exchange edi eligibility payer list as of june 26,...

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Payer ID Payer Name Eligibility 270/271 Dental 270/271 10431 AARP X 10619 Administrative Services Inc X 10561 Advantage by Bridgeway Health Solutions X 10562 Advantage by Buckeye Community Health Plan X X 10563 Advantage by Managed Health Services X X 10564 Advantage by Superior HealthPlan X X 10004 Aetna X X 10397 Aetna Long Term Care X X 10594 Affinity Health Plan X X 10661 Affinity Health Plan Medicare X 10398 AFLAC - Dental X 10663 AFLAC - Medicare Supplemental X X 10006 Aftra Health Fund X X 10007 Alabama Medicaid X X 10798 Alan Sturm and Associates - Dental X 10654 Allegiance Benefit Plan Management X X 10786 Altus Dental X 10487 American Family Insurance Group-Medicare Supp & PPO X X 10664 American Health Medicare X 10829 American Medical Security (AMS) X X 10595 American National Insurance X 10596 American National Life Ins Texas X 10016 American Postal Workers Union (APWU) X X 10017 American Republic Insurance Company (ARIC) X X 10538 American Retirement Life Ins Co. Medicare Supp X X 10018 AmeriChoice of New Jersey (Commercial) X X 10019 AMERIGROUP X 10416 AmeriHealth Administrators X X 10640 AmeriHealth Caritas Louisiana (LaCare) X X 10340 AmeriHealth Caritas Pennsylvania X X 10020 Ameritas Group - Ameritas Life Insurance Co. X X 10232 Ameritas Group - First Ameritas of New York X 10233 Ameritas Group - First Reliance Standard Life X 10234 Ameritas Group - Reliance Standard Life X 10236 Ameritas Group - Standard Insurance X Exchange EDI Eligibility Payer List As of June 26, 2014

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Page 1: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

10431 AARP X

10619 Administrative Services Inc X

10561 Advantage by Bridgeway Health Solutions X

10562 Advantage by Buckeye Community Health Plan X X

10563 Advantage by Managed Health Services X X

10564 Advantage by Superior HealthPlan X X

10004 Aetna X X

10397 Aetna Long Term Care X X

10594 Affinity Health Plan X X

10661 Affinity Health Plan Medicare X

10398 AFLAC - Dental X

10663 AFLAC - Medicare Supplemental X X

10006 Aftra Health Fund X X

10007 Alabama Medicaid X X

10798 Alan Sturm and Associates - Dental X

10654 Allegiance Benefit Plan Management X X

10786 Altus Dental X

10487 American Family Insurance Group-Medicare Supp & PPO X X

10664 American Health Medicare X

10829 American Medical Security (AMS) X X

10595 American National Insurance X

10596 American National Life Ins Texas X

10016 American Postal Workers Union (APWU) X X

10017 American Republic Insurance Company (ARIC) X X

10538 American Retirement Life Ins Co. Medicare Supp X X

10018 AmeriChoice of New Jersey (Commercial) X X

10019 AMERIGROUP X

10416 AmeriHealth Administrators X X

10640 AmeriHealth Caritas Louisiana (LaCare) X X

10340 AmeriHealth Caritas Pennsylvania X X

10020 Ameritas Group - Ameritas Life Insurance Co. X X

10232 Ameritas Group - First Ameritas of New York X

10233 Ameritas Group - First Reliance Standard Life X

10234 Ameritas Group - Reliance Standard Life X

10236 Ameritas Group - Standard Insurance X

Exchange EDI Eligibility Payer List

As of June 26, 2014

Page 2: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10237 Ameritas Group - Standard Insurance of New York X

10559 Antares X X

10641 Arbor Health Plan X

10868 Arise Health Plan Medicare Select Policy X

10021 Arizona Medicaid (AHCCCS) X

10022 Arizona Physicians IPA (APIPA) X

10023 Arkansas Medicaid X X

10230 Assurant Health - John Alden Insurance Company (JALIC) X X

10087 Assurant Health - Time Insurance Company (FIC) X X

10227 Assurant Health - Union Security Insurance Company (FBIC) X X

10529 Asuris Northwest Health X X

10472 AultCare X X

10869 Avera Health Plans X

10024 AvMed Health Plans X X

10813 Bankers Life & Casualty X

10707 Banner Health Plans X

10831 BCBS Delaware X

10025 BCBS of Alabama X X

10027 BCBS of Arizona X X

10028 BCBS of Arkansas X X

10461 BCBS of Central New York X X

10029 BCBS of Colorado (Wellpoint) X X

10030 BCBS of Connecticut (Wellpoint) X X

10031 BCBS of Florida X X

10032 BCBS of Georgia (Wellpoint) X X

10530 BCBS of Hawaii X X

10033 BCBS of Illinois X X

10258 BCBS of Indiana (Wellpoint) X X

10396 BCBS of Iowa X X

10034 BCBS of Kansas X X

10473 BCBS of Kansas City X X

10259 BCBS of Kentucky (Wellpoint) X X

10035 BCBS of Louisiana X X

10036 BCBS of Maine (Wellpoint) X X

10037 BCBS of Massachusetts X X

Page 3: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10519 BCBS of Michigan (Institutional) X X

10038 BCBS of Michigan (Professional) X X

10039 BCBS of Minnesota X X

10040 BCBS of Mississippi X X

10322 BCBS of Missouri (Wellpoint) X X

10516 BCBS of Montana X

10384 BCBS of Nebraska X X

10260 BCBS of Nevada (Wellpoint) X X

10261 BCBS of New Hampshire (Wellpoint) X X

10041 BCBS of New Jersey (Horizon) X X

10042 BCBS of New Mexico X X

10043 BCBS of New York (Empire) X X

10323 BCBS of New York (Excellus) X X

10383 BCBS of North Carolina X X

10478 BCBS of North Dakota X X

10044 BCBS of Ohio (Wellpoint) X X

10582 BCBS of Oklahoma X X

10045 BCBS of Oregon (Regence) X X

10524 BCBS of Pennsylvania (Highmark) [Institutional] X X

10046 BCBS of Pennsylvania (Highmark) [Professional] X X

10304 BCBS of Rhode Island X X

10047 BCBS of South Carolina X X

10395 BCBS of South Dakota (Wellmark) X X

10430 BCBS of Tennessee X X

10048 BCBS of Texas X X

10469 BCBS of the Rochester Area (NY) X X

10470 BCBS of Utica-Watertown (NY) X X

10624 BCBS of Vermont X X

10049 BCBS of Virginia (Wellpoint) X X

10462 BCBS of West Virginia X X

10498 BCBS of Western New York X X

10299 BCBS of Wisconsin (Wellpoint) X X

10480 BCBS of Wyoming X X

10665 Benefit Management Inc X

10256 Best Choice Health Plan X

Page 4: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10050 Best Life and Health X

10187 Better Health Plans (Unison Health Plans) X

10803 Blue Benefit Administrators of Mass X

10262 Blue Cross Independence (Pennsylvania) X X

10264 Blue Cross Northeastern Pennsylvania X X

10051 Blue Cross of California (Wellpoint) X X

10638 Blue Cross of Idaho X X

10326 Blue Cross of Washington and Alaska (Premera) X X

10325 Blue Cross Pennsylvania (Capital) X X

10053 Blue Shield of California X X

10052 Blue Shield of Idaho (Regence) X X

10499 Blue Shield of North Eastern New York X X

10054 Blue Shield of Washington (Regence) X X

10504 BlueChoice HealthPlan South Carolina Medicaid X X

10429 Bluegrass Family Health X

10556 BMC HealthNet Plan X X

10821 Boon Group X

10399 Bravo Health, Inc. X X

10827 Bridgespan X

10783 Brokers National - Dental X

10055 California Medicaid (Medi-Cal) X

10458 Capital District Physicians’ Health Plan (CDPHP) X X

10660 CAPROCK X X

10806 Care Improvement Plus X

10270 Carefirst Blue Cross Blue Shield X X

10056 CarePlus Health Plan X X

10822 CarePoint Medicare Advantage X

10057 CareSource Health X

10058 Cariten Healthcare X

10059 Cariten Senior Health X

10762 Carolina Care Plan, Inc. (CCP) X X

10667 CDS Group Health X X

10668 Celtic Insurance X

10567 Cenpatico - Arizona X X

10568 Cenpatico - Florida X X

Page 5: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10569 Cenpatico - Georgia X X

10631 Cenpatico - Illinois X

10570 Cenpatico - Indiana X X

10571 Cenpatico - Kansas X X

10632 Cenpatico - Kentucky X

10588 Cenpatico - Massachusetts X X

10769 Cenpatico - Mississippi X

10768 Cenpatico - Missouri X

10770 Cenpatico - New Hampshire X

10572 Cenpatico - Ohio X X

10573 Cenpatico - South Carolina X

10633 Cenpatico - Texas X

10634 Cenpatico - Wisconsin X

10766 Cenpatico Behavioral Health X X

10767 Cenpatico Behavioral Health Texas X

10560 Centene - Absolute Total Care X

10763 Centene - Advantage by Peach State X X

10764 Centene - Advantage by Sunshine State X

10565 Centene - Bridgeway Arizona X

10566 Centene - Buckeye Community Health X X

10759 Centene - California Health & Wellness X

10589 Centene - Celticare X X

10761 Centene - Coordinated Care X X

10765 Centene - Granite State Health Plan X

10760 Centene - Home State Health Plan X X

10620 Centene - Kentucky Spirit Health Plan X

10704 Centene - Magnolia Health Plan X X

10586 Centene - Managed Health Services Indiana X

10587 Centene - Managed Health Services Wisconsin X X

10865 Centene - New Hampshire Healthy Families X

10590 Centene - Peach State Health Plan X X

10451 Centene - Sunshine State Health Plan X X

10592 Centene - Superior Health Plan TX X X

10866 Centene - Total Care Carolina X

10771 Centene Advantage Plans X

Page 6: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10666 CenterLight Healthcare X X

10884 Central California Alliance for Health X

10450 Central Reserve Insurance Company X X

10539 Central Reserve Life Ins Co. Medicare Supp X X

10486 Central States Fund X X

10744 Central States Indemnity X

10061 CHAMPVA/Spina Bifida/Children of Women Vietnam Vets X X

10447 CHC - Advantra (TX, NM, AZ Only) X X

10307 CHC - Advantra Freedom X X

10419 CHC - Advantra Savings X X

10216 CHC - Altius Health Plans X X

10212 CHC - Coventry Health and Life (Oklahoma) X

10405 CHC - Coventry Health and Life (Tenn) X X

10448 CHC - Coventry Health and Life - Nevada X X

10481 CHC - Coventry Health Care Federal X X

10449 CHC - Coventry Missouri X X

10642 CHC - COVENTRYCARES OF KENTUCKY X X

10440 CHC - CoventryOne X X

10076 CHC - Delaware X X

10206 CHC - Georgia X X

10219 CHC - Group Health Plan (GHP) X

10221 CHC - HealthCare Inc. (Promina) X X

10207 CHC - Iowa X X

10208 CHC - Kansas X X

10210 CHC - Louisiana X

10085 CHC - Mail Handlers Benefit Plan X X

10211 CHC - Nebraska X

10428 CHC - University of Missouri X

10551 CHC Florida X X

10222 CHC HealthCare USA X X

10224 CHC Illinois X X

10226 CHC of Carolinas X X

10225 CHC Virginia X

10214 CHC West Virginia X X

10062 CIGNA-GreatWest X X

Page 7: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10852 Colonial Penn Life X

10064 Colorado Access X

10065 Colorado Medicaid X X

10066 Community Care of Oklahoma X

10329 Community Health Plan of Washington (CHPW) X X

10421 Community HealthFirst Medicare Advantage X

10303 ConnectiCare X

10067 Connecticut Medicaid X X

10669 Consolidated Associates Railroad X

10540 Continental General Ins Co. Medicare Supp X X

10454 Continental General Insurance Company X

10610 Cook Children’s Health Plan X

10068 Cooperative Benefit Administrators (CBA) X X

10701 CoOportunity X

10311 CoreSouce (FMH) X X

10071 CoreSource (Little Rock) X X

10072 CoreSource (MD,PA,IL,NC,IN,AZ,MN) X X

10074 CoreSource (OH) X X

10670 Country Life Insurance Company X

10880 Covenant Administrators (TPA) X

10084 Coventry Healthcare National Network X

10218 CoventryCares of Maryland X

10223 CoventryCares of Michigan X X

10548 CoventryCares of Nebraska X X

10614 CoventryCares of Pennsylvania X X

10217 CoventryCares of Virginia X X

10215 CoventryCares of West Virginia X X

10838 Cox Health Plan X

10541 CSA Fraternal Life Medicare Supp X

10671 CTI Administrators X X

10577 DakotaCare X

10653 Dean Health Plan X X

10780 DeCare Dental Health Insurance X

10828 Definity Health X

10293 Delaware Medicaid X X

Page 8: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10709 Delta Dental Ins. Co. - Alabama X

10710 Delta Dental Ins. Co. - Florida X

10711 Delta Dental Ins. Co. - Georgia X

10712 Delta Dental Ins. Co. - Louisiana X

10713 Delta Dental Ins. Co. - Mississippi X

10714 Delta Dental Ins. Co. - Montana X

10715 Delta Dental Ins. Co. - Nevada X

10716 Delta Dental Ins. Co. - Texas X

10717 Delta Dental Ins. Co. - Utah X

10705 Delta Dental of California X

10718 Delta Dental of Colorado X

10719 Delta Dental of Connecticut X

10720 Delta Dental of Delaware X

10721 Delta Dental of Hawaii X

10722 Delta Dental of Indiana X

10723 Delta Dental of Maryland X

10724 Delta Dental of Michigan X

10725 Delta Dental of Minnesota X

10726 Delta Dental of Nebraska X

10727 Delta Dental of New Jersey X

10728 Delta Dental of New Mexico X

10729 Delta Dental of New York X

10730 Delta Dental of North Carolina X

10731 Delta Dental of North Dakota X

10732 Delta Dental of Ohio X

10733 Delta Dental of Pennsylvania X

10734 Delta Dental of Rhode Island X

10735 Delta Dental of Tennessee X

10736 Delta Dental of Virginia X

10737 Delta Dental of Washington DC X

10738 Delta Dental of Washington State X

10739 Delta Dental of West Virginia X

10740 DeltaCare USA - Claims X

10741 DeltaCare USA - Encounters X

10787 Dental Benefit Providers X

Page 9: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10331 Denver Health Medical Plan X

10578 Deseret Mutual (DMBA) X X

10077 Director's Guild X X

10078 District of Columbia Medicaid X

10616 Emblem Health X X

10784 Employee Benefit Services - Dental X

10601 Essence Healthcare X X

10807 Evercare X

10772 Everence Financial X

10860 Evergreen Health Co-Op X

10082 Fallon Community Health Plan X

10427 FamilyCare X

10672 FCE Benefit Administrators Inc X

10083 Federated Insurance Company X X

10459 Fidelis Care New York X X

10859 Fidelis SecureCare of Michigan X

10870 FirstCare X

10799 Flex Compensation - Dental X

10811 Florida Combined Life - DENTAL X

10615 FLORIDA HEALTH CARE PLANS X

10333 Florida Hospital Healthcare System X

10086 Florida Medicaid X

10839 Florida True Health X X

10502 Freedom Blue X

10602 Fresenius Medical Care X

10629 Gateway Health Plan X

10611 Geisinger Health Plan X X

10612 Geisinger Health Plan Gold X X

10603 Generations Healthcare X X

10088 Georgia Medicaid X X

10745 Gerber Life Insurance X

10808 GHI X

10509 Gilsbar X X

10652 Golden Rule Insurance X X

10394 Government Employees Hospital Association (GEHA) X X

Page 10: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10543 Great American Life Insurance Co. Medicare Supp X X

10608 Group Health Cooperative X X

10781 Group Health Cooperative of South Central Wisconsin - Dental X

10583 Group Practice Affiliates X

10788 Guardian Life Insurance Co. of America - Dental X

10514 Harmony Health Plan X X

10091 Hawaii Medicaid X X

10785 Hawaii Medical Assurance Association - Dental X

10871 Health Alliance Medical Plan (IL) X

10308 Health Alliance Medical Plans (HAP) X

10220 Health America of PA X X

10092 Health Choice Arizona X X

10673 Health First Health Plan X X

10674 Health First Insurance X

10385 Health Net National X X

10627 Health New England X

10484 Health Partners of MN X X

10098 Health Partners of Philadelphia X

10362 Health Plan of San Mateo X

10657 Health Plan of Upper Ohio Valley X

10823 Health Share of Oregon X X

10463 Healthcare Solutions Group X

10597 HEALTHe Exchange X

10510 HealthEase X X

10511 HealthEase Kids X X

10656 HealthEZ X X

10099 Healthfirst New York X

10438 Healthfirst of New Jersey X

10248 HealthMarkets (Chesapeake National Life) X

10127 HealthMarkets (Mega Life and Health Insurance) X

10129 HealthMarkets (Mid-West National Life) X

10131 HealthMarkets (TransAmerica Life) X

10500 HealthNow X

10804 HealthPlan of Nevada X

10802 HealthPlans Inc X X

Page 11: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10309 HealthPlus of Michigan X

10621 HealthScope X

10003 HealthSmart Benefit Solutions (Wells Fargo TPA) X

10789 Healthsource Provident - Dental X

10552 HealthSpring X X

10824 Healthy Texas X

10795 Hershey Healthsmile - Dental X

10406 HIPNY X

10335 Hometown Health X

10337 Horizon NJ Health X X

10100 Humana X X

10861 IBM Insurance Outsourcing Services X

10101 Idaho Medicaid X X

10747 Ideal Life Insurance X

10757 IlliniCare Health Plan X

10102 Illinois Medicaid X X

10417 Independence Administrators X X

10536 Independent Health X

10103 Indiana Medicaid X

10104 Inland Empire Health X

10842 Integral Quality Care Florida X

10585 Integrated Mental Health Services X

10105 Inter Valley Health Plan X

10107 Iowa Medicaid X X

10675 Island Home Insurance X

10108 Jackson Memorial Hospital Health Plan X

10267 Johns Hopkins Health Plan X X

10110 Kaiser Foundation Health Plan of Colorado X X

10111 Kaiser Foundation Health Plan of Hawaii X X

10676 Kaiser Foundation Health Plan of Hawaii (DHMO Choice) X

10112 Kaiser Foundation Health Plan of Ohio X

10113 Kaiser Foundation Health Plan of the Mid-Atlantic X

10114 Kaiser Foundation Health Plan of the Northwest X

10238 Kaiser Permanente of Georgia X

10115 Kaiser Permanente of Northern CA X X

Page 12: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10239 Kaiser Permanente of Southern CA X X

10116 Kansas Medicaid X

10857 Kentucky Health Exchange X

10117 Kentucky Medicaid X X

10754 Key Benefits Administrators (IN) X

10300 Keystone Mercy Health X X

10341 Kitsap Physician Services X X

10748 KSKJ Life X

10677 Leon Medical Centers Health Plan X X

10843 Lifewise Arizona X

10651 Lifewise Health Plan of Oregon X X

10650 Lifewise Health Plan of Washington X X

10678 Lincoln Financial X

10749 Lincoln Heritage X

10755 Loomis Company X

10830 Louisiana Health Exchange X

10756 Louisiana Healthcare Connections X X

10118 Louisiana Medicaid X X

10119 Lovelace Health Plan X

10544 Loyal American Life Insurance Co. Medicare Supp X

10649 Magellan Behavioral Health X

10867 Magnacare X

10121 Maine Medicaid X X

10122 MAMSI Health Plan X

10679 MAPFRE Life Puerto Rico X

10680 MAPFRE Medicare Excel X

10435 Maricopa Care Advantage (Arizona) X

10434 Maricopa Health Plan (Arizona) X

10289 Maryland Medicaid X

10124 Massachusetts Medicaid X

10598 MDWise Hoosier Alliance X X

10682 Med-Pay Inc X X

10681 MedBen X X

10272 MedCost Benefit Services X

10125 Medica X

Page 13: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10683 Medical Associates Health Plan/Health Choices X

10126 Medical Mutual of Ohio X X

10001 Medicare (Part A & B) X

10800 Medigold Health Plans X

10844 MedStar Family Choice X

10845 MedStar Health Plan X

10130 Mega Life (Oklahoma City) X

10133 Mercy Care Plan (Arizona) X X

10644 Meridian Health Plan of Illinois X

10635 Meritain Health X X

10134 MetLife Dental Family X

10135 Metropolitan Health Plan (MHP) X X

10659 MHNET Behavioral Health X

10136 Michigan Medicaid X X

10392 Michigan Medicaid Pending Eligibility X X

10138 Michigan MIChild X

10139 Minnesota Medicaid X X

10140 Mississippi Children's Health Insurance Program X

10141 Mississippi Medicaid X X

10142 Mississippi State Employees and Teachers X

10702 Missouri Care X X

10143 Missouri Medicaid X X

10144 MMSI (Mayo Health) X X

10145 Molina Healthcare of California X X

10445 Molina Healthcare of Florida X X

10685 Molina Healthcare of Illinois X

10250 Molina Healthcare of Michigan X X

10523 Molina Healthcare of Missouri X

10146 Molina Healthcare of New Mexico X X

10251 Molina Healthcare of Ohio X X

10815 Molina Healthcare of South Carolina X

10391 Molina Healthcare of Texas X X

10252 Molina Healthcare of Utah X X

10253 Molina Healthcare of Washington X

10628 Molina Healthcare of Wisconsin X X

Page 14: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10147 Montana Medicaid X X

10687 Municipal Health Benefit Fund X X

10872 Mutual Assurance Administrators X

10686 Mutual Health Services X X

10382 Mutual of Omaha X

10148 MVP Health Care (New York) X X

10149 National Association of Letter Carriers (NALC) X

10812 National Telecommunications Cooperative Association (NTCA) X X

10150 Nationwide Specialty Health X

10376 NEHEN - Harvard Pilgrim Health Care X X

10377 NEHEN - Neighborhood Health Plans X X

10379 NEHEN - Tufts Associated Health Plan X

10151 Neighborhood Health Partnership X

10630 Neighborhood Health Plan (RI) X

10688 Network Health Insurance Corp X

10626 Network Health Plan of MA X X

10706 Network Health Plan of WI X

10152 Nevada Medicaid X X

10153 New Hampshire Medicaid X X

10154 New Jersey Medicaid X X

10247 New Mexico Medicaid X X

10155 New York Medicaid X X

10873 NGS American X

10156 North Carolina Medicaid X X

10157 North Dakota Medicaid X X

10537 Nova Healthcare Administrators X X

10466 NovaSys Health X

10515 Ohana Health Plan X X

10158 Ohio Medicaid X

10159 Oklahoma Medicaid X

10477 Optima/Sentara X

10160 Oregon Medicaid X X

10881 Oscar X

10161 Oxford Health Plans X

10375 Pacific Source Health Plan X

Page 15: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10689 Panamerican Life Puerto Rico (PALIC) X

10369 Partners National Health Plans of NC X

10164 Partnership Health Plan of California X

10368 Passport Health Plan X X

10782 Patriot Dental X

10165 Pennsylvania Medicaid X X

10471 PHCS Savility Payers X

10166 Phoenix Health Plan X

10658 Physicians Health Plan Northern IN X X

10167 Physicians Mutual Insurance Company X

10882 Piedmont X

10825 Piedmont Wellstar HealthPlans X

10408 Pittman and Associates X

10691 Preferred Care Partners X X

10847 Preferred Health System of Kansas X

10169 PreferredOne X X

10848 Premier Health X

10646 Presbyterian Health Plan X X

10692 Primary PhysicianCare Inc X X

10170 Principal Financial Group (Nippon Life) X X

10490 Priority Health X X

10172 Providence Health Plan X

10545 Provident American Life & Health Ins. Co. Mcare Supp X

10790 Provident Preferred Network - Dental X

10574 Public Employees Health Program X

10743 Puritan Life Insurance X

10637 Qualcare X

10553 Qualchoice X

10508 QuikTrip Corporation X

10414 Recall Systems - Boon-Chapman Benefit Admin X X

10411 Recall Systems - Corporate Benefit Service X X

10174 Recall Systems - Group & Pension Administrators X X

10241 Recall Systems - Mississippi Admin Services X

10242 Recall Systems - Professional Benefits Administrators X X

10246 Recall Systems - Underwriters Safety & Claims X

Page 16: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10175 Rocky Mountain Health Plan X

10751 Royal Neighbors of America X

10875 S and S Healthcare Strategies X

10849 San Francisco Health Plan X

10177 San Joaquin Health Plan X

10533 Sanford Health Plan X

10876 Santa Clara Family Health Plan X

10816 Schaller Anderson Aetna Better Health of New York X

10817 Schaller Anderson Delaware Physicians, Inc X

10818 Schaller Anderson MajestaCare VA X

10693 Schaller Anderson Maryland Physicians Care X X

10694 Schaller Anderson Mercy Care X

10695 Schaller Anderson Missouri Care X

10643 Schaller Anderson Parkland Community Health Plan X

10696 Schaller Anderson Texas CHRISTUS X

10360 Scott & White Health Plan X

10792 Securian Dental X

10793 Securian/Patriot Dental X

10864 Security Health Plan X

10520 Select Health SC X X

10575 Select Health Utah X X

10178 Senior Care Action Network (SCAN) HMO X

10697 Senior Health Services Center-Univ American Family Co. X

10752 Shenandoah Life Insurance X

10282 Sierra Health Services X

10081 Significa Benefit Services X X

10826 Simply Healthcare Plans X X

10179 South Carolina Medicaid X

10180 South Dakota Medicaid X

10591 Special Agents Mutual Benefit Assoc X

10546 SPJST Medicare Supplement X

10593 Standard Life and Accident Insurance X X

10833 Star HRG X

10645 State Farm X

10750 State Mutual Med Supp X

Page 17: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10512 StayWell X X

10513 Staywell Kids X X

10753 Sterling Investors Life Insurance X

10183 Student Insurance X X

10294 SummaCare Health Plan X

10758 Sunflower State Health (Kansas) X

10794 TennDent X

10184 Tennessee Medicaid X

10604 TexanPlus North Texas Area X X

10605 TexanPlus Southeast Texas Area X X

10186 Texas Medicaid X X

10698 The Kempton Company X X

10318 Three Rivers Health Plans (Unison Health Plan) X

10505 Today's Option X X

10606 Today’s Health X X

10805 Total Healthcare X

10607 Tribute-SelectCare of Oklahoma X

10189 TRICARE X

10879 TRICARE for Life X X

10190 Trustmark Insurance X

10352 UCare of Minnesota X X

10501 UMR X X

10285 Unicare (Wellpoint) X

10791 UNICARE - Dental X

10599 Union Pacific Railroad Employees Health Systems X

10810 United Concordia Companies, Inc. - DENTAL X

10809 United Concordia Federal Employees Program - DENTAL X

10002 United Healthcare X X

10835 United Healthcare Community Plan - Kansas X

10836 United Healthcare Facets Detroit Community and State X

10834 United Healthcare Facets Pittsburgh Community and State X

10837 United Healthcare Nevada Market X

10192 United Healthcare Plan of River Valley X

10655 United Healthcare SecureHorizons X

10547 United Teacher Assoc Insurance Co. Mcare Supp X

Page 18: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10349 Unity Health Plans X

10535 Univera X

10193 Universal Care of California X

10699 University Care Advantage Arizona X

10194 University Family Care X

10433 University Physicians Care Advantage (Arizona) X

10439 University Physicians Healthcare Group (Arizona) X

10288 UPMC Health Plan (Tristate) X

10195 USAA Life Insurance Company X

10648 UTAH MEDICAID X X

10196 VA Fee Basis Program X X

10850 VA Healthcare X

10858 Vantage Health Plan,Inc X

10197 Vermont Medicaid X X

10198 Virginia Medicaid X X

10483 VISTA X

10468 VIVA Health X X

10600 VNS CHOICE X X

10407 Vytra X

10424 Washington Medicaid X X

10853 Washington National X

10554 WEA Trust X X

10532 WEB-TPA, Inc X

10488 Wellcare Health Plans X X

10814 Wellsense X

10200 West Virginia Medicaid X X

10201 Western Health Advantage X

10797 Wilson McShane - Dental X

10576 Windsor Medicare Extra X X

10202 Wisconsin Medicaid X X

10452 Wisconsin Medicaid Chronic Disease Program X X

10453 Wisconsin Medicaid Well Woman Program X

10700 World Corp X

10386 World Insurance (ARIC) X X

10878 WPS Health Insurance X X

Page 19: Exchange EDI Eligibility Payer List As of June 26, 2014exchangeedi.com/.../2014/06/Exchange-EDI-Eligibility-List-062014.pdf · Payer ID Payer Name Eligibility 270/271 Dental 270/271

Payer ID Payer Name Eligibility 270/271 Dental 270/271

Exchange EDI Eligibility Payer List

As of June 26, 2014

10203 Writer's Guild X

10204 Wyoming Medicaid X X

10796 Zenith Administrators (MN) - Dental X