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Employee Benefit - Excel

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Employee Benefit document sample

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									                         PAYER LIST
              Attached is the CPS Payer List for:

            * Participating and Commercial Dental Payers (9 pages)

                   * Blue Cross Blue Shield Payers (2 pages)

                             * Medicaid Payers(2 pages)


If an insurance company is not on this list, please use the Payer ID of 06126.


Enroll Column: If “Yes”, contact your eBusiness Support Technician at 800-475-5036
and request the electronic enrollment paperwork.
If “No”, then enrollment paperwork is not required.


Additional Information Column: Includes important information specific to the payer.




***For an updated payer list, please visit our customer help website Dr.
Smilegood. Within EagleSoft, simply click on Online, World Wide Web
Links, Doctor Smilegood. The updated list will be found under Hot Topics
to the left or can be found by doing a search for Payer List.
                                                                    **CPS Payer List**
                                            PARTICIPATING and COMMERICAL Dental
                                                        October 2005
                                        Payer                                      ID     Enroll              Additional Information
A & I Benefit Plan Administrators (Portland, OR)                                  CX044     No
Acclaim                                                                           64071     No
Acordia National (Charleston, WV)                                                 87815     No
ACS Benefits Service, Inc (P.O. Box 2000, Winston-Salem, NC)                      72468     No     aka ACS Consulting Serivces, Inc.
Activa Benefit Services, LLC (Grand Rapids, MI)                                   38255     No     aka Amway Corporation
Advantage Dental Plan, Inc                                                        93524     No
Aetna                                                                             60054     No
Aetna US Healthcare Encounters                                                    68246     No
Aflac (1932 Wynnton Rd, Columbus, GA)                                             58066     No
AH & L                                                                            80705     No
Alaska Children's Services, Inc.                                                  91136     No
Alaska Electric Health & Welfare Fund (Anchorage, AK)                             92600     No
Alaska Laborers Construction Industry Trust                                       91136     No
Alaska Pipe Trades Local 375                                                      91136     No
Alaska United Food & Comm. Workers Health & Welfare Trust                         91136     No
Allied Administrators (San Francisco, CA)                                         94177     No
ALTA Health & Life Insurance Co                                                   80705     No
Altus (P.O. Box 1557, Providence, RI)                                             50503     No
America General                                                                   13545     No     aka United States Life Insurance Company
American Administrative Group, Inc (AAG) (Dallas, TX)                             75240     No
American Benefits Management (North Canton, OH)                                   34187     No
American Medical Security                                                         CX001     No
American Postal Workers Union Health Plan / APWU                                  44444     No
Ameritas Life Insurance Corp.                                                     47009     No
Amway Corporation                                                                 38255     No     aka Activa Benefit Services, LLC
Anthem Health & Life (New Jersey)                                                 80705     No
APA Partners, Inc. (P.O. Box 1506, Latham, NY)                                    16140     No
Arkansas Best Corp - Choice Benefits                                              75278     No
Assurant Employee Benefits (every state EXCEPT AL & WI)                           70408     No     aka Fortis Benefits
Athens Area Health Plan Select (Athens, GA)                                       95691     No
Atlantic Dental Inc. /ADI                                                                          ***Must reside or practice within the state of FL***
                                                                                  CX052    Yes
(2100 & 2801 Ponce DeLeon Blvd., Coral Gables, FL)                                                 aka Florida Dental Management Group (FDMG)
Automotive Machinists Local 289 Health & Welfare Trust                            91136     No
Bankers United Life                                                               74227     No
BCI Administrators Inc (West Bloomfield, MI)                                      49153     No
Bell Atlantic                                                                     68241     No
Benecare Dental Plan (Chestnut St, Philadelphia, PA)                              23210     No
Benefit Administrators of IL                                                      36149     No
Benefit Coordinators Corporation (111 Ryan Court, Ste. 300, Pittsburgh, PA)       25145     No
Benefit Plan Administrators Co.                                                   39081     No
Benefit Planners (TX)                                                             74223     No
Benefit Systems & Services, Inc. / BSSI (IL)                                      36342     No
Benesys, Inc (PO Box 81189 Lafayette, LA)                                         37248     No
Best Life & Health Insurance Company                                              95604     No
Better Health Plans of South Carolina                                             32006     No
Big Lots Associate Benefit Plan (EBMC) (Dublin,OH)                                CX025     No
Boilermakers National Health & Welfare Fund                                       36609     No     aka International Brotherhood of Boilermakers
Boon-Chapman Benefit Administrators (Austin, TX)                                  74237     No
Boston University Dental Healthplan (80 East Concord St. Boston, MA)              04210     No
Bridgeport LLC (St. Charles, MO)                                                  CX028     No
Brokers National (Austin or Houston, TX)                                          CX032     No
Brown & Brown/United Benefits/Fringe (Daytona Beach, FL)                          59069     No
Businessmen's Assurance / BMA (NE)                                                47009     No
Canada Life Assurance Company (Altanta, GA)                                       CX061     No


                                                                              Page 2
                                                                     **CPS Payer List**
                                         PARTICIPATING and COMMERICAL Dental
                                                     October 2005
                                    Payer                                           ID     Enroll             Additional Information
Cannon Cochran Management Services, Inc.                                           37105     No
Capital Dental of Houston, TX                                                      CX037     No
Carpenters Health and Welfare Trust Fund of St. Louis (St. Louis, MO)              25125     No
Caterpillar Inc.                                                                   37060     No
CBCA Administrators (Fort Worth, TX)                                               55438     No
Cement Masons & Plasterers Health & Welfare Trust                                  91136     No
CHAMPVA-HAC (PO Box 65024, Denver, CO)                                             84147     No
Choice Plus                                                                        68241     No     aka TRW
Christian Brothers Services                                                        61271     No
CIGNA ( except Plantation, FL)                                                     62308     No
CIGNA Dental Health (CDH) ( P.O Box 1809 or P.O. Box 189062 Plantation, FL or                       Addt'l Enrollment Paperwork for contracted HMO providers
                                                                                   10050    Yes
P. O. Box 2125 Glendale, CA)                                                                        only.

CIGNA Flex Care (New Mexico only)                                                  62310     No
Civil Service Employees Association (CSEA) (Latham, NY)                            CX054     No
CNA Health Partners of Arkansas                                                    71063     No
Coast Hotels & Casinos, Inc./DBA Coast Benefits (Las Vegas, NV)                    37310     No
Commonwealth Administrators, LLC (Lexington, KY)                                   37237     No
Community Health Electronic Claims / CHEC                                          75261     No
COMP - Ohio (33 Fitch Blvd., Austintown, OH)                                       34177     No
CompDent (Chicago, IL)                                                             CX021     No
Comprehensive Benefits Administrator, Inc. (P.O. Box 2365, Burlington, VT)         03036     No
Connecticut Carpenters Health Fund (Hamden, CT)                                    37307     No
Connecticut General                                                                62308     No
Consolidated Group Dental                                                          61305     No
Cooperative Benefit Administrators / CBA                                           52132     No
CoreSource of Little Rock (Little Rock, AR)                                        75136     No
CoreSource of PA, MD, IL                                                           35182     No
CoreSource of NC, IN                                                               35180     No
CoreSource of OH                                                                   35183     No
CoreStar (Tucson AZ, Jackson MN or Brooklyn Center MN)                             41045     No     aka Northwestern National Life
Corporate Benefit Services (Charlotte, NC)                                         56116     No
Corporate Benefit Services of America / CBSA (Minneapolis, MN)                     41124     No
Covenant Administrators, Inc.                                                      58102     No
Coventry Health Care of Georgia, Inc.                                              25148     No
Custom Benefit Adminstrators (LaCrosse, WI)                                        39170     No
CustomCare                                                                         68241     No
Delta Dental (Northeast) (ME, NH, VT)                                              02027     No
Delta Dental Insurance Co. (AK, AL, FL, GA, LA, MS, MT, NV, TX, UT)                94276     No
Delta Dental Insurance Company / DDIC                                              94276     No
Delta Dental of Alabama                                                            94276     No
Delta Dental of Alaska                                                             94276     No
Delta Dental of Arizona                                                            86027     No
Delta Dental of Arkansas                                                          CDAR1      No
Delta Dental of California (San Francisco,CA or PO Box 997330 Sacramento,CA)       77777     No     MUST have Claims Office ID of CA00
Delta Dental of California/Tricare Retiree Dental (Sacramento, CA)                CDCA1      No     Use 06126 for PO Box 537010, Sacramento, CA 95853
Delta Dental of Colorado                                                           84056     No
Delta Dental of Delaware                                                           51022     No
Delta Dental of Florida                                                            94276     No
Delta Dental of Georgia                                                            94276     No
Delta Dental of Idaho                                                              82029     No
Delta Dental of Illinois                                                           05030     No
Delta Dental of Indiana                                                            CDIN1     No
Delta Dental of Iowa                                                               CDIA1     No
Delta Dental of Kansas                                                            CDKS1      No


                                                                               Page 3
                                                                    **CPS Payer List**
                                          PARTICIPATING and COMMERICAL Dental
                                                      October 2005
                                   Payer                                         ID     Enroll             Additional Information
Delta Dental of Kentucky                                                       CDKY1      No
Delta Dental of Louisianna                                                      94276     No
Delta Dental of Maryland (Pennsylvania)                                         23166     No     includes Maryland
Delta Dental of Massachusetts                                                   04614     No
Delta Dental of Michigan                                                        CDMI0     No
Delta Dental of Minnesota                                                      CDMN1      No
Delta Dental of Mississippi                                                     94276     No
Delta Dental of Missouri                                                        43090     No
Delta Dental of Montana                                                         94276     No
Delta Dental of Nebraska                                                       CDNE1      No
Delta Dental of Nevada                                                          94276     No
Delta Dental of New Jersey                                                      22189     No
Delta Dental of New Mexico                                                      85022     No
Delta Dental of New York (Mechanicsburg, PA)                                    11198     No
Delta Dental of North Carolina                                                  56101     No
Delta Dental of North Dakota                                                   CDND1      No
Delta Dental of Ohio                                                           CDOH1      No
Delta Dental of Oklahoma                                                       CDOK1      No
Delta Dental of Oregon                                                         CDOR1      No
Delta Dental of Pennsylvania                                                    23166     No     includes Maryland
Delta Dental of Rhode Island                                                    05029     No
Delta Dental of South Dakota                                                    54097     No
Delta Dental of Tennessee                                                      CDTN1      No
Delta Dental of Texas                                                           94276     No
Delta Dental of Utah                                                            94276     No
Delta Dental of Washington (state of WA)                                        91062     No
Delta Dental of Washington DC                                                   52147     No
Delta Dental of West Virginia                                                   31096     No
Delta Dental of Wisconsin                                                       39069     No
Delta Dental of Wyoming                                                        CDWY1      No
Delta Dental Plan of South Carolina in Missouri                                 43091     No
Delta Dental Plan of Virginia                                                  CDVA1      No
deneX/SG (PO Box 2767, Houston, TX)                                            CX049      No
Dental Benefit Providers (Bethesda, MD)                                         52133     No
Dental Care Plus                                                                CX035     No
Dental Health Systems (Stockton, CA)                                            94235     No
Dental Network                                                                  CX034     No
DentaQuest                                                                      04356     No
Denti-Cal **Change form name to Electronic Denti-Cal                            94146    Yes
Diversified Administrative Corporation (Marlborough, CT)                        CX040     No
Doral Dental Plan of Wisconsin                                                  CX014    Yes
EBC, Inc. of WI                                                                 37257     No
EBS Benefit Solutions                                                           CX043     No
EHI                                                                             73288     No
EMPHESYS                                                                        73288     No     aka Employers Health of WI / EHIC
Empire Blue Cross Blue Sheild (PO Box 791 or 852 Minneapolis, MN)              CBNY1      No
Employee Benefit Concepts                                                       38241     No
Employee Benefit Consultants of WI                                              37257     No
Employee Benefit Management Corp / EBMC (Dublin, OH)                            CX025     No
Employee Benefit Mgt Services - EBMS (Billings, MT or Salt Lake City, UT)       81039     No
Employee Benefit Plan Administration / EBPA (P.O. Box 2000, Hampton, NH)        03036     No
Employee Group Services / EGS (P.O. Box 75008, Cedar Rapids, IA)                CX022     No
Employee Plans, LLC (P.O. Box 2362, Fort Wayne, IN)                             35112     No
Employee Security Inc.                                                          54098     No


                                                                            Page 4
                                                                    **CPS Payer List**
                                            PARTICIPATING and COMMERICAL Dental
                                                        October 2005
                                       Payer                                           ID     Enroll              Additional Information
Employer Plan Service (Houston, TX)                                                   CX031     No
Employers Health Insurance                                                            73288     No
Employers Health of Wisconsin / EHIC                                                  73288     No     aka EMPHESYS
Employers Insurance of Wausau                                                         39026     No
Employers Mutual, Inc.        (Jacksonville, FL)                                      59297     No
Enstar Natural Gas - Grp# P61                                                         91136     No
EQUICOR                                                                               62308     No
Equitable                                                                             62308     No
Equitable Plan Services (Oklahoma City, OK)                                           73126     No
Erin Group Administrators in PA (Lancaster, PA)                                       CX046     No
Essex Dental Benefits (St. Louis, MO)                                                 43168     No
E-V Benefits Management, Inc.                                                         34159     No     aka North American Benefits Network/NABN
ExclusiCare                                                                           71412     No
Family Members Dental Plan / FMDP                                                     CX002    Yes
Fed Ex Freight East, Inc. (Harrison, AR)                                              71056     No
Federated Mutual Health Ins (Owatonna, MN)                                            41041     No
First Ameritas Life Insurance Corporation of NY                                       72630     No
First Commonwealth (PO Box 3344, Chicago, IL)                                         64246     No     old address PO Box 2459, Spokane, WA
First Fortis Life Insurance                                                           70408     No
First Health                                                                          87043     No
First Reliance Standard (NY Business)                                                 13317     No
FitzHarris & Company, Inc.                                                            11244     No
FlexCare                                                                              68241     No
Florida Dental Management Group (FDMG)                                                                 ***Must reside or practice within the state of FL***
                                                                                      CX052    Yes
(2100 & 2801 Ponce DeLeon Blvd., Coral Gables, FL)                                                     aka Atlantic Dental Inc./ADI
Florida Hospital Waterman (Eustis, FL)                                                48116     No
Florida Power & Light                                                                 68241     No
FMH Benefit Services Inc. (KS)                                                        48117     No
Fortis Benefits (every state EXCEPT AL)                                               70408     No     aka Assurant Employee Benefits
Fortis Insurance Company (WI)                                                         39065     No     formerly Time Insurance
Fraternal Order of Police - Dental Division (Philadelphia, PA)                        CX041     No
Gallagher Benefit Administrators, Inc/GBA (Lisle, IL; San Antonio, TX; Jackson,
                                                                                      37283     No
MS; San Francisco, CA)

                                                                                                       aka CIMR One GE Financial / GE Health;
GEGA- GE Group Administrators c/o CIMR (PO Box 150809 Arlington, TX 76015)            75238     No
                                                                                                       formerly Phoenix Group Services Inc.

GEGA- GE Group Administrators c/o CIMR (PO Box 100252 Columbia, SC                                     aka CIMR One GE Financial / GE Health;
                                                                                      06143     No
29223)                                                                                                 formerly Phoenix Group Services Inc.
GE Group Life Assurance (Greenfield, MA 01301)                                        67814     No     aka Phoenix Home Life, Phoenix American Life, Phoenix
                                                                                                       Mutual
GEHA / Government Employers Hospital Association                                      44054     No
General American Life Insurance Company                                               63665     No
GHI - New York / Group Health Inc.                                                    13551     No
GIC                                                                                   80314     No
Gilsbar (Covington, LA and Jackson, MS)                                               07205     No
Glassworkers Health & Welfare Fund                                                    91136     No
Great-West Life & Annuity Ins. Co.                                                    80705     No
Great-West Life & Annuity Ins. Co. (Kennett, MO address ONLY)                         63665     No     formerly American General
Group Administrators Ltd. (Schaumberg, IL)                                            36338     No
Group Benefit Administrators (Hendersonville, TN)                                     72153     No
Group Dental Services of Houston, TX                                                  CX036     No
Group Health Inc / GHI (NY)                                                           13551     No
Group Health Managers (Redford, MI)                                                   38194     No
Group Link of Indiana                                                                 CX015     No
Guardian Life Insurance Company of America                                            64246     No     Claims with Guardian as secondary payer must be mailed.
Harrington Benefit Services                                                           95266     No     aka R.E. Harrington, Inc.



                                                                                  Page 5
                                                                 **CPS Payer List**
                                         PARTICIPATING and COMMERICAL Dental
                                                     October 2005
                                     Payer                                  ID     Enroll             Additional Information
Harrington Benefit Services (OK)                                           59142      No    formerly Health Plan Services in OK
Harrington Benefit Services, Inc. (TPMC)                                   06131      No
Health Claims Services (Boise, ID)                                         82018      No
Health Economics Group Inc                                                 CX039      No
Health Future, LLC (Medford, OR)                                           30946      No
Health Management Systems                                                  84097      No    aka Managed Dental Care Network
Health Network of America (HNA of NJ)                                      20199      No
Health Partners of Minnesota - Commercial                                  CX009      No
Health Partners of Tennessee (PO Box 3490, Jackson, TN)                    62157      No
Health Plan Services (Oklahoma City, OK)                                   59142      No
Health Plans, Inc (Westborough, MA)                                        CX055      No
Health Resources Incorporated / HRI (Evansville, IN)                       CX019      No
Health Risk Management, Inc.                                               41170      No
Healthcare Management Administrators (HMA) (Bellevue, WA)                 HMA01       No
Healthplex, Inc.                                                           11271      No
HealthSCOPE Benefits, Inc                                                  71063      No    formerly CNAHealth Partners, Little Rock, AR
Healthsource Provident / CIGNA                                             68195      No    Claims edited under CIGNA's edits, Payer ID 62308
Hoosier Dental (Indianapolis, IN)                                          CX015      No
Hotel & Restaurant Employees Health Trust                                  91136      No
HRM Claim Management                                                       41170      No
Humana (PO Box 14611, Lexington, KY & PO Box 5620,Madison,WI)              73288      No
Humana Military (PO Box 19081, Green Bay, WI)                              73288      No
I.E. Shaffer (West Trenton, NJ)                                            22175      No
IBI                                                                        41124      No
Illinois Central Hospital Association                                      36600      No
Insurance Design Administrators (Oakland, NJ)                              13315      No
Insurance Management Services (Elko, NV)                                   88006      No
Integra Administrative Group                                               51020      No
International Brotherhood of Boilermakers                                  36609      No    aka Boilermakers Nathional Health & Welfare Fund
Iowa Benefits Inc.                                                         41124      No
Jefferson Pilot                                                            CX061      No
J.F. Molloy and Associates                                                 61271      No
JLT Service Corporation                                                    14168      No    formerly Jardine Group Services
John Alden Life Insurance Co.                                              41099      No
John Deere Health Care                                                     95378      Yes
John Hancock Health Security                                               65099      No
John Hancock Mutual Life Ins                                               65099      No
John Hancock Preferred Health                                              65099      No
JP Farley Corporation (PO Box 458022, Westlake, OH 44145)                  34136      No
Kanawha Insurance Co (Lancaster or Greenville, South Carolina)             57038      No
Kansas City Life Insurance Company (Kansas City, MO)                       CX058      No
Kempton Company (OK)                                                       73100      No
Life Insurance Company of Boston & New York                                78140      No
LifeRe (San Antonio, TX)                                                   CX047      No
LifeWise/Washington Employers Trust (Seattle, WA)                          91663      No
Lincoln National (WI)                                                      73288      No
Local 135 Health Benefits                                                  35107      No
Lovelace Health Plan                                                       62310      No
Lovelace Insurance                                                         62310      No
Lovelace Senior Options / LSO                                              62310      No
Lovelace Senior Plan / LSP                                                 62310      No
Machigonne Benefit Adm. (Bangor or Portland, ME)                           10317      No
Mahoney Benefit Administration, LLC (Richardson, TX)                       CX042      No
Mail Handlers Benefit Plan                                                 62413      No


                                                                       Page 6
                                                                  **CPS Payer List**
                                           PARTICIPATING and COMMERICAL Dental
                                                       October 2005
                                     Payer                                     ID     Enroll              Additional Information
MAMSI / Mid Atlantic Medical Service Inc.                                     CX033     No
Managed Dental Care Network                                                   84097     No     aka Health Management Systems
Managed Health Services (WI State Employees)                                  CX014     No
Manulife, W.J. Sutton Co. (Toronto Ontario, Canada)                           98010     No
Mariott                                                                       68241     No
Mass Mutual                                                                   80314     No
MBS (MedCost Benefit Services located in Winston Salem, NC)                   56205     No
MedBen (Newark, OH)                                                           74323     No
Medcost                                                                       56205     No
Medica (PO Box 1519 or 7645 Metro Blvd, Minneapolis, MN)                      CX026     No
Medical Benefits Mutual (Newark, OH)                                          74323     No
Medical Mutual of Ohio (MMO)                                                  CB833     No
MEGA Life & Health Insurance Company (North Richland Hills, TX)               59226     No
MetElect                                                                      65978     No
MetLife                                                                       65978     No     aka Travelers
MetLife Healthcare Network                                                    65978     No
Metropolitan Life Insurance Co.                                               65978     No
Michigan Regional Council of Carpenters Employee Benefits Plan (2075 W.
                                                                              38238     No
Big Beaver Suite 700, Troy, MI 48084)
Mid-America Associates, Inc. (Madison Heights, MI)                            37281     No
Midwest Dental Benefits, Inc. (2236 Marshall Avenue, Suite 100, St. Paul,
                                                                              41101     No
MN 55104
Mid-West National Life Insurance Co. of Tennessee Student Insurance           74227     No
Minneapolis Prudential Business                                               68241     No
Mississippi Select Healthcare (PO Box 3209, Gulfport, MS 39505)               64088     No
Motorola                                                                      36111     No
Mountain States Administrative Services (Tucson, AZ)                          86040     No
Mutual of Omaha (PO Box 69416, Harrisburg, PA)                                CX007    Yes     Administered by United Concordia
Mutual of Omaha Insurance Company                                             71412     No
Mutually Preferred                                                            71412     No
N.W. International Assoc of Machinists & Aerospace Engineers Benefits Trust
                                                                              91136     No
Dental Program
N.W. Ironworkers Health & Security Trust Fund                                 91136     No
N.W. Roofers & Employers Health & Security Trust Fund                         91136     No
N.W. Textile Processors                                                       91136     No
National Benefit Administrators - NC (Parsippany, NJ)                         56176     No
National Benefit Administrators - NJ (Parsippany, NJ)                         56175     No
National Elevator Industry Benefit Plans of PA (Newtown Square, PA)           CX045     No     aka NEIB
National Rural Letter Carrier Association                                     71412     No

National Telecommunications Cooperative Association(NTCA) (Asheville, NC)     52120     No

NCAS (Charlotte, NC)                                                          75191     No
NCAS (Fairfax, VA)                                                            75190     No
NEIB of PA (Newtown Square, PA)                                               CX045     No     aka National Elevator Industry Benefit Plans of PA
New England Dental Administrators (P.O. Box 2006, Concord, NH)                43351     No
Nippon Life Insurance Company of America                                      81264     No
North America Administrators, L.P.
                                                                              65085     No
(P.O. Box 1984 and P.O. Box 25207, Nashville, TN)
North American Benefits Network (NABN)                                        34159     No     aka E-V Benefits Management, Inc.
Northeast Delta Dental (ME, NH, VT)                                           02027     No
Northern Nevada Trust Fund (Reno, NV)                                         88027     No
Northwest Dental Services (OR)                                                93525     No
Northwestern National Life                                                    41045     No     aka CoreStar
Nova Healthcare Administrators, Inc.                                          16644     No


                                                                        Page 7
                                                                     **CPS Payer List**
                                          PARTICIPATING and COMMERICAL Dental
                                                      October 2005
                                     Payer                                             ID     Enroll             Additional Information
Nyhart (Indianapolis, IN)                                                             37299     No
ONE Health Plan                                                                       80705     No
Operating Engineers Locals 302 & 612 Health & Security Fund                           91136     No
Oregon Dental Service / ODS                                                           CDOR1     No
Pacific Life & Annuity (100 W. Clarendon Ave Ste 2000 or P.O. Box 34799 or P.O. Box
                                                                                      67466     No
33699, Phoenix, AZ)
Pacificare Dental and Vision HMO (Santa Ana, CA)                                      CX060     No
Pacificare Dental and Vision PPO (Santa Ana, CA)                                      CX053     No
PacificSource Health Plans (P.O. Box 7068, Eugene, OR)                                93029     No
Pacific Union - Nevada                                                                CX056     No
Pacific Union - Texas                                                                 CX057     No
Patient Advocate                                                                      10525     No
Paul Revere                                                                           47009     No
Phoenix American Life (Greenfield, MA)                                                67814     No     aka GE Group Life Assurance - Greenfield, MA
Phoenix Home Life Mutual Insurance Company (Greenfield, MA)                           67814     No     aka GE Group Life Assurance - Greenfield, MA
Phoenix Mutual (Greenfield, MA)                                                       67814     No     aka GE Group Life Assurance - Greenfield, MA
Physicians Plus Ins. Co (WI State Employees)                                          CX014     No
Pinnacle Claims Management, Inc. (Fresno, CA)                                         24735     No
PM Group                                                                              67466     No
Poly America Medical & Dental Benefits Plan (Grand Prairie, TX)                       32680     No
POMCO (Syracuse, NY)                                                                  16111     No
Prairie States Enterprises, Inc. (Chicago, IL)                                        36373     No
Preferred Dental Organization / PDO                                                   68241     No
Premier Dental (P.O Box 47126, Plymouth, MN)                                          CX029     No
Primary Physician Care, Inc. (P.O. Box 11088, Charlotte, NC)                          56144     No
PrimeCare (WI State and Fed Employees and Medicaid)                                   CX014     No
Principal Financial Group                                                             61271     No
Principal Life Insurance Co.                                                          61271     No
Professional Benefit Administrators, Inc. (PO Box 4687, Oak Brook, IL)                36331     No
Professional Claim Administrators                                                     41163     No
Protective Life                                                                       70408     No
Provident Life & Accident                                                             68195     No
Provident Life & Accident Ins. Co. of America                                         68195     No
Provident Life & Casualty                                                             68195     No
Provident Preferred Network                                                           68195     No
PruCare                                                                               60054     No
PruCare HMO                                                                           60054     No
PruCare Plus                                                                          60054     No
Prudential                                                                            60054     No
Prudential Health Care Systems                                                        60054     No
PruNetwork                                                                            60054     No
Puget Sound Benefits Trust                                                            91136     No
Puget Sound Electrical Workers Trust                                                  91136     No
QUADMED (555 South 108th Street Wes Allis, WI 53214-1145)                             39197     No
R.E. Harrington                                                                       95266     No
Regency Employee Benefits (Port Huron, MI)                                            38221     No
Reliance Standard Life                                                                36088     No
ReliaStar (Oxnard, CA)                                                                80314     No
RMSCO (Liverpool & Syracuse, NY)                                                      16117     No
Rochester Public Schools (615 7th Street, Rochester, MN 55902)                        41625     No
Rocky Mountain Life Dental                                                            84102     No
SafeGuard (Laguna Hills and Aliso Viejo, CA)                                          CX030     No
Santa Barbara Cottage Hospital (Santa Barbara, CA)                                    37288     No
Seabury & Smith (P.O. Box 1520, Iowa City, IA)                                        CX023     No


                                                                               Page 8
                                                                  **CPS Payer List**
                                            PARTICIPATING and COMMERICAL Dental
                                                        October 2005
                                     Payer                                      ID     Enroll                 Additional Information
Select Administrative Services (PO Box 3209, Gulfport, MS 39505)               64088     No
SelectCare (Coca Cola)                                                         68241     No
Self Insured Benefit Administrators (Clearwater, FL)                           59111     No
Self Insured Services Company / SISCO (P.O. Box 389, Dubuque, IA)              CX020     No
Self-Funded Plans, Inc. (Cleveland, OH)                                        34131     No
Sentry Insurance A Mutual Company (Stevens Point, WI)                          39033     No
Sentry Insurance Company (Stevens Point, WI)                                   39033     No
Sentry Life of NY (Stevens Point, WI)                                          39033     No
Serentas Dental Care Solutions                                                 CX038     No
Sinclair Health Plan (Salt Lake City, UT)                                      84076     No
Southern Group Administrators (Winston Salem, NC)                              56131     No
Southwestern Bell                                                              68241     No
Southwestern Bell Exec.                                                        68241     No
Standard Insurance Company of New York                                         13411     No
Standard Insurance Company of Oregon                                           93024     No
State of Texas Dental Plan                                                     57254     No
Stoner and Associates                                                          31121     No
Stowe Associates (Atlanta, GA)                                                 58128     No
Student Insurance                                                              74227     No
Sun Life Financial of Canada                                                   47009     No
Sun Trust Bank, Inc.                                                           68241     No
Superior Dental Care                                                           31117     No
TDC (ONLY for 1100 Employers Blvd., PO Box 1100, Green Bay, WI)                73288     No
The Carpenters Health & Welfare Trust Fund of Greater St. Louis (St. Louis,
                                                                               25125     No
MO)
The Dental Companies (1100 Employers Blvd, PO Box 1100, Green Bay, WI)         73288     No
The Dental Concern (for 1100 Employers Blvd, PO Box 1100, Green Bay, WI)       73288     No
The MEGA Life & Health Insurance Company (North Richland Hills, TX)            59226     No
Three Rivers Health Plans, Inc. (PO Box 967, Monroeville, PA)                  25175     No
Time Insurance                                                                 39065     No
Tower Life Insurance (San Antonio, TX)                                         69493     No
TPA / Travelers Plan Administrators (every state EXCEPT GA)                    65978     No
Travelers                                                                      65978     No     aka Metlife
Tricare Active Reservists (PO Box 69411, Harrisburg, PA)                       CX002    Yes     Old address was: PO Box 19081, Green Bay, WI
Trigon Blue Cross Blue Shield of Colorado                                      84103     No
Trusted Plan Service Corporation                                               91078     No
Trustmark Insurance                                                            61425     No
TRW                                                                            68241     No     aka Choice Plus
TSRDP Dental Claims (PO Box 69411, Harrisburg, PA)                             CX002    Yes     Old address was: PO Box 19081, Green Bay, WI
UICI - Administrators - State of Nevada                                        74223     No     Phone #800-315-3440
UNICARE Major Accounts                                                         80314     No     formerly UNICARE Life & Health & Mass Mutual
Uniform Medical Plan/ Harrington Benefit Services (Seattle, WA)                75243     No
Union Labor Life Insurance Company (King of Prussia, PA)                       13142     No
United Concordia Dental Plus (PO Box 69422, Harrisburg PA)                     CX013    Yes     Old address was: PO Box 898269, Camp Hill PA 17089
United Concordia Tricare Active Reservists (PO Box 69411, Harrisburg PA)       CX002    Yes     Old address was: PO Box 19081, Green Bay, WI
United Concordia TSRDP (PO Box 69411, Harrisburg PA)                           CX002    Yes     Old address was: PO Box 19081, Green Bay, WI
United Concordia(TRICARE FMDP) (PO Box 69411, Harrisburg PA)                   CX002    Yes     Old address was: PO Box 898220, Camp Hill PA 17089
United Concordia-Fee for Service (PO Box 69421, Harrisburg PA)                 CX007    Yes     Old address was: PO Box 898268, Camp Hill PA 17089
United Healthcare (Bethesda, MD or Salt Lake City, UT)                         52133    No
United Medical Resources (Cincinnati, OH)                                      33108    No
United of Omaha                                                                71412    No
United States Life Insurance Company (Neptune, NJ)                             13545    No      aka America General
University of Washington Students & Graduate Appts.                            91136    No
VA Fee Basis Programs                                                          12116    No
Varian Health Care Plan                                                        68241    No
Washington Dental Service                                                      91062    No


                                                                           Page 9
                                                               **CPS Payer List**
                                     PARTICIPATING and COMMERICAL Dental
                                                 October 2005
                                Payer                                     ID     Enroll             Additional Information
Washington Employers Trust (Seattle, WA)                                 37294      No
Washington State Council of County & City Employees                      91136      No
Wausau Ins Co / Wausau Benefits Inc.                                     39026      No    aka Employers Insurance of Wausau
WEA Insurance Group                                                      39151      No
webTPA / Community Health Electronic Claims / CHEC                       75261      No
Wellpoint Dental (Oxnard & Woodland Hills, CA)                           47198      No    aka Blue Cross of CA
West Coast Stationary Engineers Health & Security Trust Fund             91136      No
Western Grower's (Newport Beach, CA)                                     24735      No
Whatcom Medical Bureau                                                   93200      No    TPA Washington
Xantus Health Plan (Nashville, TN)                                       62154      No




** For an updated payer list, please visit our website at www.eaglesoft.net

** If the insurance company is not on this list, please use the Payer ID of 06126.

ENROLL: If “Yes”, contact your eBusiness Specialist at 800-475-5036 to request paperwork.
          If “No”, then enrollment paperwork is not required.
Additional Information: Includes important information specific to the payer.




                                                                    Page 10
                                                               **Payer List**
                                                      BLUE CROSS BLUE SHIELD DENTAL
                                                               October 2005

State                                               Payer                                         ID     Enroll             Additional Information
                                                                                                                  aka Premera Blue Cross
 AK     Blue Cross of Washington & Alaska                                                        47570     No
                                                                                                                  aka Northstar Administrators
                                                                                                                  aka Blue Cross of Washington & Alaska
 AK     NorthStar Administrators                                                                 47570     No
                                                                                                                  aka Premera Blue Cross
                                                                                                                  aka Blue Cross of Washington & Alaska
 AK     Premera Blue Cross                                                                       47570     No
                                                                                                                  aka Northstar Administrators
 AK     Health Management Systems                                                                84097     No     aka Managed Dental Care Network
 AL     Blue Cross and Blue Shield of Alabama                                                    CBAL1    Yes     *R035*
                                                                                                                  *R035* Claims with BCBS of AR as the secondary payer
 AR     Blue Cross Blue Shield of Arkansas (PO Box 69413 or PO Box 69420 Harrisburg PA)          CBAR1    Yes     must be mailed on paper.
                                                                                                                  Old address: PO Box 898230 Camp Hill, PA 17089
 AZ
 CA     Blue Cross of California (Oxnard & Woodland Hills, CA)                                   47198     No     aka Wellpoint Dental
 CO     Blue Cross and Blue Shield Colorado Dental                                               84099     No     Please send FEP claims on paper or use 06126.
 CO     Anthem Blue Cross Blue Shield (555 Middle Creek Parkway, Colorado Springs, CO)           84103     No     aka Trigon Blue Cross Blue Shield
 CO     Trigon Blue Cross Blue Shield (555 Middle Creek Parkway, Colorado Springs, CO)           84103     No     aka Anthem Blue Cross Blue Shield
 CT     Anthem Blue Cross and Blue Shield of Connecticut (North Haven, CT)                       84105     No
 CT     Blue Care Family Plan (Blue Cross of CT)                                                 00700     No
 DC
 DE     Blue Cross Blue Shield of Delaware                                                       53287     No
 FL
                                                                                                                  Must practice within one of the following states to send
 GA     Blue Cross Blue Shield of Georgia      (see additional information)                      CBGA1    Yes
                                                                                                                  electronically: AL, FL, GA, NC, SC and TN
 HI
 IA     Blue Cross and Blue Shield of Iowa                                                       CBIA1    Yes     (FEP Claims) Must reside or practice within the state of IA
 IA     Blue Cross and Blue Shield of Iowa                                                       CBIA2    Yes     Must reside or practice within the state of IA
 ID     Blue Cross of Idaho                                                                      CBID1    Yes     Must reside or practice within the state of ID
 ID     Blue Shield of Idaho                                                                     CBID2    Yes     Must reside or practice within the state of ID
 IL     Blue Cross and Blue Shield of Illinois                                                   CB621    Yes
 IN     Anthem Blue Cross Blue Shield of Indiana (PO Box 37180, Louisville, KY)                  84105    No      Please send FEP claims on paper or use 06126.
 KS     Blue Cross Blue Shield of Kansas (Topeka, KS)                                            CBKS1    Yes
 KY     Anthem Blue Cross Blue Shield of Kentucky (PO Box 37180, Louisville, KY)                 84105     No
 LA     Blue Cross and Blue Shield of Louisiana                                                  23739    Yes     Must reside or practice within the state of LA
 MA     Blue Cross and Blue Shield of Massachusetts                                              CBMA1    Yes     *R035*
 MD
 ME
 MI     Blue Cross and Blue Shield of Michigan                                                   CBMI1     No
 MN     Empire Blue Cross Blue Sheild (PO Box 791 or 852 Minneapolis, MN)                        CBNY1     No
 MN
 MO
 MS
 MT
 NC     Blue Cross Blue Shield of North Carolina (PO Box 30568, Salt Lake City, UT)              52133     No     Claims administered by Dental Benefit Providers
 NC     Blue Cross Blue Shield of North Carolina (PO Box 2100, Winston-Salem, NC)                61473     No
 NC     Blue Cross Blue Shield of North Carolina - FEP Employees (PO Box 35, Durham, NC)         61472     No
 NC     Blue Cross Blue Shield of North Carolina - NC Health Choice (PO Box 30025, Durham, NC)   61472     No
 ND     Blue Cross Blue Shield of North Dakota (North Dakota Dental Service Corp.)               CX004    Yes     *R035*
 NE     Blue Cross Blue Shield of Nebraska                                                       CBNE1    Yes     Add'l Enrollment Paperwork for In-State providers ONLY
 NH
 NJ     Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ)                            22099    Yes
 NM     Blue Cross of New Mexico (Belleville, IL)                                                CBNM1     No
 NV     Blue Cross and Blue Shield Nevada Dental                                                 84101     No     Please send FEP claims on paper or use 06126.
 NY     Empire Blue Cross Blue Sheild (PO Box 791 or 852 Minneapolis, MN)                        CBNY1     No
 NY     Blue Cross Blue Shield of Rochester NY                                                   CBNYR     No
 OH     Medical Mutual of Ohio (MMO)                                                             CB833     No
 OH     Anthem Blue Cross Blue Shield of Ohio (PO Box 37010, Louisville, KY) (OH, KY, IN, VA)    84105     No
 OK
        Regence Blue Cross and Blue Shield of OR
 OR                                                                                              CB850    Yes     *R035* aka Regence Life and Health
        (PO Box 30805, Salt Lake City, UT or PO Box 1271, Portland, OR)
 OR     Regence Life and Health (PO Box 1271, Portland, OR)                                      CB850    Yes     *R035* aka Regence Blue Cross and Blue Shield of OR
 PA     Pennsylvania Blue Shield (PO Box 69413, Harrisburg PA)                                   CB865    Yes     *R035* Old address: PO Box 898230, Camp Hill PA 17089
 PA     Pennsylvania Blue Shield (PO Box 69401, Harrisburg PA)                                   CB865    Yes     *R035* Federal Claims Only
 PA     Pennsylvania Blue Shield Dental Plus (PO Box 69422, Harrisburg PA)                       CBPA2    Yes     *R035* Old address: PO Box 898236, Camp Hill PA 17089



                                                                                         11
                                                             **Payer List**
                                                    BLUE CROSS BLUE SHIELD DENTAL
                                                             October 2005

State                                             Payer                                        ID     Enroll            Additional Information
  RI    Blue Cross and Blue Shield of Rhode Island                                            CB870    Yes
  SC
  SD
  TN    Blue Cross and Blue Shield of Tennessee                                               CBTN1    Yes     *R035* Please send FEP claims on paper or use 06126.
  TX    Blue Cross and Blue Shield of Texas                                                   CB900     No
  US
  UT
  VA    Trigon Blue Cross Blue Shield (555 Middle Creek Parkway, Colorado Springs, CO)        84103     No     aka Anthem Blue Cross Blue Shield
  VA    Trigon Blue Cross and Blue Shield - Virginia                                          CB923     No     aka Anthem Blue Cross Blue Shield
  VA    Anthem Blue Cross and Blue Shield (555 Middle Creek Parkway, Colorado Springs, CO)    84103     No     aka Trigon Blue Cross Blue Shield
  VA    Anthem Blue Cross and Blue Shield - Virginia                                          CB923     No     aka Trigon Blue Cross Blue Shield
  VT
                                                                                                               aka Premera Blue Cross
 WA     Blue Cross of Washington & Alaska                                                     47570     No
                                                                                                               aka Northstar Administrators
                                                                                                               aka Blue Cross of Washington & Alaska
 WA     NorthStar Administrators                                                              47570     No
                                                                                                               aka Premera Blue Cross
                                                                                                               aka Blue Cross of Washington & Alaska
 WA     Premera Blue Cross                                                                    47570     No
                                                                                                               aka Northstar Administrators
 WA     Health Management Systems                                                             84097     No     aka Managed Dental Care Network
 WA     Regence of WA (PO Box 30271, Salt Lake City, UT)                                      93200     No
 WA     Regence of WA (FEP) (PO Box 31207, Salt Lake City, UT)                                93200     No
 WA     Regence Blue Shield of WA - Boeing Plans (PO Box 91015, Seattle, WA)                  93200     No
 WA     Regence Blue Shield of WA (PO Box 21267, Seattle, WA)                                 93200     No
 WA     Regence Blue Shield of WA (FEP) (PO Box 21709, Seattle, WA)                           93200     No
 WA     Regence Care of WA (PO Box 30271, Salt Lake City, UT or PO Box 2088, Seattle, WA)     93200     No
 WA     Regence Northwest Health                                                              93200     No
                                                                                                               *R035*
  WI    Blue Cross and Blue Shield of United Wisconsin                                        CB950    Yes     Claims with BCBS of WI as the secondary payer must be
                                                                                                               mailed on paper
 WV
 WY



** For an updated payer list, please visit our website at www.eaglesoft.net
** If the insurance company is not on this list, please use the Payer ID of 06126.

ENROLL: If “Yes”, contact your eBusiness Specialist at 800-475-5036 to request paperwork.
         If “No”, then enrollment paperwork is not required.
Additional Information: Includes important information specific to the payer.




                                                                                         12
                                                                    **Payer List**
                                                                  MEDICAID DENTAL
                                                                    October 2005
State                                 Payer                                  ID     Enroll                       Additional Information
 AK     Alaska Medicaid                                                     CKAK1     Yes
 AL     Medicaid of Alabama                                                 CKAL1     Yes    *R035*
 AR     Medicaid of Arkansas                                                CKAR1     Yes
 AZ
 CA     Denti-Cal                                                           94146     Yes
 CO     Colorado Medicaid                                                   CKCO1     Yes    *R035* CO Medicaid claims routed to Consultec
 CT     Medicaid of Connecticut                                             CKCT1     Yes    CT Medicaid claims routed to Electronic Data Systems
 DC
        Medicaid of Delaware (P.O. Box 907 or P.O. Box 908, New Castle,
 DE                                                                         CKDE1     Yes
        DE, 19720)
 FL     Medicaid of Florida                                                 CKFL1     Yes    *R035* Medicaid claims administered by Electronic Data Systems
 GA     Medicaid of Georgia                                                 CKGA1     Yes    Medicaid claims administered by ACS
 HI
 IA     Medicaid of Iowa                                                    CKIA1     Yes
 ID     Medicaid of Idaho                                                   CKID1     Yes
 IL     Illinois Medicaid                                                   CKIL1     Yes    Medicaid claims administered by Doral Dental of WI
 IN     Medicaid of Indiana                                                 CKIN1     Yes    *R035*
 KS     Kansas Medicaid                                                     CKKS1     Yes    Medicaid claims administered by Doral Dental of WI
 KY     Doral Dental of Kentucky / Region 3 (Mequon, WI)                    CKKY3     Yes    Medicaid claims administered by Doral Dental of WI
 KY     Medicaid of Kentucky                                                CKKY1     Yes    *R035* Medicaid claims administered by Unisys
 LA     Medicaid of Louisiana (Adult Dental)                                CKLA2     Yes    *R035*
 LA     Medicaid of Louisiana (EPSDT)                                       CKLA1     Yes    *R035*
 MA     Medicaid of Massachusetts                                           CKMA1     Yes    Medicaid claims administered by Unisys
 MD     Medicaid of Maryland - PhysiciansCare MCO                           CX014     Yes    Medicaid claims administered by Doral Dental of WI
        Medicaid of Maryland - Dept of Health and Mental Hygiene
 MD                                                                         CKMD1     Yes
        (P.O. Box 1935, Baltimore, MD)
 ME     Medicaid of Maine                                                   CKME1     Yes    *R035*

 MI     Michigan Medicaid                                                   CKMI1     Yes    Claims where MI Medicaid is the secondary payer must be mailed *R035*

 MN     Health Partners of Minnesota - Medicaid                             CX010     No     MN Medicaid claims administered by Health Partners
 MN     Medicaid of Minnesota                                               CKMN1     Yes
 MO     Medicaid of Missouri                                                CKMO1     Yes    Medicaid claims administered by GTE Data Services Inc.
        Medicaid of Missouri - Blue Advantage (Blue Cross Blue Shield of
 MO                                                                         CX014     Yes    Medicaid claims administered by Doral Dental of WI
        Kansas City), FirstGuard Health Plan, HealthCare USA in St.Louis
 MS     Mississippi Medicaid                                                CKMS1     Yes    *R035*
 MT     Montana Medicaid                                                    CKMT1     Yes
 NC     Medicaid of North Carolina                                          CKNC1     Yes    *R035*
 ND
 NH     Medicaid of New Hampshire                                           CKNH1     Yes
 NJ     Medicaid of New Jersey                                              CKNJ1     Yes
 NM     Medicaid of New Mexico                                              CKNM1     Yes    Medicaid claims administered by ACS
        Medicaid of New Mexico - Molina Healthcare of New Mexico
 NM     (formerly Cimarron), Lovelace Community Health Plan, Presbyterian   CX014     Yes    Medicaid claims administered by Doral Dental of WI
        Salud
 NV     Medicaid of Nevada                                                  CKNV1     Yes
 NY     Medicaid of New York                                                CKNY1     Yes    Medicaid claims administered by Computer Science Corp
 NY     Medicaid of New York (Dental Clinics only)                          CKNY2     Yes    Medicaid claims administered by Computer Science Corp
 OH     Medicaid of Ohio                                                    CKOH1     Yes    Medicaid claims administered Quadax

                                                                                             Maximum of 21 procedures lines per claim. Claims where CareSource is the
 OH     CareSource - Dayton, OH                                             CKOH2     No     secondary Payer must be mailed on paper (1 South Main Street, Dayton,
                                                                                             OH 45402). Pre-determination claims cannot be sent electronically.

 OK     Medicaid of Oklahoma                                                CKOK1     Yes    Medicaid claims administered by Unisys
        Medicaid of Oregon (OMAP Office of Medical Assistance Program
 OR                                                                         CKOR1     No
        PO Box 14953 Salem, OR 06143)

        Medicaid of Pennsylvania - (Dept of Public Welfare, PO Box 8015,
 PA                                                                         CKPA1     No     Medicaid claims administered by Electronic Data Systems
        Harrisburg, PA 17105)

                                                                            Page 13
                                                         **Payer List**
                                                       MEDICAID DENTAL
                                                         October 2005
State                                Payer                     ID     Enroll                       Additional Information
        Medicaid of Pennsylvania - UPMC Health Plan, Health
 PA                                                           CX014     Yes    Medicaid claims administered by Doral Dental of WI
        Partners in Philadelphia
 RI     Medicaid of Rhode Island                              CKRI1     Yes
 SC     Medicaid of South Carolina                            CKSC1     Yes
 SD
 TN     Medicaid of Tennessee - BlueCare (TennCare)           CX014     Yes    Medicaid claims administered by Doral Dental of WI
 TX     Medicaid of Texas                                     CKTX1     Yes    *R035* aka National Heritage Insurance Co.
 UT     Medicaid of Utah                                      CKUT1     No
 VA     Medicaid of Virginia                                  CKVA1     Yes    Medicaid claims administered by Doral Dental of WI
 VT     Medicaid of Vermont                                   CKVT1     Yes
 WA     Medicaid of Washington                                CKWA1     Yes    *R035*
 WI     Wisconsin Medicaid                                    CKWI1     Yes
 WV     Medicaid of West Virginia                             CKWV1     Yes
 WY     Wyoming Medicaid                                      CKWY1     Yes



** For an updated payer list, please visit our website at www.eaglesoft.net
** If the insurance company is not on this list, please use the Payer ID of 06126.

ENROLL: If “Yes”, contact your eBusiness Specialist at 800-475-5036 to request paperwork.
          If “No”, then enrollment paperwork is not required.
Additional Information: Includes important information specific to the payer.




                                                              Page 14

								
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