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State Name of Payer Eligibility Claim Status Claim Status-Batch File
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NAT'L AARP X X X*SC Absolute Total Care X X X* X*MS Acclaim TPA X X
NAT'L ACS Benefit Services X XOH Accountable Care Management Group X XCA Accountable IPA X*PA Administrative Concepts X FL Administrative Services Inc XAZ Advantage (Bridgeway Health Solutions) XOH Advantage (Buckeye Community Health Plan) XWI Advantage (Managed Health Services) XTX Advantage (Superior HealthPlan) X
MULTI Advantage Health (MI, LA) XCA Advantek Benefit Administrators X*
NAT'L Advantra Freedom Medicare X XNAT'L Aetna X X X* X* X X
CA Aetna Better Health (CA) XIL Aetna Better Health (IL) X XFL Aetna Better Health (FL) X XKS Aetna Better Health (KS) X XKY Aetna Better Health (KY) X XLA Aetna Better Health (LA) X XMD Aetna Better Health (MD) X XMI Aetna Better Health (MI) X XNJ Aetna Better Health (NJ) X XNV Aetna Better Health (NV) X XNY Aetna Better Health (NY) X XOH Aetna Better Health(OH) X XPA Aetna Better Health (PA) X XTX Amerihealth Caritas (DE) X XTX Aetna Better Health (TX) X XVA Aetna Better Health (VA) XWV Aetna Better Health (WV) X
NAT'L Aetna Enhanced X*NAT'L Aetna Long Term Care X XNAT'L Aetna Retiree Medical Plan X XNAT'L Aetna Senior Supplemental X X
NY Affinity Health Plan X X X*NY Affinity Health Plan Essential X*NY Affinity Health Plan Exchange X*
PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 1
State Name of Payer Eligibility Claim Status Claim Status-Batch File
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
NAT'L AFLAC X XNAT'L AFLAC Medicare Supplement X X
NY Agewell New York X*NAT'L AIM X* X*
AL Alabama Medicaid X* X X*CA Alameda Alliance for Health X * X*AK Alaska Medicaid (Batch) X*AK Alaska Medicaid X*
NAT'L All Savers X XOR AllCare Health X* X*GA Alliant Health Plans X
NAT'L Allegiance X XNAT'L Allied Benefit Systems X X
CA Allied Physicians X* X*MA AllWays Health Partners X X*AR AllWell (AR) XSC Allwell (SC) XHI AlohaCare X
NAT'L AltaMed X* X*AL Alternative Insurance Resources X XAR Ambetter of Arkansas X X*GA Ambetter of Georgia XIL Ambetter of Illinois X X
NC Ambetter of North Carolina XMULTI AmeriBen X X X* X*MULTI American Family Insurance Group X X
PR American Health Medicare Eligibility XNAT'L American Income Life Insurance Company XNAT'L American National Life Insurance Company X X
TX American National Life Insurance Company of Texas X XNAT'L American Network Ins. Medicare Supplement X XNAT'L American Postal Workers Union (APWU) X XNAT'L American Republic Insurance Company X XNAT'L American Retirement Life Insurance Company X XMULTI Amerigroup X X X* X*MULTI Amerigroup Medicare XMULTI AmeriHealth Administrators X*
DC AmeriHealth Caritas District of Columbia X X X*DE AmeriHealth Caritas Delaware X XLA AmeriHealth Caritas Louisiana X X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 2
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
NH AmeriHealth Caritas New Hampshire X XMULTI AmeriHealth Caritas Pennsylvania X* X X* X* X*
PA AmeriHealth Caritas Pennsylvania Aligned X XPA AmeriHealth Caritas Pennsylvania Community HealthChoices X XMI AmeriHealth Caritas VIP Care Plus Medicaid X XMI AmeriHealth Caritas VIP Care Plus Medicare X
MULTI AmeriHealth Commercial (DE, NJ, PA) X* X X*PA AmeriHealth Northeast PA XPA AmeriHealth PA New West XPA AmeriHealth VIP Care X
NAT'L Ameritas Life Insurance Company X XCA Angeles IPAOH Antares X X*CO Anthem (CO) X*
MULTI Anthem Blue Cross Blue Shield (CO, CT, IN, KY, ME, NH, NV, OH, VA) X X X* (CT,IN,KY,ME,NH) X* X*
GA Anthem Blue Cross Blue Shield of GA X XIN Apex Benefit Services XWI Arise Health Plan X*WI Arise Health Plan Medicare Select Policy X X AZ Arizona Medicaid X X*AZ Arizona Physicians IPA XAR Arkansas Medicaid X* XAR Arkansas Total Care X
NAT'L Aspire (CHOMP) X*CA Aspire Health Advantage X*
NAT'L ASR Health Benefits XCA Associated Hispanics IPA X* X*WA Asuris Northwest Health Plan X X
NAT'L Atrezzo KePro X*OR ATRIO Health Plans X*OH AultCare X
MULTI Aurora Health Care UMR (IL, WI) X*NAT'L Automated Benefit Services X XNAT'L Auxiant XMULTI Avera Health Plans X X
FL AvMed Health Plans X X* X*GA Bankers Fidelity Life Insurance Company X X
NAT'L Bankers Life and Casualty X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 3
State Name of Payer Eligibility Claim Status Claim Status-Batch File
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
KY Baptist Health Plan Medicare Advantage XFL BayCare Select Health Plans X XTX BaylorScott and White Health Plan XLA BCBS LA Medicare Advantage XMN BCBSMN Blue Plus Medicaid XNY BCBS of Central New York (see Excellus BCBS) XNY BCBS of Western New York X
NAT'L Beacon Health Options/Value Options X* X*NAT'L Beacon Health Strategies X*
CA Bellavista X*NAT'L Benefit Administrative Systems X*
NE Benefit Management Inc X XOK Best Choice Plus - Broward Health (FL) X
NAT'L Best Life and Health X XFL Better Health Plans of Florida X
MULTI Better Health Plan Medicaid (PA, SC, TN) known as Unison Health Plan X X
MA Blue Benefit Administrators XAL Blue Cross Blue Shield of Alabama X XAK Blue Cross Blue Shield of Alaska (Premera) X XAZ Blue Cross Blue Shield of Arizona X XAZ Blue Cross Blue Shield of Arizona Advantage X XAR Blue Cross Blue Shield of Arkansas X* XGA Blue Cross Blue Shield of Georgia X X X*HI Blue Cross Blue Shield of Hawaii (HMSA) XIL Blue Cross Blue Shield of Illinois X X X*KS Blue Cross Blue Shield of Kansas X X X*KS Blue Cross Blue Shield of Kansas City X XLA Blue Cross Blue Shield of Louisiana X X* X* X*MD Blue Cross Blue Shield of Maryland (CareFirst) XMA Blue Cross Blue Shield of Massachusetts X X X* XMI Blue Cross Blue Shield of Michigan X X X*MN Blue Cross Blue Shield of Minnesota X XMS Blue Cross Blue Shield of Mississippi X XMO Blue Cross Blue Shield of Missouri X X X*MT Blue Cross Blue Shield of Montana X X X*NE Blue Cross Blue Shield of Nebraska X XNM Blue Cross Blue Shield of New Mexico X X X*NC Blue Cross Blue Shield of North Carolina X X X*ND Blue Cross Blue Shield of North Dakota X X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 4
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
OK Blue Cross Blue Shield of Oklahoma X* X X* X*RI Blue Cross Blue Shield of Rhode Island X XNY Blue Cross Blue Shield of Rochester (see Excellus BCBS) XSC Blue Cross Blue Shield of South Carolina X* X X* X*SC Blue Cross Blue Shield of South Carolina BlueChoice X* XSC Blue Cross Blue Shield of South Carolina Companion XSC Blue Cross Blue Shield of South Carolina State Health X*TN Blue Cross Blue Shield of Tennessee X X X*TN Blue Cross Blue Shield of Tennessee (BlueCare) X XTN Blue Cross Blue Shield of Tennessee (Out-of-State) X XTN Blue Cross Blue Shield of Tennessee (TennCare Select) X XTX Blue Cross Blue Shield of Texas X X X*TX Blue Cross Blue Shield of Texas Medicaid STAR/CHIP X XTX Blue Cross Blue Shield of Texas Medicaid STAR Kids XNY Blue Cross Blue Shield of Utica-Watertown (see Excellus BCBS) XVT Blue Cross Blue Shield of Vermont XNY Blue Cross Blue Shield of Western New York XWI Blue Cross Blue Shield of Wisconsin X X X*WY Blue Cross Blue Shield of Wyoming X XIL Blue Cross Community Health Plans X X X*IL Blue Cross Community Health Plans Medicare X XMI Blue Cross Complete of Michigan X XIL Blue Cross Medicare Advantage X X
CA Blue Cross of California X X X*ID Blue Cross of Idaho X X*PA Blue Cross of Northeast Pennsylvania XCA Blue Shield of California X X X* X*NY Blue Shield of Northeastern New York XWA Blue Shield of Washington XTX Boon-Chapman TPA X XTX Boon Group X XMA Boston Medical Center HealthNet X X*MT Boulder Administration Services X*CA Brand New Day X*
MULTI Bravo Health Plan Medicare (MD, PA, DC, TX) X X X*MULTI Bridgespan Health (ID, OR, UT, WA) X X
AZ Bridgeway Arizona X XMULTI Bright Health XMULTI Bright Health Medicare Advantage X
OH Buckeye X X X* X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 5
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
NAT'L Butler Benefit Services, Inc. XNAT'L C and O Employees Hospital Association X X
CA Califormia Children Services X* X*CA California Foundation for Medical Care X* X*CA California Health and Wellness X X X* X*CA CalOptima X X X* X*AZ CapConnect X*PA Capital BlueCross X X X* X* X*NY Capital District Physicians Health X
NAT'L Capitol Administrators X XNAT'L Caprock Health Plans XMULTI Care Centrix X* X*MULTI Care Improvement Plus X
NY Care Management Company (CMO) XCA Care1st of California X* X*
NAT'L CareCore National X* X*OH CareFactor X*MD CareFirst (Blue Cross Blue Shield of Maryland) X X X*VA CareFirst (Blue Cross Blue Shield of Virginia) X X X*DC CareFirst (Blue Cross Blue Shield of Washington DC) X X X*TX Care N Care Insurance Company X XNC Carolina Complete Health XFL CarePlus Health Plan X X X*
MULTI CareSource (GA, IN, KY, OH, WV) X XOH CareSource Ohio X* X*GA CareSource Georgia X* X*KY CareSource Kentucky X* X*CT CarePartners of Connecticut XOR Cascade X* X*NV CDS Group Health X XMA CeltiCare X XCA Cencal Health Plan X X*
MULTI Cenpatico (AZ,FL,GA,IL,IN,KS,KY,MA,MS,MO,OH,SC,TX,WI) X XAZ Cenpatico (AZ) X XFL Cenpatico (FL) X XGA Cenpatico (GA) X XIL Cenpatico (IL) X XIN Cenpatico (IN) X XKS Cenpatico (KS) X XKY Cenpatico (KY) X X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 6
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
MA Cenpatico (MA) X XMS Cenpatico (MS) X XMO Cenpatico (MO) X XOH Cenpatico (OH) X XSC Cenpatico (SC) X XTX Cenpatico (TX) (IMHS) X XWI Cenpatico (WI) X XCA Center IPA X*NY Centivo X*CA Central California Alliance Health X X X* X*CA Central Health Medicare Plan X*
NAT'L Central Reserve Life Insurance Co. Medicare Supplement X XTX Central Senior Care X XAZ Centurion Arizona Health Plan X X
NAT'L Cerner Health Plan X XMULTI Central States Funds X XNAT'L Central States Indemnity X
KY CGS Medicare Part B Kentucky Batch X*NAT'L CHAMPVA X XMULTI CHC Altius Health Plan/CHC Nevada X X
SC CHC Cares of South Carolina X XNC CHC of Carolinas X X
MULTI CHC of Kansas/CHC of Oklahoma X XMULTI CHC of MO, MS, AR, TN X XMULTI CHC of Texas X X
VA CHC of Virginia X XWV CHC of West Virginia X X
MULTI CHF Medicare Advantage XCA CHOC Health Alliance X*
MULTI CHP Direct XMULTI Childrens Mercy PCN X
PA Choice PA X*NAT'L Christian Brothers Services X XNAT'L Christie Student Health Plans X X
TX CHRISTUS Health Plan X XNM CHRISTUS Health Plan New Mexico Health Insurance Exchange X XNM CHRISTUS Health Plan New Mexico Medicare Advantage X XTX CHRISTUS Health Plan Texas Health Insurance Exchange X
NAT'L CIGNA X X X* X* XMULTI Cigna-HealthSpring (AL, FL, IL) X X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 7
State Name of Payer Eligibility Claim Status Claim Status-Batch File
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
TN Cigna-HealthSpring Tennessee (HMO, POS and M+C) XMN Clarion Health X XNJ Clover Health X
NAT'L CMFG Life Insurance X XNAT'L Colonial Penn X
CO Colorado Access X CO Colorado Medicaid X X X* X*WI Common Ground X XMA Commonwealth Care Alliance X* X*IL Community Care Alliance of Illinois X*
OK Community Care of Oklahoma X XCA Community Family Care X*TX Community First Health Plans X XCA Community Health Center Network X* X*TX Community Health Choice X X* X*WA Community Health First (CHF) Medicare Advantage XCA Community Health Group X* X*NE Community Health Options XWA Community Health Plan of Washington X X* X*MI Community Health Plan Services X*
NAT'L Concentrix Insurance Solutions X XCT ConnectiCare X XCT ConnectiCare Medicare X XCT Connecticut Department of Social Services X*CT Connecticut Medicaid X* X X*
NAT'L Consolidated Associates Railroad XMA Consolidated Health Plan X*PR Constellation Health (Inmediata Health Group Corp) XMI Consumer Mutual of Michigan XOH Consumers Life X
NAT'L Continental General Insurance Company Medicare Supplement XTX Cook Children’s Health Plan XNE Cooperative Benefit Administrators (CBA) X XWA Coordinated Care X X X* X*
MULTI CoreSource (AR, IL, IN, MD, NC, OH, PA) X XMULTI CoreSource (AZ, MN) X
KS CoreSource Kansas (FMH) X XNAT'L Corporate Benefit Service X XNAT'L Country Life Insurance Company X
IL CountyCare Behavioral X X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 8
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
IL CountyCare X X* X* X*CA County Medical Services X* X*
NAT'L Covenant Administrators X XNAT'L Coventry Advantra Savings X X
VA Coventry CHC - Carenet X XID Coventry CHC Altius Health X XOH Coventry CHC Carelink Commercial X XOH Coventry CHC Carelink Medicaid X X
MULTI Coventry CHC Healthcare Inc. X XMO Coventry CHC Healthcare USA (MO) X XNV Coventry Health and Life – NV X XOK Coventry Health and Life – OK X XTN Coventry Health and Life – TN X X
NAT'L Coventry Health Care Federal X XNAT'L Coventry Health Care National X X X*
DE Coventry Health Care of Delaware X XGA Coventry Health Care of Georgia X XIL Coventry Health Care of Illinois XIA Coventry Health Care of Iowa X X
NAT'L Coventry Health Care of Kansas City X XNAT'L Coventry Health Care of Kansas, Wichita X X
LA Coventry Health Care of Louisiana X XNE Coventry Health Care of Nebraska X XVA Coventry Health Care of Southern Services X X
MULTI Coventry Health Care of the Carolinas (NC, SC) X XMULTI Coventry Vista/Summit X X
KY CoventryCares of Kentucky X XPA CoventryCares of Pennsylvania X XWV CoventryCares of West Virginia X
MULTI CoventryOne X XNAT'L Cox Health Plans X
NY Crystal Run Health Plans XNAT'L CSA Fraternal Live Medicare Supplement X X
NV Culinary Health Fund UNITE HERE Health XNAT'L Custom Design Benefits X*MULTI Cypress XNAT'L D H Evans X
SD DakotaCare X*WI Dean Health Plan X XWI Dean Health Plan Medicaid X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 9
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
DE Delaware Medicaid X*CA Delta Dental of California XCO Delta Dental of Colorado XGA Delta Dental of Georgia XOH Delta Dental of Ohio Xpa Delta Dental of Pennsylvania X
NAT'L Delta Health Systems X*NAT'L DentaQuest X
CO Denver Health Medical Plan XCO Denver Health Medical Plan Medicaid XCO Denver Health Medical Plan Medicare XUT Deseret Mutual XFL Devoted Health XMD Diamond Plan X X
NAT'L Directors Guild XMULTI District 9 IAM and AW Welfare Trust X X
DC District of Columbia Medicaid XME Diversified Administration Corporation X XTX Driscoll Health Plan XNY ElderPlan XCA El Proyecto del Barrio via MedPoint Mgmt X*NY Emblem Health X X X* X* X* X*ME EMHS Employee Health Plan X
MULTI EMI Health (AZ, UT) XNY Empire Blue Cross Blue Shield X X X* X* X* X*
NAT'L Employee Benefit Management Services X X X*NAT'L Employee Benefits Administration (EBA) X
CA Employee Health Systems X*AR Empower Healthcare Solutions XNY ePaces eMed NY X* X*
NAT'L EPIC Life Insurance XNAT'L EPSI, Inc. X
UT Equitable Life and Casualty XMULTI Essence Healthcare X X X* X*NAT'L Everence Financial X
MD Evergreen Health XNAT'L Evicore X* X*NAT'L Exceedent Health X
NY Excellus BCBS (Provides BCBS of Western NY through Blue Exchange) X X*CA Exceptional Care, Huntington Park X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 10
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
NAT'L EZ Cap X*MA Fallon Community Health X
NAT'L Farm Bureau Health Plans XMULTI FCE Benefit Administrators XMULTI Federated Life Insurance Company X XMULTI FHP Childrens Mercy Care Network X
NY Fidelis Care Medicaid & Medicare X X* X* X*NAT'L Fidelity Security Life Insurance Company XMULTI First Administrators X*
NY First Ameritas of New York X XWA First Choice Health X* X* X*SC First Choice VIP Care Plus Medicaid XSC First Choice VIP Care Plus Medicare XGA First Medical Network XNC FirstMedicare Direct X*
NAT'L First Reliance Statndard Life X XTX FirstCare X X X*NC FirstCarolinaCare Insurance Company X X*FL Florida Blue X X X* X* XFL Florida eQ Health Suite X*FL Florida Hospital Care Advantage X* X*FL Florida Hospital Healthcare System XFL Florida Medicaid X XFL Florida True Health X XCA Food, Bakery, Confection Workers Fund of So Cal X XMS Fox/Everett X*IL Fox Valley Medicine X*FL Freedom Health X* X*
MULTI Fresenius Health Partners (AZ, CA, NC) XPA Gateway Health Plan X X*
NAT'L GEHA X XPA Geisinger Health Plan X X*PA Geisinger Health Plan Gold XGA Georgia Medicaid X X X* X*GA Georgia Medicaid Batch X X*
NAT'L Gilsbar TPA X XNAT'L Global Health X*NAT'L Globe Life and Accident Insurance Company X X
NY Globe Life Insurance Company of New York X XCA Gold Coast X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 11
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
CA Golden Coast HP X*NAT'L Golden Rule X XNAT'L Government Employees Hospital Association (GEHA) X X
NH Granite State Health Plan X XNAT'L Great American Life Insurance Company Medicare X XMULTI Greek Catholic Union XNAT'L Group Administrators X*
TX Group and Pension TPA X XNAT'L Group Health Cooperative Eau Claire X*NAT'L Grouplink X
WI Group Practice Affiliates XNAT'L Guardian Life Insurance Dental XMULTI Harken Health X XMULTI Harmony Health Plan (A WellCare affiliated plan) X X X*MULTI Harmony Health Plan Medicare X XMULTI Harvard Pilgrim (MA, NH) X X X* X*MULTI Harvard Pilgrim Stride (MA, NH) X*
HI Hawaii Medical Assurance Association XHI Hawaii Medical Service Association (BCBS of Hawaii) XHI Hawaii Medicaid XDC Health Services for Children with Special Needs XIL Health Alliance Medical Plan of IL X X X*
MULTI Health Alliance Plan (IN, WI, OH, MI) XPA Health America of Pennsylvania X XNV Health Care Partners X* X*AZ Health Choice Arizona X XOK Health Choice Oklahoma X
NAT'L Health Cost Solutions X XNAT'L Health Design Plus X*
FL Health First Insurance Inc. XFL Health First Health Plans X X X*CA Health Net Medi-Cal X
MULTI Health Net National Commercial (AZ, CA, CT, NJ, NY, OR) X X X* X* X*AZ Health Net of Arizona X X
MULTI Health Net of the Northeast XMA Health New England XMN Health Partners of Minnesota X*PA Health Partners of Philadelphia X XNV Health Plan of Nevada X X*CA Health Plan of San Joaquin Medicaid X X* X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 12
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
CA Health Plan of San Mateo XOH Health Plan of Upper Ohio Valley XOH Health Plan of Upper Ohio Valley Medicaid XOH Health Plan of Upper Ohio Valley Medicare X
NAT'L Health Plans Inc. X*MI Health Plus of MI XDC Health Services for Children with Special Needs X XOR Health Share of Oregon XNC Health Team Advantage XWI Health Tradition Health Plan XWA Healthcare Management X XMO Healthcare Inc. X XLA Healthcare LA X*NY HealthCare Partners IPA X*MO Healthcare USA (MO) X XCA HealthComp Administrators XFL HealthEase (A WellCare affiliated plan) X XFL HealthEase Kids (A WellCare affiliated plan) X XCA HealthEdge Administrators X X
NAT'L HealthEZ XNJ Healthfirst of New Jersey X XNY Healthfirst of New York Medicaid & Medicare X X X*
NAT'L Healthgram X XTX HealthHelp X* X*IL HealthLink HMO X*
NY HealthNow XNAT'L HealthPlans, Inc. X
NY Healthplex X*NAT'L HealthScope XNAT'L HealthSmart X X X* X*
LA Healthy Blue X XIN Healthy Indiana Plan XTX Healthy Texas X
MULTI Heartland National Life Insurance Company XMN Hennepin Health Medicaid XMN Hennepin Health Medicare XTX Heritage Physician Network (Houston) X XPA Highmark Blue Cross Blue Shield X X X*DE Highmark Blue Cross Blue Shield of Delaware X*WV Highmark Blue Cross Blue Shield of West Virginia X X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 13
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
PA Highmark Blue Shield NaviNet X* X*WI Highmark Senior Solutions X XCA Hill Physicians Medical Group X*MO Home State X XNV Hometown Health X X* X*NJ Horizon Blue Cross Blue Shield of New Jersey X X X* X* X* X XNJ Horizon NJ Health Medicaid X X
NAT'L HM Care Advantage XTN HSBS Memphis X X
NAT'L Humana X X X* X* XKY Humana CareSource (KY) X XCT Husky Health Connecticut X* X*GA IBEW Local 508 Health Plan X XID Idaho Medicaid X X
NAT'L IHC Health Solutions X XIL IlliniCare Health Plan X X X* X*IL Illinois Medicaid X XPA Independence Administrators XPA Independence Blue Cross FOC X X X* X* X*NY Independent Health XIN Indiana Medicaid X X X* X*IN Indiana University Health Plans XCA Inland Empire Health Plan (IEHP) Commercial X X* X*CA Inland Empire Health Plan (IEHP) Medicaid XCT Innovation Health X*
MULTI Innovista Health Solutions X* X*TX Insurance Management Services X*
NAT'L Insurers Administrative Corporation (IAC) X XDE INTEGRA Administrative Group X X
NAT'L Integral Quality Care X* X* X*TX Integrated Mental Health Services XCA Inter Valley Health Plan XPR Internation Medical Card XVA INTotal Health X*IA Iowa Medicaid X XIA Iowa Total Care X
GU Island Home Insurance XNAT'L John Alden Life Insurance Company (see Fortis) X
MD Johns Hopkins Advantage MD XMD Johns Hopkins Priority Partners & EHP X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 14
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
MD Johns Hopkins US Family Health Plan XMULTI Kaiser Foundation Health Plan Mid - Atlantic ( DC, MD, VA) X
MULTI Kaiser Foundation Health Plan of CO, HI and the Northwest (OR & WA) X
MULTI Kaiser Foundation Health Plan of Washington X X X*NAT'L Kaiser Permanente Insurance Co KPIC X
GA Kaiser Permanente of Georgia XCA Kaiser Permanente of Southern CA XCA Kaiser Permanente of Northern CA XCA Kane County IPA X X*KS Kansas Medicaid XKS Kansas Medicaid (Batch) XTX Katy Medical Group X X
NAT'L Kemper Benefits XOK Kempton Company X XKY Kentucky Medicaid X X
MULTI KePro X*MULTI KePro Medicaid X*
CA Kern Health Network X*NAT'L Key Benefit Administrators X XNAT'L Key Healthy Partners X
CA Key Medical Group X* X*MULTI KeySolution X
PA Keystone First X X X*PA Keystone First Aligned X XPA Keystone First Community Health Choices X XPA Keystone Health Plan East Commercial X XPA Keystone VIP Choice X XWA Kitsap Physician Services X
NAT'L KSKJ Life XCA L.A. Care X XLA LaCare X
NAT'L Leggett and Platt XFL Leon Medical Centers Health Plans X X
NAT'L Liberty National Life Insurance Company X XMULTI Lifemap (AK, ID, MT, OR, UT, WA, WY) X X
AZ Lifeprint X*AZ Lifewise Health Plan of Arizona XOR Lifewise Health Plan of Oregon XWA Lifewise Health Plan of Washington X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 15
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
NAT'L Lincoln Financial Group X XNAT'L Lincoln Heritage XNAT'L Local 1199 XNAT'L LoneStar TPA XNAT'L Loomis X X
LA Louisiana Healthcare Connections X X X*LA Louisiana Medicaid X X*NM Lovelace Salud Health Plan Medicaid X
NAT'L Loyal American Life Insurance Company Medicare X XMULTI Loyal Christian Benefit Association X
TN Lucent Health XNAT'L Maestro Health XNAT'L Magellan X
VA Magellan Complete Care of Virginia XNJ MagnaCare X X X* X*MS Magnolia Health Plan X X X*ME Maine Medicaid X X*
MULTI Managed Care of America X XCA Managed Health Network X XIN Managed Health Services Indiana X XWI Managed Health Services Wisconsin X XPR MAPFRE Life Puerto Rico XPR MAPFRE Medicare Excel XAZ Maricopa Care Advantage (AZ) XAZ Maricopa Health Plan X XME Martins Point XME Martins Point Medicare XMD Maryland Medicaid XMD Maryland Physicians Care X X* X*MA Massachusetts Medicaid X XCA Maverick Medical Group X*FL MCNA Dental XIN MDWise Health Indiana Plan X*IN MDWise Methodist X*IN MDWise ProHealth X*IN MDWise Select Health Network X*IN MDWise St. Catherine X*IN MDWise St. Francis X*IN MDWise St. Margaret Mercy X*IN MDWise St. Vincent X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 16
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PAYER LIST: ELIGIBILITY, CLAIMS STATUS, AUTHORIZATIONS, NOTICE OF ADMISSION
IN MDWise Total Health X*IN MDWise Wishard X*FL Med 3000 X*
MULTI MedCost Benefit Services Employers (NC, SC) X X* X* X*NAT'L MeDecision X*MULTI Medica (IA, MN, ND, NE, SD, WI) X X
MN Medica Health Plan Solutions XFL Medica Health Plans of Florida X
NAT'L Medica Marketplace (IFB) XMULTI Medical Associates Health Plan/Health Choices X XMULTI Medical Benefits Administrators / MedBen X
OH Medical Benefits Administrators Inc. (Newark OH) XOH Medical Benefits Companies (Newark OH) XOH Medical Benefits Mutual (Newark OH) X
MULTI Medical Benefits Mutual / MedBen XMULTI Medical Benefits Mutual Life Insurance Co. X
CA Medi-Cal Medicaid X X* X*PR Medical Card Systems XOH Medical Mutual of Ohio X X X* X*CA Medi-Cal Share of Cost XIA Medical Associates Health Plan/Health Choices X X
NAT'L Medicare Part A DDE X*NAT'L Medicare Part A & B X
FL Medicare and Much More (MMM) of Florida XPR Medicare y Mucho Mas MMM X
NAT'L Medico Insurance Company X XMULTI Med-Pay X X
IN MedPartners X*CA MedPoint Management X*
NAT'L MedSolutions X*NAT'L MedStar Select X
AZ Mercy Care Plan X XAZ Mercy Maricopa Intergrated Care XIL Meridian Health Plan of Illinois X X*
NAT'L Meritain Health X X X*NAT'L MetLife Dental X
NY MetroPlus (Medicare/Medicaid) X XNAT'L MHNET Behavioral Health X X
WI MHS Health Wisconsin X*MULTI MHS Medicaid X* X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 17
State Name of Payer Eligibility Claim Status Claim Status-Batch File
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FL Miami Children's Health Plan XMI Michigan Complete Health X XMI Michigan Medicaid X XMI Michigan Medicaid Pending Eligibility XMN Minnesota Medicaid X*CA Mission IPA X*MS Mississippi eQ Health Suite X*MS Mississippi Medicaid X XMS Mississippi State Employees and Teachers X XMO Missouri Care Health Plan X XMO Missouri Medicaid X* XOR Moda Health X X X*CA MolinaID Molina (ID) XIL Molina (IL) X X
NY Molina (NY) X*PR Molina (PR) X XSC Molina (SC) X XWI Molina (WI) X X X
MULTI Molina Healthcare Medicaid (CA, FL, IL, MI, MO, NM, OH, TX, UT, WA) X X* X* X* X*MT Montana Medicaid X XAR Municipal Health Benefit Fund X X
NAT'L Mutual Health Services X XNAT'L Mutual Medical Plans X XMULTI MVP Healthcare (NY, NH, VT) X* XNAT'L Mutual of Omaha Commercial XNAT'L Mutual of Omaha Medicare Advantage X X
CA My Group Health X*NAT'L NaphCare XNAT'L National Association of Letter Carriers (NALC) X XMULTI Nationwide Health Plans (CA, OH) X XNAT'L NCTA X*
NE Nebraska Medicaid (Batch) XNE Nebraska Medicaid XNE Nebraska Total Care X XFL Neighborhood Health Partnership XRI Neighborhood Health Plan of RI X X* X* X*WI Network Health (WI) X XWI Network Health Insurance Corp. X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 18
State Name of Payer Eligibility Claim Status Claim Status-Batch File
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NV Nevada Medicaid XMULTI New Century X* X*
TX New Era Life Insurance X XNH New Hampshire Healthy Families XNH New Hampshire Medicaid XNJ New Jersey Medicaid X*NM New Mexico Health Connections X X* X*NM New Mexico Medicaid X XNY New York Medicaid XNY New York Medicaid Batch X*CA NIA X* X*
MULTI Nippon Life Insurance Company X XCA NIVANO X* X*IL NGS Medicare Part B Illinois Batch X*
NY NGS Medicare Part B New York Upstate X*ID Noridian Medicare Part B Idaho X*MT Noridian Medicare Part B Montana X*CA Noridian Medicare Part B Northern California X*ND Noridian Medicare Part B North Dakota X*OR Noridian Medicare Part B Oregon X*WY Noridian Medicare Part B Wyoming X*NC North Carolina Medicaid X X X* X*ND North Dakota Medicaid X X
MULTI Northwest Administrators (CA,NV,OR,WA) X XNY Nova Healthcare Administrators XAR NovaSys X XLA Novitas Medicare Part B Louisiana X*TX Novitas Medicare Part B Texas X*HI Ohana Health Plan (A WellCare affiliated plan) X XOH Ohio Medicaid XOK Oklahoma Employees Group Insurance Division X XOK Oklahoma Medicaid X X*OK Old Surety Life Insurance Company X XFL Oncology Analytics X* X*
MULTI Operating Eng Local 428 Health and Welfare X XVA Optima Health XFL Optimum Healthcare X* X*MD OptumHealth Behavorial Solutions X
MULTI OptumCare (AZ,CA,CO,CT,FL,IN,MA,NV,NJ,NY,OH,TX,UT) XGA Orange County Fire Authority X X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 19
State Name of Payer Eligibility Claim Status Claim Status-Batch File
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OR Oregon Medicaid X X* X*NY Orthet Online X*NY Orthonet X*
MULTI Oscar (CA, NY, TX) XMULTI Oxford Health Plan (NY, CT, DE, NJ, PA, RI) X X X* X* X* XMULTI Pacific Source Health Plan (OR, ID, MT) X X X* X* X* X*MULTI PacificSource Admininstrators (OR, ID, MT) X
OR PacificSource Community Solutions X XMULTI PacificSource Medicare (OR, ID) XMULTI PacifiCare (CA, NM, OK, OR, TX, WA) X XNAT'L PAi X*
GA Palmetto Medicare Part B Georgia Batch X*NC Palmetto Medicare Part B North Carolina Batch X*SC Palmetto Medicare Part B South Carolina Batch X*LA Pan-American Life Insurance Company X X
NAT'L Panamerican Life Puerto Rico XOH Paramount X X*OH Paramount Medicaid XOH Paramount Medicare XTX Parkland Community Health Plan X XNY Partners Health Plan (NY) X*CA Partnership Health Plan of California Commercial X X* X*CA Partnership Health Plan of California Medicaid XKY Passport Health Plan X XKY Passport Health Plan Medicare X X
NAT'L Path Administrators X XGA Peach State Health Plan X X X* X*UT PEHP XPA Penn Treaty Network America Ins. Medicare Supplement X XPA Pennsylvania Health and Wellness X XPA Pennsylvania Medicaid X XLA Peoples Health X XPA PerformCare X XIL PersonalCare (Coventry) X X
NAT'L Personal Insurance Administrators (PIA) X XMI PHP of Mid-Michigan XTN PHP of TN Medicaid XIN Physicians Health Plan of Northern Indiana XCA Physicians Medicald Group San Jose X* X*CA Physicians Medical Group, Santa Cruz (PMG) X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 20
State Name of Payer Eligibility Claim Status Claim Status-Batch File
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NAT'L Physicians Mutual Insurance Company X XWI Physicians Plus Insurance Corporation X
NAT'L PIA X*NAT'L Piedmont X XNAT'L Piedmont WellStar Health Plan X
CA Pinnacle Claims Management X*TX Pinnacle Physician Management Org XPR Plan De Salud Hospital Menonita XSC Planned Administrators Inc. X XNV Plumbers Pipefitters Local 525 Health and Welfare Trust X X
NAT'L POMCO X*CA PPMC Direct X* X*
NAT'L Prairie States X*NAT'L Preferred Care Partners X X
CA Preferred IPA X*MULTI Preferred One (MN, IA, MT, MI, ND, SD) X X*
AK, WA Premera Blue Cross X X X* X* X*PA Premier Health Plan XNM Presbyterian Health Plan X* X* X*FL Prestige Health Choice X X X*
NAT'L Primary Care Associates X* X*CA Prime Community Care X* X*MN PrimeWest X
NAT'L Principal Financial Group X XMI Priority Health Plan X X*IN Pro Health X
NAT'L Professional Benefit Administrators XNAT'L Professional Claims Management X*NAT'L Prominence Health Plan X X X* X*NV, TX Prominence Health Plan Medicare Advantage X*
CA Prospect Medical Group X*MULTI Providence Health Plan (OR, WA) X X X*NAT'L Provident American Life & Health Insurance Company X XNAT'L Psychcare X*
PR Puerto Rico Medicaid XNAT'L Puitan Life Insurance XNAT'L QualCare X X
AR QualChoice of Arkansas X X*WA Qualis Health WA X* X*
MULTI Quartz ASO X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 21
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MULTI QuickTrip X XCA Regal X* X*OR Regence Blue Cross Blue Shield of Oregon X X UT Regence Blue Cross Blue Shield of Utah X XID Regence Blue Shield of Idaho X X X*
WA Regence Blue Shield of Washington X XMULTI Regence Group Administrators (OR, WA) X XNAT'L Reliance Standard Life X XNAT'L Reserve National Insurance Co. X
RI Rhode Island Medicaid X*TX RightCare XCA River City X* X*CO Rocky Mountain Health Plan X X*CO Rocky Mountain Medicaid Health Plan X
NAT'L Royal Neighbors of America XOR Samaritan Health / Intercommunity Health X* X*
NAT'L S and S Healthcare Strategies X XMULTI Sanford Health Plan X X*MULTI Sanford Health Plan Medicare X
CA Sanford Regional Health Plan X*CA San Francisco Health Plan XCA Santa Clara County IPA X*CA Santa Clara Family Health Plan (Valley Health Plan Network only) X X*CA SCAN Medicare Supplement XCA SCFHP (Santa Clara Family Health Plan) X X*TX Scott and White Health Plan Commercial and Medicare XGA Secure Health Plans Of Georgia X*WI Security Health Plan XMS Select Administrative Services XSC Select Health of South Carolina X X X*TX Select Senior Clinic X XOK SelectCare of Oklahoma X XTX SelectCare of Texas (Beaumont) X XTX SelectCare of Texas (Golden Triangle) X XTX SelectCare of Texas (Houston) X XTX SelectCare of Texas (Integranet) X XTX SelectCare of Texas (Kelsey-Seybold) X XTX SelectCare of Texas (Memorial Clinical Assoc) X XTX SelectCare of Texas (Northwest Diagnostic) X
ID, UT SelectHealth X X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 22
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VA Selman and Company X XNV Senior Dimensions X
MULTI Senior Whole Health Medicaid (NY, MA) XMULTI Senior Whole Health Medicare (NY, MA) X
CA Sharp Health Plan X XVA Shenandoah Life Insurance Company XPA Significa Benefit Services X XIN SIHO Insurance Services XNC Silverback TPA XNV SilverSummit Health Plan XTN SimplePay XFL Simply Better Health X* X*FL Simply Healthcare Plans X X X* X*FL Simply Healthcare Plans Medicaid X XFL Simply Healthcare Plans Medicare X X
NAT'L SisCo Benefits X XCA South Atlantic IPA X* X*SC South Carolina Medicaid X XSC South Carolina State Health Plan (Blue Cross Blue Shield of SC) XPA South Central Preferred X*MN South Country Health Alliance Medicaid X Xmn South Country Health Alliance Medicare XSD South Dakota Medicaid X
NAT'L Special Agents Mutual Benefits Association X XNAT'L Specialties & Paper Products X
PA Spectrum Health XNAT'L SPJST Medicare Supplement X XMULTI SRT Administrators XNAT'L Standard Insurance X X
NY Standard Insurance of New York X XNAT'L Standard Life and Accident Insurance Company X XNAT'L State Farm XNAT'L Star HRG X XNAT'L State Mutual Medicare Supplement X
FL StayWell (A WellCare affiliated plan) X XFL StayWell Kids (A WellCare affiliated plan) X X
NAT'L Stewart C. Miller X XMULTI Stonebridge Life Insurance X XNAT'L Student Insurance X
OH SummaCare X X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 23
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NAT'L Summit America Insurance Services X XAR Summit Community Care XKS Sunflower State Health Plan X X X*FL Sunshine State Health Plan X X X* X*CA Superior Choice Medical Group X*TX Superior Health Plan X X X* X* X*
NAT'L Sutter Health Plus X*CA Sutter Select XCA SynerMed Direct X*TN TennCare XTX TexanPlus (Integranet) X XTX TexanPlus (Kelsey-Seybold) X XTX TexanPlus North Texas Area X XTX TexanPlus Southeast Texas Area X XTX Texas Childrens Health Plan X*TX Texas First Health Plan (TOPA) X XTX Texas Medicaid X XTX Texas Medicaid Long Term Care X*
NAT'L The ULLICO Family of Companies X XMULTI Three Rivers Health Plan (PA, SC, WV) X XNAT'L Thrivent XMULTI TLC Benefit Solutions (GA, TN) X
TX TML Intergovernmental Employee Benefits Pool X*ME, NY Todays Options X X X*
WI Together with Childrens Community Health Plan XMI Total Health Care X
NAT'L TransactRX Part D X XNY Transamerica Financial Life Insurance X
NAT'L Transamerica Life Insurance XNAT'L Transamerica Premier Life Insurance X XNAT'L TRICARE East X X*NAT'L TRICARE West X X X*NAT'L TRICARE For Life X NAT'L TRICARE Overseas X X
OH TriHealth Benefit Solutions XOR Trillium X X* X*PR Triple-S Advantage XPR Triple-S Salud (BCBS Puerto Rico) X
NAT'L TRISTAR X*AZ TriWest Healthcare X* X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 24
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NAT'L Trustmark X XMULTI Tufts Health Plan (MA, NH) X X* X* X* X* X*
MA Tufts Health Public Plans X MN Ucare Minnesota X
NAT'L UHC Secure Horizons AARP Medicare Supp X XFL Ultimate Health Plans X X
NAT'L UMR Wausau X X X* X*MULTI Underwriters Safety and Claims XNAT'L UNICARE X XNAT'L Unified Group Services X*NAT'L Union Pacific Railroad Employees X XNAT'L Unison Health Plan X XNAT'L United American Insurance Company Eligibility X X
OH United Commercial Travelers X*NAT'L United Concordia Companies, Inc. XNAT'L United Healthcare X X X* X* X XNAT'L United Healthcare Enhanced X*NAT'L United Mine Workers Association X XNAT'L United Teacher Associates Ins Co Medicare Supplement X XNAT'L UnitedHealth Community Plan X X*NAT'L UnitedHealthCare Life Insurance Company X
FL UnitedHealthCare Neighborhood Health Partnership NHP (FL) XNV UnitedHealthcare Nevada X X* X*
NAT'L UnitedHealthcare Secure Horizons XNAT'L UnitedHealthcare Shared Services X
WI Unity Health Plan XNY Univera XMD Universal Benefit Corp X XFL Universal Health Care Group XAZ University Care Advantage Arizona X XAZ University Family Care X XHI University Health Alliance X*AZ University of Arizona Health Plans - UHM X XMO University of Missouri X XPA University of Pittsburgh Medical Center Health Plan XUT University of Utah Health Plan XAZ University Physicians Care Advantage X X
MULTI UPMC Health Plans X X X*NAT'L USAA Life Insurance Company X XNAT'L USAA Medicare Supplement X X
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 25
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NAT'L US Department of Labor X*UT Utah Medicaid XUT Utah Medicaid (Batch) X
NAT'L VA Fee Basis Program X* XNAT'L VA Health Administration Center X
CA Valley Care Program XCA Valley Health Plan X X* X*PA Vantage Health X XVT Vermont Medicaid X XNY Village Care Max X*TX Village Family Practice X XVA Virginia Medicaid X X*VA Virginia Premier Health Plan X*NY Visiting Nurse Services of New York X XFL Vista Health Plan X X
NAT'L Vista/Summit X XAL VIVA Health X X*FL Vivida Health XWA Washington Medicaid X X X*WI WEA Trust X
NAT'L WEB-TPA X XNH Well Sense Health Plan X
MULTI Wellcare (FL, GA, HI, KY, IL, MO, NE, NY, OH, SC) X X X* X* X*WI WellFirst Health X
NAT'L WellMed X* X* X*MULTI Wellmark Blue Cross Blue Shield (IA, SD) X X X* X*NAT'L WellNet X X
WV West Virginia CHIP XWV West Virginia Family Health Plan X XWV West Virginia Medicaid XWV West Virginia PEIA X
NAT'L Western and Southern Financial Group X XCA Western Growers Assurance Trust X*CA Western Health Advantage X XNM Western Sky Community Care X X
MULTI Windsor Medicare Extra (AR, MS) X XWI Wisconsin Chronic Disease Program X XWI Wisconsin Medicaid X XWI Wisconsin Well Women Program X XWI WPS Health Insurance X X X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 26
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IN WPS Medicare Part B Indiana X*MI WPS Medicare Part B Michigan X*MO WPS Medicare Part B Missouri X*OR WVP Health Authority X* X*WY Wyoming Medicaid X XNY YourCare X MT Zenith America - Montana Retail Stores X*
As of 01/17/2020 * Indicates a payer that requires additional enrollment information. 27
