Clearance EDI Eligibility Payer List

To request a connection to a payer not on the list below, please submit a New Payer Connection Request.

Reference the CAQH web site for CORE Certified payers.

See Legend for explanation of Payer List.

Payer Name Change Healthcare Payer ID

Payer-assigned Payer ID

Connectivity Type Available

Authorization Required

1199 National Benefit Fund 1199NB 13162 Both Portal

A & I Benefit Plan AIBPL1 93044 Portal Portal

AARP AARP 36273 Both Portal

Absolute Total Care CNTENE 68069 X12 No

Acclaim ACCLA1 64071 Portal Portal

ACS Benefit Services ACSBE1 72467 Portal Portal

Administrative Services ADMIN 59141 X12 No

Advantage by Bridgeway CNTENE 68069 X12 No

Advantage by Buckeye (Bridgeway Advantage Plan)

CNTENE 68069 X12 No

Advantage by Managed Health Services CNTENE 68069 X12 No

Advantage by Superior Health Plan CNTENE 68069 X12 No

Advantra Freedom CHCADF 25152 X12 No

Adventist ADVEN1 95340 Portal Portal

AdviCare WELLCR 45423 Portal Portal

AETNA AETNA 60054 Both Portal

Aetna Better Health of Florida ABHFL 128FL Both Portal

Aetna Better Health of Illinois ABHILL 26337 Both Portal

Aetna Better Health of Kentucky COVCKY ABHKY1

128KY Both No

Aetna Better Health of Louisiana ABHLA1 128LA Portal Portal

Aetna Better Health of Michigan ABHMI 128MI X12 No

Aetna Better Health of New York ABHNY 34734 X12 No

Aetna Better Health of Ohio ABHOH 50023 Portal Portal

Aetna Better Health of Pennsylvania ABHPA 23228 Both Portal

Aetna Better Health of Texas ABHTX 00364 X12 No

Aetna Better Health of Virginia CHCCN

ABHVA1

128VA Both Portal

Aetna Better Health of West Virginia ABHWV1 128WV Portal Portal

AETNA Long Term Care AETLTC 60054 X12 No

Aetna SSI ATNSSI 62118 Both Portal

Affinity Essentials AFFNY1 23334 Portal Portal

Affinity Health Plan AFFIN 13334 Both Portal

Affinity Health Plan Medicare Advantage AHPMCR 13333 X12 Portal

AFLAC (Dental only) AFLAC X12 No

AgeWell New York AWNY1 AWNY6 Portal Portal

Alabama Blue Cross Blue Shield ALBCSI 00010BC Both Portal

ALBCSP 00510

Alabama Medicaid ALCAID 752548221 Both Portal

Alaska Medicaid AKMCD1 AKMEDICAID

FHSC

Both

Portal

Alameda Alliance for Health ALAHP1 95327 Portal Portal

Alignment Health Care ALHC1 CCHPC Portal Portal

All Savers Health Plan ALLSA1 Portal Portal

Allegiance Benefit Plan Management, Inc ALGNC1 81040 Portal Portal

Alliant Health Plans ALLNT1 58234 Both Portal

Allied Benefit ALBENS 37308 Both Portal

Alohacare ALOHA 990309519 Both Portal

Allwell from Absolute Total Care CNTENE 68069 X12 No

Allwell from Arkansas Health & Wellness CNTENE 68069 X12 No

Allwell from Buckeye Health Plan CNTENE 68069 X12 No

Allwell from Health Net CNTENE 68069 X12 No

Allwell from Home State Health CNTENE 68069 X12 No

Allwell from Louisiana Healthcare Connections CNTENE 68069 X12 No

Allwell from Managed Health Services CNTENE 68069 X12 No

Allwell from Managed Health Services Health Wisconsin

CNTENE 68069 X12 No

Allwell from Magnolia Health CNTENE 68069 X12 No

Allwell from PA Health & Wellness CNTENE 68069 X12 No

Allwell from Peach State Health Plan CNTENE 68069 X12 No

Allwell from Sunflower Health Plan CNTENE 68069 X12 No

Allwell from Sunshine Health CNTENE 68069 X12 No

Allwell from Superior HealthPlan CNTENE 68069 X12 No

Altius ALTIUS SX113 X12 No

AMA Insurance AMAIA1 AMAIA X12 Portal

Amalgamated Life AMGMT1 13550 Portal Portal

Ambetter from Buckeye Community Health Plan CNTENE 68069 X12 No

Ambetter from CeltiCare Health Plan CNTENE 68069 X12 No

Ambetter from Health Net CNTENE 68069 X12 No

Ambetter from Homestate Health CNTENE 68069 X12 No

Ambetter from Magnolia Health CNTENE 68069 X12 No

Ambetter from Managed Health Services CNTENE 68069 X12 No

Ambetter from Peach State Health Plan CNTENE 68069 X12 No

Ambetter from Sunshine Health CNTENE 68069 X12 No

Ambetter from Superior Health CNTENE 68069 X12 No

Ambetter Illinicare Health CNTENE 68069 X12 No

Ambetter New Hampshire Healthy Families CNTENE 68069 X12 No

Ambetter of Arkansas CNTENE 68069 X12 No

Ameriben Solutions AMERBN 75137 Both Portal

American Health Medicare AMHMED 660650587 X12 No

American Medical Security (AMS) AMMEDS 81400 X12 No

American National Insurance Company AMNIC 74048 X12 No

American National Life Insurance Company of Texas

ANLITX 10596 X12 No

American Postal Workers Union AMPWU 44444 X12 No

American Republic Insurance (MAP) AMRRP1 42011 Both Portal

American Retirement Life Insurance Company Medicare Supplement

ARLIMS 10538 X12 No

America's Choice Health Plans AMRCH1 20029 Portal Portal

AmericasHealth Plan AMRHP1 Portal Portal

AmeriChoice AMCHO1 UFNEP Portal Portal

AmeriGroup AMRGRP 27514 Both Portal

AmeriHealth Administrators TPA AMHADM 54763 X12 No

AmeriHealth Caritas Delaware AHCDE 77799 X12 No

AmeriHealth Caritas District of Columbia AHCDC1 77002 Portal Portal

AmeriHealth Caritas Iowa AHCIA 77075 Both Portal

AmeriHealth Caritas Louisiana LACAR 27357 Both Portal

AmeriHealth Caritas Pennsylvania AMHLTH 22248 Both Portal

AmeriHealth Caritas VIP Care Michigan ACVMI1 77013 Portal Portal

AmeriHealth Caritas VIP Care Pennsylvania AMCVC 77062 X12 No

Amerihealth Mercy Health Plan - Medicaid HMO AMHLTH 22248 X12 No

Amerihealth New Jersey/Delaware - HMO PAIBCE 95044 Both Portal

Ameritas Life Insurance Company AMRTAS 00425 X12 No

Amida Care Medicare AMICM1 79966 Portal Portal

Antares Management Solutions ANTAR 34192 X12 No

Anthem Blue Cross (fka CA Blue Cross) CABC2 47198 Portal Portal

Arise Health Plan Medicare Select Policy AHPMSP 39158 X12 No

Arizona Blue Cross Blue Shield AZBCBS 53589 Both Portal

Arizona Foundation AZFND1 860629899 Portal Portal

Arizona Medicaid AZCAID 866004791 Both Portal

Arizona Physicians IPA AZPIPA 03432 X12 No

Arizona Physicians IPA Healthcare Group AZPIPA 03432 X12 No

Arkansas Blue Cross Blue Shield ARBCBS 00520 Both Portal

X12

Arkansas Medicaid ARCAID 716007869 Both Portal

ASI Corporation ASICR1 Portal Portal

ASR Health Benefits ASRHL1 Portal Portal

Asuris Northwest ASURNH 93221 Both Portal

Atrio Health Plans ATRIO1 MP-AD/

MP_ADVANTAGE

Portal

Portal

AultCare AULTCR 341488123 X12 No

Aultra Administrative Group ALTRA1 Portal Portal

Automated Benefit Services ABSERV 383269272 Both Portal

Automated Group Administration AUGRP1 37280 Portal Portal

Auxiant Health AUXHE1 Portal Portal

Avera Health Plans AVERA1 46045 Portal Portal

Avesis TPA AVSIS1

AVSIS2

87098 Portal Portal

AVMed AVMED 59274 Both Portal

Bankers Fidelity BKFID1 Portal Portal

Bankers Life and Casualty Company BNKLIF Both Portal

Banner Health Network MDSUN 12X42 X12 No

Banner University Family Care BUFCR 66901 X12 No

BAS Health BASHL1 36149 Portal Portal

Beacon BCNHL1 43324 Portal Portal

Bell County Indigent Health Care BCIHC1 Portal Portal

Benefit Administration Services, Ltd (BAS LTD) BNADM1 41205 Portal Portal

Benefit Plan Administrators BPAM1 37118 Portal Portal

Benefits Management Inc BNMGT1 48611 Portal Portal

BeneSys Administration BENESY1 Portal Portal

Best Choice Health Plan BCHP X12 No

Best Life and Health BSTLFE 95604 X12 No

Better Health Plan of Florida FLBTHE 20488 Both Portal

Block Vision SUPVS1 Block Vision Portal Portal

Blue Choice Health Plan of South Carolina BLCHHP 922 X12 No

Blue Cross Blue Shield Arizona Advantage MDSUN 77078 X12 No

Blue Cross Blue Shield of National Capital Area - CareFirst

DCBCBS 00080

00580

Both Portal

Blue Cross Blue Shield of Western New York Medicaid MCO

BWNYMC 00246 X12 No

Blue Cross Community Health Plans BCCOM MCDIL X12 No

Blue Cross Medicare Advantage PPO/HMO BLMADV X12 No

Blue Medicare PPO/HMO of North Carolina NCPNHP 56152 X12 No

Bluegrass Family Health dba Baptist Health Plan BLGRSS 611241101 Both Portal

Boon-Chapman Benefit Administrators, Inc. BNCHAP 74238 X12 No

Boon Group (The) BOONGR BOONG X12 No

Boston Medical Center Health Plan BMCHLT 13337 Both Portal

Boulder Administration Services BASRV1 Portal Portal

Bravo Health BRAVO1 52192 Portal Portal

Bridgespan BDSPH1 BRIDG Portal Portal

Bridgeway Health Solutions CNTENE 68069 X12 No

Buckeye Community Health CNTENE 68069 X12 X12

Cal Optima Direct CALOP CALOP Both Portal

California Blue Cross CABC 47198 X12 No

California Blue Cross CABC2 47198 Portal Portal

California Blue Shield CABS 94036 Both Portal

California Health and Wellness CNTENE 68069 X12 No

California Medicaid (Medi-Cal) CACAID 610442 Both Portal

X12

Capital Blue Cross of Pennsylvania PACAPB 23045 X12 No

Capital District Physicians Health Plan CDPHP 95491 Both Portal

Capital Health Plan CAPTAL 95112 X12 No

Capitol Administrators CPADM1 68011 Portal Portal

CapRock Health Plans CAPRO1 CAPHP Portal Portal

Care 1st Health Plan of Arizona CRFRAZ 57116 X12 No

Care Improvements Plus CRIMPL 77082 Both Portal

Care N Care CAREN1 Portal Portal

Care Wisconsin Health Plan CAREW1 27004 Portal Portal

Care1st Health Plan CAFRS1 57115 Portal Portal

CareFirst Federal Employee Program CARFEP X12 No

CareMore IPA CRMRE CARMO Both Portal

CareOregon CAREO1 93975 Portal Portal

CarePlus Health Plans, Inc. CRPLUS 95092

65031

X12 No

CareSsource HMO CRSRC1 31114 Portal Portal

CareSource of Indiana CSRCIN INCS1 X12 No

CareSource of Ohio CRSROH 31114 X12 No

CareSource of West Virginia CSRCWV WVCS1 X12 No

Carpenters Health and Welfare Trust Fund of St. Louis

CARHLT X12 No

CBA Blue CBABL1 03036 Portal Portal

CDS Group Health CDSGP1 88022 Portal Portal

Celtic Insurance CNTENE 68069 X12 No

CeltiCare Massachusetts Behavioral Health (CBH)

CENPAT 68068 X12 No

Celticare Massachusetts Medical CNTENE 68069 X12 No

CenCal Health CENCL1

CACAID

000000953865941 Portal

Portal

Cenpatico Behavioral Health - Arizona CENPAT 68068 X12 No

Cenpatico Behavioral Health - Florida CENPAT 68068 X12 No

Cenpatico Behavioral Health - Georgia CENPAT 68068 X12 No

Cenpatico Behavioral Health - Illinois CENPAT 68068 X12 No

Cenpatico Behavioral Health - Indiana CENPAT 68068 X12 No

Cenpatico Behavioral Health - Kansas CENPAT 68068 X12 No

Cenpatico Behavioral Health - Mississippi CENPAT 68068 X12 No

Cenpatico Behavioral Health - Missouri CENPAT 68068 X12 No

Cenpatico Behavioral Health - New Hampshire CENPAT 68068 X12 No

Cenpatico Behavioral Health - Ohio CENPAT 68068 X12 No

Cenpatico Behavioral Health - South Carolina CENPAT 68068 X12 No

Cenpatico Behavioral Health - Texas CENPAT 68068 X12 No

Cenpatico Behavioral Health - Wisconsin CENPAT 68068 X12 No

Centerlight Healthcare CTRLT1 13360 Portal Portal

Centinela Valley IPA Medical CENTI1 MPM03 Portal Portal

Central California Alliance for Health CCALL1 CCA01 Portal Portal

Central Health Medicare Plan HMO CNHLT1 CHCPI Portal Portal

Central Reserve Life Insurance Company Medicare Supplement

CRLIMS X12 No

Central States Fund CSTFND X12 No

Central States Indemnity CTLST1 Portal Portal

CHAMPVA / Spina Bifida / Children of Women Vietnam Veterans

CHMPVA 84146 X12 No

Chinese Community Health Plan CCHP1 94302 Portal Portal

Christian Brothers Services CBSER1 38308 Both Portal

Christian Care Ministries CCMIN1 59355 Portal Portal

Chronic Renal Program RENAL1 Portal Portal

CIGNA CIGNA 62308 Both Portal

Cigna HealthSpring Tennessee Alabama HSPRNG HSTN Both Portal

Cincinnati Financial CINFN1 46871 Portal Portal

Cincinnati Health Plan CRSROH 31114 X12 No

Citrus Health CITRS1 10207 Portal Portal

City of Austin MAP SHMAP1 SHMAP Portal Portal

Claims Management Service Incorporated CLMSMS X12 No

Clover Health CLOVE1 77023 Portal Portal

CMO The Care Management Company CMOCO1 Portal Portal

CMS Medicare CMSMED / CMSHSP X12 X12

Colonial Penn Life Insurance Company CPLIC Both Portal

Colorado Access COACCS COACC Both Portal

Colorado Blue Cross Blue Shield COBCBS 00050 Both Portal

Colorado Medicaid COCAID 77016 X12 No

Columbus Health Plan CRSROH 31114 X12 No

Commonwealth Care Alliance CWCAL1 14315 Portal Portal

Community Care Managed Healthcare Plans of Oklahoma

OKCMCR 73143 Both Portal

Community First COMMF1 COMMF Portal Portal

Community Health Choice COMHC 48145 Both Portal

Community Health Choice Texas - HIM COMHC 60495 X12 No

Community Health First Medicare Advantage CHFMAP X12 No

Community Health Group COMHG1 953766170 Portal Portal

Community Health Plans of Michigan COMHP1 38325 Portal Portal

Community Health Plan of Washington (CHPWA) WACHP 12T30

CHPWA

Both Portal

Community Health Solutions COMHS1 Portal Portal

Conifer Health Solutions CONHS1 CAPMN Portal Portal

Connecticare CONNCR 06105 Both Portal

ConnectiCare VIP Medicare Advantage – DOS >12/31/16

CONADV 783750001 Both Portal

ConnectiCare VIP Medicare Advantage – DOS <1/1/17

EMBLEM 783750001 Both Portal

Connecticut Blue Cross and Blue Shield CTBCBS 00060 Both Portal

Connecticut Medicaid CTCAID 061274678 X12 No

Conseco CNSCO1 Portal Portal

Consociate and Dansig CNSDN1 37135 Portal Portal

Consolidated Associates Railroad CNSRR 75284 X12 No

Consolidated Health Plans CONHP1 87843 Portal Portal

Constellation Health Services CONSHS 660778289 X12 No

Continental Benefits CONTB1 35245 Portal Portal

Continental General Insurance Company CONGEN 71404 Portal Portal

Continental General Insurance Company Medicare Supplement

CGICMS X12 No

Continental Life CNTLF1 Portal Portal

Contra Costa CNTRA1 -

CCHP

Portal

Portal

Cook Children's Health Plan COOKCH CCHP1 X12 No

Cooperative Benefit Administrators CPBNAD 52132 X12 No

Coordinated Care CNTENE 68069 X12 No

Coresource of Arizona/ Minnesota AZCSRC

MNCSRC

41045 Both Portal

Coresource of Illinois ILCSRC 35182 Both Portal

Coresource of Kansas City CSFMH 48117 Both Portal

Coresource of Little Rock ARCSRC 75136 Both Portal

Coresource of Maryland MDCSRC 35182 Both Portal

Coresource of Ohio OHCSRC 35183 Both Portal

Coresource of Pennsylvania PACSRC 35182 Both Portal

Corporate Benefit Services CPBNSV 56116 X12 No

Country Life Insurance Company CTRYL1 Portal Portal

Covenant Administrators, Inc. (Atlanta, GA) COVEN1 58102 Portal Portal

CoventryCares of Michigan OMNCRE 25150 X12 No

Coventry Health and Life - Oklahoma CVHLOK 25133 X12 No

Coventry Health Care Advantra (Arizona, New Mexico, Texas only)

CHCADV X12 No

Coventry Health Care CareLink CHCCL 25140 X12 No

Coventry Health Care Delaware DECHC 25130 X12 No

Coventry Health Care Federal CHCFED X12 No

Coventry Health Care Florida/Vista/Summit FLCHC 10551 X12 No

Coventry Health Care Georgia GACHC 25127 X12 No

Coventry Health Care Group Health Plan CHCGHP 25141 X12 No

Coventry Health Care Iowa IACHC 25132 X12 No

Coventry Health Care Illinois PRSNLC 25146 X12 No

Coventry Health Care Kansas KCCHC 10208 Both Portal

Coventry Health Care Louisiana LACHC 25135 X12 No

Coventry Health Care Missouri CHCMO 87043 X12 No

Coventry Health Care National Network (aka First Health Network)

FRSTHL 73159 X12 No

Coventry Health Care Nebraska NECHC 25136 Both Portal

Coventry Health Care Nebraska Medicaid NECVMD X12 No

Coventry Health Care Southern Health Systems CHCSHS 25128 X12 No

Coventry Health Care Virginia COVVA1 Portal Portal

Coventry Health Care Vista CHCVST 55248 X12 No

Coventry Health Care Wellpath WPCHC 25133 X12 No

Coventry Health Life - Tennessee CVHLTN 25141 X12 No

Coventry University of Missouri CHCUOM X12 No

CoventryOne - CHC CHCCVT 25133 X12 No

Cox Health Plan COXHP 00019 X12 No

Create CREATE CREA8 X12 No

Crescent Health Solutions CRESH1 56213 Portal Portal

Crystal Run Health Plans CRYST1 46120 Portal Portal

Culinary Health Fund CULHF1 59140 Portal Portal

Custom Design Benefits CSTDS1 82056 Portal Portal

DakotaCare DAKOTA DAKOTACARE Both Portal

Davis Vision DAVIS1 Portal Portal

DCIPA Health Plan DCIPA1 Portal Portal

Dean Health Plan DEANHP 391535024 Both Portal

Dean Heath Plan Administrative Services (ASO) DNADM1 Porta; Portal

Delaware Blue Cross Blue Shield DEBCBS 00070

00570

X12 X12

Delaware Medicaid DECAID DE_TXIX X12 X12

Delta Dental DDENT1 94276 Portal Portal

Delta Health Systems DELTA1 DHS01 Portal Portal

DentaQuest Government Services DQEST1 62154 Portal Portal

Denver Health Medical Plan DNVHMP 84135 X12 No

Deseret Mutual Benefits Association DMBA HT000006-001 Both Portal

X12

Diamond Plan (Maryland Medicaid) DIAMPL X12 No

Director's Guild DIRGLD X12 No

District of Columbia Blue Cross Blue Shield - Carefirst

CRFST1 00080 Portal Portal

District of Columbia Medicaid DCCAID 77033 Both Portal

Dominion Dental DMNDN1 Portal Portal

Driscoll Children's Health Plan DRCHP1 74284 Portal Portal

Dunn & Associates DUNN1 35186 Portal Portal

EBMS EBMS1 81039 Both Portal

Educators Mutual Insurance Association EMIHE1 HT000214-001 Portal Portal

Elder Health Bravo Health ELDRHL 52192 X12 No

ElderPlan, Inc ELDER1 31625 Portal Portal

Eldorado Computing, Inc. ELDOC1 Portal Portal

Employee Benefit Consultants EMPBN1 37257 Portal Portal

Employee Benefit Management Corp EBMC1 31074 Portal Portal

Employee Benefit Systems EMBEN1 42149 Portal Portal

Employee Plans EMPLN1 35112 Portal Portal

Epoch Health EPOCH1 28777 Portal Portal

Equitable Life Insurance EQUIT1 HT007509-001 Portal Portal

ES Beveridge and Associates ESBEV1 34108 Portal Portal

Essence ESSNCE 20818 Both Portal

Everence EVERE1 35605 Portal Portal

Evergreen Health Plan EVRGR1 45319 Both Portal

EyeMed Vision Care EYMED1 31165 Portal Portal

Fallon Community Health Plan FALLON FALLON837I Both Portal

FamilyCare Medicaid FMLCR1 PHD01 Portal Portal

FamilyCare Medicaid Mental Health FMLCR1 FCM01 Portal Portal

FamilyCare Medicare DOS >12/31/2012 FMLCR1 PHR01 Portal Portal

Farm Bureau Health Plans FRMBHP 62045 Both Portal

Federated Insurance Company FEDICO 41041 X12 No

Fidelis Care New York FDCRNY 11315 Both Portal

First Administrators Inc. WLMRK1 FAMR1 Portal Portal

First Ameritas of New York AMTSNY X12 No

First Choice Health FRSTC1 91131 Portal Portal

First Health Network FRSTHL 73159 X12 No

First Medical Health Plan (Reform) FIRMED GHP660537624 Both Portal

First Reliance Standard Life FSTREL X12 No

FirstCare Health Plans FRTCR1 94999 Portal Portal

FirstCarolinaCare FCCARE 56196 X12 No

Fiserv Health - Kansas FSRVK1 62061 Portal Portal

Fiserv Health - Lexington FSRVL1 Portal Portal

Florida Blue Cross Blue Shield FLBCBS 00590 Both Portal

Florida Health Care Plan FLHLTH 59322 X12 No

Florida Medicaid FLCAID 77027 X12 No

Fox Everett FXEVT1 64069 Portal Portal

Freedom Health FRDHL1 41212 Portal Portal

Fresenius Total Health (PPO SNP) FRSNHP 43197 X12 No

Friday Health Plans of Colorado COCHP1 H0657 Portal Portal

Gateway Health Plan – Medicaid PA GATEHP 25169 X12 No

Gateway Health Plan – Medicare Assured OH GATEHP 91741 Both Portal

Gateway Health Plan – Medicare Assured PA GATEHP 60550 X12 No

GEHA Dental Connection Federal GEHAD1 Portal Portal

Geisinger Health Plan GEISHP 75273 X12 No

Geisinger Health Plan Gold GHPG 10612 X12 No

Georgia Blue Cross Blue Shield GABCBS 00101

00601

Both Portal

Georgia Medicaid GACAID 77034 Both Portal

Gilsbar, Inc. GILSB1 07205 Portal Portal

Global Care Medical Group IPA GLOBA1 MPM05 Portal Portal

Global Health OKC GHOKC1 GHOKC Portal Portal

Gold Coast Health Plan GDCHP1 77160 Portal Portal

Golden Rule Insurance Company GLDRUL 37602 Both Portal

Government Employee Health Association (GEHA)

GEHA 44054 Both Portal

Great American Life Insurance Company Medicare Supplement

GALIMS X12 No

Great West Healthcare GWSTHC 80705 Both Portal

Group and Pension Administrators GPADM 48143 Both Portal

Group Health Cooperative of Eau Claire GRPHL1 95192 Portal Portal

Group Practice Affiliates GRPAFL X12 No

Group Resources GRPRC1 Portal Portal

Guardian GUARD1 64246 Portal Portal

Gulf South Risk Services GULFS1 Portal Portal

Gundersen Lutheran Health Plan GUNDER

GUNDE1

39180 Both Portal

HAP/AHL/Curanet HAPMI 382242827 X12 No

Harken Health HKHLTH 43313 X12 No

Harrington Health HRGTN 59143 X12 No

Harrington Health CSI HRGTN 21132 X12 No

Harvard Community Health Plan HPSTR1 04245 Portal Portal

Harvard Pilgrim Health Care (MA) HRVPGM HPHC0001 Both Portal

Hawaii HMSA HMSA 990040115 Both Portal

Hawaii Mainland Administrators HMA1 Portal Portal

Hawaii Medicaid HICAID 996001089 Both Portal

Hawaii Medical Assurance Association HMAA1 48330 Portal Portal

Health Alliance Medical Plans of Illinois HLTAIL HEALTH ALLIANCE MEDICAL P

Both Portal

Health Alliance Plan of Michigan HAPMI 382242827 Both Portal

Health America/Health Assurance (PA and OH) CHCHA 25126 Portal Portal

Health Cost Solutions HCOST1 62111 Portal Portal

Health Choice Generations HCHGN1 62180 Portal Portal

Health Choice of Arizona AZHLCH 62179 Both Portal

Health Design Plus HLTDS1 34158 Portal Portal

Health First Health Plan HLFRT 95019 Both Portal

Health First Insurance HLTHFT X12 No

Health First TPA (Tyler, Texas) HEALT1 75234 Portal Portal

Health Management Administrators HMAX1 86066 Portal Portal

Health Management Administrators – Western Region

HMAWR HMA01 X12 No

Health Net MediCal HLTHNT Both Portal

Health Net National HLTHNT X12 No

Health Net of Arizona, California, Oregon Health Net Individual Medicare Advantage Plan Health Net Individual Family Plans

CNTENE 68069 X12 No

Health Net of California HLTHNT 95567 X12 No

Health Net of Oregon HLTHNT 95567 X12 No

Health Net of the Northeast and Arizona HLTHNT 06108

38309

X12 No

Health New England HLTNE 04286 X12 No

Health New England HLTNE1 04286 Portal Portal

Health Partners HLPRT1 HEALTHPARTNERS Portal Portal

Health Partners of Minnesota HLPTMN HEALTHPARTNERS X12 X12

Health Partners of Philadelphia HPPHIL 80142 X12 No

Health Partners TN HLPTT1 62157 Portal Portal

Health Plan of Nevada HPLNV1 76342 Portal Portal

Health Plan of San Joaquin SJHP 68035 Both Portal

Health Plan of San Mateo HPOSM HPSM1 X12 No

Health Plans Inc. HLPLN1 HPHC0001 Portal Portal

Health Share of Oregon HLTHS1 Portal Portal

Healthcare, Inc. HCINC X12 No

Healthcare Management Administrators HCMGT1 HMA01 Portal Portal

Healthcare Management Administrators – Western Region

HMAWR HMA01 X12 No

HealthCare Partners IPA HPIPA1 11328 Portal Portal

Healthcare Partners of California HCPCA1 HCP01 Portal Portal

HealthChoice Oklahoma HLTCH1 22521 Portal Portal

HealthComp HLCMP1 85729 Portal Portal

HEALTHe Exchange HLTHEX 20356 X12 No

Healthfirst of New Jersey HFSTNJ X12 No

Healthfirst of New York NYHFST 80141 Both Portal

Healthgram, Inc. HGRAM 56144 Both Portal

HealthNow HLTNW1 55204 Portal Portal

Healthplex HLPLX1 Portal Portal

Healthscope Benefits, Inc. HLTSCP 71063 Both Portal

HealthSmart Benefit Solutions SMART1 37283 Portal Portal

HealthSmart Benefit Solutions fka Wells Fargo TPA

ACORDN 87815 Portal Portal

HealthSun HLSUN1 HESUN Portal No

Healthy Blue AMGRLA 58532 X12 No

Healthy San Francisco HLTHSF1 Portal Portal

Heartland National Life Insurance Company HRTNT1 HT007509-002 Portal Portal

Hennepin Health METHPL 1566

-

X12 No

Highmark BCBS DE Health Options GHPHHO

DEHLT1

47181 Both

Portal

Hill Physicians Medical Group HLPHS1 HIL01 Portal Portal

HIP of Greater NY EMBLEM 552470001 Both Portal

HIP-Health Insurance Plan of Greater New York HIPNY 552470001 X12 No

HomeState Health Plan CNTENE 68069 X12 No

Hometown Health Network - Nevada HOMTWN 88023

95677

Both Portal

Horizon NJ Health HZMRCY 22326 Both Portal

Hudson Health Plan NYMVP 14165 Both Portal

Humana HUMANA 61101 X12 No

Humana - CareSource of Kentucky CSRCKY KYCS1 Both Portal

iCare, Independent Care Health INDCH1 11695 Portal Portal

Idaho Blue Cross Boise IDBLCB BLUEC X12 No

Idaho Blue Shield Regence IDBCS 00611 Both Portal

Idaho Medicaid IDCAID 445454161 X12 No

Ideal Life Insurance Company IDEAL1 Portal Portal

IdealCare IDLCR1 1140 Portal Portal

Illinicare Health Plan CNTENE 68069 X12 No

Illinois Blue Cross Blue Shield ILBCBS 00621 X12 No

Illinois Medicaid ILCAID 37-1320188 Both Portal

IMCare IMCARE 41600 X12 No

INDECS Corporation INDEC1 40585 Portal Portal

Independence Administrators INDADM TA720 X12 No

Indiana Blue Cross Blue Shield INBCBS 00130

00630

Both Portal

Indiana Medicaid INCAID HP Both Portal

Individual Assurance Company IACO1 30360 Portal Portal

Inland Empire Health Plan IEHP IEHP1 Both Portal

Insurance Administrators of America (IAA) ALLSA1 Portal Portal

Insurance Management Administrators IMADM1 -

72091

Portal

Portal

Integra BMS INBMS1 56139 Portal Portal

Integrated Mental Health Services INTMHS X12 No

INTotal Health INTOT1 3511A Portal Portal

Iowa Blue Cross Blue Shield - Wellmark IABCBS 88848 Both Portal

X12

Iowa Medicaid IACAID 18049 Both Portal

IU Health Plans IUHLT1 IUHPLNS Portal Portal

IU Health Plan Medicare Advantage IUHLTH IUHPLNS X12 No

JAI Medical JAIMD1 JAI01 Portal Portal

JAS Benefits JASBN1 Portal Portal

Johns Hopkins Health Plan JHHP 72189 X12 No

Johns Hopkins USFHP JHUSF1 52123 Portal Portal

JP Farley JPFAR1 34136 Portal Portal

Kaiser Foundation Health Plan of Colorado COKAIS RH003 X12 X12

Kaiser Foundation Health Plan of Georgia GAKAIS RH008 X12 X12

Kaiser Foundation Health Plan of Hawaii HIKAIS RH0011 X12 X12

Kaiser Foundation Health Plan of Mid-Atlantic KSRMDA RH010 X12 X12

Kaiser Foundation Health Plan of North West KAISNW RH002 X12 X12

Kaiser Foundation Health Plan of Northern California

KSRNCA 94135

RH009

X12 X12

Kaiser Foundation Health Plan of Southern California

KSRSCA 94134 X12 X12

Kaiser Foundation Health Plan of Washington /

Kaiser Foundation Health Plan of Washington Options

GRPNW 91051 Both Portal

Kaiser Self Funded Plan - Harrington/Fiserv HRGTN 94320 X12 No

Kansas Blue Cross Blue Shield KSBCBS 47163 X12 No

Kansas City Blue Cross Blue Shield - Kansas City, MO

KCBCBS 47171 X12 No

Kansas Medicaid KSCAID 481124839 Both Portal

Kentucky Blue Cross Blue Shield KYBCBS 00060 Both Portal

Kentucky Medicaid KYCAID KYMEDICAID X12 No

Kern Health KERN1 77039 Portal Portal

Key Benefit Administrators, Inc. KEYBEN 37217 Both Portal

Key Solutions KEYSOL 37323 X12 No

Keystone East HMO PAIBCE 95056 X12 No

Keystone First KMHPLN 23284 Both Portal

Keystone VIP Choice KVIPC1 84223 Portal Portal

Kidney Disease Program of Maryland MDKDP1 Portal Portal

Klais and Company KLAIS1 34145 Portal Portal

KSKJ Life – American Slovenian Catholic Union KSKJL1 Portal Portal

LA Care Health Plan LACRE1 LACAR Portal Portal

Leon Medical Center Health Plan LEONM1 37316 Portal Portal

Lifeprint Health Plan LFPRT1 LIFE1 Portal Portal

Lifestyle Health Plan LIFES1 2700U

27005

Portal Portal

Lifetime Benefit Solutions LIFBEN EBSRM X12 No

Lifewise Healthplan of Oregon WAPBC 93093 X12 No

Lifewise Healthplan of Washington WAPBC2 91049 Portal Portal

Lifeworks Advantage (ISNP Plan) LFWRK1 LWA01 Portal Portal

Lincoln Heritage LCNHG1 Portal Portal

Louisiana Blue Cross Blue Shield LABCBS 53120 Both X12

Portal

Louisiana Health Connections CNTENE 68069 X12 No

Louisiana Medicaid LACAID LA-DHH-

MEDICAID

Both Portal

Loyal American Life Insurance Company Medicare Supplement

LALIMS 13193 X12 No

LSU Health Plan LSUHP1 Portal Portal

Magellan Complete Care of Virginia MCCVA1 MCCVA Portal Portal

Magellan Healthcare MAGLAN 01260 Both

Portal

MagnaCare MAGNA 11303 Both Portal

Magnolia Health Plan - Mississippi CNTENE 68069 X12 No

Mail Handlers Benefit Plan (formerly First Health for Mail Handlers)

FHFMH 62413 X12 No

Maine Blue Cross Blue Shield MEBCBS 20180

00680

X12 No

Maine Community Health Options MECOH1 45341 Portal Portal

Maine Medicaid MECAID ME_MMIS_4MOLINA Both Portal

Managed Care of America MCA X12 No

Managed Care Systems

Managed Care Systems (Delano Regional Medical)

MNGCS1 Portal Portal

Managed Health Services - Indiana CNTENE 68069 X12 No

Managed Health Services - Wisconsin CNTENE 68069 X12 No

Manatee Health MNTEE1 41555 Portal Portal

Manhattan Life MNHTN1 Portal Portal

Mapfre MAPFRE 4600012 Both Portal

Maricopa Care Advantage (Arizona) MARIAD X12 No

Maricopa Health Plan (Arizona) MARIHP 09908 X12 No

Martins Point MRTNP1 MPHC2 Portal Portal

Maryland Blue Cross Blue Shield - Carefirst MDBCBS 00190

00690

Both Portal

Maryland Medicaid MDCAID 526002033MCP Both Portal

X12

Maryland Physician Care CNTENE 41001 X12 No

Massachusetts Blue Cross Blue Shield MABCBS 00200 X12 No

Massachusetts Medicaid MACAID DMA7384 Both Portal

MassHealth MASHL1 DMA7384 Portal Portal

MassHealth Dental MADNT1 Portal Portal

Maxor Administrative Services MAXOR1 92805 Portal Portal

Mayo Clinic Health Solutions MMSI 41154 X12 No

McLaren Health Plan MCLRN1

MCLRN2

38338 Portal Portal

MDWise Healthy Indiana Plan MDWise Hoosier Care Connect MDWise Hoosier Healthwise

WISE

WISE1

31354

91313

35191

Both Portal

MED3000 CMS Kids Title XXI KIDXX1 M3FL0014 Portal Portal

MedCare Omni IPA MCORE1 Portal Portal

MedCost Benefit Services MEDCST 56205 Both Portal

MEDecision MEDSN1 Portal Portal

Medica Health Plan UHC 94265 Both Portal

Medica Health Plan MEDI21 94265 Portal Portal

Medica2 MEDI21 12422 Portal Portal

Medica Health Plan of Florida UHC 78857 No X12

Medical Associates Health Plan FFS MAHP MEDICAL ASSOCIATES HEALTH

Portal Portal

Medical Benefits Administrator (Newark, OH) MDBEN 74323 Both Portal

Medical Card System (MCS) MCSPR

MCSPR1

660396197P

660396197P

Both Portal

Medical Mutual of Ohio - ProLink MMUTOH 29076 X12 No

Medical Services Initiative MDSRV1 Portal Portal

Medicare (CMS) Part A, B, and C CMSMED X12 X12

CMSHSP

Medico Insurance Company MDICO

MDICO1

23160 Both Portal

Medigold HMO MEDGLD 95655 X12 No

Medova Healthcare LIFES1 2700U

27005

Portal Portal

MedPartners Administrative Services 412MP MPASV1 412MP Portal Portal

MedPartners Administrative Services 441MP MPASV1 441MP Portal Portal

MedStar Family Choice MSFC1 521995799 Portal Portal

MedStar Medicare Choice MEDSTR 251MS X12 No

MedStar Select MEDSTR 251MS X12 No

Memorial Hermann Health Solutions MHRMN1 MHHNP Portal Portal

Mental Health Network (MHNET) MENTAL

MENTA1

74289 Both Portal

Mercy Care Plan of Arizona AZMCP 86052 Both Portal

Mercy Mericopa Integrated Care MMICR 33628 X12 No

MercyCare of Wisconsin MERCWI 39114 X12 No

Meridian Health Plan MERID1 13189 Portal Portal

Meridian Health Plan of Illinois MERIL X12 No

Meritage Medical Network MRNPA1 IP097 Portal Portal

Meritain Health (North American Health Plan) MERITN 64157 X12 No

Mercer MRCR1 Portal Portal

Metro Plus Health Plan METPL 13265 Both Portal

Michigan Blue Cross Blue Shield MIBCSI 00210 X12

MIBCSP 00710 X12

Michigan Child MICAID X12 No

Michigan Complete Health CNTENE 68069 X12 No

Michigan Medicaid MICAID D00111 X12 X12

Michigan Medicaid Champ MICMP1 D00111 Portal Portal

Michigan Medicaid Pending MICAID X12 No

Mid Atlantic Medical Services, Inc. (MAMSI) UHC 52148 X12 No

Mid-American Benefits (Elite Choice) MIDAB1 22823 Portal Portal

Minnesota Blue Cross and Blue Shield 1402 00220

00720

Both Portal

Minnesota Care MNUCAR 363573805 X12 No

Minnesota Medicaid 1468 411674742 Both Portal

Minnesota Senior Health Options (MSHO) MNUCAR 363573805

X12 No

Minuteman Health MNTMN1 Portal Portal

Mississippi Blue Cross Blue Shield MSBCBS 00230 Both Portal

Mississippi Blue Cross State Employee Health Plan

MSSEHP X12 No

Mississippi CHIP MSCHIP X12 No

Mississippi Medicaid MSCAID 77032

X12 No

Missouri Blue Cross Blue Shield MOBCBS 00241 X12 No

Missouri Medicaid MOCAID 0954897

431754897

Both Portal

MMM Healthcare PMCHO1 660592131 Portal Portal

MMM Healthcare (Reform) MMMHRF 660653763 Both Portal

Moda Health MDAHLT 930989307 Both Portal

Molina Healthcare of California CAMLNA 38333 X12 No

Molina Healthcare of Florida FLMLNA 51062 Both Portal

Molina Healthcare of Illinois MOLIL 20934 Both Portal

Molina Healthcare of New Mexico NMMLNA 09824 X12 No

Molina Healthcare of Ohio OHMLNA 20149 Both Portal

Molina Healthcare of Puerto Rico (Reform) MOLPR1 81794 Portal Portal

Molina Healthcare of South Carolina SCMLNA 46299 X12 No

Molina Healthcare of Texas TXMLNA 20554 X12 No

Molina Healthcare of Utah UTMLNA SX109 X12 No

Molina Healthcare of Virginia VAMLNA 26176 X12 No

Molina Healthcare of Washington WAMLNA 38336 X12 No

Molina Healthcare of Wisconsin MLNAWI ABRI1 X12 No

Molina of Michigan MIMLNA 38334 X12 No

Monarch Health Care of California MHCCA1 IP095 Portal Portal

Montana Blue Cross Blue Shield MTBCBS BCBS Both Portal

Montana Medicaid MTCAID 77039 X12 No

Montefiore Contract Management Organization MOCMO 13174 X12 No

Mountain State Blue Cross Blue Shield - West Virginia

WVBCBS 54828 Both Portal

X12

Mountain States Administrative Services MNTST1 86040 Portal Portal

Mutual of Omaha MUTOMH 71412 Both Portal

MVP Health Plans of New York NYMVP 14165 Both Portal

National Association of Letter Carriers NAOLC 62308 X12 No

National Claims Administrative Services NCAS1 75191

75190

Portal Portal

National General Benefits Solutions NATGE1 Portal Portal

National Rural Letter Carriers Association NRLCA1 Portal Portal

National Vision NTVIS1 743033381 Portal Portal

NE AmeriChoice HMO AMRNE1 UFNEP Portal Portal

Nebraska Blue Cross Blue Shield NEBCBS 00260

00760

X12 No

Nebraska Medicaid NEMCD1 NEMEDICAID Both Portal

X12

Nebraska Total Care CNTENE 68069 X12 No

Neighborhood Health Plan NGHBHP NHP Both Portal

Neighborhood Health Plan of Rhode Island RINHP 05047 Both Portal

Network Health of Massachusetts NTHLMA 04332 Both Portal

Network Health Plan Wisconsin NTWHL 39144 X12 No

Network Medical IPA NTMED1 Portal Portal

Nevada Blue Cross Blue Shield NVBCBS 00265 X12 No

Nevada Checkup - CHIP CAIDNV SKNV0 No Yes

Nevada Medicaid NVCAI1 Portal Portal

Nevada Medicaid CAIDNV NVM FHSC FA No Yes

New ERA Life Insurance Company NWERAL 75281 Both Portal

New Hampshire Blue Cross Blue Shield NHBCBS 00770 X12 No

New Hampshire Healthy Families CNTENE 68069 X12 No

New Hampshire Medicaid NHCAID 026000618 Both Portal

New Jersey Blue Cross Blue Shield NJBCBS 22099 Both Portal

New Jersey Medicaid NJCAID 012

610515

Both Portal

New Mexico Blue Cross Blue Shield NMBCBS 00790 Both Portal

New Mexico Health Connections NMHCO1 45129 Portal Portal

New Mexico Medicaid NMCAID NMMAD Both Portal

New York Blue Cross Blue Shield Central New York

NYEXCL 00305

00805

X12 nO

New York Blue Cross Blue Shield Northeastern NYBSN1 00800 Portal Portal

New York Blue Cross Blue Shield Rochester Area

NYEXCL 00304

00804

X12 No

New York Blue Cross Blue Shield Utica-Watertown

NYEXCL 00306

00806

X12 No

New York Blue Cross Blue Shield Western NYBCBS 00801 X12 No

New York Empire Blue Cross and Blue Shield EMHECH 00303

00803

Both Portal

New York Excellus Blue Cross Blue Shield NYEXCL X12 No

New York Group Health Incorporated (GHI) – HMO

EMBLEM 255311997 Both Portal

New York Group Health Incorporated (GHI) – PPO

EMBLEM 135511997 Both Portal

New York Group Health Inc. EMBLEM 135511997 Portal Portal

New York Independent Health Association (IHA) Western

NYIHAW 95308 X12 No

New York Medicaid (Inpatient and Outpatient) NYCAID 141797357 Both Portal

X12

NGS American, Inc CSFMH1 38225 Portal Portal

Nippon Life Insurance Company of America NLICOA 81264 X12 No

North American Administrators NAA1 65085 Portal Portal

North Carolina Blue Cross Blue Shield NCBCBS 560894904 Both Portal

North Carolina Medicaid NCCAID DNC00 X12 No

North Dakota Blue Cross Blue Shield NCBCBP

NCBCBI

X12 X12

North Dakota Medicaid 1487 NDDHSMED X12 No

North Shore LIJ CareConnect NSHCC1 46227 Portal Portal

Northern Virginia Blue Cross Blue Shield VANBCS X12 No

Northwest Administrators Inc NWADM1 NWADM Portal Portal

Nova Healthcare Administrators NOVAHC 16644 X12 No

NovaSys Health Network CNTENE 68069 X12 No

NY Group Health Incorporated (GHI) - Commercial

EMBLM1 135511997 Portal Portal

NY Group Health Incorporated (GHI) - Commercial

GRPIN1 135511997 Portal Portal

ODS Health MDAHLT 930989307 Both Portal

Ohio Blue Cross Blue Shield OHBCBS 00332

00834

Both Portal

Ohio Bureau for Children with Medical Handicaps BCMH1 BCMHODH Portal Portal

Ohio BWC OHBWC1 31147 Portal Portal

Ohio Medicaid OHCAID MMISODJFS Both Portal

X12

Oklahoma Blue Cross Blue Shield OKBCBS 00840 X12 No

Oklahoma Department of Corrections HLTCH1 Portal Portal

Oklahoma Medicaid OKCAID 731476619 Both Portal

Optical Managed Vision OPTMV1 Portal Portal

Optum Health OPTMH1 00773 Portal Portal

Oregon Blue Cross Blue Shield - Regence ORRBCS 00851 X12 No

Oregon Medicaid ORCAID ORDHS X12 No

Oscar Health OSCAR1 Portal Portal

Oxford Health Plan OXFORD 06111 X12 No

Oxford LIfe OXLIF1 76112 Portal Portal

PA Health & Wellness CNRENE 68069 X12 No

PacifiCare of Arizona - HMO AZPAC X12 No

PacifiCare of California - HMO CAPAC X12 No

PacifiCare of Colorado- HMO COPAC X12 No

PacifiCare of Oklahoma - HMO PACOK X12 No

PacifiCare of Oregon - HMO ORPAC 95958 X12 No

PacifiCare of Texas - HMO TXPAC X12 No

PacifiCare of Washington - HMO WAPAC X12 No

PacificSource Administrators (PSA) PSHLTH 93031 X12 No

PacificSource Health PSHLTH 93029 X12 No

PacificSource Medicare PSHLTH 20377 X12 No

PAI Benefits (Planned Administrators, Inc.) PAIB1 Both Portal

Paramount PRMNT 4198872500 Both Portal

Parkcare Insurance PRKCR1 Portal Portal

Partners Health Plan PRTNR1 14966 Portal Portal

Partnership Health Plan of California PRTHP PHC100680301406 Both Portal

Passport Health Plan PASSHP 61129 Both Portal

Patient Advocates, LLC PTADV1 10525 Portal Portal

Peach State Health Plan (GA Medicaid CMO) CNTENE 68069 X12 No

Pekin Insurance PEKIN1 37086 Portal Portal

Pennsylvania Blue Cross Blue Shield - Highmark PABCBS 54771 Both Portal

12B60 X12

Pennsylvania Independence Amerihealth HMO PAIBCE 95044 Both Portal

Amerihealth New Jersey PPO PAIBCE 60061 Both Portal

Pennsylvania Independence Amerihealth PPO PAIBCE 95044 Both Portal

Pennsylvania Independence Blue Cross PAIBCE 54704

X12 No

Pennsylvania Medicaid PACAID 236003113 Both Portal

Peoples Health Network PEOPLE 72126 Both Portal

Personal Insurance Administrators PIADMN 95397 X12 No

Puerto Rico MMM Inmediata MMMHRF 660653763 Both Portal

Physicians Health Plan of Michigan (PHP) PHPMI 37330 Portal Portal

Physicians Health Plan of Northern Indiana (PHP)

PHPNI 12399 Both Portal

Physicians Mutual Insurance Company PHYSMT 47027 X12 No

Physicians Plus Insurance Corporation PHYPLS 39156 Both Portal

Piedmont Care PDMNT1 06607 Portal Portal

Pinnacle Claims Management PNNCL1 24735 Portal Portal

Pittman and Associates PITTMN 37224 X12 No

Poly Medical and Dental Benefits Plan PAMDB X12 No

Plan de Salud Hospital Menonita PDSHM 660636242 X12 No

Plan de Socios Auxilio Mutua PDSAM 660178704 X12 No

POMCO POMCO1 16111 Portal Portal

Populytics SPCTM1 23253

001256

Portal Portal

PPMC PPMC1 Portal Portal

Prairie States Enterprises PRSTE1 36373 Portal Portal

Preferred Care Partners UHC 65088 X12 No

Preferred Medicare Choice (PMC) PMC 660592131 Both Portal

Preferred Medicare Choice (Reform) PMCHOR 660592131GHP Both Portal

Preferred Health Plan, Inc. PRFHP1 61106 Portal Portal

Preferred One PRFONE 411479744 X12 No

Premier Health Plan PREMH

PREMH1

251PR Both Portal

Prepaid Medical Assist Program (PMAP) MNUCAR 363573805 X12 No

Presbyterian Health Plan PRESB1 05003 Portal Portal

Prestige Health Choice PREST1 77003 Both Portal

Primary Provider Management Company (PPMC) PPMC1 Portal Portal

Prime West PRMWST 11678 X12 No

Principal Financial Group PRFGRP

PRFGR2

61271 Both Portal

Priority Health of Michigan PRIRTY PRIORITY HEALTH PRIORITY

Both Portal

Professional Benefit Administrators - Illinois ILPBA 36331 Both Portal

Professional Benefit Administrators - Ohio OHPBA Both Portal

Prominence Health Medicare Advantage PRMAD1 Portal Portal

Prominence Health Plan PPO/HMO STMRH1 88029 Portal Portal

Prospect Medical Systems PROMG1 IP105 Portal Portal

Providence Health Plan (OR) PROVHP PHP01 Both Portal

Providence Preferred PPO PROVH1 PHP0U Portal Portal

Provident American Life & Health Insurance Company Medicare Supplement

PALHMS X12 No

Public Employee Health Plan (UT) PEHP HT000158-001 X12 No

Puritan Life Insurance Company of America PRTN1 Portal Portal

QualCare QULCR1 23342 Portal Portal

QualCare, Inc. QUALC 23342 X12 No

QualChoice of Arkansas QUCHO 35174 Both Portal

Quartz ASO QUARTZ QUARTZASO X12 No

Quartz Benefits Underwritten by Gundersen Health

GUNDE1 Portal Portal

Quartz Benefits Underwritten by Unity Health Plans

UNTYHP X12 No

QuikTrip Corporation QTCORP 73067 X12 No

Regal Medical Group RGLMD1 REGAL Portal Portal

Regional Care REGCA1 47076 Portal Portal

Reliance Standard Life RELSTD X12 No

Reserve National Insurance RESNI 73066 X12 No

Rhode Island Blue Cross Blue Shield RIBCBS 00370

00870

Both Portal

RiverLink Health RVRLH1 42172 Portal Portal

Rhode Island Medicaid RIMCD1 056000522 Portal Portal

RMSCO RMSCO1 16117 Portal Portal

Rocky Mountain Health Plan (HMO) RKYMHP 840614905 Both Portal

Royal Neighbors of America RYLNB1 Portal Portal

Samaritan Health Plan SAMAR1 953327434 Portal Portal

San Diego County Medical Services (CMS) CNTYM1 MSO11 Portal Portal

San Francisco Health Plan SFHP 943226498 Both Portal

Sanford Health Plan SNFDHP SHP Both Portal

Santa Clara Family Health Plan SCFHP 24077 X12 No

Sante Community Physicians SANTE1 77038 Portal Portal

Scan Health Plan SCANH1 SCAN1 Portal Portal

Scion Dental SCION1 Portal Portal

Scott and White Health Plan SAWHP 88030 X12 No

Seafarers International Union SEFIU1 Portal Portal

Secure Health Plans of Georgia SECGA1 28530 Portal Portal

Security Health Plan SECHP1 39045 Portal Portal

Select Administrative Services SAS1 Portal Portal

Select Health SC SCSLHT 23285 X12 No

SelectHealth (UT) UTSLHT HT000015-001 X12 No

Senior Care Action Network - SCAN HMO (CA) SCNHMO SCAN1 X12 No

Senior Health Services-Universal American Family of Companies

SHSUAF X12 No

Senior Whole Health of New York SRWH 83035 X12 No

Sentara Health Plan / Optima OPTSNT 62170

54154

X12 No

Sentinel Security Life SSLCO1 87020 Portal Portal

Seton Care Plus (ICare) SCARE1 Portal Portal

Seton Healthcare Network Employee Health Plan - Texas

SETEM1 SHEBP Portal Portal

Sharp Health Plan SHARP SHP01 X12 No

Shenandoah Life Insurance Company SHNDH1 Portal Portal

Sierra Health Services SIERA 76342 Both Portal

Significa Benefit Services, Inc. ERINGP 23250 X12 No

SIHO Insurance Services SIHO 77153 X12 No

Silver Summit Health Plan CNTENE 68069 X12 No

Simple Vision SMPVS1 Portal Portal

Simply Health Care Plans SIMPLY 27094 Both Portal

SISCO SISCO1 SISCO Portal Portal

SoundPath Health SNDPHL 42172 Both Portal

South Carolina Blue Cross Blue Shield SCBCBS 401 X12 No

South Carolina Medicaid SCCAID SCXIX Both Portal

South Dakota Blue Cross Blue Shield IABCBS 88848 Both Portal

South Dakota Medicaid SDCAID SD48MED X12 No

Southwest Service Administrators, Inc. SOWST1 CX100 Portal Portal

Special Agents Mutual Benefit Association SAMBAN X12 No

Spectrum Administrators, Inc. SPCTM1 23253 Portal Portal

SPJST Medicare Supplement SPJSMS X12 No

SS Healthcare SSHLC1 31441 Portal Portal

Standard Insurance STDINS X12 No

Standard Insurance of New York STDINY X12 No

Standard Life and Accident Insurance Company SLAICO 01758 X12 No

State Farm Insurance Companies STFARM 31053 X12 No

State Mutual Insurance Company STMTL1 Portal Portal

Sterling Insurance STERL1 Both Portal

Stirling and Stirling STIRL1 06089 Portal Portal

SummaCare Health Plan SUMCHP 95202 Both Portal

Summit Admin Services SMTAS1 86083 Portal Portal

Sunflower State CNTENE 68069 X12 No

Sunshine State Health Plan CNTENE 68069 X12 No

Superior Health Plan - Texas CNTENE 68069 X12 No

Superior Vision SUPVS1 Portal Portal

Sutter Select STRSL1 Portal Portal

Tall Tree Administrators TLLTR1 88067 Portal Portal

TCC Benefits Administrator TCCBE1 Portal Portal

Teachers Health Trust TCHRS1 88019 Portal Portal

Tennessee Blue Cross Blue Shield TNBCBS 12B45

SB890

Both Portal

Tennessee Medicaid TNCAID 12K46

SKTN2

Both Portal

TexanPlus North Texas Area TXPLNT 10604 X12 No

TexanPlus Southeast Texas Area TXPLSE X12 No

Texas Blue Cross Blue Shield TXBCBS 12B31

SB900

X12 No

Texas Children’s Health Plan (CHIP) TXCHIP 76048 Both Portal

Texas Medicaid TXCAID 12K64

SKTX0

Both Portal

The Health Plan HMTWN1 34150 Portal Portal

The Loomis Company LOOMS1 23223 Portal Portal

Thrivent Financial THRVNT THRIV Both No

Thrivent Financial Aid Association for Lutheran Medicare

THRVNT 30167 Both No

Thrivent Financial Lutheran Brotherhood Medicare

THRVNT 30166 Both No

TML Intergovernmental Employee Benefits Pool TMLBP1 Portal Portal

Today's Health TODHLT WITH1

20081

X12 No

Today's Option TDYOPT 48055 Both Portal

Total Carolina Care CNTENE 68069 X12 No

Total Health Care TLHCH1 38201 Portal Portal

TR Paul Inc TRPAL1 37230 Portal Portal

TransactRX Infusion and Specialty RXINF RX001 X12 No

TransactRX Part D RXPTD PARTD X12 No

TransAmerica Life Insurance Company TRANS1 Portal Portal

TRICARE for Life TRCRU TDFIC Both Portal

TRICARE Overseas Program OVRSEA 101201 X12 No

TriCare – West Region TRICAR

TRCRW1

99726 Both Portal

Trillium Community Health Plan CNTENE 68069 X12 No

Triple-S Advantage PRSSA 973MA Both Portal

Triple-S Salud PRSSS1 973 Portal Portal

TRISTAR TRSTR1 Portal Portal

Trusted Health Plan TRSTH1 L0230 Portal Portal

Trustmark TRSMRK 61425 Both Portal

Tuality Health Alliance TUALI1 THA01 Portal Portal

Tufts Health Plans (MA) TUFTS 170558746 X12 No

UCare Complete (Minnesota Disabled Health Options - MNDHO)

MNUCAR 363573805 Both Portal

UCare for Seniors MNUCAR 363573805 Both Portal

UCare of Minnesota MNUCAR 363573805 Both Portal

UCare Select MNUCAR 363573805 Both Portal

UHA Health UHAHL1 990263440 Portal Portal

Ultimate Health Plans ULTHP 77022 Portal Portal

UMR - Wausau UMRWAU 39026 X12 No

UMWA Health & Retirement Funds UNWA

UMWA1

52180 Both Portal

Underwriters Safety and Claims UWTRSC X12 No

Unicare UNICAR 80314 Both Portal

Unified Group Services UNIFI1 35198 Portal Portal

Union Pacific Railroad Employee Health Systems UPREHS 87042 Both Portal

Unison Health Plan UHC 25175 X12 No

United American Insurance Company UNTDA Both Portal

United Behavioral Health UHC 16412 Portal Portal

United Commercial Travelers of America UNCOM1 Portal Portal

United Concordia Dental Insurance UNICO1 Portal Portal

United Healthcare UHC 87726 Both Portal

United HealthCare Community Plan – Tenncare JDHS 95378 Both Portal

only

United Healthcare WEST - Pacificare of California

UHC2 95958 Portal Portal

United Healthcare Community Plan of Michigan UHCGLH 95467 X12 No

UMR fka UMR Wausau UMRWAU 39026 Both Portal

United Mine Workers of America UMWA1 52180 Portal Portal

United Resources Network UNTDRN 41194 X12 No

United Teacher Association Insurance Company Medicare Supplement

UTAIMS X12 No

UnitedHealthcare Dental Benefit Providers UHCDB1 52133 Portal Portal

UnitedHealthcare Shared Services UNHIS1 Portal Portal

UnitedHealthcare Student Resources STDNT 74227 X12 No

Unity Health Insurance UNTYHP 1UNTY X12 No

Univera UNIVNY UNINW Both Portal

University Family Care UNVFC 09830 X12 No

University of Arizona Health Plan UNIVAZ 45437 X12 No

University of Maryland Health Advantage UMDHP1 45282 Portal Portal

University of Maryland Health Partners UMDHP1 45281 Portal Portal

University of Utah Health Plan UNUTHP HT001755-

300

X12 No

University Physicians Care Advantage (Arizona) UPCADV Both Portal

University Physicians Healthcare Group (Arizona) UPHGRP Both Portal

UPMC Health Plan (PA) UPMC 95216 X12 No

UPMC Vision Advantage UPMCV1 25184 Portal Portal

Upper Peninsula Health Plan MICMP1 38337 Portal Portal

US Virgin Islands Blue Cross Blue Shield BUSVI1 232184623 Portal Portal

USAA Life Insurance Company USALCO 74095 X12 No

Utah Blue Cross UTREBC HT000001-

001

X12 No

Utah Blue Cross FEP UTFEPI HT000001-

100

X12 No

Utah Blue Shield UTREBS HT000001-

100

X12 No

Utah Blue Shield FEP UTFEPP HT000001-

012

X12 No

Utah Medicaid UTCAID HT000004-

001

X12 X12

VA Health Administration Center VAHAC X12 No

Valley Health Plan VALHP1 Portal Portal

Value Options VALOP1 FHC & Affiliates Portal Portal

Vantage Health Plan VANTAG 72128 Both Portal

Ventura County Health Care Plan VCHCP1 VCHCP Portal Portal

Vermont Blue Cross Blue Shield VTBCS1 BCBS009301 Both Portal

Vermont Medicaid VTCAID 752548221 Both Portal

Veteran's Administration Fee Basis Program VETFBP 12115 X12 No

Veteran's Administration HAC VETHAC 84146 X12 No

VillageCareMAX VCMX1 26545 Portal Portal

Virginia Premier VAPRM1

VAPRM2

VPN001 Portal Portal

Virginia Premier Complete Care VAPCC1 VPCCI/VPCCP Portal Portal

Virginia Blue Cross Blue Shield VABCBS 058916206CMSCOS Both Portal

Virginia Medicaid VACAID VMAP

FHSC

FA

Both Portal

Vision Care Direct VISCD1 Portal Portal

Viva Health Care and Viva Medicare VIVAHL 63114 Both Portal

VNS Choice VNSCHC Both Portal

Volusia Health Network VOLHN2 59266 Portal Portal

VSP Vision VSPVS1 94-1632821 Portal Portal

VYTRA Healthcare EMBLEM 222647447 Both Portal

Washington and Alaska Premera Blue Cross Blue Shield

WAPBCS 00430 Both Portal

Washington Medicaid WACAID 77045 Both Portal

Washington National WANATL Both Portal

Washington Regence Blue Shield WARBCS 00932 Both Portal

Washington State Health Insurance Pool WASHP1 Portal Portal

WebTPA WEBTPA 75261 Both Portal

Welborn Health WLBRN1 Portal Portal

Wellcare Health Plans of Kentucky WELLC4 Portal Portal

Wellcare Health Plan / Staywell WELLCR 14163 Both Portal

Wellforce Administrators WLFRC1 Portal Portal

WellMed WLLMD1 WELM2 Portal Portal

Wellpath Enhanced WLPTH1 25133 Portal Portal

West Virginia Family Health Plan WVFMHP 45276 X12 No

West Virginia Medicaid WVCAID WV_MMIS_4MOLINA X12 No

Western Growers Assurance Trust WGA1 24735 Portal Portal

Western Health Advantage WSTHA 68039 X12 No

Wisconsin Blue Cross Blue Shield WIBCBS 00450

00950

Both Portal

Wisconsin Educators Association (WEA) WEATST 39151 X12 No

Wisconsin Medicaid WICAID WISC_TXIX Both Portal

Wisconsin Medicaid Chronic Disease Program WICDP WISC_WCDP X12 No

Wisconsin Medicaid Well Woman Program WIWWP WISC_WWWP X12 No

WPS Commercial / Regular Business WPSCR WPS Both Portal

Wyoming Blue Cross Blue Shield WYBCBI

WYBCBP

00460

00960

X12 X12

Wyoming Medicaid WYCAID 77046 X12 No

YourCare Health Plan YURCRE 15003 Both Portal

Zavata, Inc. (formerly HPS Paradigm) ZAVTA1 58227 Portal Portal

Zenith Administrators ZNITH1 Portal Portal

Legend

Payer Name

Payer ID: Change Healthcare-assigned Payer ID.

Connectivity Type Available: Indicates X12, Portal, or Both

Authorization Required:

X12 or Portal: Payer requires authorization for providers to submit through Change Healthcare for the Connectivity Type indicated; click the

link to obtain instruction.

No: No authorization required for the Connectivity Type indicated.

X12 Request Details: Click the Request link to obtain X12 payer-specific requirements.

X12 Surcharge: Per transaction fee required by the payer for submitting X12 eligibility transactions. Surcharges do not apply to Portal eligibility

transactions.

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This documentation contains confidential, proprietary and trade secret information of Change Healthcare Operations LLC and is protected under United States and international copyright and other

intellectual property laws. This documentation is subject to change without notice.