc. GHI HMO SELECT CNE--GHIHMSE-01 25531 25531 GHP (GROUP HEALTH PLAN) CNE--GROHEPL-01 25141 25141 GI INNOVATIVE MANAGEMENT CNE--GIINMAN-01 58204 58204 GIC INDEMNITY PLAN CNE--GICINPL-01 80314 80314 GILSBAR, INC. CNE--GILSBAR-01 07205 07205 GLOBAL CARE INC CNE--GLOBCAR-01 07689 07689 GMS, INC CNE--GMSINCO-01 47083 47083 GLASSWORKERS HEALTH & WELFARE CNE--GLAHEWE-01 91136 91136 Group Number (F29) req'd GOLDEN RULE INSURANCE CO. CNE--GOLRUIN-01 37602 37602

GOLDEN TRIANGLE PHYSICIAN ALLIANCE CNE--GOLTRPH-01 72189 72189 SELECTCARE OF TEXAS (GTPA)

GOV'T EMPLOYEES HOSP ASSOC CNE--GOVEMHO-01 44054 44054 GEHA GRANT PHYSICIANS PRACTICE ASSO CNE--GRAPHPR-01 37234 37234 GREAT LAKES HEALTH PLAN CNE--GRELAHE-01 95467 95467 GREAT-WEST LIFE ASSURANCE CO. CNE--GREWELI-01 80705 80705 AKA Great-West Healthcare GREAT-WEST HEALTHCARE CNE--GREWEHE-02 63665 63665 Formerly General American GROUP ADMINISTRATORS, LTD. CNE--GROADLT-01 36338 36338 GROUP AND PENSION ADMIN CNE--GROPEAD-01 48143 48143 GROUP BENEFIT ADMINISTRATORS CNE--GROBEAD-01 72153 72153 Hendersonville, TN GROUP HEALTH COOP MADISON,WI CNE--GROHEWI-01 39167 39167 South Central Wisconsin

GROUP HEALTH COOP. EAST CNE--GROHECO-02 91121 91121 Eastern Washington State. Call payor prior to sending

GROUP HEALTH COOP. WEST CNE--GROHECO-01 91051 91051 Western Washington State. Payor setup req'd call payor 1st

GROUP HEALTH COOPERATIVE CNE--GROHECO-03 39167 39167 South Central Wisconsin www.ghcscw.com

GROUP HEALTH INC. (GHI) CNE--GROHEIN-02 13551 13551 New York

GROUP HEALTH INC. (GHI) CNE--GHIMCRP-01 22937 22937 MEDICARE PRIVATE FEE FOR SERV

GROUP HEALTH MANAGERS CNE--GROHEMA-01 38194 38194

GROUP HEALTH OPTIONS INC CNE--GROHEWA-01 91121 91121

WA STATE - All GHO products, Options and Alliant can be send electronically

GROUP HEALTH OPTIONS INC CNE--GROHEOP-01 91051 91051 Western Washington State. Call Payor prior to sending

GROUP INSURANCE SERVICE CENTER CNE--GROINSE-01 37276 37276

GROUP PRACTICE AFFILIATES CNE--GROPRAF-01 68046 68046 Enrollment req'd prior to sending claims

GUARDIAN LIFE INS CO AMERICA CNE--GUALIIN-01 64246 64246 H.E.R.E.I.U WELFARE FUND CNE--HEREIU--01 37114 37114 HAP/AHL/CURANET CNE--HAPAHLC-01 38224 38224 Provider ID required HARMONY HEALTH PLAN OF ILLINOIS CNE--HARHEPL-02 36406 36406 Wellcare provider ID required HARMONY HEALTH PLAN OF INDIANA CNE--HARHEPL-01 36405 36405 Wellcare provider ID required HARRINGTON BENEFIT SERVICES CNE--HARBESE-01 95266 95266 Harrington; RE Harrington

HARRINGTON HEALTH-KANSAS- FNA FiServe Health-Kansas CNE--FISERHE-01 62061 62061

Formerly Willis Admin Services Corp

HAWAII MANAGEMENT ALLIANCE ASSO CNE--HAWMAAL-01 99208 99208 HMAA HCH ADMINISTRATION CNE--HCHADMI-01 37111 37111 ILLINOIS HCH ADMINISTRATION CNE--HCHADMI-02 37215 37215 Formerly John P Pearl Associates

HCHA ALBQ NM SELF FUNDED CNE--HCHALNM-01 37329 37329

HCN CNE--HEACANE-01 42102 42102 Health Care Network of Wisconsin - Health EOS

HCS - HEALTH CLAIMS SERVICE CNE--HEACLSE-01 82018 82018 BOISE, ID HDPC - PREMIER HEALTHCARE CNE--PREMHEA-01 90023 90023 HDPC/ALLIANCE PHYSICIANS CNE--ALLIPHY-01 20257 20257 HEALTH ADMINISTRATION SERVICE CNE--HEAADSE-01 34185 34185 HEALTH ALLIANCE MEDICAL PLANS CNE--HEAALME-01 77950 77950 HEALTH AMERICA, INC. CNE--HEAAMIN-01 25126 25126 HEALTH AMERICAN/HEALTH ASSUR. CNE--HEAAMHE-01 25126 25126

HEALTH ASSURANCE PLAN/W VA CNE--WESVAHE-01 25139 25139 Commercial Claims Only AKA Carelink

HEALTH ASSURANCE/HLTH AMERICA CNE--HEAASHE-01 25126 25126

HEALTH CARE NETWORK OF WISCONSIN CNE--HEACANE-01 42102 42102 HCN - Located in Wisconsin HEALTH CHOICE GENERATIONS CNE--HEACHGE-01 62180 62180 HEALTH COST SOLUTIONS CNE--HEACOSO-01 62111 62111 HEALTH DESIGN PLUS CNE--HEADEPL-01 34158 34158 Hudson, Ohio HEALTH EOS CNE--HEALEOS-01 34080 34080 also know as Multiplan HEALTH EZ CNE--HEALTEZ-01 16120 16120 HEALTH FIRST TPA - -TYLER,TEXAS. CNE--HEAFITX-01 75234 75234 HEALTH FUTURE LLC CNE--HEALFUT-01 30946 30946 HEALTH MARKET CARE ASSURED CNE--HEAMACA-01 62295 62295 HEALTH NET ARIZONIA CNE--HEANEAZ-01 38309 38309 Unique Provider ID req'd HEALTH NET -CALIF ENCOUNTERS CNE--HEANEEN-01 95570 95570 Contact Payor prior to sending HEALTH NET OF CA. CNE--HEANECA-01 95567 95567 Contact Payor prior to sending HEALTH NET OF THE NORTHEAST CNE--HEANENE-01 06108 06108 Provider Network ID req'd HEALTH NET OREGON CNE--HEANEOR-01 95567 95567 Contact Payor prior to sending HEALTH NET PEARL CNE--HEANEPE-01 SX185 SX185 HEALTH NETWORK AMERICA CNE--HEANEAM-01 20199 20199 HEALTH NETWORK ONE CNE--HEANEON-01 65062 65062 HEALTH OPTIONS OF ILLINOIS CNE--HEAOPIL-01 36368 36368

HEALTH PARTNERS MINNESOTA CNE--HEAPAMN-01 SX009 SX009 ENROLL REQ'D CALL PROMPT FOR ASSIST.

HEALTH PARTNERS (TN) CNE--HEAPATN-01 62157 62157 Jackson, Tennessee HEALTH PARTNERS OF PHILADELPHI CNE--HEAPAPH-01 80142 80142 Provider Network ID req'd HEALTH PAYMENT SYSTEMS INC CNE--HEAPASY-01 20270 20270 HEALTH PLAN OF MICHIGAN CNE--HEAPLMI-01 83253 83253 HEALTH PLAN OF SAN JOAQUIN CNE--HEAPLSJ-01 68035 68035

HEALTH PLANS INC CNE--HEAPLIN-01 44273 44273 Claims are printed and mailed to payor

HEALTH PLUS PHSP CNE--HEAPLPH-01 11324 11324 Brooklyn, NY Call payor prior to sending claims

HEALTH RISK MANAGEMENT CNE--HEARIMA-01 41170 41170 (Also known as HRM) HEALTH RISK MANAGEMENT CNE--HEARIMA-02 55438 55438

HEALTH SERVICES CONSULTING GROUP INC CNE--HEASECO-01 20896 20896

HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS CNE--HEASECH-01 37290 37290 HEALTH SERVICES PREFERRED CNE--HEASEPR-01 34167 34167 by Emerald Health HEALTH SYSTEMS INTERNATIONAL CNE--ECOHHSI-01 27008 27008 ECOH HEALTH VALUE MANAGEMENT - DE CNE--HEAVAMA-01 61101 61101 Humana

HEALTHCARE PARTNERS, IPA CNE--HEAPAIP-01 11328 11328 Formerly Heritage New York Medical Group

HEALTHCARE RESOURCES NW CNE--HEACARE-01 56731 56731 HEALTHCARE SOLUTIONS GROUP CNE--HEASOGR-01 73147 73147 HEALTHCARE USA CNE--HEACAUS-01 25143 25143

HEALTHCHOICE OF AZ CNE--HEACHAZ-01 62179 62179 ARIZONA HEALTHCOMP INC CNE--HEACOIN-01 85729 85729 HEALTHEASE TAMPA,FL CNE--HEALEAS-01 59608 59608 Provider Nwrk ID req'd 5-9 digits HealthEZ CNE--HEALTEZ-02 41178 41178

HEALTHFIRST HEALTH PLAN - NJ CNE--HEAFINJ-01 80141 80141 NEW JERSEY - PROVIDER NUMBER REQ'D

HEALTHFIRST TPA - TYLER, TX CNE--HEALFTX-01 75234 75234 HEALTHFIRST, INC NEW YORK CNE--HEAFINY-01 80141 80141 Provider Network ID Req'd

HEALTHHELP NETWORKS, INC CNE--HEANETI-01 59087 59087 HHNI NKA The National Radiology Network

HEALTHLINK HMO CNE--HEALHMO-01 96475 96475 Provider Network ID Required HEALTHLINK PPO CNE--HEALPPO-01 90001 90001 Provider Network ID Required HEALTHPLAN SERVICES TAMPA ONLY CNE--HEAPLSE-01 59140 59140

HealthPartners MN CNE--HEAPAMN-01 SX009 SX009 Enrollment is req'd prior to sending - call Prompt

HEALTHSCOPE BENEFITS CNE--HEASCBE-02 71063 71063 HEALTHSMART PREFERRED CARE CNE--HEASMPR-01 75250 75250 HEALTHSOURCE - SC CNE--HEASOSC-01 06119 06119 Network providers only HEALTHSOURCE CMHC CNE--HEACMNC-01 02041 02041 HEALTHSOURCE MASSACHUSETTS CNE--HEAMAIN-01 02041 02041 HEALTHSOURCE NORTH TEXAS CNE--HEANOTX-01 75255 75255 HEALTHSOURCE OHIO CNE--HEAOHIO-01 31141 31141 HEALTHSOURCE PROV. ADMIN. CNE--HEASOPR-01 68195 68195 HEALTHSOURCE PROV. INS. CO. CNE--HEASOPI-01 68195 68195 HEALTHSOURCE, ARK. MEDICARE CNE--HEAARME-01 71075 71075 HEALTHSOURCE, GEORGIA CNE--HEASOGA-01 58210 58210 HEALTHSOURCE, KY, INC. CNE--HEAKEIN-01 61127 61127 HEALTHSOURCE, MAINE CNE--HEASOMA-01 01041 01041 Provider Network ID Required HEALTHSOURCE, NC, INC. CNE--HEANOCA-01 56147 56147 HEALTHSOURCE, NH CNE--HEASONH-01 02038 02038 Provider Network ID Required HEALTHSOURCE, TENNESSEE, INC. CNE--HEALTTN-01 62129 62129 HealthSpring CNE--HEALSPR-01 33104 33104

HEALTHSPRING OF ALABAMA- HMO CNE--HEASPAL-01 63092 63092 Provider Network ID Required Formerly The Oath

HEALTHSTAR CNE--HEASTAR-01 36332 36332

HEALTHWAYS WHOLE HEALTH NETWORKS CNE--HEAWHHE-01 58213 58213

HEALTHY OPTIONS DSHS CNE--HEALOPT-01 91051 91051 Western Washington State. Call payor prior to sending

HERITAGE CONSULTANTS FL CNE--HEACOFL-01 59230 59230 9 digit subscriber number req'd HERITAGE NEW YORK MEDICAL GRP CNE--HERNYME-01 11328 11328 KNA HealthCare Partners, IPA HFN, INC. OAK BROOK IL CNE--HFNINC--01 36335 36335 HIGH DESERT PRIMARY CARE CNE--HIGDEPR-01 33069 33069 HIGHMARK CNE--HIGHMAR-01 37323 37323 HIGHMARK - KEY FAMILY CNE--HIGHMAR-02 35145 35145 HILL PHYSICIANS MEDICAL GROUP CNE--HILPHME-01 00046 00046 HILLCREST BENEFIT ADMINISTRATORS CNE--HILBEAD-01 59347 59347 HINSDALE PHYSICIAN HEALTHCARE CNE--HINSPHE-01 36385 36385 HIP - HEALTH INS PLAN GR NY CNE--HIPGRNY-01 55247 55247 Provider enrollment req'd HMPK, INC. CNE--HMPKINC-01 61101 61101 HOLY CROSS HEALTH PARTNERS CNE--HOLCRHP-01 36412 36412 HOMETOWN HEALTH PLAN - NEVADA CNE--HOMHENV-01 88023 88023 HOMETOWN HEALTH NETWORK - OH CNE--HOMHENE-01 34150 34150 HORIZON BC/BS OF NEW JERSEY CNE--HORBCBS-01 22099 22099 HORIZON HEALTHCARE ADMIN CNE--HORHECA-01 22304 22304 HHA HORIZON MERCY CNE--HORIMER-01 22326 22326 Medicaid managed care AKA

Horizon NJ Health

HOTEL EMPLOYEES & RESTAURANT EMPLOYEES HEALTH TRUST CNE--HOTREEM-01 91136 91136 Group Number (F19) req'd HPLAN, INC. CNE--HPLANIN-01 61101 61101 HPS PARADIGM, INC. CNE--HPSPAIN-01 58227 58227 HRM CNE--HRM-----01 41170 41170

HRM CLAIM MANAGEMENT CNE--HRMCLMA-01 41170 41170 (Formerly Health Risk Management - HRM)

HSM - WEA INSURANCE C----PRACINS-01 WEA01

HSM - 7805 Hudson Rd. #190, Woodbury, MN 55125 EDI ENROLLMENT REQ'D

HSM - ECOH C----PRACINS-02 ECOH1


HSM - PREFERRED ONE C----PRACINS-03 HSMP1


HSM - SELECT CARE / AETNA C----PRACINS-04 HSMSC


HSM - BPA C----PRACINS-05 HSMBP


HSM - MMSI C----PRACINS-06 MMSI1


HUDSON HEALTH PLAN CNE--HUDHEPL-01 13335 13335 HUMANA (ENCOUNTER DATA ONLY) CNE--HUMANA--01 61102 61102 Encounters only HUMANA CARE PLAN CNE--HUMCAPL-01 61101 61101 Also, Humana Employers Health

HUMANA GROUP HEALTH PLAN CNE--HUMGRHE-01 61101 61101 Group and Rendering NPI data req'd by Payor

HUMANA HEALTH CHICAGO INS CO CNE--HUMHECH-01 61101 61101 Group and Rendering NPI data req'd by Payor

HUMANA HEALTH PLAN CNE--HUMHEPL-01 61101 61101 Group and Rendering NPI data req'd by Payor

HUMANA INSURANCE AGENCY CNE--HUMINAG-01 61101 61101 Group and Rendering NPI data req'd by Payor

HUMANA INSURANCE COMPANY CNE--HUMINCO-01 61101 61101 Group and Rendering NPI data req'd by Payor

HUMANA INS CO CHOICE CARE NETWORK CNE--HUMCHOI-01 61101 61101

DOES NOT INC HUMANA CHOICECARE OF CINCINNATI

HUMANA MEDICAL PLAN-CA CNE--HUMMEPL-01 61101 61101 Group and Rendering NPI data req'd by Payor

HUMANA MEDICAL PLAN-KY CNE--HUMMEPL-02 61101 61101 Group and Rendering NPI data req'd by Payor

HUMANA MICHEAL REESE HMO IL CNEH-HUMREIL-01 61101 61101 Group and Rendering NPI data req'd by Payor

HUMANA MICHEAL REESE HMO IN CNEH-HUMREIN-01 61101 61101 Group and Rendering NPI data req'd by Payor

HUMANA WISCONSIN HEALTH ORG CNE--HUMWIOR-01 61101 61101 Group and Rendering NPI data req'd by Payor

HUMBOLDT-DEL NORTE FOUNDATION FOR MEDICAL CARE CNE--HUMDENO-01 94154 94154 I.E. SHAFFER CNE--IESHAFF-01 22175 22175 WEST TRENTON, NJ I'Mcare CNE---IMCARE-01 41600 41600 IAA CNE--IAACLAI-01 37279 37279 IBI CNE------IBI-01 41124 41124 ICM CNE--ICM-----01 37296 37296

IHG DIRECT CNE--IHGDIRE-01 75274 75274 Claims Submission only: PO Box 2388, Stow, OH 44224

INDECS CORPORATION CNE--INDECCO-01 40585 40585 INDIANA HEALTH NETWORK CNE--INDHENE-01 35204 35204 INDIANA PROHEALTH NETWORK CNE--INDPRHE-01 35161 35161

INDIANA TEAMSTERS HLTH BENEFITS CNE--INDTEHE-01 35107 35107 Formerly Local 135 Health Benefits Fund - Indianapolis, IN

INDIVIDUAL HEALTH INS. CO. CNE--INDHEIN-01 31053 31053 INFORMED LLC/SELF FUNDING ADM CNE--INFSEFU-01 52196 52196 INGALLS PROVIDER GROUP CNE--INGPRGR-01 36348 36348

INJURED WORKERS INSURANCE FUND CNE--INJWOIN-01 52212 52212 First time Submitters - call payor prior to sending claims

INNOVATIVE HEALTHWARE SERVICES CALL PROMPT TO ENROLL

INSURANCE ADMINISTRATORS OF AMERICA, INC. CNE--INSADAM-01 37279 37279 INSURANCE DESIGN ADMINISTRATOR CNE--INSDEAD-01 13315 13315 INSURANCE MANAGEMENT SERVICES CNE--INSMASE-01 88006 88006 Elko, NV INSURERS ADMINISTRATIVE CORP CNE--INSADCO-01 86304 86304

INTEGRA ADMINISTRATIVE GROUP (Seaford, DE) CNE--INTADDE-01 51020 51020

Only: 110 S. Shipley St, Seaford, DE 19973

INTEGRA GROUP CNE--INTEGRO-01 31127 31127 INTEGRA GROUP - CHA CNE--INTEGRO-02 31129 31129 INTEGRANT / SELECTCARE OF TEXAS CNE--INTEGRA-01 74314 74314 INTEGRATED CARE NETWORK CNE--INTCANE-01 34167 34167 ICN by Emerald Health

INTEGRATED MENTAL HEALTH SERVICES CNE--INTMEHE-01 68053 68053 Call Payor Prior to Sending 1-800-716-5650

INTEGRITY BENEFIT NETWORK, INC CNE--INTBENE-01 58200 58200 Marietta, GA INTERCARE HEALTH PLANS - CO CNE--INTHEPL-01 37227 37227 INTERFACE EAP (IEAP) CNE--INTEEAP-01 60280 60280 INTERGROUP SERVICES PPO CNE--INTGRSE-01 23287 23287 INT'L BROTHERHOOD OF BOILERMAKERS CNE--INTBRBO-01 36609 36609

INTERNATIONAL EDUCATIONAL EXCHANGE SERVICES INC CNE--INTEDEX-01 16158 16158 IEES INTERNATIONAL FUNDING LTD CNE--INTEFUN-01 39182 39182

INT'L UNION OPER ENG NEW YORK CNE--INTUNOP-03 64157 64157 Local 15, 15A, 15C & 15D - Located in New York, NY

INTERWEST HEALTH CNE--INTWEHE-01 84137 84137 Acceptius Gateway payer

INTGRITAS BENEFIT GROUP CNE--INTBEGR-01 20435 20435 Claims are Printed and Mailed to Payor

IOWA BENEFITS, INC. CNE--IOWBEIN-01 41124 41124 IU MEDICAL GROUP PRIMARY CARE CNE--IUMEDGR-01 SX172 SX172 J F MOLLOY & ASSOCIATES CNE--JFMOLAS-01 61271 61271

J. SMITH LANIER AND CO ADMINISTRATORS CNE--JSLADMI-01 37272 37272 JACKSON MEMORIAL HEALTH PLAN CNE--JACMEHE-01 05014 05014 FLORIDA JOHN ALDEN LIFE CNE--JOHALLI-01 41099 41099

JOHN DEERE HEATH CARE-HERITAGE CNE--JOHDEHE-01 95378 95378

Provider enrollment req'd - Provider Netwk ID req'd KNA UnitedHealthcare of River Valley

JOHN MORRELL COMPANY CO CNE--JOHMOCO-01 38310 38310 AHPBA

JOHN MUIR MT. DIABLO HEALTH SYSTE CNE--JOHMUMT-01 68036 68036 Registration with payor is required prior to sending

JOHN MUIR PHYSICIAN NETWORK CNE--JOHMUPN-01 68036 68036 Registration with payor is required prior to sending

JOHN MUIR TRAUMA PHYSICIANS CALL PROMPT TO ENROLL

JOHN P PEARL & ASSOC LTD CNE--JOHPEAS-01 37215 37215 Now Known as HCH Administration

JOHNS HOPKINS HEALTHCARE CNE--JOHHOHE-01 52189 52189

NPI MUST BE SHARED WITH PAYOR PRIOR TO SENDING (EHP/PP)

JOHNS HOPKINS HEALTHCARE CNE--JOHHOHC-01 52123 52123

NPI MUST BE SHARED WITH PAYOR PRIOR TO SENDING (USFHP)

JOPLIN CLAIMS CNE--JOPLIN--01 43178 43178 JP FARLEY CORPORATION CNE--JPFARCO-01 34136 34136 JSL ADMINISTRATORS CNE--JSLADMI-01 37272 37272

KAISER CSI CNE--KAISCSI-01 94320 09432 California Select for Individuals FNA Kaiser PPO

KAISER FOUNDATION HEALTH PLAN CNE--KAIFOHE-02 91617 91617 Colorado

KAISER FOUNDATION HEALTH PLAN CNE--KAIFOCA-01 94135 94135 Northern CA Region Call payor prior to sending

KAISER FOUNDATION HEALTH PLAN CNE--KAIFOOH-01 34092 34092 OHIO KAISER FOUNDATION MID-ATLANTIC CNE--KAIFOMI-01 52095 52095 Mid-Atlantic States

KAISER FOUNDATION OF THE NORTHWEST CNE--KAIFONW-01 93079 93079 Only for Oregon & Washington Members

KAISER FOUNDATION OF SO. CAL. CNE--KAIFOHE-01 94134 94134 Provider Network ID required KAISER PERMENANTE OF GEORGIA CNE--KAIOFGA-01 21313 21313 KANAWHA INSURANCE CO CNE--KANINCO-01 57038 57038 KATY MEDICAL CLAIMS CNE--KATYMED-01 81812 81812 KEENAN ASSOCIATES (CA) CNE--KEENASO-01 95279 95279 KEMPTON COMPANY, THE CNE--KEMPTCO-01 73100 73100 KEMPTON GROUP ADMINISTRATORS CNE--KEMGRAD-01 73100 73100 KENTUCKY KARE CNE--KENKARE-01 61101 61101 KERN HEALTH SYSTEMS CNE--KERHESY-01 77039 77039

KEY BENEFIT ADMINISTRATORS INC CNE--KEYBEAD-01 37217 37217 Indianapolis, IN Billing submission address only

KEY SELECT CNE--KEYSELE-01 37321 37321 KEYSTONE MERCY HEALTH PLAN CNE--KEYMEHE-01 23284 23284 Medicaid managed care KINDRED HEALTH CARE CNE--KINHECA-01 61101 61101 (formerly known as VENCOR) KLAIS & COMPANY CNE--KLAANCO-01 34145 34145 KOREAN AMERICAN MEDICAL GROUP CNE--KORAMME-01 66123 66123

LAKESIDE COMPREHENSIVE HEALTH CARE CNE--LAKCOHE-01 66127 66127 LAKESIDE HEALTH SERVICES, INC CNE--LAKHESE-01 95415 95415 LAKESIDE MEDICAL GROUP CNE--LAKMEGR-01 66125 66125

LAWNDALE CHRISTIAN HEALTH CENTER CNE--LAWCHHE-01 36333 36333 LBA HEALTH PLANS CNE--LBAHEPL-01 52193 52193 LEON MEDICAL CENTER HEALTH PLAN CNE--LEOMECE-01 37316 37316 LHP CLAIMS UNIT CNE--LHPCLUN-01 37248 37248 LIBERTY HEALTH ADVANTAGE CNE--LIBHEAD-01 87071 87071 LIBERTY UNION CNE--LIBEUNI-01 37281 37281 LIFE ASSURANCE COMPANY CNE--LIFASCO-01 37281 37281 LIFE TRAC CNE--LIFETRA-01 41136 41136

LIFEWISE HEALTH PLAN OF ARIZONA CNE--LIFWIAZ-01 91155 91155

ARIZONA- ENROLLMENT REQUIRED - CALL PROMPT PRIOR TO SENDING CLAIMS

LIFEWISE, A PREMERA HEALTHPLAN CNE--LIFAPHE-01 93093 93093

OREGON - ENROLLMENT REQUIRED - CALL PROMPT PRIOR TO SENDING CLAIMS

LIFEWISE/WASHINGTON EMP TRUST CNE--LIFWAEM-01 37294 37294 LINCOLN NAT'L GREEN BAY/MADISN CNE--LINNAGR-01 61101 61101 As of 12/31/02 claims to Humana LINCOLN NAT'L-PHOENIX CNE--LINNAPH-01 61101 61101 LOCAL 135 HEALTH BENEFITS CNE--LOC135H-01 35107 35107 Indianapolis, IN LOMA LINDA UNIVERSITY HEALTH PLNS CNE--LOMLIUN-01 37267 37267

LOMA LINDA UNIV MANAGED CARE CLM CNE--LOMLIMC-01 33036 33036 Claims are printed and mailed to payor

LOVELACE SALUD CNE--LOVESAL-01 SX159 SX159 LOVELACE SANDIA HEALTH PLAN CNE--LOVSAHP-01 90328 90328 MacNeal Health Providers - CHs CNE--MACHEPR-01 36334 36334

Machigonne Benefit Administrators CNE--MACBEAD-01 10317 10317

MAGELLAN HEALTH SERVICES CNE--MAGBEHE-01 01260 01260 MAGELLAN BEHAVIORAL HEALTH

MAGNACARE CNE--MAGNACA-01 11303 11303

MAILHANDLERS BENEFIT PLAN CNE--MAIBEPL-01 62413 62413 Also known as Mailhandlers/CAC MAILHANDLERS/CAC CNE--MAILCAC-01 62413 62413 MAKSIN MANAGEMENT CORP CNE--MAKMACO-01 22195 22195 MAMSI LIFE & HEALTH INS. CO. CNE--MAMLIHE-01 52148 52148 MANAGED CARE SERVICES CNE--MANCASE-01 35162 35162 MANAGED HEALTH NETWORK CNE--MANHENE-01 22771 22771

MANAGED HEALTH SERVICES WI CNE--MANHEWI-01 39187 39187

Call payor prior to sending - Provider ID Req'd Group # no Indv req'd

MANAGED HEALTH SVCS IN INDIANA CNE--MANHESE-01 39186 39186 Call payor prior to sending - Provider ID Req'd Use Pin # only

MANAGED PHYSICAL NETWORK CNE--MANPHNE-01 41159 41159

MANATEE SERVICE CENTER FL CNE--MANSECE-01 41555 41555 Only: PO Box 1098, Bradenton, FL 34206

MANULIFE W.J. SUTTON COMPANY CNE--MANWJSU-01 98010 98010 MARQUETTE LIFE INSURANCE CO CNE--MARLIIN-01 48055 48055 MARSH ADVANTAGE CNE--MARSADV-01 13310 13310 MARYLAND PHYSICIANS CARE CNE--MARPHCA-01 22348 22348 Rendering Provider ID required MASHANTUCKET PEQUOT TRIBAL NAT CNE--MASPETR-01 37121 37121 MAYO MANAGEMENT SERVICES, INC. CNE--MAYMASE-01 41154 41154 MMSI

MBA BENEFIT ADMINISTRATORS INC SALT LAKE CITY UT CNE--MBASLUT-01 87065 87065

Claims submission address: PO Box 651109 Salt Lake City, UT 84155

MBA OF WYOMING (WORLAND, WY) CNE--MBAWOWY-01 87065 87065 Claims submission address: PO Box 98, Worland, WY 82401

MBS CNE--MBS-----01 56205 56205 MD INDIVIDUAL PRACTICE ASSOC. CNE--MDINDPR-01 52148 52148 M.D. IPA MD OPTION HEALTH PLAN CNE--MDOPTHE-01 52148 52148

MDWise Hoosier Alliance CNE--HOOSIER-01 20475 20475 Provider ID Required by Payor (Including Suffix)

MED3000 CNE--MED3000-01 52203 52203 MEDADMIN SOLUTIONS CNE--MEDADSO-02 58204 58204 MEDADMIN SOLUTIONS CNE--MEDADSO-01 58202 58202 MEDBEN (NEWARK, OH) CNE--MEDBEOH-01 74323 74323 MEDCOM CNE--MEDCOM--01 59231 59231 MEDCOST BENEFIT SERVICES CNE--MEDBESE-01 56205 56205 Also Known as MBS MEDCOST,INC CNE--MEDCOST-01 56162 56162 MedDirect CNE--MEDDIRE-01 38353 38353 MEDFOCUS CNE--MEDFOCU-01 95321 95321

MEDICA - MINNETONKA, MN CNE--MEDICA--01 94265 94265 Provider Network ID required 877-842-3210

MEDICA HEALTH CARE PLAN INC CNE--MEDHECA-01 78857 78857

MEDICAID ILLINOIS DIL--ILLINOI-01 ILMCD Edi Enrollment Req'd - Provider Number Req'd

MEDICAID INDIANA DAD--INDIANA-01 INMCD Edi Enrollment Req'd - Provider Number Req'd

MEDICAID KENTUCKY D----KENTUCK-01 KYMCD Edi Enrollment Req'd - Provider Number Req'd

MEDICAID MICHIGAN DMI--MICHIGA-01 MIMCD Edi Enrollment Req'd - Provider Number Req'd

MEDICAID MINNESOTA D----MINNESO-01 MNMCD

EDI ENROLLMENT REQ'D - CALL PROMPT FOR ASSISTANCE

MEDICAID WISCONSIN D----WISCONS-01 WIMCD Edi Enrollment Req'd - Provider Number Req'd

MEDICAID WISCONSIN HIRSP D----WIHIRSP-02 HIRSP Edi Enrollment Req'd - Provider Number Req'd

MEDICAL BENEFIT ADMINISTRATORS CNE--MEDBEAD-02 37298 37298 dba MBA of MD, Inc

MEDICAL BENEFITS MUTUAL CNE--MEDBEMU-01 74323 74323

Newark, OH Also, Medical Benefits Administrators & Medical Benefits Companies

MEDICAL CLAIMS SERVICE W VA CNE--MEDCLSE-01 04258 04258 MEDICAL CONTROL INC CNE--MEDCOIN-01 75229 75229 MEDICAL DEVELOPMENT INTERNATIONA CNE--MEDDEIN-01 52181 52181

MEDICAL MUTUAL OF OHIO CNE--MEDMUOH-01 29076 29076

Provider Number Req'd - Out of State Providers use Tax ID in Legacy and NPI in NPI fields

Medical Network of Colorado Springs CNE--MEDNECS-01 84600 84600 MEDICAL PLAN KC (MO) CNE--MEDPLKC-01 61101 61101 MEDICAL RESOURCE NETWORK (MRN) CNE--MEDRENE-01 58203 58203

MEDICAL VALUE PLAN - OHIO CNE--MEDVAPL-01 38224 38224 Aka MVP - Ohio Call Payor for provider number

MEDICARE ILLINOIS MIL--ILLINOI-01 ILMCR Edi Enrollment Req'd - Provider Number Req'd

MEDICARE INDIANA MAD--INDIANA-01 INMCR Edi Enrollment Req'd - Provider Number Req'd

MEDICARE KENTUCKY M----KENTUCK-01 KYMCR Edi Enrollment Req'd - Provider Number Req'd

MEDICARE MICHIGAN MMI--MICHIGA-01 MIMCR Edi Enrollment Req'd - Provider Number Req'd

MEDICARE MINNESOTA M----MINNESO-01 MNMCR Edi Enrollment Req'd - Provider Number Req'd

MEDICARE OHIO M----OHIO----01 OHMCR Edi Enrollment Req'd - Provider Number Req'd

MEDICARE WISCONSIN M----WISCONS-01 WIMCR Edi Enrollment Req'd - Provider Number Req'd

MEDIVERSAL CNE--MEDIVER-01 37304 37304 MedPartners CNE--MEDPART-01 35205 35205 MEDSOLUTIONS INC OF GA CNE--MEDINGA-01 62160 62160

MEGA LIFE & HEALTH CNE--MEGLIHE-01 59221 59221 Only: PO Box 982009, North Richland Hills, TX 76182

MEMIC CNE--MEMIC---01 01047 01047 MEMORIAL CLINICAL ASSOCIATES CNE--MEMCLAS-01 62181 62181 SELECTCARE OF TEXAS (MCA)

MEMORIAL INTEGRATED HEALTHCARE CALL PROMPT FOR ASSISTANCE

MEMPHIS MANAGED CARE/TLC CNE--MEMMACA-01 36193 36193 MERCER ADMINISTRATORS CNE--MERCADM-01 13310 13310 MERCY CARE PLAN CNE--MERCAPL-01 86052 86052 AHCCCS MERCY CARE PLUS CNE--MERCAPL-02 71079 71079 MERCY HEALTH PLANS CNE--MERHEPL-01 43166 43166 MERCYCARE CNE--MERCCAR-01 39114 39114 608-758-7739 payor MERIDIAN HEALTH PLAN CNE--MERIDHP-01 13189 13189

MERITAIN HEALTH / AGENCY SERVICES CNE--MERHEAG-01 64158 64158 Formerly known as Agency Services Inc

MERITAIN HEALTH/NORTH AMERICAN ADMINISTRATORS CNE--MERHENA-01 64157 64157

FKA North American Administrators

MESA MENTAL HEALTH CNE--MESMEHE-01 85035 85035

METCARE HEALTH PLANS CNE--METCAHE-01 65113 65113

METHODIST FIRST CHOICE CNE--METFICH-01 23550 23550 METRO PLUS HEALTH PLAN CNE--METPLHE-01 13265 13265 METROPOLITAN HEALTH PLAN CNE--METHEPL-01 10850 10850 METROPOLITAN LIFE INSURANCE CO CNE--METLIIN-01 87726 87726 MFC & HealthPlus Peoria CNE--MFCPEOR-01 23550 23550 AKA Methodist First Choice MICHAEL REESE PHYSICIANS GROUP CNE--MICREPH-01 37127 37127 Michigan Employee Benefit CNE--MICEMBE-01 15529 15529 MID-AMERICA ASSOCIATES, INC CNE--MIDAMAS-01 37281 37281 MID-ATLANTIC PSYCHIATRIC CNE--MIDATPS-01 52149 52149 MIDLANDS HEALTH PARTNERS CNE--MIDHEPA-01 47080 47080 AKA Midlands Choice, Inc. MIDWEST HEALTH PARTNERS CNE--MIDHEPA-02 76079 76079 MIDWEST SECURITY CNE--MIDWSEC-01 79480 79480

MID-WEST NATIONAL LIFE INS OKC CNE--MIDWEOK-01 59227 59227 Only: PO Box 548801, Oklahoma City, OK 73154

MID-WEST NATIONAL LIFE INS TN CNE--MIDWETN-01 59224 59224 Only: PO Box 982017, North Richland Hills, Tx 76182

MID-WEST NATIONAL LIFE INS - STUDENT INSURANCE CNE--MIDWEST-01 74227 74227

Only: PO Box 890025 or 809067 or 809079 or 809066 or 809036 or 809081, Dallas, TX 75380

MINNEAPOLIS PRUDENTIAL BUSINS CNE--MINPRBU-01 60054 60054 MIPS CNE--MIPS----01 05018 05018 MISSISSIPPI PUBLIC ENTITY EMPL CNE--MISPUEN-01 37233 37233

MISSISSIPPI SELECT HEALTH CARE CNE--MISSEHE-02 64088 64088 Also doing business as Select Administrative Services (SAS)

MISSOULA COUNTY MEDICAL BENEFITS CNE--MISCOME-01 37275 37275 MISSOURI CARE/MC CNE--MISCARE-01 43179 43179 MMS, LLC (MMS CLAIMS) CNE--MMSCLMS-01 62178 62178 MMSI - SEE MAYO MANAGEMENT SERVICES INC MOLINA HEALTHCARE OF CALIFORNIA CNE--MOLHECA-01 38333 38333 MOLINA HEALTHCARE OF FLORIDA CNE--MOLHCFL-01 51062 51062 MOLINA HEALTHCARE OF MICHIGAN CNE--MOLHCMI-01 38334 38334 MOLINA HEALTHCARE OF NEVADA CNE--MOLHCNV-01 20676 20676

MOLINA HEALTHCARE OF NEW MEXICO CNE--MOLHCNM-01 09824 09824 Call payor to register prior to sending claims

MOLINA HEALTHCARE OF OHIO CNE--MOLHCOH-01 20149 20149 MOLINA HEALTHCARE OF TEXAS CNE--MOLHCTX-01 20554 20554 MOLINA HEALTHCARE OF WA CNE--MOLHEWA-01 38336 38336

MOLINA HEALTHCARE OF WASHINGTON ASO CNE--MOLHEWA-02 91128 91128 MONTEFIORE CONTRACT MGMT ORG CNE--MONCOMA-01 13174 13174 Provider Network ID req'd MORRIS ASSOCIATES CNE--MORRISA-01 35092 35092 MOTOROLA, INC. CNE--MOTORIN-01 36111 36111 MOUNTAIN STATES ADMIN SVS INC CNE--MOUSTAD-01 86040 86040 Tucson, AZ MPE EMPLOYEE BENEFIT SERVICES CNE--MPEEMBE-01 37233 37233 MPE SERVICES INC CNE--MPEEBT--01 37233 37233 MPEEBT CNE--MPEEBT--01 37233 37233 MPLAN, INC. CNE--MPLANIN-01 95444 95444

MULTIPLAN INC FOR AMERICAN FAMILY CNE--MULTIPL-02 39634 39634 ONLY STATES AZ, IL, IN, AND OH

MULTIPLAN WISCONSIN PREFERRED PROVIDER NETWORK CNE--MULTIPL-01 34080 34080 AHC, HCN & WPPN Health EOS

MUNICIPAL HEALTH BENEFIT FUND CNE--MUNHEBE-01 81883 81883 MUTUAL ASSURANCE ADMIN CNE--MUTASAD-01 37256 37256

MUTUAL GROUP (THE) (US) CNE--MUTGRTH-01 59140 59140 (also claims for HealthPlan Services Tampa Only)

MUTUAL OF OMAHA INSURANCE CO CNE--MUTOMIN-01 71412 71412 MUTUALLY PREFERRED CNE--MUTPRPP-01 71412 71412 MVP HEALTH PLAN OF NY CNE--MVPHEPL-01 14165 14165 Provider Network ID req'd

MVP OHIO CNE--MEDVAPL-01 38224 38224 Medical Value Plan Ohio Call payor for provider number

NAA (NORTH AMERICA ADMIN, L.P.) CNE--NAANATN-01 65085 65085 Nashville, TN N.W. IRONWORKERS HEALTH & SEC. CNE--NWIROHE-01 91136 91136 Group Number (F15) req'd N.W. ROOFERS & EMPLOYERS HLTH CNE--NWROOEM-01 91136 91136 Group Number (F26) req'd N.W. TEXTILE PROCESSORS CNE--NWTEXPR-01 91136 91136 Group Number (F14) req'd

NABN CNE--NABN----01 34159 34159 Only: PO Box 94928 or PO Box 89476 Cleveland, OH 44101

NALC/AFFORDABLE CNE--NALCAFF-01 53011 53011 NAT'L ASSOC OF LETTER CARRIERS CNE--NATASLE-01 53011 53011 NATIONAL BENEFIT ADMIN - NC CNE--NATBEAD-01 56176 56176 NATIONAL BENEFIT ADMIN - NJ CNE--NATBENJ-01 56175 56175

NATIONAL CAPITAL PPO ORGANIZATION CNE--NATCAPP-01 90001 90001 Provider Network ID req'd NCPPO

NATIONAL HEALTH INSURANCE CO CNE--NATHEIN-01 75275 75275 NATIONAL IMAGING ASSOCIATES CNE--NATIMAS-01 SX190 SX190 NAT'L RURAL ELECTRIC CO-OP CNE--NATRUEL-01 52132 52132 NRECA NAT'L. RURAL LETTER CARRIERS CNE--NATRULE-01 71412 71412 Policy Nubmer GMG1846

NATIONAL TELECOMMUNICATIONS COOPERATIVE ASSOCIATION CNE--NATTECO-01 52104 52104 NTCA STAFF

NATIONAL TELECOMMUNICATIONS COOPERATIVE ASSOCIATION CNE--NATTECO-02 52103 52103 NTCA NATIONWIDE GROUP CNE--NATGROU-01 31417 31417 NATIONWIDE HEALTH PLANS CNE--NATHEPL-01 31417 31417 NATIONWIDE INSURANCE CNE--NATINSU-01 31417 31417 NATIONWIDE LIFE AND HEALTH CNE--NATLIHE-01 31417 31417 NATIONWIDE MUTUAL INS. CO. CNE--NATMUIN-01 31417 31417 NCAS - CHARLOTTE CNE--NCASCHA-01 75191 75191 NCAS- FAIRFAX, VA CNE--NCASFAI-01 75190 75190

NEIGHBORHOOD HEALTH PARTNERSHIP OF FLORIDA CNE--NEIHEFL-01 96107 96107

Claims Submission address of: PO Box 025680, Miami, FL 33102-5680 ONLY

NEIGHBORHOOD HEALTH PLAN MA CNE--NEIHEPL-01 04293 04293 Boston, MA

NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND CNE--NEIHERI-01 05047 05047

NHPRI - Provider and vendor number req'd prior to sending claims. Please call payor.

NEIGHBORHOOD HEALTH PROVIDERS CNE--NEIHEPR-01 11325 11325 Unique NHP/SHP Provider Number req'd

NESIKA HEALTH GROUP CNE--NESHEGR-01 37255 37255 NETCARE LIFE AND HEALTH INS CNE--NETLIHE-01 66055 66055 Hagatna, Guam

NETWORK HEALTH CNE--NETWHEA-01 04332 04332 Call provider relations prior to sending claims 617-806-8104

Network Health Insurance Corp-Medicare CNE--NETHEIN-01 77076 77076

NETWORK HEALTH PLAN OF WISCONSIN, INC CNE--NETHEPL-01 39144 39144

Provider Setup Req'd Call Carol Coulthurst 920-720-1506 -- Unique provider number also req'd

NETWORK TPA LLC CNE--NETWTPA-01 58204 58204 NEW ERA EMPLOYEE WELFARE BENEFIT PLAN TRUST CNE--NEWERAT-01 76031 76031 NEW ERA LIFE INSURANCE CO CNE--NEWERLI-01 75281 75281 NEW MARKET DIMENSIONS CNE--NEWMADI-01 65056 65056

NEW YORK NETWORK MGMT, LLC CNE--NEWYONE-01 11334 11334 Claims are printed and mailed to payor

NEW YORK PRESBYTERIAN COMM HP CNE--NYPRHEP-01 48186 48186

NEW YORK PRESBYTERIAN SYSTEM SELECT HEALTH CNE--NYPRSEH-01 24819 24819 NGS AMERICAN CNE--NGSAMER-01 38225 38225 NIPPON LIFE INSURANCE CO CNE--NIPLIIN-01 81264 81264 NJ CARPENTERS HEALTH FUND CNE--NJCARHF-01 22603 22603 NORTH AMERICAN ADMINISTRATORS CNE--NORAMAD-01 64157 64157 Now known as Meritain Health

NORTH AMERICAN BENEFITS NETWRK CNE--NORAMBE-01 34159 34159

Only: PO Box 94928 or PO Box 89476 Cleveland, OH 44101 NKA Meritain Health

NORTH AMERICAN HEALTH PLAN CNE--NORAMHE-01 64157 64157 Now known as Meritain Health

NORTH AMERICAN MED MGMT- Northern CA CNE--NORAMCA-01 E3510 E3510

Only Providers in Northern California. Call payor prior to sending

NORTH AMERICAN PREFERRED CNE--NORAMPR-01 64157 64157 Now known as Meritain Health NORTH AMERICARE CNE--NORAMER-01 64157 64157 Now known as Meritain Health NORTH BROWARD HOSPITAL DISTRICT CNE--NORBRHO-01 37314 37314 NORTH TEXAS HEALTHCARE NETWORK CNE--NORTXHE-01 35212 35212

NORTHERN CALIFORNIA SHEET METAL WORKERS HEALTH CARE PLAN CNE--NORCASM-01 38238 38238

Only Claims Submission Address: PO Box 1138, San Ramon, CA 94583

NORTHERN ILLINOIS HEALTH PLAN CNE--NORILHE-01 36347 36347

NORTHERN NEVADA TRUST FUND CNE--NORNETR-01 88027 88027

Call (775) 826-7200 to verify if you should be sending claims to this payor

NorthShore University Health System Medical Group CNE--NORUNHE-01 36364 36364 Northstar Advantage CNE--NORSTAD-01 60058 60058 NORTHWEST COMMUNITY HEALTH PARTNERS CNE--NORCOHE-01 36234 36234

NORTHWEST DIAGNOSTIC CLINIC CNE--NORDICL-01 62119 62119 SELECTCARE OF TEXAS (NWDC)

NORTHWEST SUBURBAN IPA IL CNE--NORSUIP-01 36346 36346 Illinois NOVA HEALTHCARE ADMIN CNE--NOVHEAD-01 16644 16644 NOVANET CNE--NOVANET-01 06226 06226 NOVASYS HEALTH NETWORK CNE--NOVHENE-01 71080 71080 NYHART CNE--NYHART--01 37299 37299

OAK WEST PRIMARY PHYSICIAN ASSOC CNE--OAKWEPR-01 36402 36402 OCHSNER HEALTH PLAN CNE--OCSHEPL-01 72127 72127 Provider Network ID req'd ODS HEALTH PLAN CNE--ODSHEPL-01 13350 13350 OFFICE OF GROUP BENEFITS LA CNE--OFFGRBE-01 72087 72087 Located in Louisiana OHANA HEALTH PLAN CNE--OHAHEPL-01 14163 14163 OHIO BUREAU OF WORKERS COMP C----HEATRPR-01 HEAT1 ProviderGroup/PIN req'd

OHIO HEALTH CHOICE PPO CNE--OHIHECH-01 34189 34189

Only: PO Box 93538 Cleveland, OH 44101 or PO Box 3619 Akron, OH 44309

OHIO HEALTH GROUP CNE--OHIHEGR-01 95435 95435

OK State Employees & Educators (EDS) CNE--OKSTEDS-01 22521 22521

OMNICARE, A COVENTRY HEALTH PLN CNE--OMNCOHE-01 25150 25150 For claims with date of service AFTER 10/1/2004

ONE CALL MEDICAL CNE--ONECAME-01 22321 22321

OneNet PPO, LLC CNE--ONENEPP-01 52149 52149 Name effective from 9/1/2006. Previous name Alliance PPO LLC

OPERATING ENGINEERS LOCALS 302 CNE--OPERENG-01 91136 91136 Group Number (F12) req'd on claims

OPTIMUM CHOICE NC/SC CNE--OPTCHCA-01 52152 52152 OPTIMUM CHOICE,INC. CNE--OPTICHO-01 52148 52148 OptumHealth - CMC CNE--OPHECMC-01 41194 41194

ORTHONET CORPORATION CNE--ORTHCOR-01 13381 13381 CIGNA

ORTHONET - UNIFORMED SVS FAM HP CNE--ORTUSFH-01 13382 13382 USFHP (NY & NJ) outpatient therapy claims only

ORTHONET- AETNA CNE--ORTHAET-01 13383 13383 AETNA ORTHONET - HEALTHNET CNE--ORTHOHN-01 25681 25681 OSF HEALTH PLANS CNE--OSFHEPL-01 62171 62171 OSMA HEALTH - C. L. FRATES & CO CNE--OSMAHEA-01 73071 73071

OXFORD HEALTH PLAN CNE--OXFHEPL-01 06111 06111 Provider Network ID req'd Call payor 203-459-6570 to register

P5 HEALTH PLAN SOLUTIONS OF UTAH CNE--PHEPLUT-01 87068 87068 PACIFICARE BEHAVIORAL HEALTH CNE--PACBEHE-01 33053 33053

PACIFICARE OF ARIZONA CNE--PACCAAZ-01 95964 95964

PACIFICARE/SECURE HORIZONS HMO & POS CLAIMS ONLY --- NO PPO CLAIMS

PACIFICARE HEALTH SYS CALIFORNIA CNE--PACHESY-01 95959 95959 Only PacifiCare/Secure Horizon HMO & in-area POS claims

PACIFICARE HLTH SYS CA ENCOUNT CNE--PACHECA-01 95958 95958 Encounters only

PACIFICARE OF COLORADO CNE--PACCACO-01 95962 95962


PACIFICARE HLTH SYS OKLAHOMA CNE--PACHEOK-02 95959 95959 PACIFICARE HLTH SYS OK ENCOUNT CNE--PACHEOK-01 95958 95958 Encounters only PACIFICARE HLTH SYS OR ENCOUNT CNE--PACHEOR-01 95958 95958 Encounters only

PACIFICARE HLTH SYS OREGON CNE--PACHEOR-02 95959 95959 Only PacifiCare/Secure Horizon HMO & in-area POS claims

PACIFICARE HLTH SYS TEXAS CNE--PACHETX-02 95959 95959 PACIFICARE HLTH SYS TX ENCOUNT CNE--PACHETX-01 95958 95958 Encounters only PACIFICARE HLTH SYS WA ENCOUNT CNE--PACHEWA-01 95958 95958 Encounters only

PACIFICARE HLTH SYS WASHINGTON CNE--PACHEWA-02 95959 95959 Only PacifiCare/Secure Horizon HMO & in-area POS claims

PACIFICARE HEALTH SYSTEMS PPO CNE--PACHEPP-01 95999 95999 PPO claims All States

PACIFICSOURCE HEALTH PLANS CNE--PACSOHE-01 93029 93029 Payor does not accept COB claims electronically

PAI CNE--PAICLAI-01 37287 37287 PARITY HEALTHCARE LLC CNE--PARIHEA-01 58204 58204 PARK TERRACE ENCOMPASS MEDICAL GROUP Call Prompt for assistance

PARKLAND HEALTHFIRST CNE--PARHEFI-01 66917 66917 AKA Parkland Community Health Plan

PARTNERS NAT'L HEALTH PLANS OF NORTH CAROLINA

Contracted providers only Call Prompt for assistance

PASSPORT HEALTH PLAN CNE--PASHEPL-01 61129 61129 Medicaid managed care PATIENT ADVOCATES, LLC CNE--PATIADV-01 10525 10525

PEACH STATE HEALTH PLAN CNE--PEASTHE-01 68049 68049

ENROLLMENT REQUIRED PRIOR TO SENDING, CALL PAYOR 800-225-2573 ext 25525

PEDIATRIC ASSOCIATES CNE--PEDIASO-01 20472 20472 PENNSYLVANIAS PREFERRED HEALTH NETWORK Call Prompt for assistance

PEOPLES HEALTH NETWORK CNE--PEOHENE-01 72126 72126 Network ID Required to send claims

PERFORMAX, INC CNE--PERFORM-01 41124 41124

Claims mailing address: PO Box 27267, Minneapolis, MN 55427-0267

PCC SELECT CNE--PCCSELE-01 73145 73145 PersonalCare CNE--PERCARE-01 25146 25146 PHCS SAVILITY PAYERS CNE--PHCSSAV-01 13306 13306

PHOENIX HEALTH PLAN CNE--PHOHEPL-01 03440 03440 SX146 old NAIC - Please use new # 03440

PHP - Physicians Health Plan Mid-Michigan CNE--PHPMIMI-01 37330 37330

PHP - PHYSICIANS HEALTH PLAN OF NORTHERN INDIANA CNE--PHYHPIN-01 12399 12399

Fort Wayne, IN All Claims Require NPI

PHP - PHYSICIANS HEALTH PLAN - SC CNE--PHYHESC-02 09173 09173 PHP of SOUTH MICHIGAN CNE--PHPSOMI-01 87726 87726 PHP of SOUTH MICHIGAN CNE--PHPSOMI-02 37330 37330 PHP of Southwest Michigan CNE--PHPSWMI-01 87726 87726 PHP of West Michigan CNE--PHPWEMI-01 87726 87726 PHP TennCare CNE--PHPTENN-01 62155 62155 PHYSICIAN ASSOCIATES OF LA CNE--PHYASLA-01 58204 58204 Louisiana PHYSICIAN ASSOCIATES OF THE GREATER SAN GABRIEL VALLEY Call Prompt for assistance PHYSICIAN CARE NETWORK LLC CNE--PHYCANE-03 58204 58204

PHYSICIANS ALLIANCE STONES RIVER REGIONAL IPA CNE--STONIPA-01 15749 15749

PHYSICIANS CARE NETWORK (ASR Corp) CNE--PHYCANE-01 38265 38265

new naic - old # 57098 AKA PHYSICANS CARE & PHYSICIANS CARE HEALTH PLANS

PHYSICIANS CARE NETWORK-ROCKFO CNE--PHYCANE-02 36345 36345 Only Physicians Care Network, Rockford, IL

PHYSICIANS HEALTH ASSOC IL CNE--PHYHEAS-01 37136 37136 ILLINOIS PHYSICIANS HEALTH COLLABORATIVE CNE--PHYHECO-01 20398 20398 PHYSICIANS HEALTH PLAN - SEE PHP

PHYSICIANS MUTUAL INS CO CNE--PHYMUIN-01 47027 47027

PPO CLAIMS SHOULD BE SENT TO THE ADDRESS ON THE BACK OF THE INSUREDS ID CARD

PHYSICIANS PLUS INS CORP CNE--PHYPLIN-01 39156 39156 Provider group & pin req'd PIEDMONT BEHAVIORAL HEALTH CNE--PIEDBEH-01 06607 06607 PINNACLE CLAIMS MANAGEMENT,INC CNE--PINCLMA-01 24735 24735 PINNACLE PHYSICIAN MGMT ORG CNE--PINPHMA-01 45985 45985 PINNACOL ASSURANCE CNE--PINNASS-01 84109 84109 PITTMAN & ASSOCIATES CNE--PITASSO-01 37224 37224 PIVOTAL PLAN CNE--PIVOPLA-01 64160 64160

PLANNED ADMINISTRATORS INC CNE--PLANADM-01 37287 37287 No preferred blue claims to this payor

PODI CARE MANAGED CARE CNE--PODCAMA-01 58204 58204 PODIATRY NETWORK FLORIDA CNE--PODNEFL-01 59324 59324 PODIATRY NETWORK SOLUTIONS CNE--PODNESO-01 58204 58204

POLY AMERICA MEDICAL & DENTAL BENEFIT PLANS CNE--POLYAME-01 32680 32680 POMCO CNE----POMCO-01 16111 16111 PPO OKLAHOMA CNE--PPOOKLA-01 73159 73159 PPOM, LLC CNE-----PPOM-01 38335 38335 PPOPLUS (FKA SMA PPO) CNE--PPOPLUS-01 72148 72148 Effective 1/1/2003 payor ID 72148 PPOPLUS LLC CNE--PPOPLUS-02 72148 72148 PRACTICARE CNE--PRACTIC-01 04334 04334 PRAIRIE STATES ENTERPRISES INC CNE--PRASTEN-01 36373 36373 PREFERRED BENEFITS ADMINISTRATORS CNE--PREBEAD-01 61665 61665 PREFERRED CARE FL CNE--PRECAFL-01 59291 59291 FLORIDA PREFERRED CARE NC CNE-- PRECANC-01 56178 56178 North Carolina PREFERRED CARE PARTNERS CNE--PRECAPA-01 65088 65088 Miami, Florida claims only PREFERRED CARE PARTNERS ENCOUNT CNE--PRECAEN-01 65090 65090 Encounters only PREFERRED COMMUNITY CHOICE CNE--PRECOCH-01 73145 73145

PREFERRED HEALTH CARE - PPO LANCASTER, PA (IHS GATEWAY PAYOR Call Prompt for assistance PREFERRED HEALTH PLN KY CNE--PREHEPL-02 61106 61106 Louisville, KY

PREFERRED HEALTH PROFESSIONALS CNE--PREHEPR-01 31478 31478 PREFERRED HEALTH SYSTEMS INS CNE--PREHESY-02 60110 60110 PREFERRED NETWORK ACCESS INC CNE--PRENEAC-01 36401 36401

PREFERRED ONE - CT CNE--PREONCT-01 14162 14162 Provider Network ID req'd 5-8 digits

PREFERRED ONE - MN CNE--PREFONE-01 41147 41147 PREFERRED PLUS OF KANSAS (PPK) CNE--PREPLKS-01 60110 60110 PREMIER BENEFITS, INC. CNE--PREBEIN-01 43166 43166 PREMIER HEALTH PLANS CNE--PREHEPL-01 43166 43166 PREMIER HEALTH SYSTEMS INC CNE--PREHESY-03 90440 90440 PREMIER HEALTH SYSTEMS INC CNE--PREHESY-04 90441 90441 PRESBYTERIAN (NM) CNE--PRESBNM-01 05003 05003 PRESTIGE HEALTH CHOICE CNE--PREHECH-01 45056 45056 PREVEA HEALTH INSURANCE PLAN CNE--PREHEIN-01 39185 39185 PRIMARY DELIVERY SYSTEMS CNE--PRIDESY-01 61101 61101 12/1/02 - send to Humana 61101 PRIMARY HEALTH NETWORK CNE--PRIHENE-02 82048 82048 Primary PhysicianCare, INC. CNE--PRIPHCA-01 56144 56144 PRIME BENEFITS SYSTEMS,INC-MO CNE--PRIBESY-01 61101 61101 PRIME HEALTH KANSAS CITY IN-MO CNE--PRIHEKA-01 61101 61101 PRIME HEALTH MGMT. SERV.-MO CNE--PRIHEMA-01 61101 61101 PRIME HEALTH OF KANSAS,INC.-MO CNE--PRIHEKA-02 61101 61101

PRIMESOURCE HEALTH NETWORK CNE--PRIHENE-01 04320 04320 Call payor prior to sending (410) 349-3222

PRIME VISION HEALTH CNE--PRIMEHE-01 56190 56190 PRIME WEST HEALTH PLAN CNE--PRIWEHE-01 61604 61604 PRINCIPAL FINANCIAL GROUP CNE--PRIFIGR-01 61271 61271 PRINCIPAL HEALTH CARE CNE--PRIHECA-01 61271 61271 PRINCIPAL LIFE INSURANCE CO CNE--PRILIIN-01 61271 61271 PRINCIPAL MUTUAL LIFE INS CNE--PRIMULI-01 61271 61271

PRIORITY HEALTH CNE--PRIOHEA-01 38217 38217 Call payor prior to sending-Pay to code req'd

PRISM NETWORK, INC. CNE--PRINEIN-01 37268 37268 PRISM NETWORK, INC. CNE--PRINEIN-02 37296 37296 PRISM-FIRST HEALTH CNE--PRIFIHE-01 37303 37303 PRISM-UNIVERA CNE--PRISUNI-01 37315 37315

PRO CARE HEALTH PLAN INC CNE--PROCAHE-01 38329 38329

CLAIMS ADDRESS: PO Box 3160, Detroit, MI 48203 & PO Box 3590, Detroit, MI 48203

ProCare Health Plan Medicaid CNE--PROHEPL-01 70259 70259

PROFESSIONAL BENEFIT ADMIN CNE--PROBEAD-02 59296 59296

Only: Professional Benefits Administrators Winter Park, Florida

PROFESSIONAL BENEFIT ADMIN CNE--PROBEAD-01 36331 36331

Only: Professional Benefit Admninistrators, Inc. Oak Brook, IL

PROFESSIONAL CLAIMS MANAGEMENT CNE--PROCLMA-01 37242 37242 Canton, Ohio

PROFESSIONAL INSURANCE COMPANY CNE--PROFINS-01 59041 59041 PIC - FKA GE Voluntary Benefits PIC

PROFESSIONAL RISK MANAGEMENT CNE--PRORIMA-01 34134 34134 PROTECTIVE LIFE INSURANCE COMPANY CNE--PROLIIN-01 37309 37309 PSN - FLORIDA MEDICAID (JMH) CNE--PSNFLME-01 09822 09822 PSYCHCARE, LLC CNE--PSYCHCA-01 51052 51052

PUGET SOUND BENEFITS TRUST CNE--PUGSOBE-01 91136 91136 Group Number (F25) req'd on claims

PUGET SOUND ELECTRICAL WORKERS CNE--PUGSOEL-01 91136 91136 Group Number (F33) req'd on claims

PUGET SOUND HEALTH PARTNERS INC CNE--PUGSOHE-01 42172 42172 PYRAMID LIFE INSURANCE CO CNE--PYRLIIN-01 48055 48055 QUAD MED LLC (PEWAUKEE, WI) CNE--QUADMED-01 39197 39197

QUALCARE, INC. CNE--QUALCIN-01 23342 23342 New providers must enroll - call payor (800) 992-6613, OPTION 5

QUALCHOICE OF ARKANSAS CNE--QUAOFAK-01 35174 35174 QUINCY HEALTH CARE MANAGEMENT CNE--QUIHECA-01 37129 37129 QVI RISK SOLUTIONS INC CNE--QVIRISO-01 57117 57117

RADCON INC CALL PROMPT FOR ASSISTANCE

RAILROAD MEDICARE M----TRARAME-01 TRVRR Edi Agrmt req'd - 9 digit prov # req'd

RBMS, LLC CNE--RBMSLLC-01 91176 91176 REGENCY EMPLOYEE BENEFITS CNE--REGEMBE-01 38221 38221 REGIONAL CARE INC CNE--REGICAR-01 47076 47076 RENAISSANCE PHYSICIANS ORGANIZ CNE--RENPHOR-01 76066 76066 RESERVE NATIONAL INSURANCE CNE--RESNAIN-01 73066 73066 ResourceOne Administrators CNE--RESONAD-01 37278 37278

RESURRECTION HEALTH CARE PREFERRED CNE--RESHECA-03 36396 36396

FKA FAMILY MEDICAL NETWORK CALL PAYOR PRIOR TO YOUR FIRST SUBMISSION

RMSCO, INC CNE--RMSCOIN-01 16117 16117 ROONEY LIFE INC. CNE--ROOLIIN-01 37602 37602 RUSH HEALTH ASSOCIATION CNE--RUSHHEA-01 36339 36339 RUSH PRUDENTIAL HMO CNE--RUSPRHM-01 36389 36389 HMO ONLY RWDSU BENEFIT FUND CNE--RWDSUBE-01 63070 63070 S & S HEALTHCARE STRATEGIES CNE--S&SHEST-01 31441 31441 SAGAMORE HEALTH NETWORK CNE--SAGHENE-01 35164 35164 SAGE TECHNOLOGIES CNE--SAGETEC-01 37105 37105 SAGE TECHNOLOGIES - PBS CNE--SAGETEC-02 37137 37137 SAINT MARYS HEALTH PLAN CNE--STMARHP-01 88029 88029

SAMBA CNE--SAMBA---01 37259 37259

Do not send Medicare primary claims. We receive claims directly from Medicare.

SAN JOAQUIN HEALTH ADMIN CNE--SANJOHE-01 68035 68035 SANFORD HEALTH PLAN CNE--SANHEPL-01 91184 91184 SANTE HEALTH SYSTEM & AFFILIATES CNE--SANHESY-01 77038 77038 SCAN HEALTH PLAN CNE--SCANHEP-01 72261 72261 SCAN HEALTH PLAN ARIZONA CNE--SCAHEAZ-01 73172 73172 SCAN LONG TERM CARE CNE--SCALOTE-01 20460 20460 SCHC TOTAL CARE INC CNE--SCHCTOT-01 16146 16146 Acceptius Gateway payer SEABURY & SMITH CNE--SEASMIT-01 13310 13310 SECURE HEALTH PLANS OF GA CNE--SECHEGA-01 28530 28530 Georgia

SECURE HORIZONS ARIZONA CNE--SECHOAZ-01 95964 95964


SECURE HORIZONS CALIFORNIA CNE--SECHOCA-01 95959 95959


SECURE HORIZONS COLORADO CNE--SECHOCO-01 95962 95962


SECURE HORIZONS OKLAHOMA CNE--SECHOOK-01 95959 95959


SECURE HORIZONS OREGON CNE--SECHOOR-01 95959 95959


SECURE HORIZONS TEXAS CNE--SECHOTX-01 95959 95959


SECURE HORIZONS WASHINGTON CNE--SECHOWA-01 95959 95959 PACIFICARE/SECURE HORIZONS HMO & POS CLAIMS

ONLY --- NO PPO CLAIMS

SECURITY HEALTH PLAN CNE--SECHEPL-01 39045 39045

SELECT ADMINISTRATIVE SERVICES CNE--SELADSE-01 64088 64088 Also know as Mississippi Select Health Care

SELECT BENEFIT ADMINISTRATORS CNE--SELBEAD-01 42137 42137 Des Moines, Iowa

SELECT BENEFIT ADMINISTRATORS OF AMERICA CNE--SELBEAM-01 37282 37282

Only Claims with billing address: PO Box 440, Ashland, WI 54806

SELECT BENEFIT ADMINISTRATORS, INC 93031 93031 SELECT HEALTH SOUTH CAROLINA CNE--SELHESC-01 23285 23285 SELECT SENIOR CLINIC CNE--SELSECL-01 20415 20415 SELECTCARE CNE--SELECTC-02 00014 00014

SELECTCARE OF TEXAS CNE--SELCATX-02 76045 76045 HPN Heritage Physicians Network

SelectCare of Texas CNE--SELCATX-01 61225 61225 Kelsey-Seybold

SELF INSURED BENEFIT ADMIN CNE--SELINFL-01 59111 59111

Only claims addressed to: 18167 US Highway 19 North, Suite 300, Clearwater, FL 33764

SELF INSURED PLANS LLC FL CNE--SELINPL-01 36404 36404

Only claims addressed to: 1016 Collier Center Way, Suite 200, Naples, FL 34110

SELF-FUNDED PLANS(IL,PA,OH) CNE--SELFUPL-01 34131 34131 SENIOR WHOLE HEALTH CNE--SENWHHE-01 83035 83035 SENTINEL MANAGEMENT SERVICES CNE--SENMASE-01 23249 23249

SENTRY INSURANCE A MUTUAL CO CNE--SENINMU-01 39033 39033 Subscribers Group and Insured id req'd

SENTRY LIFE INS CO CNE--SENLIIN-01 39033 39033 Subscribers Group and Insured id req'd

SENTY LIFE OF NEW YORK CNE--SENLINY-01 39033 39033 Subscribers Group and Insured id req'd

SETON CHIP VIA MEDIVIEW CNE--SETONCH-01 76056 76056 SHASTA ADMINISTRATIVE SERVICES CNE--SHAADSE-01 75280 75280 Jeld-Wen Claims Only

SHEET METAL WORKERS LOCAL 104 HEALTH CARE PLAN CNE--SHEMEWO-01 38238 38238

Billing Address Only: PO Box 1618, San Ramon, CA 94583

SIERRA HEALTH SERVICES CNE--SIEHESE-01 76342 76342 SIERRA HEALTH SERVICES CNE--SIEHEEN-01 76343 76343 Encounters only

SIGNATURE HEALTH ALLIANCE TPO CNE--SIGHEAL-01 62159 62159

Only: Signature Health Alliance, PO Box 22419, Nashville, TN 37202

SILVER CROSS MANAGED CARE ORGANIZATION CNE--SILVCRO-01 36387 36387 SISCO C----SISCO---01 SISCO Dubuque, Iowa SINCLAIR HEALTH PLAN CNE--SINHEPL-01 84076 84076 SLOANS LAKE MANAGED CARE CNE--SLOLAMA-01 84096 84096 SMITH ADMINISTRATORS CNE--SMITADM-01 02057 02057 SOLANO REGIONAL MEDICAL GROUP Call Prompt For Assistance

SONOMA COUNTY PRIMARY CARE IPA CNE--SONCOPR-01 E3510 E3510

ONLY CLAIMS FROM NORTHERN CALIFORNIA PROVIDERS

SOUND HEALTH (SISTERS OF PROV) CNE--SOUNHEA-01 91131 91131 Now known as First Choice Health Network

SOUTH CENTRAL PREFERRED - PPO YORK, PA (IHS GATEWAY PAYOR) Call Prompt For Assistance

SOUTH FL COMMUNITY CARE NETWORK CNE--SOFLCCN-01 37314 37314 NBHD SOUTH HAVEN COMMUNITY HOSPITAL Call Prompt For Assistance SOUTH POINT HOTEL & CASINO CNE--SOUPOHO-01 35227 35227 SouthCare/Healthcare Preferred CNE--SOUTHCA-02 25147 25147

SOUTHERN BENEFIT SERVICES CNE--SOUBESE-01 37318 37318

No longer processed for the following Provider Groups: Brockman Enterprises and SPS International

SOUTHERN HEALTH SERVICES CNE--SOUTHEA-01 25128 25128

SOUTHWEST SERVICE LIFE CNE--SOUSELI-01 37266 37266

Claims billing address only: PO Box 982005, Ft. Worth, TX 76182 - Unique Policy number req'd from ID card

SPECIAL AGENTS MUTUAL BENEFIT AS CNE--SEPAGMU-01 37259 37259 SPECIAL RISK INTERNATIONAL CNE--SPERIIN-01 52190 52190

SPECTRUM ADMINISTRATORS TPA CNE--SPECADM-01 23253 23253 Allentown, PA (HIS Gateway Payer)

SPINA BIFIDA - VA HAC CNE--SPINABI-01 84146 84146

ST ANTHONY MEMORIAL HEALTHCARE CNE--STANTME-01 35199 35199

CMCS Customer Service 800-352-7502 MDWISE EDI Enrollment Req'd- Call Payor

ST BARNABAS SYSTEM HLTH PLN CNE--STBARSY-01 22240 22240

ST CATHERINE HOSPITAL PHO CNE--STCATHO-01 35199 35199


ST FRANCIS HEALTH NETWORK CNE--STFRAHE-01 35199 35199


ST JOHNS CLAIMS ADMINISTRATION CNE--STJOCLA-01 37264 37264

ST MARGARET MERCY HEALTHCARE CENTERS CNE--STMARME-01 35199 35199


ST THERESE PHYSICIAN ASSOC CNE--STTPHAS-01 37116 37116

StarHRG - The Mega Life & Hlth Ins Co CNE--STARHRG-01 59225 59225

Only the following P.O. Boxes: PO Box 55270, 30870, 30888, 54150, 30069, 55400, Phoenix, AZ 58270-5270

STARMARK CNE--STARMAR-01 61425 61425

STATE FARM INSURANCE CO CNE--STAFAIN-01 31053 31053

Medical Health Ins Policies Only - Do not send Auto Accident claims-send to the agent

STATES GENERAL LIFE INSURANCE CNE--STAGELI-01 75087 75087

STAYWELL HLTH/WELLCARE CH CNE--STAHEWE-01 14163 14163 Provider Network ID req'd 5-9 digits

STERLING OPTION ONE CNE--STEOPON-01 91151 91151 STONER AND ASSOCIATES CNE--STONEAS-01 31121 31121 CINCINNATI, OHIO

STONES RIVER REGIONAL IPA - WINDSOR CNE--STORIRE-01 15752 15752

STUDENT INS/MEGA LIFE & HEALTH CNE--STUMELI-01 74227 74227

Only: PO Box 890025, 809067, 809079, 809066, 809036, 809081 Dallas, TX 75380

STUDENT INS-LIFE INS/BOSTON/NY CNE--STUINLI-01 74227 74227 STUDENT INS-MIDWEST NATL/TENN CNE--STUINMI-01 74227 74227 STUDENT INS-RELIANCE INS. CO. CNE--STUINRE-01 74227 74227 STUDENT INS-RELIANCE NAT'L INS CNE--STUINRE-02 74227 74227 STUDENT INSURANCE CNE--STUDINS-01 74227 74227 STUDENT INSURANCE-BOSTON MUT. CNE--STUINBO-01 74227 74227

SUBURBAN HEALTH ORGANIZATION CNE--SUBHEOR-01 35199 35199

CMCS Customer Service 800-352-7502 EDI Enrollment Req'd- Call Payor

SUFFOLK HEALTH PLAN OF NEW YORK CNE--SUFHEPL-01 88331 88331 Of New York SUMMACARE HEALTH PLAN CNE--SUMHEPL-01 95202 95202 SUMMACARE HMO CNE--SUMMHMO-01 95202 95202

SUMMIT AMERICA INS SERVICES INC CNE--SUMAMIN-01 37301 37301

Student Accident and Sickness, College Sports and NASCC claims only

SUN HEALTH CORPORATION CNE--SUNHECO-01 SX186 SX186

SUN LIFE AND HEALTH INS CO CNE--SUNLIHE-01 67815 67815 (U.S.) (formerly GLHIC) SUNSHINE STATE HEALTH PLAN CNE--SUNSTHE-01 68057 68057 SUPERIOR BENEFITS AKA Superior Administrators CNE--SUPBENE-01 23218 23218

Only: PO Box 27730, Santa Ana, CA 92799-7730

SUPERIOR HEALTH PLAN TEXAS CNE--SUPHEPL-01 39188 39188

Enrollment req'd, call 800-225-2573 ext 25525 prior to sending claims

SUTTER DELTA MEDICAL GROUP Call Prompt For Assistance SUTTER EAST BAY MEDICAL FOUNDATION Call Prompt For Assistance SUTTER GOULD MEDICAL FOUNDATION Call Prompt For Assistance SUTTER INDEPENDENT PHYSICIANS Call Prompt For Assistance SUTTER MEDICAL FOUNDATION Call Prompt For Assistance SUTTER MEDICAL GROUP OF THE REDWOODS Call Prompt For Assistance SWEDISH COVENANT HOSPITAL CNE--SWECOHO-01 36411 36411 TALL TREES ADMINISTRATORS CNE--TALLTRE-01 88067 88067 TARRANT HEALTH SERVICES CNE--TARHESE-01 37228 37228 TBT - TEAMSTERS BENEFIT TRUST CNE--TEABETR-01 94304 94304 TEACHERS HEALTH TRUST CNE--TEAHETR-01 88019 88019 TEAMCARE CNE--TEAMCAR-01 36215 36215 TEAMSTERS BENEFIT TRUST CNE--TEABETR-01 94304 94304 TBT TEAMSTERS LOCAL UNION #301 CNE--TEALOUN-01 36612 36612 TEXAS CHILDREN'S HEALTH PLAN CNE--TEXCHHE-01 76048 76048 TEXAS CHILDREN'S HEALTH PLN (MCD) CNE--TEXCHHE-02 75228 75228 Medicaid claims only TexasFirst Health Plan (NTX) CNE--TXFIRHE-01 13185 13185 TexasFirst Health Plan (TIOPA) CNE--TXFIRHE-02 76046 76046 TEXAS HealthSpring CNE--TXHEASP-01 33104 33104

THE CHESAPEAKE LIFE INS CO CNE--CHELIIN-02 59223 59223 Only PO Box 982016, North Richland Hills, Tx 76182

THE CHESAPEAKE LIFE INS CO - OKC CNE--CHLIOKC-01 59227 59227 Only: PO Box 548801, Oklahoma City, OK 73154

THE CHESAPEAKE LIFE INS CO - STUDENT INSURANCE CNE--CHLISTU-01 74227 74227

Only: PO Box 890025, 809067, 809079, 809066, 809036, 809081, Dallas, TX 75380-9025

THE CITY OF ODESSA CNE--THECIOD-01 75600 75600 THE DIAMOND PLAN CNE--THEDIPL-01 25131 25131 THE EPOCH GROUP L.C. CNE--THEEPGR-01 28777 28777 THE FORD METER BOX CO, INC. CNE--THEFOME-01 37305 37305 THE HEALTH EXCHANCE CNE--THEHEEX-01 20356 20356 (Cerner Corporation)

THE HEALTH PLAN CNE--THEHEPL-01 34150 34150

Massillon, Ohio & St. Clairsville, Ohio - Services ordered by outside provider require referring provider on HCFA

THE HEALTHCARE GROUP CNE--THEHEGR-01 35206 35206 THE INTEGRITY BENEFIT NETWORK CNE--THEINBE-01 58200 58200 Marietta, GA

THE LOOMIS COMPANY - TPA CNE--THELOCO-01 23223 23223 Call payor prior to sending claims 610-374-4040 EXT. 2438

THE MEGA LIFE & HEALTH INS CO CNE--THEMELI-01 59221 59221 Only PO Box 982009, North Richland Hills, TX 76182

THE MEGA LINFE & HEALTH INS - STARBRIDGE STARHRG SEE STARBRIDGE STARHRG

THE MEGA LIFE & HEALTH INS CO - OKC CNE--THEMELI-02 59227 59227 Only: PO Box 548801, Oklahoma City, OK 73154

THE MEGA LIFE - STUDENT INS See Student Insurance THE MUTUAL GROUP (US) CNE--MUTGRUS-01 59140 59140

THE NATIONAL RADIOLOGY NETWORK CNE--THENARA-01 59087 59087 FORMERLY HEALTH HELP NETWORK

THE PERFECT HEALTH INS CO CNE--THEPEHE-01 13522 13522

THE PHYSICIANS ASSURANCE CORP CNE--THEPHAS-01 31074 31074 EMPLOYEE BENEFIT MANAGEMENT CORP

THE PREFERRED HEALTHCARE SYS CNE--THEPRHE-01 04320 04320 Call payor prior to sending claims (410) 349-3222

THE UNION LABOR LIFE INS CO CNE--UNILALI-01 13142 13142

THOMAS H COOPER CNE--THOHCOO-01 SX160 SX160 THREE RIVERS HLTH PLANS - PA CNE--THRRIHE-01 25175 25175 KNA Unison Health Plan TIME INSURANCE / FORTIS CNE--TIMINSC-01 39065 39065 Now Known As Fortis TML INTERGOVERNMENTAL EMP BEN CNE--TMLINEM-01 74214 74214 TN IPA CNE--TNIPA---01 15750 15750 TODAYS HEALTH WISCONSIN CNE--TODHEWI-01 20081 20081 ABRI HEALTH PLAN INC

TODAYS OPTIONS CNE--TODAOPT-01 48055 48055 American Progressive and Pyramid Life

TODAYS OPTIONS powered BY CCRX CNE--TODAOPT-01 48055 48055 TONGASS TIMBER TRUST CNE--TONTITR-01 92620 92620 TOOLING & MANUFACTURING ASSOC CNE--TOOMAAS-01 61425 61425 TOTAL CAROLINA CARE CNE--TOTCACA-01 68055 68055 TOTAL CLAIMS ADMINISTRATION CNE--TOTCLAD-01 37314 37314 TOTAL COMMUNITY CARE CNE--TOTCOCA-01 31182 31182 TOTAL HEALTHCARE INC CNE--TOTAHEA-01 38201 38201 TOUCHPOINT HEALTH PLAN HMO CNE--TOUHEPL-01 97910 97910 TOUCHSTONE HEALTH PSO CNE--TOUHEPS-01 23856 23856

TOUCHSTONE HEALTH PARTNERSHIP CNE--TOUSTHE-01 13402 13402 On behalf of Health Net Smart Choice

TOWER LIFE INSURANCE CO CNE--TOWLIIN-01 69493 69493 TR PAUL INC CNE--TRPAUIN-01 37230 37230 TPA, INC See Third Party Administrators

TPAC THE PHYSICIANS ASSURANCE CORP CNE--THEPHAS-01 31074 31074

EMPLOYEE BENEFIT MANAGEMENT CORP

TRANSAMERICA LIFE INS CO CNE--TRALIIN-01 59222 59222 Only: PO Box 982009, North Richland Hills, Tx 76182

TRANSCHOICE - KEY BENEFIT ADMIN CNE--TRANSCH-01 37284 37284 TRAVELERS CNE--TRAVLER-01 87726 87726 TRAVELERS / CGT - PPO CNE--TRACGPP-01 87726 87726 TRAVELERS HEALTH NETWORK HMO CNEH-TRAHENE-01 87726 87726 TRAVELERS PLAN ADMINISTRATORS CNE--TRAPLAD-01 87726 87726

TRAVELERS RAILROAD MEDICARE M----TRARAME-01 TRVRR Edi Agrmt req'd - 9 digit prov # req'd

TRELLIS HEALTH PARTNERS CNE--TREHEPA-01 36397 36397 TRIBUTE - SelectCare of Oklahoma CNE--TRIBUTE-01 73117 73117

TRICARE PALMETTO CNE--TRICAPA-01 57106 57106

Tricare Northern Region Includes: CT, DE, IL, IN, KY, MA, MD, ME, MI, NC, NH, NJ, NY,OH, PA, RI, VA, VT, WI, WV AND SOME ZIP CODES IN IA/MO/TN. Provider Group & Pin Req'd - Call payor for details

TRILOGY HEALTH CNE--TRILHEA-01 98514 98514

TRINITY HEALTH PLANS CNE--TRIHEPL-01 38269 38269

Provider enrollement required, call payor prior to sending claims electronically (248) 489-5281

TriSurant CNE--TRISURA-01 34185 34185 FKA Health Administration Services - HAS

TRLHN/AS CNE--TRLHNAS-01 98514 98514 TRLHN/AU CNE--TRLHNAU-01 50884 50884 TRLHN/EB CNE--TRLHNEB-01 62777 62777 TRUE CHOICE USA CNE--TRCHUSA-01 54210 54210

TRUSTEED PLANS SERVICE CORP CNE--TRUPLSE-01 91078 91078 TRUSTMARK CNE--TRUMARK-01 61425 61425 TUFTS HEALTH PLAN CALL PROMPT FOR

ASSISTANCE

UAHC HEALTH PLAN OF TENNESSEE CNE--UAHCPTN-01 SX192 SX192 ENROLLMENT REQ'D - CALL PROMPT

UBH-UNITED BEHAVIORAL HEALTH CNE--UNIBEHE-01 87726 87726 Former MetraHealth - UNET UBH-UNITED BEHAVIORAL HEALTH CNE--UNIBEHM-01 87726 87726

UHC RAILROAD MEDICARE M----TRARAME-01 TRVRR Edi Agrmt req'd - 9 digit prov # req'd

UHP OF NEW JERSEY (CENTENE) CNE--UHPNEJE-01 22329 22329 Enrollment req'd call payor - 800-225-2573 ext 25525

UICI-ADMINISTRATORS NV CNE--UICADNV-01 74223 74223 State of Nevada only

UMR - Legacy 31107 CNE--UNIMERE-01 31107 31107 PO BOX 145804, CINCINNATI, OH 45250

UMR - Legacy FI SERVE/WAUSAU CNE--WAUSAUI-01 39026 39026 PO BOX 30541, SALT LAKE CITY, UT 84130

UMR - Legacy MIDWEST SECURITY ADMIN CNE--MIDWSEC-01 79480 79480 PO BOX 266, ONALASKA, WI 54650

UMR - FiServe - Harrington Benefits CNE--HARBESE-03 75196 75196 WESTERVILLE

UMR - FiServe - Harrington Benefits CNE--HARBESE-01 95266 95266 PO BOX 30781, SALT LAKE CITY, UT 84130

UMR - COMMONWEALTH ADMIN LLC CNE--COMMOAD-01 37237 37237 LEXINGTON UMWA HEALTH & RETIREMENT FUNDS CNE--UMWHERE-01 52180 52180 Provider Network ID req'd UNICARE INDIVIDUAL-SMALL GRP CNE--UNIINSM-01 80314 80314 UNICARE LIFE & HEALTH CNE--UNILIHE-01 80314 80314 UNICARE MAJOR ACCTS. CNE--UNIMAAC-01 80314 80314 UNICARE MAJOR ACCTS. CNE--UNIMAAC-02 80314 80314 UNICARE SPECIAL ACCOUNTS CNE--UNISPAC-01 80314 80314

UNIFIED HEALTH SERVICES CNE--UNIHESE-01 62170 62170 Worker's Compensation Claims Only

UNIFORM MEDICAL PLAN CNE--UNIMEPL-01 75243 75243 Harrington Benefit Services; Centra

UNIFORMED SERVICES FAM HLTH PL CNE--UNISEFA-01 13407 13407

UNION PACIFIC IPA CALL PROMPT FOR ASSISTANCE

UNION PACIFIC RAILROAD EMP HLT CNE--UNIPARA-01 87042 87042 UNION SECURITY INSURANCE CO CNE--UNISEIN-01 70408 70408 UNISON HEALTH PLAN CNE--UNISONH-01 62183 62183 Better Health Plans UNISON HEALTH PLAN CNE--UNIHEPL-02 25175 25175 Three Rivers

UNITED FOOD & COMM WORKERS CNE--UNIFOCO-01 36659 36659

MIDWEST UNIONS & EMPLOYERS HEALTH BENEFITS FUND

UNITED HEALTHCARE CNE--UHCARE--01 87726 87726

UNITED HEALTHCARE OF RIVER VALLEY CNE--UNIHERV-01 95378 95378 Formerly John Deere Healthcare Provider ID Req'd

UNITED HEALTHCARE OVATIONS INSURANCE SOLUTIONS (AARP) CNE--UHCAARP-01 36273 36273 UNITED HEALTHCARE WISCONSIN CNE--UNIHEWI-01 87726 87726 UNITED HEALTHCARE-METRAHEALTH CNE--UNITHEA-01 87726 87726 UNITED HEALTHCARE-TRAVELERS CNE--UNIHETR-01 87726 87726 UNITED MEDICAL ALLIANCE CNE--UNIMEAL-01 84132 84132

UNITED MEDICAL RESOURCES CNE--UNIMERE-01 31107 31107 Legacy UMR - other options see UMR Cincinnati

UNITED OF OMAHA CNE--UNIOMAH-01 71412 71412 UNITED RESOURCES NETWORK CNE--UNIRENE-01 41194 41194

UNITY HEALTH INSURANCE CNE--UNIHEIN-01 66705 66705 ENROLLMENT REQ'D - CALL 608-643-1531

UNIVERSAL CARE OF CALIFORNIA CNE--UNICACA-01 33001 33001 UNIVERSAL HEALTH CARE INC CNE--UNIHECA-01 50528 50528

UNIVERSITY FAMILY CARE CNE--UNIFACA-01 09830 09830 SX148 NO LONGER VALID US NEW # 09830

UNIVERSITY FAMILY CARE CNE--UNIFACA-02 09908 09908 Maricopa Health Plan UNIVERSITY OF MIAMI BEHAVIORAL HEALTH CALL PROMPT FOR

ASSISTANCE

UNIVERSITY OF MISSOURI CNE--UNIVEMO-01 87043 87043 UNIVERSITY OF WASHINGTON STUDE CNE--UNIWAST-01 91136 91136 Group Numer (P67) req'd UPMC HEALTH PLAN-COMMERCIAL CNE--UPMCHEA-01 23281 23281 UPPER PENINSULA HEALTH GRP TPA CNE--UPPETPA-01 37324 37324 UPPER PENINSULA HLTH PLN MI CNE--UPPPEHE-01 38337 38337 Medicaid US BENEFITS CNE--USBENEF-01 93092 93092

USAA (U.S. AUTOMOBILE ASSOC.) CNE--USAA----01 74095 74095 Property and Casualty Division Only

USFHP ST VINCENT MED CTR NY CNE--USFHPNY-01 13407 13407 UTMB CHIP/MEDIVIEW, INC. CNE--UTMCHME-01 76049 76049 UTMB HEALTHCARE SYSTEMS CNE--UTMHESY-01 76049 76049 Choice One

VA FEE BASIS PROGRAMS CNE--VAFEEBA-01 12115 12115 CLAIMS ARE PRINTED AND MAILED TO PAYOR

VALLEY PREFERRED - PPO CNE--VALLPRE-01 23253 23253 Allentown, PA (HIS Gateway Payer)

VANTAGE HEALTH PLAN, INC CNE--VANHEPL-01 72128 72128 VentureNet Healthcare CNE--VENNEHE-01 86062 86062 VERDUGO HILLS MEDICAL GROUP CNE--VERHIME-01 66126 66126 VERITY NATIONAL GROUP CNE--VERNAGR-01 75256 75256

VHAMA-WATERSTONE BENEFITS CALL PROMPT FOR ASSISTANCE

VIDA CARE CNE--VIDACAR-01 24818 24818 VILLAGE FAMILY PRACTICE CNE--VILFAPR-01 73743 73743 VIRGINIA PREMIER HEALTH PLAN CNE--VAPREHE-01 54176 54176 Enrollment req'd - call Prompt VISION CARE INCORPORATED CNE--VISCAIN-01 37297 37297 VISTA HEALTH PLAN CNE--VISHEPL-01 55248 55248 VIVA HEALTH PLAN CNE--VIVAHEA-01 63114 63114 VNS CHOICE MEDICARE CNE--VNSCHME-01 77073 77073 VOLUSIA HEALTH NETWORK CNE--VOLHENE-01 59266 59266

VYTRA HEALTHCARE CNE--VYTRAHE-01 22264 22264 WABASH MEMORIAL HOSP ASSOC CNE--WABMEHO-01 85256 85256 WASHINGTON EMPLOYERS TRUST CNE--WASEMTR-01 37294 37294 WATERSTONE BENEFIT ADMINISTRATORS CNE--WATBEAD-01 73155 73155 WEB TPA CNE--WEBTPA--01 75261 75261 WEISS HEALTH PROVIDERS CNE--WEIHEPR-01 36337 36337

WELLCARE HMO, INC. CNE--WELLHMO-01 14163 14163

Provider Network ID req'd 5-9 digits Includes Wellcare of Georgia, Louisiana, New York & Ohio

WELLCARE OF CT CNE--WELCACT-01 14164 14164 Provider Network ID req'd 5-9 digits

WELLCARE OF FLORIDA CNE--WELCAFL-01 59608 59608 Provider Network ID req'd

WELLCARE PRIVATE FEE FOR SERVICE PLANS CNE--WELLFFS-01 77072 77072 WELLPATH CNE--WELLPAT-01 25129 25129

WELLS FARGO THIRD PARTY ADMINISTRATORS INC CNE--WEFATPA-01 87815 87815

WELLS FARGO THIRD PARTY ADMINISTRATORS INC CNE--WEFATPA-02 37272 37272 FKA JSL Administrators WEST COAST STATIONARY ENGINEER CNE--WESCOST-01 91136 91136 Group Number (F13) req'd WEST COVINA MEDICAL GROUP CNE--WESCOME-01 66124 66124 WESTERN GROWERS/PINNACLE CLMS CNE--WESGRPI-01 24735 24735 WESTERN HEALTH INC CNE--WESTHEA-01 37306 37306 WESTERN MUTUAL INSURANCE CNE--WESMUIN-01 37247 37247 WESTERN SOUTHERN FINANCIAL GRP CNE--WESSOFI-01 31048 31048 CINCINNATI, OHIO WEYCO, INC. CNE--WEYCOIN-01 38232 38232

WILLIAM C EARHART CNE--WILCEAR-01 93050 93050

WINDSOR HOME NETWORK CNE--WINHONE-01 11696 11696 Call Payor prior to sending claims (615) 371-0433

WINDSOR MEDICARE EXTRA CNE--WINMEEX-01 62153 62153 WILLIAM J SUTTON & COMPANY CNE--WILJSUT-01 98010 98010 Toronto, Canada WISCONSIN AUTO & TRUCK DEALERS CNE--WISAUTR-01 39200 39200 WORKSITE BENEFIT SERVICES LLC CNE--WORBESE-01 20333 20333 WORLD INSURANCE COMPANY CNE--WORINCO-01 75276 75276 WPP- ElderCare WISCONSIN CNE--WPPELDW-01 77080 77080 WPPN CNE--MULTIPL-01 34080 34080 Multiplan - Health EOS WPS COMMERCIAL C----WISPHSE-01 WPSCO Edi Agrmt req'd - Prov id = tax id WRITERS' GUILD INDUSTRY HEALTH CNE--WRIGUIN-01 23710 23710 YAVAPAI COUNTY CNE--YAVACOU-01 09829 09829 YOUNG LIFE CNE--YOUNLIF-01 75285 75285

Documents

Prompt Solutions 2009 Payor List · AMERICAN BENEFITS MANAGEMENT CNE--AMEBEMA-01 34187 34187 Billing Submission Address only: P.O. Box 35008 North Canton, ... Pacificare High Plains,