Real-time Claim Status Payer List - ENS _Electronic Network Systems_

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Real-time Claim Status Payer List - ENS _Electronic Network Systems_ Powered By Docstoc
					       Ingenix Claim Status Payer List
       ANSI HIPAA 276/277
       (As of 06-21-11)




                                                             Payer ID
                                                                                                                                                                                     Enrollment   Submission
                            Payer Name                        2100A          State                           Additional Information                                                                          Type
                                                                                                                                                                                      required       Type
                                                              NM109
This payer is new or has been altered in the last 90 days. Please verify that your system is setup correctly for this payer
AARP-UnitedHealthcare Ins Co                                  36273           ALL       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1     T
                                                                                        ID or NPI.
Aetna Health Plans (AHP)                                      60054           ALL       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1     G
                                                                                        ID or NPI.
Aetna Health Plans PPO                                        60054           ALL       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1     G
                                                                                        ID or NPI.
AHP of New Jersey, Parsippany                                 60054           ALL       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1     G
                                                                                        ID or NPI.
AHP of New Jersey, Purchase, NY                               60054           ALL       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1     G
                                                                                        ID or NPI.
Altius Health Plans                                           00364           ALL       Loop 2100B must contain Service Provider Number assigned by the                                FALSE       4010A1     G
                                                                                        payer and/or NPI.
American Medical Securities                                   Testing         ALL                                                                                                      FALSE       4010A1     T
California Anthem Blue Cross (WellPoint Health Network)       00540           CA        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NC
                                                                                        ID or NPI.
CIGNA Behavioral Health                                       62308           ALL       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1     T
                                                                                        ID, Provider Number or NPI. The 2200D Loop REF02 must contain:
                                                                                        Behavioral. The GS03 must contain: CHC Behavioral. These fields
                                                                                        are case sensitive.
Cigna Healthcare (Medical)                                    62308           ALL       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1     T
                                                                                        ID or NPI.
Colorado Anthem Blue Cross and Blue Shield (WellPoint Health  COBLS           CO        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NC
Network)                                                                                ID or NPI.
Connecticut Anthem Blue Cross and Blue Shield (WellPoint      CTBLS           CT        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NC
Health Network)                                                                         ID or NPI.
Coventry Carelink Medicaid                                    00182           WV        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Diamond Plan (MD Medicaid)                           00177           MD        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health - Health Care USA                             00186           MO        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health America/Health Assurance of Pennsylvania      00148         PA, OH      Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health Care Altius Health Plan                       00364           UT        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health Carelink                                      00160           WV        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health Carenet                                       00190           VA        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health Group Health Plan                             00184         IL, MO      Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health of Carolinas/Wellpath                         00164         NC, SC      Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health of Delaware                                   00166           DE        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health of Georgia                                    00154           GA        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health of Iowa                                       00170            IA       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health Care of Illinois/ Personal Care               00179            IL       Loop 2100B must contain Service Provider Number assigned by the                                FALSE       4010A1     G
                                                                                        payer and/or NPI.
Coventry Health of Kansas (Kansas City)                       00172         KS, MO      Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health of Kansas (Wichita)                           00174         KS, MO      Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health of Louisiana                                  00158            LA       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health of Nebraska                                   00176         IA, NE      Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Health Southern Health Services                      00156           VA        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry HealthCare Inc. (Promina)                            00193           GA        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Coventry Personal Care                                        00179            IL       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Definity Health                                               87726           ALL       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1     T
                                                                                        ID or NPI.
First Health                                                  87043           ALL       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
First Health (Mail Handlers)                                  00251           ALL       Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Florida Blue Shield                                            FLBLS          FL        Provider ID (Loop 2100B NM108/NM109) should contain either Tax                                 FALSE       4010A1    NP
                                                                                        ID or NPI.
Florida Medicaid                                              FLMCD           FL        Enrollment required. Call Chad Hilton at (719)277-7545 ext. 1265.                              TRUE        4010A1    NP

Georgia Anthem Blue Cross Blue Shield (WellPoint Health                         GABLS                GA           Provider ID (Loop   2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
Network)                                                                                                          ID or NPI.
Government Employees Hospital Association (GEHA)                                44054               ALL           Provider ID (Loop   2100B NM108/NM109) should contain either the     FALSE       4010A1     P
                                                                                                                  Tax ID or NPI.
Great West                                                                      80705               ALL           Provider ID (Loop   2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                                  ID or NPI.
Humana                                                                          61101               ALL           Provider ID (Loop   2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NP
                                                                                                                  ID or NPI.
Indiana Anthem Blue Cross and Blue Shield (WellPoint Health                     INBLS                IN           Provider ID (Loop   2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NC
Network)                                                                                                          ID or NPI.
Kentucky Anthem Blue Cross Blue Shield (WellPoint Health                        KYBLS                KY           Provider ID (Loop   2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NC
Network)                                                                                                          ID or NPI.
MAHP/MAMSI (Previous payer ID was 54128)                                        87726               ALL           Provider ID (Loop   2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                                  ID or NPI.
Maine Anthem Blue Cross and Blue Shield (WellPoint Health                       MEBLS                ME           Provider ID (Loop   2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NC
Network)                                                                                                          ID or NPI.
Medica Health Plans                                                             94265               ALL           Provider ID (Loop   2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                                  ID or NPI.

       -----------
       NP or NC: Non Participating Payers. Ingenix charges a per transaction fee for non-par payers
       For up-to-date payer information, please access the payer list from the Ingenix website at: http://www.enshealth.com
        Ingenix Claim Status Payer List
        ANSI HIPAA 276/277
        (As of 06-21-11)




                                                                               Payer ID
                                                                                                                                                                                    Enrollment   Submission
                             Payer Name                                         2100A               State                              Additional Information                                               Type
                                                                                                                                                                                     required       Type
                                                                                NM109
Missouri Anthem Blue Cross and Blue Shield (WellPoint Health                    MOBLS                MO            Provider ID (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NC
Network)                                                                                                           ID or NPI.
Mutual of Omaha                                                                  71412               ALL                                                                              FALSE       4010A1     T
Neighborhood Health Partners of Florida                                          95123               ALL     Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI
Nevada Anthem Blue Cross and Blue Shield (WellPoint Health                       NVBLS             NV        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NC
Network)                                                                                                     ID or NPI.
New Hampshire Anthem Blue Cross and Blue Shield (WellPoint                       NHBLS             NH        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NC
Health Network)                                                                                              ID or NPI.
Ohio Anthem Blue Cross and Blue Shield (WellPoint Health                         OHBLS             OH        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NC
Network)                                                                                                     ID or NPI.
Ohio Valley HMO, Cincinnati (Aetna)                                              60054             ALL       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     G
                                                                                                             ID or NPI.
Oxford Health Plans                                                              06111             ALL       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
PacifiCare of Arizona (HMO)                                                      95964             AZ        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
PacifiCare of California (HMO)                                                   95959             CA        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
PacifiCare of Colorado (HMO)                                                     95962             CO        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
PacifiCare of Nevada (HMO)                                                       95970             NV        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
PacifiCare of Oklahoma (HMO)                                                     95959             OK        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
PacifiCare of Oregon (HMO)                                                       PHSOR             OR        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
PacifiCare of Texas (HMO)                                                        PHSTX              TX       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
PacifiCare of Washington (HMO)                                                   PHSWA             WA        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
PacifiCare PPO (All States)                                                      95999             ALL       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
PHP of Georgia, Atlanta (Aetna)                                                  60054             ALL       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     G
                                                                                                             ID or NPI.
PHP of North Ohio, Cleveland (Aetna)                                             60054             ALL       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     G
                                                                                                             ID or NPI.
Primary Choice (Aetna Health Plan of NY/NJ)                                      60054             ALL       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     G
                                                                                                             ID or NPI.
Select Choice (Aetna Health Plan of NY/NJ)                                       60054             ALL       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     G
                                                                                                             ID or NPI.
Senior Choice (Aetna Health Plan of NY/NJ)                                       60054             ALL       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     G
                                                                                                             ID or NPI.
Southwest Health Plan (Aetna HMO)                                                60054           OK, TX      Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     G
                                                                                                             ID or NPI.
Three Rivers Health Plans                                                        00199             TN        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NP
                                                                                                             ID or NPI.
Three Rivers Health Plans/Unison MedPLUS (Medicaid)                              00198        OH, PA, TN, SC Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NP
                                                                                                             ID or NPI.
UniCare (WellPoint Health Network)                                                 UNI             ALL       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
UnitedHealthcare                                                                 87726             ALL       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
UnitedHealthcare                                                                   UHC             ALL       Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1     T
                                                                                                             ID or NPI.
Virginia Anthem Blue Cross and Blue Shield (WellPoint Health                     VABLS             VA        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NC
Network)                                                                                                     ID or NPI.
Wisconsin Anthem Blue Cross and Blue Shield (WellPoint Health                    WIBLS             WI        Provider ID       (Loop 2100B NM108/NM109) should contain either Tax     FALSE       4010A1    NC
Network)                                                                                                     ID or NPI.




        -----------
        NP or NC: Non Participating Payers. Ingenix charges a per transaction fee for non-par payers
        For up-to-date payer information, please access the payer list from the Ingenix website at: http://www.enshealth.com
This payer is new or has been altered in the
last 90 days. Please verify that your system

				
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posted:8/24/2011
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