MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
AARP1 AARP Dental Insurance Plan Yes No No No No No
AHP01 Abri Health Plan Yes No No No No No
60054 AETNA Yes No Yes No No No
68246 Aetna DMO Yes No No No No No
58066 AFLAC Yes No No No No No
94177 Allied Administrators Yes No No No No No
50503 Altus Dental Yes No No No No No
34187 American Benefits Management Yes No No No No No
ADP01 American Dental Payor of WI Yes No No No No No
AHG01 American Health Group Yes No No No No No
86047 AmeriChoice - New Jersey Medicaid Yes No No No No No
86048 AmeriChoice - New York Medicaid Yes No No No No No
86001 AmeriChoice - NJ Medicare Yes No No No No No
86002 AmeriChoice - NY Medicare Yes No No No No No
86003 AmeriChoice - PA Medicare Yes No No No No No
86049 AmeriChoice - Pennsylvania Medicaid Yes No No No No No
61301 Ameritas Yes No Yes No No No
84103 Anthem BC/BS Virginia Yes No No No No No
80705 Anthem Health & Life Ins Co of NJ Yes No No No No No
39065 Assurant Health Yes No No No No No
ADN01 Atlantic Dental (FL) Yes No No No No No
CX052 Atlantic Dental Inc Yes No No No No No
A2051 BAC Local 15 Welfare Fund (Kansas) Yes No No No No No
60054 Bell Atlantic Yes No No No No No
23210 BeneCare Dental Plan Yes No No No No No
25145 Benefit Coordinators Corporation Yes No No No No No
39081 Benefit Plan Administrators, Inc Yes No No No No No
BMX01 Benemax Yes No No No No No
37248 Benesys, Inc (LA) Yes No No No No No
BNMK1 BenMark (Mississippi) Yes No No No No No
CX025 Big Lots Associate Benefit Plan Yes No No No No No
00700 Blue Care Family Plan Yes No No No No No
65358 Blue Cross Blue Shield Conn- Anthem Yes No No No No No
23739 Blue Cross Blue Shield Louisiana Yes No No No No No
MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
47198 Blue Cross of California/Wellpoint Yes No No No No No
65358 Blue Cross of Connecticut (Anthem) Yes No No No No No
CB621 Blue Cross of Illinois (IL) Yes No No No No No
84100 Blue Cross of New Mexico Yes No No No No No
BWI01 Blue Cross of Wisconsin Yes No No No No No
CBAL1 Blue Cross/Blue Shield of Alabama Yes No No No No No
CBAR1 Blue Cross/Blue Shield of Arkansas Yes No No No No No
84099 Blue Cross/Blue Shield of Colorado Yes No No No No No
00700 Blue Cross/Blue Shield of Conn. Yes No No No No No
SB601 Blue Cross/Blue Shield of Georgia Yes No No No No No
00621 Blue Cross/Blue Shield of Illinois Yes No No No No No
84105 Blue Cross/Blue Shield of Indiana Yes No No No No No
84105 Blue Cross/Blue Shield of Kentucky Yes No No No No No
BME01 Blue Cross/Blue Shield of Maine Yes No No No No No
BCBSM Blue Cross/Blue Shield of Michigan Yes No No No No No
84101 Blue Cross/Blue Shield of Nevada Yes No No No No No
BNH01 Blue Cross/Blue Shield of New Hamp Yes No No No No No
22099 Blue Cross/Blue Shield of New Jers Yes No No No No No
84105 Blue Cross/Blue Shield of Ohio Yes No No No No No
CB900 Blue Cross/Blue Shield of Texas Yes No No No No No
BSCA1 Blue Shield of California Yes No No No No No
99996 Blue Shield of Pennsylvania Yes No No No No No
04210 Boston Univ Dental Health Plan Yes No No No No No
61301 Businessmens Assurance Yes No No No No No
CLF01 C.L. Frates & Company Yes No No No No No
80705 Canada Life Assurance Company Yes No No No No No
37105 Cannon Cochran Management Services Yes No No No No No
A2005 Cement Masons Local 518 (Kansas) Yes No No No No No
60054 Choice Plus Yes No No No No No
61271 Christian Brothers Services Yes No No No No No
62308 CIGNA Yes No Yes No No No
CSL01 Citizens Security Life Yes No No No No No
CMS01 Claims Management Services (WI) Yes No No No No No
CCS01 Clayton County Self Funded Dental Yes No No No No No
MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
CX021 CompDent / CompBenefits Yes No No No No No
34177 Compensation Programs of Ohio, Inc. Yes No No No No No
03036 Comprehensive Benefits Admin., Inc Yes No No No No No
61305 Consolidated Group Dental Yes No No No No No
62308 Continental Dental Yes No Yes No No No
58102 Covenant Administrators, Inc. Yes No No No No No
39170 Custom Benefit Administators (WI) Yes No No No No No
60054 CustomCare (Southwestern Bell/Exec) Yes No No No No No
DEW01 D. Edward Wright TPA Yes No No No No No
94276 DDIC Yes No Yes No No No
DDAL1 Delta Dental Ins. Co. - Alabama Yes No Yes No No No
DDFL1 Delta Dental Ins. Co. - Florida Yes No Yes No No No
DDGA1 Delta Dental Ins. Co. - Georgia Yes No Yes No No No
DDLA1 Delta Dental Ins. Co. - Louisiana Yes No Yes No No No
DDMS1 Delta Dental Ins. Co. - Mississippi Yes No Yes No No No
DDTX1 Delta Dental Ins. Co. - Texas Yes No Yes No No No
DDUT1 Delta Dental Ins. Co. - Utah Yes No Yes No No No
02027 Delta Dental Northeast (ME NH VT) Yes No No No No No
DDAK1 Delta Dental Of Alaska Yes No No No No No
86027 Delta Dental of Arizona Yes No Yes No No No
71056 Delta Dental of Arkansas Yes Yes Yes No Yes No
77777 Delta Dental of California Yes No Yes No No No
DDPCO Delta Dental of Colorado Yes No Yes No No No
22189 Delta Dental of Connecticut Yes No Yes No No No
51022 Delta Dental of Delaware Yes No Yes No No No
82029 Delta Dental of Idaho Yes No No No No No
05030 Delta Dental of Illinois Yes No Yes No No No
DDPI Delta Dental of Indiana Yes No Yes No No No
CDIA1 Delta Dental of Iowa Yes No Yes No No No
CDKY1 Delta Dental of Kentucky Yes No No No No No
23166 Delta Dental of Maryland Yes No Yes No No No
04614 Delta Dental of Massachusetts Yes No No No No No
DDPM Delta Dental of Michigan Yes No Yes No No No
43090 Delta Dental of Missouri Yes No No No No No
MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
DDMT1 Delta Dental of Montana Yes No No No No No
DDNV1 Delta Dental of Nevada Yes No No No No No
22189 Delta Dental of New Jersey Yes No Yes No No No
DDPNM Delta Dental of New Mexico Yes No Yes No No No
11198 Delta Dental of New York Yes No Yes No No No
DDPO Delta Dental of Ohio Yes No Yes No No No
DDPOK Delta Dental of Oklahoma Yes No Yes No No No
23166 Delta Dental of Pennsylvania Yes No Yes No No No
05029 Delta Dental of Rhode Island Yes No No No No No
43091 Delta Dental of South Carolina - MO Yes No No No No No
54097 Delta Dental of South Dakota Yes No No No No No
DDPTN Delta Dental of Tennessee Yes No Yes No No No
54084 Delta Dental of Virginia Yes Yes Yes No Yes No
52147 Delta Dental of Washington DC Yes No Yes No No No
91062 Delta Dental of Washington State Yes No No No No No
31096 Delta Dental of West Virginia Yes No Yes No No No
39069 Delta Dental of Wisconsin Yes Yes Yes No No No
52133 Dental Benefit Providers Yes No No No No No
DCP01 Dental Care Plus (OH) Yes No No No No No
64246 Dental Guard Prefered Yes No No No No No
DNOA1 Dental Network of America Yes No No No No No
CX034 Dental Network of America (IL) Yes No No No No No
DSL01 Dental Select Yes No No No No No
04356 DentaQuest Yes No No No No No
11271 Detectives Endowment Association Yes No No No No No
HSP01 District Council 37 - AFL-CIO Yes No No No No No
25160 Diversified Group (Maryland) Yes No No No No No
DOM01 Dominion Dental Yes No No No No No
CX014 Doral Dental of Wisconsin Yes No No No No No
03036 EBPA (NH) / CBA (VT) Yes No No No No No
38241 Employee Benefit Concepts Yes No No No No No
37257 Employee Benefit Consultants Yes No No No No No
CX025 Employee Benefit Management Corp Yes No No No No No
73288 Employers Health Yes No No No No No
MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
62308 Equicor / Equitable Yes No Yes No No No
73126 Equitable Plan services Yes No No No No No
43168 Essex Dental Benefits Yes No No No No No
34159 E-V Benefits Management, Inc. Yes No No No No No
72630 First Ameritas Life Ins Corp of NY Yes No No No No No
71005 First Reliance Standard Yes No No No No No
11244 Fitzharris & Company Yes No No No No No
60054 FlexCare Yes No No No No No
60054 Florida Power & Light Yes No No No No No
70408 Fortis Benefits Insurance Company Yes No No No No No
39065 Fortis Insurance (Individual Plans) Yes No No No No No
GCU01 GCU Local 8-M/96B Health & Welfare Yes No No No No No
44054 GEHA Yes No No No No No
63665 General American Life Insurance Co. Yes No No No No No
CX014 Georgia Medicaid, Grady Healthcare Yes No No No No No
13551 GHI - New York - (Group Health Inc) Yes No No No No No
80314 GIC Yes No No No No No
GWD01 Golden West Dental Yes No No No No No
72153 Group Benefit Administrators (TN) Yes No No No No No
CX015 Group Link of Indiana Yes No No No No No
64246 Guardian Yes No No No No No
25160 Health Aspex (Maryland) Yes No No No No No
82018 Health Claim Service Yes No No No No No
DX029 Health Comp Yes No No No No No
CX039 Health Economics Group Inc. Yes No No No No No
CX029 Health Partners (MN) Yes No No No No No
CX019 Health Resources Yes No No No No No
11271 HealthPlex Yes No No No No No
68195 Healthsource Provident Yes No No No No No
HGL01 Heavy & General Laborers Yes No No No No No
95378 Heritage National Healthplan Yes No No No No No
CX013 Hershey Healthsmile Yes No No No No No
54771 Highmark Yes Yes Yes Yes Yes Yes
CX015 Hoosier Dental Yes No No No No No
MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
73288 Humana Yes No No No No No
22175 I.E. Shaffer Yes No No No No No
IAT01 IATSE Atlanta Health & Welfare Fund Yes No No No No No
EWF01 IBEW 369 Yes No No No No No
A1117 IBEW Local 117 Health/Welfare Fund Yes No No No No No
A1317 IBEW Local 38 Health/Welfare Fund Yes No No No No No
A1461 IBEW Local 461 Welfare Fund Yes No No No No No
A1464 IBEW Local 464 Yes No No No No No
A4681 IBEW Local 481 Yes No No No No No
36600 Illinois Central Hospital Assoc Yes No No No No No
ICW01 Indiana Carpenters Welfare Fund Yes No No No No No
52196 InforMed, LLC Yes No No No No No
88006 Insurance Management Services Yes No No No No No
51020 Integra Administrative Group Yes No No No No No
61271 J. F. Molloy and Associates Yes No No No No No
JPF01 Jefferson Pilot Yes No No No No No
JEN01 Jenkins & Associates Yes No No No No No
41099 John Alden Life Insurance Yes No No No No No
65099 John Hancock Health Security Plan Yes No No No No No
34136 JP Farley Corporation Yes No No No No No
KBT01 Kansas Building Trades Yes No No No No No
A2032 Kansas City Laborers Welfare Fund Yes No No No No No
A1004 Laborers Metro Detroit Healthcare Yes No No No No No
LSH01 Laborers Southeast Health & Welfare Yes No No No No No
73288 Lincoln National of Wisconsin Yes No No No No No
NYT01 Local 1149 Baldwinsville, NY Yes No No No No No
GCU01 Local 8-M & 96B Health & Welfare Yes No No No No No
MAMS1 MAMSI Yes No No No No No
CX014 Managed Health Svcs - WI Employees Yes No No No No No
98010 Manulife, W.J. Sutton Co. Yes No No No No No
60054 Marriott Yes No No No No No
CX014 Maryland Physicians Care MCO Yes No No No No No
56205 MedCost Benefit Services (MBS) Yes No No No No No
56205 Medcost of North Carolina Yes No No No No No
MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
CKAL1 Medicaid - Alabama Yes No No No No No
CX014 Medicaid - Arizona Maricopa Health Yes No No No No No
CKCO1 Medicaid - Colorado Yes No No No No No
CX014 Medicaid - Connecticut - HealthNet Yes No No No No No
CX014 Medicaid - District of Columbia Yes No No No No No
CX014 Medicaid - Idaho - BCI of Idaho Yes No No No No No
CX014 Medicaid - Illinois - Amerigroup Yes No No No No No
CX014 Medicaid - Illinois MAP Yes No No No No No
CKIN1 Medicaid - Indiana Yes No No No No No
CKIA1 Medicaid - Iowa Yes No No No No No
CX014 Medicaid - Kansas MAP Yes No No No No No
CX014 Medicaid - Kentucky - Passport FFS Yes No No No No No
CX014 Medicaid - Kentucky - Passport Hlth Yes No No No No No
CX014 Medicaid - Maryland - Amerigroup Yes No No No No No
CX014 Medicaid - Maryland - Coventry Yes No No No No No
CX014 Medicaid - Maryland - HELIX Yes No No No No No
CX014 Medicaid - Maryland - Priority Part Yes No No No No No
CKMA1 Medicaid - Massachusetts Yes No No No No No
CKMI1 Medicaid - Michigan Yes No No No No No
CX014 Medicaid - Minnesota - UCare Yes No No No No No
CKMS1 Medicaid - Mississippi Yes No No No No No
CKMO1 Medicaid - Missouri Yes No No No No No
CX014 Medicaid - Missouri - BC BS KC Yes No No No No No
CX014 Medicaid - Missouri FirstGuard Yes No No No No No
CKNM1 Medicaid - New Mexico Yes No No No No No
CX014 Medicaid - New Mexico - Molina Yes No No No No No
CKND1 Medicaid - North Dakota Yes No No No No No
CKOH1 Medicaid - Ohio Yes No No No No No
CX014 Medicaid - Ohio - Amerigroup Yes No No No No No
CX014 Medicaid - Ohio - Anthem BC BS Yes No No No No No
CX014 Medicaid - Ohio - Buckeye Health Yes No No No No No
CX014 Medicaid - Ohio - Molina Yes No No No No No
CX014 Medicaid - Ohio - Unison Health Pln Yes No No No No No
CKSC1 Medicaid - South Carolina Yes No No No No No
MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
CKTX1 Medicaid - Texas Yes No No No No No
CKVT1 Medicaid - Vermont Yes No No No No No
CKWA1 Medicaid - Washington State Yes No No No No No
CX014 Medicaid of GA, Grady Healthcare Yes No No No No No
CKKY3 Medicaid of KY (Doral Dental) Yes No No No No No
CX014 Medicaid of MD PhysiciansCare MCO Yes No No No No No
CX014 Medicaid of MO Blue Advantage Yes No No No No No
CX014 Medicaid of MO Community Care Plus Yes No No No No No
CX014 Medicaid of MO Community Hlth Plan Yes No No No No No
CX014 Medicaid of MO FirstGuard Hlth Plan Yes No No No No No
CX014 Medicaid of MO HealthCare USA Yes No No No No No
CX014 Medicaid of MO HealthNet Yes No No No No No
CX014 Medicaid of MO TrumanCare Yes No No No No No
CX014 Medicaid of NE United HealthCare Yes No No No No No
86047 Medicaid of New Jersey Yes No No No No No
86048 Medicaid of New York Yes No No No No No
CX014 Medicaid of NM Cimmaron Health Plan Yes No No No No No
CX014 Medicaid of NM Lovelace CHP Yes No No No No No
CX014 Medicaid of NM Presbyterian Salud Yes No No No No No
CX014 Medicaid of OH Emerald HMO Yes No No No No No
CX014 Medicaid of OH Health Power HMO Yes No No No No No
CX014 Medicaid of OH Personal Physicians Yes No No No No No
CX014 Medicaid of OH United HealthCare Yes No No No No No
CX014 Medicaid of OK Community Care Yes No No No No No
CX014 Medicaid of OK Heartland Hlth Plan Yes No No No No No
CX014 Medicaid of OK Unicare Health Plan Yes No No No No No
CX014 Medicaid of PA Best Health Care Yes No No No No No
CX014 Medicaid of PA Gateway Health Plan Yes No No No No No
CX014 Medicaid of PA Health Partners Yes No No No No No
CX014 Medicaid of PA Oaktree Yes No No No No No
86049 Medicaid of Pennsylvania Yes No No No No No
CX014 Medicaid of Tennessee, BlueCare Yes No No No No No
CX014 Medicaid of Virginia Yes No No No No No
CX014 Medicaid of Wisconsin, Humana / TDC Yes No No No No No
MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
CX014 Medicaid of Wisconsin, PrimeCare Yes No No No No No
CX014 Medicaid of Wisconsin-Doral Dental Yes No No No No No
MNM01 Mennonite Mutual Aid Yes No No No No No
65978 MetLife Yes Yes Yes No No No
38238 MI Regional Council of Carpenters Yes No No No No No
A1404 MI State Painters Insurance Fund Yes No No No No No
A1432 Michigan Laborers Health Care Fund Yes No No No No No
A1402 Millwrights Local 1102 Hlth/Welfare Yes No No No No No
34159 NABN (Cleveland, OH) Yes No No No No No
DX072 National Pacific Dental (CA) Yes No No No No No
DX017 National Pacific Dental (TX) Yes No No No No No
95123 Neighborhood Health Yes No No No No No
DX101 Nevada Pacific Dental Yes No No No No No
43351 New England Dental Administrators Yes No No No No No
66893 New England Financial Yes No No No No No
81264 Nippon Life Insurance Co. Yes No No No No No
65085 North America Administrators, L.P. Yes No No No No No
16644 Nova Healthcare Administrators Inc. Yes No No No No No
NYT01 NY State Teamsters Yes No No No No No
OAC01 Ohio AFSCME Care Plan Yes No No No No No
ATPA1 Operating Engineers Locals 302/612 Yes No No No No No
CLF01 OSMA Health (Formerly PLICO OK) Yes No No No No No
DX066 Pacific Union Dental (CA) Yes No No No No No
93029 PacificSource Health Plans Yes No No No No No
47009 Paul Revere/Provident Yes No No No No No
PRW01 Pavers / Road Builders Welfare Fund Yes No No No No No
CX068 Physicians Mutual (Dental) Yes No No No No No
CX014 Physicians Plus Ins, WI Employees Yes No No No No No
PIP01 Pipe Trades Industry Health/Welfare Yes No No No No No
PIP02 Pipefitters 597 Yes No No No No No
PCM01 Plasterers/Cement Masons Local 148 Yes No No No No No
00621 PreDent Yes No No No No No
60054 Preferred Dental Organization (PDO) Yes No No No No No
CX009 Premier Dental (MN) Yes No No No No No
MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
56144 Primary Physician Care, Inc. Yes No No No No No
CX014 PrimeCare WI State/Federal Emplyees Yes No No No No No
61271 Principal Financial Group Yes No No No No No
36331 Professional Benefit Administrators Yes No No No No No
70408 Protective Life / Dental Care Yes No No No No No
68195 Provident Life & Casualty Ins. Co. Yes No No No No No
68195 Provident Life and Accident Ins Co Yes No No No No No
68195 Provident Preferred Network Yes No No No No No
60054 Prudential Yes No No No No No
QM001 Quad Med Yes No No No No No
68381 Reliance Standard Life Yes No No No No No
80314 ReliaStar Yes No No No No No
41625 Rochester Public School (MN) Yes No No No No No
CX030 SafeGuard Yes No No No No No
CX030 SafeGuard Health Enterprises, Inc Yes No No No No No
SCD01 Secure Care Dental Yes No No No No No
64088 Select Administrative Services Yes No No No No No
60054 SelectCare (Coca Cola) Yes No No No No No
34131 Self Funded Plans Inc. of Cleveland Yes No No No No No
59111 Self Insured Ben Administrators Yes No No No No No
SMW01 Sheet Metal Workers Local 91 Yes No No No No No
SLI01 Shenandoah Life Insurance Company Yes No No No No No
ASO SIDS Yes No No No No No
SEI01 Southeastern SEIU Health & Welfare Yes No No No No No
SPD01 Southwest Preferred Dental Org Yes No No No No No
60054 Southwestern Bell Yes No No No No No
60054 Southwestern Bell Exec-Custom Care Yes No No No No No
60054 Southwestern Bell Exec-SW Bell Yes No No No No No
DX033 SRC - Strategic Resource Company Yes No No No No No
93024 Standard Insurance Yes No No No No No
89009 Standard Insurance Co. of New York Yes No No No No No
STR01 Starmount Insurance Yes No No No No No
31121 Stoner and Associates Yes No No No No No
58128 Stowe Associates Yes No No No No No
MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
47009 Sun Life of Canada Yes No No No No No
31117 Superior Dental Care Yes No No No No No
73288 TDC (The Dental Companies) Yes No No No No No
TDN01 The Dental Network Yes No No No No No
TIC01 TIC International, Inc. Yes No No No No No
39065 Time Insurance Yes No No No No No
65978 Travelers Yes Yes No No No No
73288 Tricare Active Reservists Yes No No No No No
DDPFS Tricare Retirees Yes No Yes No No No
91078 Trusteed Plans Service Corporation Yes No No No No No
60054 TRW Yes No No No No No
73288 TSRDP Dental Claims Yes No No No No No
A5205 UFCW Local 400 Health and Welfare Yes No No No No No
UFC01 UFCW of Central Ohio Yes No No No No No
UFC02 UFCW of Cleveland Yes No No No No No
62308 UFT Wellfare Fund Yes No Yes No No No
80314 UNICARE Major Accounts Yes No No No No No
65099 UNICARE Special Accounts Yes No No No No No
13142 Union Labour Life Insurance Company Yes No No No No No
89070 United Concordia Yes Yes Yes Yes Yes Yes
52133 United Healthcare Yes No No No No No
13545 United States Life Yes No No No No No
VHP01 Valley Health Plan Yes No No No No No
60054 Varian Health Care Plan Yes No No No No No
91062 Washington Dental Service Yes No No No No No
73155 Waterstone Benefit Administrators Yes No No No No No
39026 Wausau Benefits Yes No No No No No
47198 Wellpoint Dental Services Yes No No No No No
CX014 WI Employees - Managed Health Svcs Yes No No No No No
CX014 WI Employees - Physicians Plus Yes No No No No No
62154 Xantus Health Plan (TN) Yes No No No No No
MDE PARTICIPATED PAYER LIST
837D 270 276
Payer ID Payer Name
Batch Real Real Batch Real Batch
Yes - Payer is ready to receive the stream; No -
Payer is not ready to receive the stream.
270_R 270 Realtime Transaction
270_B 270 Batch Transaction
276_R 276 Realtime Transaction
276_B 276 Batch Transaction
837D_R 837D Realtime Transaction
837D_B 837D Batch Transaction