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eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information Americas 1st Choice Health Plans of North Carolina Inc.26078 COMMERCIAL N Americas 1st Choice Health Plans of North Carolina Inc.26078 COMMERCIAL N Americas 1st Choice Health Plans of South Carolina Inc.20553 COMMERCIAL N Americas 1st Choice Health Plans of South Carolina Inc.20553 COMMERCIAL N Arroyo Vista Family Health Center NMM01 COMMERCIAL N Arroyo Vista Family Health Center NMM01 COMMERCIAL N Lakeside Medical Group 66125 COMMERCIAL N Lakeside Medical Group 66125 COMMERCIAL N Optimum Healthcare Inc. 20133 COMMERCIAL N Optimum Healthcare Inc. 20133 COMMERCIAL N Primary Care Associates Medical Group IP079 COMMERCIAL N Primary Care Associates Medical Group IP079 COMMERCIAL N Texas First Health Plans (TIOPA) 76046 COMMERCIAL N Texas First Health Plans (TIOPA) 76046 COMMERCIAL N
1-888-OHIOCOMP (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
1-888-OHIOCOMP (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.1199 National Benefit Fund 13162 COMMERCIAL N1199 National Benefit Fund 13162 COMMERCIAL N
1st MN--Atlanta GA 29076 COMMERCIAL N
1st Medical Network is part of the
Medical Mutual Family of
Companies. Former payer ID
58203.
1st MN--Atlanta GA 29076 COMMERCIAL N
1st Medical Network is part of the
Medical Mutual Family of
Companies. Former payer ID
58203.
1st Medical Network - Atlanta GA 29076 COMMERCIAL N
1st Medical Network is part of the
Medical Mutual Family of
Companies. Former payer ID
58203.
1st Medical Network - Atlanta GA 29076 COMMERCIAL N
1st Medical Network is part of the
Medical Mutual Family of
Companies. Former payer ID
58203.21st Century Health and Benefits 59069 COMMERCIAL N21st Century Health and Benefits 59069 COMMERCIAL N21st Century Insurance and Financial Services 51028 COMMERCIAL N For Minnesota Only21st Century Insurance and Financial Services 51028 COMMERCIAL N For Minnesota Only
3-Hab (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
3-Hab (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.3P ADMIN 20413 COMMERCIAL N3P ADMIN 20413 COMMERCIAL NA & I Benefit Plan Administrators 93044 COMMERCIAL NA & I Benefit Plan Administrators 93044 COMMERCIAL N
A.G.I.A. Inc. 95241 COMMERCIAL N
Claims are printed and mailed to
the payer.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 1
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
A.G.I.A. Inc. 95241 COMMERCIAL N
Claims are printed and mailed to
the payer.AAG Benefit Plan Administrators Inc. 75240 COMMERCIAL NAAG Benefit Plan Administrators Inc. 75240 COMMERCIAL NAAG-American Administravie Group ( Formerly Icon Benefit Admin)75185 COMMERCIAL NAAG-American Administravie Group ( Formerly Icon Benefit Admin)75185 COMMERCIAL N
ABMA (Alta Bates Medical Assocs) Medical Corp (Hnet Sr. and Secure Horizon)E3510 COMMERCIAL P
Only claims from providers in
Northern California. Please
contact the EDI Dept for North
American Medical Management
(NAMM) - Northern California
Lead/Supervisor at 1-800-956-
8000 prior to initial submission of
claims.
ABMA (Alta Bates Medical Assocs) Medical Corp (Hnet Sr. and Secure Horizon)E3510 COMMERCIAL P
Only claims from providers in
Northern California. Please
contact the EDI Dept for North
American Medical Management
(NAMM) - Northern California
Lead/Supervisor at 1-800-956-
8000 prior to initial submission of
claims.ACMG 87066 COMMERCIAL NACMG 87066 COMMERCIAL N
ACS Benefit Services Inc. 72467 COMMERCIAL N
DO NOT send ACS/Health Net or
ACS Inc. Medicaid claims to this
payer ID. This payer ID is for ACS
Benefit Services. Inc. ONLY.
ACS Benefit Services Inc. 72467 COMMERCIAL N
DO NOT send ACS/Health Net or
ACS Inc. Medicaid claims to this
payer ID. This payer ID is for ACS
Benefit Services. Inc. ONLY.ACS Rewards Administration Center 36112 COMMERCIAL NACS Rewards Administration Center 36112 COMMERCIAL NADOC (Affiliated Doctor's of Orange County) ADOCS COMMERCIAL NADOC (Affiliated Doctor's of Orange County) ADOCS COMMERCIAL NADVANCED DATA SOLUTIONS 58202 COMMERCIAL NADVANCED DATA SOLUTIONS 58202 COMMERCIAL NADVANTICA BENEFITS 59374 COMMERCIAL NADVANTICA BENEFITS 59374 COMMERCIAL NAEQUITAS CAPITAL MANAGEMENT Call COMMERCIAL NAEQUITAS CAPITAL MANAGEMENT Call COMMERCIAL NAFFINITY MEDICAL GROUP 46594 COMMERCIAL NAFFINITY MEDICAL GROUP 46594 COMMERCIAL NAFTRA Health Fund 13346 COMMERCIAL NAFTRA Health Fund 13346 COMMERCIAL NAGA 37280 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 2
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationAGA 37280 COMMERCIAL NAHPO (Cleveland OH) 31138 COMMERCIAL NAHPO (Cleveland OH) 31138 COMMERCIAL NALICARE 13550 COMMERCIAL NALICARE 13550 COMMERCIAL N
ALPS CompCare (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
ALPS CompCare (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.AMA Insurance Agency TH071 COMMERCIAL NAMA Insurance Agency TH071 COMMERCIAL NAMCO 62176 COMMERCIAL NAMCO 62176 COMMERCIAL NAMERIGROUP Community Care of New Mexico 27514 COMMERCIAL NAMERIGROUP Community Care of New Mexico 27514 COMMERCIAL NAMERIGROUP Georgia 27514 COMMERCIAL NAMERIGROUP Georgia 27514 COMMERCIAL NAMVI/Prospect Health Network (Prospect Medical Group)PROSP COMMERCIAL NAMVI/Prospect Health Network (Prospect Medical Group)PROSP COMMERCIAL NAPAC (Pinnacle Health Resources) (Prospect Medical Group)PROSP COMMERCIAL NAPAC (Pinnacle Health Resources) (Prospect Medical Group)PROSP COMMERCIAL NAPS Healthcare Inc. 54160 COMMERCIAL NAPS Healthcare Inc. 54160 COMMERCIAL N
APS Paper Claim 54100 COMMERCIAL N
Claims will be printed and mailed
to APS Paper Claim 54100.
APS Paper Claim 54100 COMMERCIAL N
Claims will be printed and mailed
to APS Paper Claim 54100.ARAZ Group 16120 COMMERCIAL NARAZ Group 16120 COMMERCIAL N
ASC of Oho Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
ASC of Oho Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.ASR 38265 COMMERCIAL NASR 38265 COMMERCIAL NASR Corporation 38265 COMMERCIAL NASR Corporation 38265 COMMERCIAL NASR Health Benefits 38265 COMMERCIAL NASR Health Benefits 38265 COMMERCIAL N
ASW \ Lifewise 37294 COMMERCIAL N
Payer moved to live with vision
and dental claims on 6/22. Now
they are allowing all other
medical claim submitter to send.
ASW \ Lifewise 37294 COMMERCIAL N
Payer moved to live with vision
and dental claims on 6/22. Now
they are allowing all other
medical claim submitter to send.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 3
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
ATA-FL 65064 COMMERCIAL N
ONLY Physical Occupational and
Speech Therapy Claims for the
following FLORIDA Health Plans
should be submitted to this payer
ID: Aetna Health Plan CarePlus
JMH Health Plan Sunshine State
Health Plan WellCare Health Plan
ATA-FL 65064 COMMERCIAL N
ONLY Physical Occupational and
Speech Therapy Claims for the
following FLORIDA Health Plans
should be submitted to this payer
ID: Aetna Health Plan CarePlus
JMH Health Plan Sunshine State
Health Plan WellCare Health PlanAXA Assistance_USA 65101 COMMERCIAL NAXA Assistance_USA 65101 COMMERCIAL NAbrazo Advantage Health Plan 3443 COMMERCIAL NAbrazo Advantage Health Plan 3443 COMMERCIAL N
Absolute Total Care 68055 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
866-433-6041 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Absolute Total Care 68055 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
866-433-6041 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.Access Administrators TH067 COMMERCIAL NAccess Administrators TH067 COMMERCIAL NAccess IPA CM001 COMMERCIAL NAccess IPA CM001 COMMERCIAL NAccess IPA REGAL COMMERCIAL NAccess IPA REGAL COMMERCIAL NAcclaim 64071 COMMERCIAL NAcclaim 64071 COMMERCIAL NAcclaim Repricing 21356 COMMERCIAL NAcclaim Repricing 21356 COMMERCIAL NActiva Benefit Services 88056 COMMERCIAL NActiva Benefit Services 88056 COMMERCIAL NAdministration Systems Research Corporation 38265 COMMERCIAL NAdministration Systems Research Corporation 38265 COMMERCIAL NAdministrative Concepts Inc. 22384 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 4
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationAdministrative Concepts Inc. 22384 COMMERCIAL NAdministrative Services Inc. 59141 COMMERCIAL NAdministrative Services Inc. 59141 COMMERCIAL NAdvanced Medical Management AMM01 COMMERCIAL NAdvanced Medical Management AMM01 COMMERCIAL NAdvantage Health Solutions 35209 COMMERCIAL NAdvantage Health Solutions 35209 COMMERCIAL NAdvantage Med Grp NMM01 COMMERCIAL NAdvantage Med Grp NMM01 COMMERCIAL NAdvantage Preferred Plus 77070 COMMERCIAL NAdvantage Preferred Plus 77070 COMMERCIAL NAdvantage by Bridgeway Health Solutions 68056 COMMERCIAL NAdvantage by Bridgeway Health Solutions 68056 COMMERCIAL NAdvantage by Buckeye Community Health Plan 68056 COMMERCIAL NAdvantage by Buckeye Community Health Plan 68056 COMMERCIAL NAdvantage by Managed Health Services 68056 COMMERCIAL NAdvantage by Managed Health Services 68056 COMMERCIAL NAdvantage by Superior HealthPlan 68056 COMMERCIAL NAdvantage by Superior HealthPlan 68056 COMMERCIAL NAdvantek Benefit Administrators 83077 COMMERCIAL NAdvantek Benefit Administrators 83077 COMMERCIAL N
Advantra Freedom 25133 COMMERCIAL N
Formerly payer ID 25152. Now
part of Coventry Consolidated
payer ID.
Advantra Freedom 25133 COMMERCIAL N
Formerly payer ID 25152. Now
part of Coventry Consolidated
payer ID.
Advantra Savings 25133 COMMERCIAL N
Formerly payer ID 25152. Now
part of Coventry Consolidated
payer ID.
Advantra Savings 25133 COMMERCIAL N
Formerly payer ID 25152. Now
part of Coventry Consolidated
payer ID.Adventist Health System West - Roseville CA 95340 COMMERCIAL NAdventist Health System West - Roseville CA 95340 COMMERCIAL N
AdvoCare Incorporated (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
AdvoCare Incorporated (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Advocate Health Centers 36320 COMMERCIAL N
Please contact Advocate
Physician Partners Debbie Motz
at (847)635-4182 for questions or
more information for both payer
IDs.
Advocate Health Centers 36320 COMMERCIAL N
Please contact Advocate
Physician Partners Debbie Motz
at (847)635-4182 for questions or
more information for both payer
IDs.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 5
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Advocate Physician Partners 65093 COMMERCIAL N
Please contact Advocate
Physician Partners Debbie Motz
at (847)635-4182 for questions or
more information for both payer
IDs.
Advocate Physician Partners 65093 COMMERCIAL N
Please contact Advocate
Physician Partners Debbie Motz
at (847)635-4182 for questions or
more information for both payer
IDs.Aetna 60054 COMMERCIAL NAetna 60054 COMMERCIAL NAetna Affordable Health Choices (SM) - SRC 57604 COMMERCIAL NAetna Affordable Health Choices (SM) - SRC 57604 COMMERCIAL NAffiliated Doctors of Orange County (ADOC) ADOCS COMMERCIAL NAffiliated Doctors of Orange County (ADOC) ADOCS COMMERCIAL NAffiliated Physicians Group APG01 COMMERCIAL NAffiliated Physicians Group APG01 COMMERCIAL N
Affinity Health Plan 13334 COMMERCIAL P
Please contact Affinity's EDI
Coordinator before submitting
claims electronically at
[email protected] or call
(718)794-7592.
Affinity Health Plan 13334 COMMERCIAL P
Please contact Affinity's EDI
Coordinator before submitting
claims electronically at
[email protected] or call
(718)794-7592.
Affinity Medicare Advantage 13333 COMMERCIAL N
When submitting to this payer ID
please ensure the following: The
claim is for a Medicare Advantage
Member the date of service is
equal to or greater than 1/1/10
and the subscriber ID you submit
is 9 characters in length.
Affinity Medicare Advantage 13333 COMMERCIAL N
When submitting to this payer ID
please ensure the following: The
claim is for a Medicare Advantage
Member the date of service is
equal to or greater than 1/1/10
and the subscriber ID you submit
is 9 characters in length.
Affordable Benefit Administrators Inc. 95426 COMMERCIAL N
Claims with the following address
should only be sent to this payer
id. ABA P.O. Box 10787 Burbank
CA 91510-0787
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 6
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Affordable Benefit Administrators Inc. 95426 COMMERCIAL N
Claims with the following address
should only be sent to this payer
id. ABA P.O. Box 10787 Burbank
CA 91510-0787
Agate Resources Inc. (LIPA) 20048 COMMERCIAL N
Please contact Risa Rhodes at
(514) 762-2165 for the Agate
Resources Inc. (LIPA) Payer ID
Agate Resources Inc. (LIPA) 20048 COMMERCIAL N
Please contact Risa Rhodes at
(514) 762-2165 for the Agate
Resources Inc. (LIPA) Payer ID
Agency Services Inc 64158 COMMERCIAL N Now known as Meritain Health
Agency Services Inc 64158 COMMERCIAL N Now known as Meritain Health
Alaska Children's Services Inc. 91136 COMMERCIAL N
Please enter Group Number (P68)
when submitting claims.
Alaska Children's Services Inc. 91136 COMMERCIAL N
Please enter Group Number (P68)
when submitting claims.Alaska Electrical Health & Welfare Fund 92600 COMMERCIAL NAlaska Electrical Health & Welfare Fund 92600 COMMERCIAL N
Alaska Laborers Construction Industry Trust 91136 COMMERCIAL N
Please enter Group Number (F23)
when submitting claims.
Alaska Laborers Construction Industry Trust 91136 COMMERCIAL N
Please enter Group Number (F23)
when submitting claims.
Alaska Pipe Trades Local 375 91136 COMMERCIAL N
Please enter Group Number (F24)
when submitting claims.
Alaska Pipe Trades Local 375 91136 COMMERCIAL N
Please enter Group Number (F24)
when submitting claims.
Alaska United Food & Commercial Workers Health & Welfare Trust91136 COMMERCIAL N
Please enter Group Number (F45)
when submitting claims.
Alaska United Food & Commercial Workers Health & Welfare Trust91136 COMMERCIAL N
Please enter Group Number (F45)
when submitting claims.Allegiance Benefit Plan Management Inc. 81040 COMMERCIAL NAllegiance Benefit Plan Management Inc. 81040 COMMERCIAL N
Alliance Healthcare/Florida for Stones River Regional IPA13079 COMMERCIAL N
This Payer ID should be used for
Stones River Regional IPA -
Alliance Healthcare Florida claims
only.
Alliance Healthcare/Florida for Stones River Regional IPA13079 COMMERCIAL N
This Payer ID should be used for
Stones River Regional IPA -
Alliance Healthcare Florida claims
only.
Alliance The (A Wisconsin provider network) Call COMMERCIAL N
ID cards should show mailing
address of PO Box 44365 Madison
WI 53744. Call Dave Sell at 608-
210-6656 to obtain Payer ID.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 7
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Alliance The (A Wisconsin provider network) Call COMMERCIAL N
ID cards should show mailing
address of PO Box 44365 Madison
WI 53744. Call Dave Sell at 608-
210-6656 to obtain Payer ID.Alliant Health Plans of Georgia 58234 COMMERCIAL NAlliant Health Plans of Georgia 58234 COMMERCIAL NAllied Administrators (San Francisco CA) 94177 COMMERCIAL NAllied Administrators (San Francisco CA) 94177 COMMERCIAL NAllied Benefit Systems 37308 COMMERCIAL NAllied Benefit Systems 37308 COMMERCIAL NAllied Health Systems Chiropractic SX156 COMMERCIAL NAllied Health Systems Chiropractic SX156 COMMERCIAL NAllied Physicians NMM01 COMMERCIAL NAllied Physicians NMM01 COMMERCIAL NAlpha Data TH085 COMMERCIAL NAlpha Data TH085 COMMERCIAL N
Alta Bates Medical Group A0701 COMMERCIAL N
Payer ID is only for dates of
service after 7/1/2010.
Alta Bates Medical Group A0701 COMMERCIAL N
Payer ID is only for dates of
service after 7/1/2010.
Alta Bates Medical Group Call COMMERCIAL P
Network ID required on all claims.
Call Sutter Connect EDI
Department at (800) 611-5191 to
obtain Network ID prior to first
submission.
Alta Bates Medical Group Call COMMERCIAL P
Network ID required on all claims.
Call Sutter Connect EDI
Department at (800) 611-5191 to
obtain Network ID prior to first
submission.
Alta Senior Care (Hnet Sr and Secure Horizons only) E3510 COMMERCIAL P
Only claims from providers in
Northern California. Please
contact the EDI Dept for North
American Medical Management
(NAMM) - Northern California
Lead/Supervisor at 1-800-956-
8000 prior to initial submission of
claims.
Alta Senior Care (Hnet Sr and Secure Horizons only) E3510 COMMERCIAL P
Only claims from providers in
Northern California. Please
contact the EDI Dept for North
American Medical Management
(NAMM) - Northern California
Lead/Supervisor at 1-800-956-
8000 prior to initial submission of
claims.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 8
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Altius (Utah) 25133 COMMERCIAL N
Formerly Payer ID SX113. Now
part of the Consolidated payer ID.
Altius (Utah) 25133 COMMERCIAL N
Formerly Payer ID SX113. Now
part of the Consolidated payer ID.Amalgamated Life 13550 COMMERCIAL NAmalgamated Life 13550 COMMERCIAL NAmalgamated Life - PA / Alicare 13343 COMMERCIAL NAmalgamated Life - PA / Alicare 13343 COMMERCIAL N
AmeraPlan 38219 COMMERCIAL N
Claims are printed and mailed to
the payer.
AmeraPlan 38219 COMMERCIAL N
Claims are printed and mailed to
the payer.AmeriBen Solutions Inc. 75137 COMMERCIAL NAmeriBen Solutions Inc. 75137 COMMERCIAL N
AmeriChoice of New Jersey Personal Care Plus (Medicare)86001 COMMERCIAL N
All claims submitted require your
AmeriChoice assigned Provider ID
Number. Please contact
AmeriChoice at (888) 362-3368
for your Provider ID Number.
AmeriChoice of New Jersey Personal Care Plus (Medicare)86001 COMMERCIAL N
All claims submitted require your
AmeriChoice assigned Provider ID
Number. Please contact
AmeriChoice at (888) 362-3368
for your Provider ID Number.AmeriChoice of New Jersey Inc. (Medicaid NJ) 86047 COMMERCIAL NAmeriChoice of New Jersey Inc. (Medicaid NJ) 86047 COMMERCIAL N
AmeriChoice of New York Personal Care Plus (Medicare)86002 COMMERCIAL N
All claims submitted require your
AmeriChoice assigned Provider ID
Number. Please contact
AmeriChoice at (866) 362-3368
for your Provider ID Number.
AmeriChoice of New York Personal Care Plus (Medicare)86002 COMMERCIAL N
All claims submitted require your
AmeriChoice assigned Provider ID
Number. Please contact
AmeriChoice at (866) 362-3368
for your Provider ID Number.AmeriChoice of New York Inc. (Medicaid NY) 86048 COMMERCIAL NAmeriChoice of New York Inc. (Medicaid NY) 86048 COMMERCIAL N
AmeriChoice of Pennsylvania Personal Care Plus (Medicare)86003 COMMERCIAL N
All claims submitted require your
AmeriChoice assigned Provider ID
Number. Please contact
AmeriChoice at (800) 345-3627
for your Provider ID Number.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 9
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
AmeriChoice of Pennsylvania Personal Care Plus (Medicare)86003 COMMERCIAL N
All claims submitted require your
AmeriChoice assigned Provider ID
Number. Please contact
AmeriChoice at (800) 345-3627
for your Provider ID Number.AmeriChoice of Pennsylvania Inc. (Medicaid PA) 86049 COMMERCIAL NAmeriChoice of Pennsylvania Inc. (Medicaid PA) 86049 COMMERCIAL NAmeriHealth Administrators 54763 COMMERCIAL NAmeriHealth Administrators 54763 COMMERCIAL NAmeriHealth HMO New Jersey and Delaware 23037 COMMERCIAL NAmeriHealth HMO New Jersey and Delaware 23037 COMMERCIAL N
AmeriHealth Mercy Health Plan 22248 COMMERCIAL N
Medicaid managed care. For EDI
support please e-mail
AmeriHealth Mercy Health Plan 22248 COMMERCIAL N
Medicaid managed care. For EDI
support please e-mail
[email protected]'s PPO 16120 COMMERCIAL NAmerica's PPO 16120 COMMERCIAL NAmerica's TPA 41178 COMMERCIAL NAmerica's TPA 41178 COMMERCIAL NAmericaid Community Care (Maryland) 27517 COMMERCIAL NAmericaid Community Care (Maryland) 27517 COMMERCIAL NAmericaid Community Care (New Jersey) 27516 COMMERCIAL NAmericaid Community Care (New Jersey) 27516 COMMERCIAL NAmerican Administrative Group 75240 COMMERCIAL NAmerican Administrative Group 75240 COMMERCIAL N
American Administrators (West Des Moines Iowa) 42112 COMMERCIAL N
Please check the Insured ID card
to verify the Payer ID before
submitting claims. If you have
questions please contact Provider
Relations at 800-456-4584.
American Administrators (West Des Moines Iowa) 42112 COMMERCIAL N
Please check the Insured ID card
to verify the Payer ID before
submitting claims. If you have
questions please contact Provider
Relations at 800-456-4584.
American Administrators dba Select Benefit Administrators (W.DesMoines IA)42137 COMMERCIAL N
Please check the Insured ID card
to verify the Payer ID before
submitting claims. If you have
questions please contact Provider
Relations at 800-456-4584.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 10
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
American Administrators dba Select Benefit Administrators (W.DesMoines IA)42137 COMMERCIAL N
Please check the Insured ID card
to verify the Payer ID before
submitting claims. If you have
questions please contact Provider
Relations at 800-456-4584.American Behavioral 63103 COMMERCIAL NAmerican Behavioral 63103 COMMERCIAL NAmerican Behavioral FEP/ITS 63106 COMMERCIAL NAmerican Behavioral FEP/ITS 63106 COMMERCIAL NAmerican Behavioral-LifeSynch 63101 COMMERCIAL NAmerican Behavioral-LifeSynch 63101 COMMERCIAL NAmerican Benefit Plan Administrators 95170 COMMERCIAL NAmerican Benefit Plan Administrators 95170 COMMERCIAL N
American Benefits Management (North Canton OH) 34187 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
P.O. Box 35008 N. Canton OH
44735
American Benefits Management (North Canton OH) 34187 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
P.O. Box 35008 N. Canton OH
44735American Chiropractic Network (ACN) 41161 COMMERCIAL NAmerican Chiropractic Network (ACN) 41161 COMMERCIAL NAmerican Chiropractic Network IPA of NY (ACNIPA) 41160 COMMERCIAL NAmerican Chiropractic Network IPA of NY (ACNIPA) 41160 COMMERCIAL NAmerican Community Mutual Insurance 60305 COMMERCIAL NAmerican Community Mutual Insurance 60305 COMMERCIAL NAmerican Family Insurance TH095 COMMERCIAL NAmerican Family Insurance TH095 COMMERCIAL NAmerican Family PPO Policies Administered by Am Rep56071 COMMERCIAL NAmerican Family PPO Policies Administered by Am Rep56071 COMMERCIAL NAmerican General 62030 COMMERCIAL NAmerican General 62030 COMMERCIAL NAmerican Healthcare Alliance 1066 COMMERCIAL NAmerican Healthcare Alliance 1066 COMMERCIAL N
American Imaging Management Inc. 36369 COMMERCIAL N
Assigned Group Policy Plan ID is
required. To obtain please call
American Imaging Management
Inc. at (800) 252-2021.
American Imaging Management Inc. 36369 COMMERCIAL N
Assigned Group Policy Plan ID is
required. To obtain please call
American Imaging Management
Inc. at (800) 252-2021.American International Group Inc. (AIG) 87726 COMMERCIAL N Plan of UnitedHealthcareAmerican International Group Inc. (AIG) 87726 COMMERCIAL N Plan of UnitedHealthcare
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 11
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
American LIFECARE 72099 COMMERCIAL N
Please enter the Group Number
from ID card when submitting
claims. Payer ID valid only for
claims with a billing submission
address of 1100 Poydras Street
Suite 2600 New Orleans LA
70163-2602.
American LIFECARE 72099 COMMERCIAL N
Please enter the Group Number
from ID card when submitting
claims. Payer ID valid only for
claims with a billing submission
address of 1100 Poydras Street
Suite 2600 New Orleans LA
70163-2602.American Medical Security Inc. 81400 COMMERCIAL NAmerican Medical Security Inc. 81400 COMMERCIAL NAmerican Medical and Life Insurance 23212 COMMERCIAL NAmerican Medical and Life Insurance 23212 COMMERCIAL NAmerican National Ins. Co. (ANICO) 74048 COMMERCIAL NAmerican National Ins. Co. (ANICO) 74048 COMMERCIAL N
American Postal Workers Union Health Plan 44444 COMMERCIAL N
Claims for the state of Maine
ONLY must be sent on paper to
MedNet P. O. Box 15440 Portland
ME 04112.
American Postal Workers Union Health Plan 44444 COMMERCIAL N
Claims for the state of Maine
ONLY must be sent on paper to
MedNet P. O. Box 15440 Portland
ME 04112.American Progressive Life and Health Insurance Company48055 COMMERCIAL NAmerican Progressive Life and Health Insurance Company48055 COMMERCIAL NAmerican Republic Insurance 42011 COMMERCIAL NAmerican Republic Insurance 42011 COMMERCIAL NAmerican Whole Health Networks TH117 COMMERCIAL NAmerican Whole Health Networks TH117 COMMERCIAL NAmerican Worker Health Plan 37322 COMMERCIAL NAmerican Worker Health Plan 37322 COMMERCIAL NAmerigroup Community Care 27514 COMMERCIAL NAmerigroup Community Care 27514 COMMERCIAL N
Amerigroup Corporation (Ft Worth) 27514 COMMERCIAL N
Formally Americaid Community
Care (Dallas/Ft. Worth).
Amerigroup Corporation (Ft Worth) 27514 COMMERCIAL N
Formally Americaid Community
Care (Dallas/Ft. Worth).
Amerigroup Corporation (Houston) 27515 COMMERCIAL N
Formerly Americaid Community
Care (Houston).
Amerigroup Corporation (Houston) 27515 COMMERCIAL N
Formerly Americaid Community
Care (Houston).Amerigroup Florida 27519 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 12
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationAmerigroup Florida 27519 COMMERCIAL NAmerigroup Illinois 27518 COMMERCIAL NAmerigroup Illinois 27518 COMMERCIAL NAmerigroup Ohio 27518 COMMERCIAL NAmerigroup Ohio 27518 COMMERCIAL N
Amida Care 24818 COMMERCIAL N Formerly known as VidaCare
Amida Care 24818 COMMERCIAL N Formerly known as VidaCareAnchor Benefit Consulting Inc. 53085 COMMERCIAL NAnchor Benefit Consulting Inc. 53085 COMMERCIAL NAncillary Benefit Services (ABS) 86062 COMMERCIAL NAncillary Benefit Services (ABS) 86062 COMMERCIAL NAncillary Care Management/ACM 3172 COMMERCIAL NAncillary Care Management/ACM 3172 COMMERCIAL NAngeles IPA (SynerMed) SYMED COMMERCIAL NAngeles IPA (SynerMed) SYMED COMMERCIAL NAntares Management Solutions 34192 COMMERCIAL NAntares Management Solutions 34192 COMMERCIAL N
Apex Benefit Services 34196 COMMERCIAL N
Apex is also a Medicaid payer and
will accept claims with either a
Medicaid or Commercial
classification
Apex Benefit Services 34196 COMMERCIAL N
Apex is also a Medicaid payer and
will accept claims with either a
Medicaid or Commercial
classificationAppleCare Medical Management APP01 COMMERCIAL NAppleCare Medical Management APP01 COMMERCIAL NArcadian Management Services Inc 77045 COMMERCIAL NArcadian Management Services Inc 77045 COMMERCIAL NArizona Foundation for Medical Care (AFMC) 86062 COMMERCIAL NArizona Foundation for Medical Care (AFMC) 86062 COMMERCIAL NArizona Physicians IPA 3432 COMMERCIAL NArizona Physicians IPA 3432 COMMERCIAL NArkansas Best Corporation - Choice Benefits 75278 COMMERCIAL NArkansas Best Corporation - Choice Benefits 75278 COMMERCIAL NArkansas Municipal League 71603 COMMERCIAL NArkansas Municipal League 71603 COMMERCIAL N
Arnett Health Plans 95440 COMMERCIAL N
Payer requires unique Provider ID
for billing rendering or referring
provider fields. Contact Arnett
Health Plan's EDI Coordinator at 1-
888-448-7440 for additional
information prior to first claims
submission.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 13
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Arnett Health Plans 95440 COMMERCIAL N
Payer requires unique Provider ID
for billing rendering or referring
provider fields. Contact Arnett
Health Plan's EDI Coordinator at 1-
888-448-7440 for additional
information prior to first claims
submission.Associates for Health Care Inc. (AHC) 36326 COMMERCIAL NAssociates for Health Care Inc. (AHC) 36326 COMMERCIAL N
Association Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry Consolidated
payer ID. Including Combined
Government Health Plan &
Contract Health Insurance Plan.
Association Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry Consolidated
payer ID. Including Combined
Government Health Plan &
Contract Health Insurance Plan.Assurant Health 39065 COMMERCIAL NAssurant Health 39065 COMMERCIAL N
Assurant Health Self-Funded (Ft. Mill SC) 37313 COMMERCIAL N
MUST VERIFY ALL CLAIMS
SHOULD GO TO PAYER IN FT. MILL
SC
Assurant Health Self-Funded (Ft. Mill SC) 37313 COMMERCIAL N
MUST VERIFY ALL CLAIMS
SHOULD GO TO PAYER IN FT. MILL
SCAssurant MiniMed-Key Family 37323 COMMERCIAL NAssurant MiniMed-Key Family 37323 COMMERCIAL NAssureCare Inc. 88035 COMMERCIAL NAssureCare Inc. 88035 COMMERCIAL NAssured Benefits Administrators 74240 COMMERCIAL NAssured Benefits Administrators 74240 COMMERCIAL N
Asuris Northwest/MedAdvantage SX179 COMMERCIAL N
Payer must receive
REF*1B*Provider ID in Billing and
Rendering even when NPI is
submitted.
Asuris Northwest/MedAdvantage SX179 COMMERCIAL N
Payer must receive
REF*1B*Provider ID in Billing and
Rendering even when NPI is
submitted.Athens Area Health Plan Select 95691 COMMERCIAL NAthens Area Health Plan Select 95691 COMMERCIAL NAtlantic Medical Insurance 22285 COMMERCIAL NAtlantic Medical Insurance 22285 COMMERCIAL NAtlanticare [also known as Horizon HealthCare Admin (HHA)]22304 COMMERCIAL NAtlanticare [also known as Horizon HealthCare Admin (HHA)]22304 COMMERCIAL NAtlantis Health Plan 13853 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 14
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationAtlantis Health Plan 13853 COMMERCIAL N
Atlas Administrators TH004 COMMERCIAL N
Currently only accepts UCO
Providers. The group number
must be 8 characters in length.
Only one of the characters can be
a dash. If the group number is
entered then the group name
must also be entered.
Atlas Administrators TH004 COMMERCIAL N
Currently only accepts UCO
Providers. The group number
must be 8 characters in length.
Only one of the characters can be
a dash. If the group number is
entered then the group name
must also be entered.
AultComp Managed Care Organization (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
AultComp Managed Care Organization (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Aultra Administrative Group 37242 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
P.O. Box 35276 Canton OH 44735-
5276
Aultra Administrative Group 37242 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
P.O. Box 35276 Canton OH 44735-
5276Automated Benefit Services 38259 COMMERCIAL NAutomated Benefit Services 38259 COMMERCIAL N
Automated Group Administration Inc. 37280 COMMERCIAL N
Please send these EDI claims to
the Payer ID of the PPO shown on
the Member's ID Card. If you
have any questions please call
260-489-6447 (703).
Automated Group Administration Inc. 37280 COMMERCIAL N
Please send these EDI claims to
the Payer ID of the PPO shown on
the Member's ID Card. If you
have any questions please call
260-489-6447 (703).
AvMed Inc. 59274 COMMERCIAL N
The Insured ID and Patient ID fro
this payer must be the 11-digit
Member ID.
AvMed Inc. 59274 COMMERCIAL N
The Insured ID and Patient ID fro
this payer must be the 11-digit
Member ID.
AvatarComp (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
AvatarComp (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 15
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationAvera Health Plans 46045 COMMERCIAL NAvera Health Plans 46045 COMMERCIAL NAveraAdvantage 48055 COMMERCIAL NAveraAdvantage 48055 COMMERCIAL NAverde Health 26355 COMMERCIAL NAverde Health 26355 COMMERCIAL N
Avesis Third Party Administrators 87098 COMMERCIAL N
These payer is live for VISION
CLAIMS ONLY.
Avesis Third Party Administrators 87098 COMMERCIAL N
These payer is live for VISION
CLAIMS ONLY.BCI Administrators Inc. 49153 COMMERCIAL NBCI Administrators Inc. 49153 COMMERCIAL N
BEACON HEALTH STRATEGIES 43324 COMMERCIAL N
Beacon requires submission of
the member's Plan ID. Please
follow the link to our payer fact
sheet for ID's and further
instructions.
BEACON HEALTH STRATEGIES 43324 COMMERCIAL N
Beacon requires submission of
the member's Plan ID. Please
follow the link to our payer fact
sheet for ID's and further
instructions.
BENEFIT MANAGEMENT SERVICES Call COMMERCIAL N
Please contact Chris Burak at
(704) 321-3156 for payer id
information.
BENEFIT MANAGEMENT SERVICES Call COMMERCIAL N
Please contact Chris Burak at
(704) 321-3156 for payer id
information.BHSG of Tennessee SX002 COMMERCIAL NBHSG of Tennessee SX002 COMMERCIAL N
BMC HealthNet Plan 13337 COMMERCIAL N
Submissions to BMCHP must
include the correct 12 digit
BMCHP Provider ID # including all
leading zeros.
BMC HealthNet Plan 13337 COMMERCIAL N
Submissions to BMCHP must
include the correct 12 digit
BMCHP Provider ID # including all
leading zeros.BMGI - Benefit Management Group Inc. 20018 COMMERCIAL NBMGI - Benefit Management Group Inc. 20018 COMMERCIAL NBPA/Benefit Plan Administrators (North Dakota) 37286 COMMERCIAL NBPA/Benefit Plan Administrators (North Dakota) 37286 COMMERCIAL NBPS Inc. 13310 COMMERCIAL NBPS Inc. 13310 COMMERCIAL N
BSI Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
BSI Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.Bakersfield Family Medical Center BKRFM COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 16
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationBakersfield Family Medical Center BKRFM COMMERCIAL NBanner Health AZ SX145 COMMERCIAL NBanner Health AZ SX145 COMMERCIAL NBanner Health Co - ROCKY MOUNTAIN HMO GREELEYSX145 COMMERCIAL NBanner Health Co - ROCKY MOUNTAIN HMO GREELEYSX145 COMMERCIAL NBanner Health Co. - ANTERO GREELEY SX145 COMMERCIAL NBanner Health Co. - ANTERO GREELEY SX145 COMMERCIAL NBanner Health Co. - ANTERO HIGH PLAINS SX145 COMMERCIAL NBanner Health Co. - ANTERO HIGH PLAINS SX145 COMMERCIAL NBanner Health Co. - ANTERO MOUNTAIN SHADOWS SX145 COMMERCIAL NBanner Health Co. - ANTERO MOUNTAIN SHADOWS SX145 COMMERCIAL NBanner Health Co. - CHOICE PLUS SX145 COMMERCIAL NBanner Health Co. - CHOICE PLUS SX145 COMMERCIAL NBanner Health Co. - HMO GREELEY SX145 COMMERCIAL NBanner Health Co. - HMO GREELEY SX145 COMMERCIAL NBanner Health Co. - HMO HIGH PLAINS SX145 COMMERCIAL NBanner Health Co. - HMO HIGH PLAINS SX145 COMMERCIAL NBanner Health Co. - HMO MOUNTAIN SHADOWS SX145 COMMERCIAL NBanner Health Co. - HMO MOUNTAIN SHADOWS SX145 COMMERCIAL NBanner Health Co. - PACIFICARE GREELEY SX145 COMMERCIAL NBanner Health Co. - PACIFICARE GREELEY SX145 COMMERCIAL NBanner Health Co. - PACIFICARE HIGH PLAINS SX145 COMMERCIAL NBanner Health Co. - PACIFICARE HIGH PLAINS SX145 COMMERCIAL NBanner Health Co. - PACIFICARE MOUNTAIN SHADOWSSX145 COMMERCIAL NBanner Health Co. - PACIFICARE MOUNTAIN SHADOWSSX145 COMMERCIAL NBanner Health Co. - ROCKY MOUNTAIN HMO HIGH PLAINSSX145 COMMERCIAL NBanner Health Co. - ROCKY MOUNTAIN HMO HIGH PLAINSSX145 COMMERCIAL NBanner Health Co. - SECURE HORIZONS GREELEY SX145 COMMERCIAL NBanner Health Co. - SECURE HORIZONS GREELEY SX145 COMMERCIAL NBanner Health Co. - SECURE HORIZONS HIGH PLAINS SX145 COMMERCIAL NBanner Health Co. - SECURE HORIZONS HIGH PLAINS SX145 COMMERCIAL NBanner Health Co. - SECURE HORIZONS MOUNTAIN SHADOWSSX145 COMMERCIAL NBanner Health Co. - SECURE HORIZONS MOUNTAIN SHADOWSSX145 COMMERCIAL NBanner Medisun 77078 COMMERCIAL NBanner Medisun 77078 COMMERCIAL NBascom Palmer Eye Care Network - New Century HealthNCH06 COMMERCIAL NBascom Palmer Eye Care Network - New Century HealthNCH06 COMMERCIAL NBass Administrators Inc. 37248 COMMERCIAL NBass Administrators Inc. 37248 COMMERCIAL NBeech Street 95377 COMMERCIAL NBeech Street 95377 COMMERCIAL NBehavioral Health Systems 63100 COMMERCIAL NBehavioral Health Systems 63100 COMMERCIAL NBellflower Hospital (Synermed) SYMED COMMERCIAL NBellflower Hospital (Synermed) SYMED COMMERCIAL NBencomp National Corporation 33192 COMMERCIAL NBencomp National Corporation 33192 COMMERCIAL NBenefit Admin Services 88055 COMMERCIAL NBenefit Admin Services 88055 COMMERCIAL NBenefit Administrative Systems 36149 COMMERCIAL NBenefit Administrative Systems 36149 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 17
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Benefit Coordinators Corporation (Pittsburgh PA) 25145 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
111 Ryan Court Suite 300
Pittsburgh PA 15205.
Benefit Coordinators Corporation (Pittsburgh PA) 25145 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
111 Ryan Court Suite 300
Pittsburgh PA 15205.Benefit Management Services Inc. 999 COMMERCIAL NBenefit Management Services Inc. 999 COMMERCIAL NBenefit Management Systems Inc 37212 COMMERCIAL NBenefit Management Systems Inc 37212 COMMERCIAL N
Benefit Management Inc. of KS 48611 COMMERCIAL N
This payer will only accept
medical and hospital claims for
these groups listed:
BMI187BMI219BMI234BMI236B
MI214.BMI241BMI617
BMI245.BMI246
Benefit Management Inc. of KS 48611 COMMERCIAL N
This payer will only accept
medical and hospital claims for
these groups listed:
BMI187BMI219BMI234BMI236B
MI214.BMI241BMI617
BMI245.BMI246Benefit Plan Administrators 88052 COMMERCIAL NBenefit Plan Administrators 88052 COMMERCIAL N
Benefit Plan Administrators Co. (Eau Claire WI) 39081 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
P.O. Box 1128 Eau Claire WI
54702-1128.
Benefit Plan Administrators Co. (Eau Claire WI) 39081 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
P.O. Box 1128 Eau Claire WI
54702-1128.
Benefit Plan Administrators Inc. (Roanoke VA) 37118 COMMERCIAL N
Please call Mary Bender at (540)
345-2721 to verify if you should
be sending to the Benefit Plan
Administrators Inc. in Roanoke
VA.
Benefit Plan Administrators Inc. (Roanoke VA) 37118 COMMERCIAL N
Please call Mary Bender at (540)
345-2721 to verify if you should
be sending to the Benefit Plan
Administrators Inc. in Roanoke
VA.Benefit Planners Inc. 74223 COMMERCIAL NBenefit Planners Inc. 74223 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 18
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationBenefit Systems & Services Inc. (BSSI) 36342 COMMERCIAL NBenefit Systems & Services Inc. (BSSI) 36342 COMMERCIAL NBenesight 87265 COMMERCIAL N (Formerly known as The TPA)Benesight 87265 COMMERCIAL N (Formerly known as The TPA)Benesys 37248 COMMERCIAL NBenesys 37248 COMMERCIAL NBenesys Inc. 37248 COMMERCIAL NBenesys Inc. 37248 COMMERCIAL N
Berkshire Health Partners - PPO Wyomissing PA (IHS Gateway Payer)Call COMMERCIAL N
Before submitting please contact
Lori Calpino at (610) 372-8044
ext. 3019
Berkshire Health Partners - PPO Wyomissing PA (IHS Gateway Payer)Call COMMERCIAL N
Before submitting please contact
Lori Calpino at (610) 372-8044
ext. 3019Berkshire Lehigh Partners Call COMMERCIAL NBerkshire Lehigh Partners Call COMMERCIAL NBest Life & Health Insurance Co. 95604 COMMERCIAL NBest Life & Health Insurance Co. 95604 COMMERCIAL NBetter Health Plans of South Carolina 32006 COMMERCIAL NBetter Health Plans of South Carolina 32006 COMMERCIAL N
Better Health Plans Inc. 62183 COMMERCIAL N
Now known as Unison Health
Plan
Better Health Plans Inc. 62183 COMMERCIAL N
Now known as Unison Health
PlanBlue Benefit Administrators of MA 3036 COMMERCIAL NBlue Benefit Administrators of MA 3036 COMMERCIAL N
Blue Grass Family Health/SRRIPA ONLY 15754 COMMERCIAL N
This Payer ID should be used for
Stones River Regional IPA - Blue
Grass Family Health claims
Blue Grass Family Health/SRRIPA ONLY 15754 COMMERCIAL N
This Payer ID should be used for
Stones River Regional IPA - Blue
Grass Family Health claimsBluegrass Family Health 61124 COMMERCIAL NBluegrass Family Health 61124 COMMERCIAL NBoilermakers National Health & Welfare Fund 36609 COMMERCIAL NBoilermakers National Health & Welfare Fund 36609 COMMERCIAL NBoon-Chapman Benefit Administrators Inc. 74238 COMMERCIAL NBoon-Chapman Benefit Administrators Inc. 74238 COMMERCIAL N
Boston Medical Center Health Plan Inc. 13337 COMMERCIAL N
Submissions to BMCHP must
include the correct 12 digit
BMCHP Provider ID # including all
leading zeros.
Boston Medical Center Health Plan Inc. 13337 COMMERCIAL N
Submissions to BMCHP must
include the correct 12 digit
BMCHP Provider ID # including all
leading zeros.Boulder Administration Services 20381 COMMERCIAL NBoulder Administration Services 20381 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 19
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Bravo Health 52192 COMMERCIAL N
Formerly known as Elder Health
Inc. serving members in
Pennsylvania Maryland Delaware
Texas and Washington DC. Not to
be confused with ElderPlan in NY.
Bravo Health 52192 COMMERCIAL N
Formerly known as Elder Health
Inc. serving members in
Pennsylvania Maryland Delaware
Texas and Washington DC. Not to
be confused with ElderPlan in NY.
Bravo Health 52192 COMMERCIAL N
Formerly known as Elder Health
Inc. serving members in
Pennsylvania Maryland Delaware
Texas and Washington DC. Not to
be confused with ElderPlan in NY.
Bravo Health 52192 COMMERCIAL N
Formerly known as Elder Health
Inc. serving members in
Pennsylvania Maryland Delaware
Texas and Washington DC. Not to
be confused with ElderPlan in NY.
Bridgestone/Firestone See Comments COMMERCIAL N
?call CSU for the payor ID.? The
CSU telephone number is 330 379
4500.
Bridgestone/Firestone See Comments COMMERCIAL N
?call CSU for the payor ID.? The
CSU telephone number is 330 379
4500.
Bridgeway Arizona 68054 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept. at 1-
866-475-3129 to verify your
provider info is on file in the
Health Plans claim system. This
will prevent rejections and allow
payments to be made in a timely
manner.
Bridgeway Arizona 68054 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept. at 1-
866-475-3129 to verify your
provider info is on file in the
Health Plans claim system. This
will prevent rejections and allow
payments to be made in a timely
manner.BritCay 22286 COMMERCIAL NBritCay 22286 COMMERCIAL NBrockerage Concepts Inc. 51037 COMMERCIAL NBrockerage Concepts Inc. 51037 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 20
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationBrodart 35182 COMMERCIAL NBrodart 35182 COMMERCIAL N
Brokerage Service Inc Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
Brokerage Service Inc Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.Broward Health 37314 COMMERCIAL NBroward Health 37314 COMMERCIAL NBrown & Toland Medical Group 94316 COMMERCIAL NBrown & Toland Medical Group 94316 COMMERCIAL NBrown and Toland Medical Group BTSS1 COMMERCIAL NBrown and Toland Medical Group BTSS1 COMMERCIAL N
Buckeye Community Health 32004 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
866-296-8731 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Buckeye Community Health 32004 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
866-296-8731 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.Butler Benefit 42150 COMMERCIAL NButler Benefit 42150 COMMERCIAL NC&O Employees Hospital Association 23708 COMMERCIAL NC&O Employees Hospital Association 23708 COMMERCIAL NC. L. Frates & Co - OSMA Health 73071 COMMERCIAL NC. L. Frates & Co - OSMA Health 73071 COMMERCIAL NCAP Management Systems 95399 COMMERCIAL NCAP Management Systems 95399 COMMERCIAL NCAPSTONE HEALTH PLAN INC 86044 COMMERCIAL NCAPSTONE HEALTH PLAN INC 86044 COMMERCIAL N
CBA Blue 3036 COMMERCIAL N
Formerly known as
Comprehensive Benefits
Administrator Inc.
CBA Blue 3036 COMMERCIAL N
Formerly known as
Comprehensive Benefits
Administrator Inc.CBCA Administrators 55438 COMMERCIAL NCBCA Administrators 55438 COMMERCIAL NCDO Technologies 87065 COMMERCIAL NCDO Technologies 87065 COMMERCIAL NCDPHP SX065 COMMERCIAL N Par for BillingCDPHP SX065 COMMERCIAL N Par for BillingCDS Group Health 88022 COMMERCIAL NCDS Group Health 88022 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 21
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationCHA Health 23171 COMMERCIAL NCHA Health 23171 COMMERCIAL N
CHAMPVA - HAC 84146 COMMERCIAL N
CHAMPVA - HAC is not associated
with and does not process claims
for TRICARE (formerly CHAMPUS).
CHAMPVA - HAC 84146 COMMERCIAL N
CHAMPVA - HAC is not associated
with and does not process claims
for TRICARE (formerly CHAMPUS).CHCcares of South Carolina 25151 COMMERCIAL NCHCcares of South Carolina 25151 COMMERCIAL NCHOC - Children's Hospital Of Orange County Health Alliance33065 COMMERCIAL NCHOC - Children's Hospital Of Orange County Health Alliance33065 COMMERCIAL NCHP DIRECT SUPERMED 90441 COMMERCIAL NCHP DIRECT SUPERMED 90441 COMMERCIAL N
CHP/RPU (FABOH) Call COMMERCIAL N
Payer ID rendering provider and
location number required to
submit claims. Please call Dave
Sell at (608) 210-6656 to obtain.
CHP/RPU (FABOH) Call COMMERCIAL N
Payer ID rendering provider and
location number required to
submit claims. Please call Dave
Sell at (608) 210-6656 to obtain.CIGNA 62308 COMMERCIAL NCIGNA 62308 COMMERCIAL NCIGNA - PPA 62308 COMMERCIAL NCIGNA - PPA 62308 COMMERCIAL NCIGNA - PPO 62308 COMMERCIAL NCIGNA - PPO 62308 COMMERCIAL NCIGNA Behavioral Health SX071 COMMERCIAL NCIGNA Behavioral Health SX071 COMMERCIAL NCIGNA Health Plan - HMO 62308 COMMERCIAL NCIGNA Health Plan - HMO 62308 COMMERCIAL NCIGNA Medicare Advantage 86033 COMMERCIAL NCIGNA Medicare Advantage 86033 COMMERCIAL NCM Administrators Inc 56211 COMMERCIAL NCM Administrators Inc 56211 COMMERCIAL N
COOPERATIVE MANAGED CARE SERVICES 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502
COOPERATIVE MANAGED CARE SERVICES 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502
CRA Managed Care (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 22
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
CRA Managed Care (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.CWIBENEFITS INC. 57080 COMMERCIAL NCWIBENEFITS INC. 57080 COMMERCIAL NCadent Administrators 33192 COMMERCIAL NCadent Administrators 33192 COMMERCIAL NCadent Underwriters 33192 COMMERCIAL NCadent Underwriters 33192 COMMERCIAL NCal-Optima Direct CALOP COMMERCIAL NCal-Optima Direct CALOP COMMERCIAL NCalifornia Eye Care - New Century Health NCH05 COMMERCIAL NCalifornia Eye Care - New Century Health NCH05 COMMERCIAL NCannon Cochran Management Services Inc. Metairie LA71057 COMMERCIAL NCannon Cochran Management Services Inc. Metairie LA71057 COMMERCIAL NCapital Community Health Plan 87726 COMMERCIAL NCapital Community Health Plan 87726 COMMERCIAL NCapital District Physician's Health Plan SX065 COMMERCIAL N Par for BillingCapital District Physician's Health Plan SX065 COMMERCIAL N Par for Billing
Capital Health Plan 95112 COMMERCIAL N
Payer will accept either rendering
provider UPIN or NPI on claims.
Before submitting NPI please call
Capital Health Plan at 850-523-
7361 to register your NPI
numbers with them.
Capital Health Plan 95112 COMMERCIAL N
Payer will accept either rendering
provider UPIN or NPI on claims.
Before submitting NPI please call
Capital Health Plan at 850-523-
7361 to register your NPI
numbers with them.Capitol Administrators 68011 COMMERCIAL NCapitol Administrators 68011 COMMERCIAL NCare 1st Health Plan of Arizona 57116 COMMERCIAL NCare 1st Health Plan of Arizona 57116 COMMERCIAL NCare Improvement Plus 77082 COMMERCIAL NCare Improvement Plus 77082 COMMERCIAL NCare To Care 41222 COMMERCIAL NCare To Care 41222 COMMERCIAL NCare Wisconsin Health Plan (Trizetto) 27004 COMMERCIAL NCare Wisconsin Health Plan (Trizetto) 27004 COMMERCIAL N
CareCentrix 11345 COMMERCIAL P
Enrollment required prior to
claim submission. Please contact
Rebecca Sweetman by email
Rebecca.Sweetman@CareCentrix.
com
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 23
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
CareCentrix 11345 COMMERCIAL P
Enrollment required prior to
claim submission. Please contact
Rebecca Sweetman by email
Rebecca.Sweetman@CareCentrix.
comCareCore National 14182 COMMERCIAL NCareCore National 14182 COMMERCIAL NCareCore National - Healthnet 14184 COMMERCIAL NCareCore National - Healthnet 14184 COMMERCIAL NCareCore National LLC (Aetna Radiology Claims) 14179 COMMERCIAL NCareCore National LLC (Aetna Radiology Claims) 14179 COMMERCIAL NCareCore National LLC (Oxford Radiology Claims) 14180 COMMERCIAL NCareCore National LLC (Oxford Radiology Claims) 14180 COMMERCIAL NCareCore National LLC - Health Net New Jersey 14185 COMMERCIAL NCareCore National LLC - Health Net New Jersey 14185 COMMERCIAL N
CareCore National LLC - WellCare New York POS 11 Rad Claims14188 COMMERCIAL N
WellCare New York POS 11
Radiology Claims Only. Claims for
members in the following
counties should be submitted to
WellCare: Monroe Erie Wayne
and Onondaga.
CareCore National LLC - WellCare New York POS 11 Rad Claims14188 COMMERCIAL N
WellCare New York POS 11
Radiology Claims Only. Claims for
members in the following
counties should be submitted to
WellCare: Monroe Erie Wayne
and Onondaga.CareCore National LLC - WellCare New York POS 11 Rad Claims74289 COMMERCIAL NCareCore National LLC - WellCare New York POS 11 Rad Claims74289 COMMERCIAL NCareFirst Administrators/NCAS 75191 COMMERCIAL NCareFirst Administrators/NCAS 75191 COMMERCIAL NCareOregon Inc. 93975 COMMERCIAL NCareOregon Inc. 93975 COMMERCIAL NCarePlus Cardiology - New Century Health NCH04 COMMERCIAL NCarePlus Cardiology - New Century Health NCH04 COMMERCIAL NCarePlus Dermatology - New Century Health NCH01 COMMERCIAL NCarePlus Dermatology - New Century Health NCH01 COMMERCIAL N
CarePlus Health Plans Inc. 65031 COMMERCIAL N
(Formerly Physicians Healthcare
Plans Inc)
CarePlus Health Plans Inc. 65031 COMMERCIAL N
(Formerly Physicians Healthcare
Plans Inc)CarePlus Oncology - New Century Infusion Solutions NCH07 COMMERCIAL NCarePlus Oncology - New Century Infusion Solutions NCH07 COMMERCIAL NCarePlus Urology - New Century Health NCH03 COMMERCIAL NCarePlus Urology - New Century Health NCH03 COMMERCIAL NCareSource OH 31114 COMMERCIAL NCareSource OH 31114 COMMERCIAL N
CareWorks (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 24
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
CareWorks (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Carelink Health Plan 25133 COMMERCIAL N
Formerly payer ID 25139. Now
part of Coventry Consolidated
payer ID. Carelink Commercial &
Advantra claims only. For
Carelink Medicaid send claims to
payer ID 25140
Carelink Health Plan 25133 COMMERCIAL N
Formerly payer ID 25139. Now
part of Coventry Consolidated
payer ID. Carelink Commercial &
Advantra claims only. For
Carelink Medicaid send claims to
payer ID 25140
Carelink Medicaid 25133 COMMERCIAL N
Formerly Payer ID 25140. Now
part of Coventry Consolidated
payer ID.
Carelink Medicaid 25133 COMMERCIAL N
Formerly Payer ID 25140. Now
part of Coventry Consolidated
payer ID.
Carelink Medicaid 25140 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Carelink Medicaid 25140 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Carelink Medicaid 25140 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Carelink Medicaid 25140 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.Caremore CM001 COMMERCIAL NCaremore CM001 COMMERCIAL N
Carenet 25133 COMMERCIAL N
Formerly Payer ID 25142. Now
part of Coventry Consolidated
payer ID.
Carenet 25133 COMMERCIAL N
Formerly Payer ID 25142. Now
part of Coventry Consolidated
payer ID.
Carenet 25142 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 25
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Carenet 25142 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Carenet 25142 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Carenet 25142 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Careworks 10010 COMMERCIAL N
Payer is receiving NSF 3.0. eMCDS
file is sent to OKC and then
translated to NSF3.0. Files are
then pushed to Careworks'
Production Server.
Careworks 10010 COMMERCIAL N
Payer is receiving NSF 3.0. eMCDS
file is sent to OKC and then
translated to NSF3.0. Files are
then pushed to Careworks'
Production Server.Carilion Clinic Medicare Health Plan 77015 COMMERCIAL NCarilion Clinic Medicare Health Plan 77015 COMMERCIAL N
Carolina Care Plan 29076 COMMERCIAL N
Carolina Care Plan is part of the
Medical Mutual Family of
Companies. Former payer ID
57105.
Carolina Care Plan 29076 COMMERCIAL N
Carolina Care Plan is part of the
Medical Mutual Family of
Companies. Former payer ID
57105.
Carolina Crescent Health Plan Inc. SX191 COMMERCIAL N
Enrollment forms are available on
our website
Carolina Crescent Health Plan Inc. SX191 COMMERCIAL N
Enrollment forms are available on
our websiteCarolina Summit Healthcare Inc. 56195 COMMERCIAL NCarolina Summit Healthcare Inc. 56195 COMMERCIAL NCarpenter's Health and Welfare Trust Fund of St. Louis25125 COMMERCIAL N Utilizes the CMR Network.Carpenter's Health and Welfare Trust Fund of St. Louis25125 COMMERCIAL N Utilizes the CMR Network.Cedars-Sinai Medical Network Services 95166 COMMERCIAL NCedars-Sinai Medical Network Services 95166 COMMERCIAL NCeltiCare 68060 COMMERCIAL NCeltiCare 68060 COMMERCIAL N
Cement Masons & Plasterers Health & Welfare Trust 91136 COMMERCIAL N
Please enter Group Number (F16)
when submitting claims.
Cement Masons & Plasterers Health & Welfare Trust 91136 COMMERCIAL N
Please enter Group Number (F16)
when submitting claims.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 26
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Cenpatico - Arizona 68048 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
866-495-6748 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Cenpatico - Arizona 68048 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
866-495-6748 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.Cenpatico - FL 68058 COMMERCIAL NCenpatico - FL 68058 COMMERCIAL N
Cenpatico - Georgia 68050 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
800-947-0633 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Cenpatico - Georgia 68050 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
800-947-0633 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Cenpatico - Indiana 68052 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
877-647-4848 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Cenpatico - Indiana 68052 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
877-647-4848 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 27
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Cenpatico - Kansas 68047 COMMERCIAL P
Prior to submitting claims please
call Provider Relations Dept at 1-
866-896-7293 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Cenpatico - Kansas 68047 COMMERCIAL P
Prior to submitting claims please
call Provider Relations Dept at 1-
866-896-7293 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.Cenpatico - OHIO 68051 COMMERCIAL NCenpatico - OHIO 68051 COMMERCIAL NCenpatico Massachuetts 68061 COMMERCIAL NCenpatico Massachuetts 68061 COMMERCIAL NCenpatico South Carolina 68059 COMMERCIAL NCenpatico South Carolina 68059 COMMERCIAL NCentene Advantage Plans 68056 COMMERCIAL NCentene Advantage Plans 68056 COMMERCIAL NCentral Benefits Life 31118 COMMERCIAL NCentral Benefits Life 31118 COMMERCIAL NCentral Benefits Mutual 31118 COMMERCIAL NCentral Benefits Mutual 31118 COMMERCIAL NCentral Benefits National 31118 COMMERCIAL NCentral Benefits National 31118 COMMERCIAL NCentral Reserve Life 34097 COMMERCIAL N Non Medicare SupplementCentral Reserve Life 34097 COMMERCIAL N Non Medicare SupplementCentral SeniorCare 62218 COMMERCIAL NCentral SeniorCare 62218 COMMERCIAL NCentral States Health & Welfare Funds 36215 COMMERCIAL NCentral States Health & Welfare Funds 36215 COMMERCIAL NCentral Valley Medical Group 77035 COMMERCIAL NCentral Valley Medical Group 77035 COMMERCIAL N
Central Valley Medical Group E3510 COMMERCIAL P
Only claims from providers in
Northern California. Please
contact the EDI Dept for North
American Medical Management
(NAMM) - Northern California
Lead/Supervisor at 1-800-956-
8000 prior to initial submission of
claims.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 28
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Central Valley Medical Group E3510 COMMERCIAL P
Only claims from providers in
Northern California. Please
contact the EDI Dept for North
American Medical Management
(NAMM) - Northern California
Lead/Supervisor at 1-800-956-
8000 prior to initial submission of
claims.
Centre for Health Care Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected]
Centre for Health Care Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected] Health Solutions 48120 COMMERCIAL NCentury Health Solutions 48120 COMMERCIAL NChautauqua County Healthcare Plan (Mayville NY) 16600 COMMERCIAL NChautauqua County Healthcare Plan (Mayville NY) 16600 COMMERCIAL N
Chesapeake Life Insurance Company - Insurance Center59223 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
the following: P.O. Box 982017
North Richland Hills TX 76182.
Chesapeake Life Insurance Company - Insurance Center59223 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
the following: P.O. Box 982017
North Richland Hills TX 76182.Chesterfield Resources Inc. 34154 COMMERCIAL NChesterfield Resources Inc. 34154 COMMERCIAL NChild Health and Disability Prevention Treatment AMM03 COMMERCIAL NChild Health and Disability Prevention Treatment AMM03 COMMERCIAL N
Children First Medical Group 94321 COMMERCIAL N
For questions regarding claim
status providers will need to
contact payer: CFMG Provider
Customer Service 510-428-3154.
Children First Medical Group 94321 COMMERCIAL N
For questions regarding claim
status providers will need to
contact payer: CFMG Provider
Customer Service 510-428-3154.Children of Women Vietnam Veterans-VA HAC 84146 COMMERCIAL NChildren of Women Vietnam Veterans-VA HAC 84146 COMMERCIAL NChildren's Medical Services - Broward NORTH 37314 COMMERCIAL NChildren's Medical Services - Broward NORTH 37314 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 29
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationChildrens Physician Medical Group CPMG1 COMMERCIAL NChildrens Physician Medical Group CPMG1 COMMERCIAL NChildrens Specialist of San Diego CSSD2 COMMERCIAL NChildrens Specialist of San Diego CSSD2 COMMERCIAL NChinese Community Health Plan 94302 COMMERCIAL NChinese Community Health Plan 94302 COMMERCIAL NChoice One/UTMB CHIP Health Plan 76049 COMMERCIAL NChoice One/UTMB CHIP Health Plan 76049 COMMERCIAL NChristian Brothers Services 61271 COMMERCIAL NChristian Brothers Services 61271 COMMERCIAL NCincinnati Financial Corporation 46871 COMMERCIAL NCincinnati Financial Corporation 46871 COMMERCIAL NCitrus Health TH130 COMMERCIAL NCitrus Health TH130 COMMERCIAL NCitrus Valley Physicians Medical Group CVPG1 COMMERCIAL NCitrus Valley Physicians Medical Group CVPG1 COMMERCIAL NCity of Amarillo TH107 COMMERCIAL NCity of Amarillo TH107 COMMERCIAL NCity of Visalia TKFMC COMMERCIAL NCity of Visalia TKFMC COMMERCIAL NClaims Management Services 39141 COMMERCIAL NClaims Management Services 39141 COMMERCIAL NClaimsWare Inc. dba ManageMed 57080 COMMERCIAL NClaimsWare Inc. dba ManageMed 57080 COMMERCIAL NClaimshop- Employers Coalition on Health 27008 COMMERCIAL NClaimshop- Employers Coalition on Health 27008 COMMERCIAL NClarendon's Healthy Kids 33192 COMMERCIAL NClarendon's Healthy Kids 33192 COMMERCIAL NClarian Health Plans Inc. 95444 COMMERCIAL NClarian Health Plans Inc. 95444 COMMERCIAL NClearchoice Health Plan / COIHS 77201 COMMERCIAL NClearchoice Health Plan / COIHS 77201 COMMERCIAL NClubMD 37272 COMMERCIAL NClubMD 37272 COMMERCIAL NCoastal Administrative Services 77052 COMMERCIAL NCoastal Administrative Services 77052 COMMERCIAL NCofinity 38335 COMMERCIAL NCofinity 38335 COMMERCIAL NColonial Healthcare 37123 COMMERCIAL NColonial Healthcare 37123 COMMERCIAL NColonial Medical 22284 COMMERCIAL NColonial Medical 22284 COMMERCIAL NColorado Access 84129 COMMERCIAL NColorado Access 84129 COMMERCIAL NColumbia United Providers 91162 COMMERCIAL NColumbia United Providers 91162 COMMERCIAL NCommerce Benefits Group 34181 COMMERCIAL NCommerce Benefits Group 34181 COMMERCIAL NCommonwealth Care Alliance 14315 COMMERCIAL NCommonwealth Care Alliance 14315 COMMERCIAL NCommunity Care BHO 23282 COMMERCIAL NCommunity Care BHO 23282 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 30
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationCommunity Care Managed Health Care Plans of Oklahoma73143 COMMERCIAL NCommunity Care Managed Health Care Plans of Oklahoma73143 COMMERCIAL NCommunity Care Organization 39126 COMMERCIAL NCommunity Care Organization 39126 COMMERCIAL NCommunity Choice of Michigan 38325 COMMERCIAL NCommunity Choice of Michigan 38325 COMMERCIAL NCommunity Claims Administration 26231 COMMERCIAL NCommunity Claims Administration 26231 COMMERCIAL NCommunity Family Care (SynerMed) SYMED COMMERCIAL NCommunity Family Care (SynerMed) SYMED COMMERCIAL NCommunity First TH005 COMMERCIAL NCommunity First TH005 COMMERCIAL NCommunity Health Alliance 35193 COMMERCIAL NCommunity Health Alliance 35193 COMMERCIAL NCommunity Health Choice 48145 COMMERCIAL NCommunity Health Choice 48145 COMMERCIAL NCommunity Health Electronic Claims/CHEC/webTPA 75261 COMMERCIAL NCommunity Health Electronic Claims/CHEC/webTPA 75261 COMMERCIAL NCommunity Health Network of CT 62149 COMMERCIAL NCommunity Health Network of CT 62149 COMMERCIAL N
Community Health Plan 90010 COMMERCIAL N
Located in St. Joseph MO. Service
area includes NW Missouri NE
Kansas SW Iowa and SE Nebraska.
Community Health Plan 90010 COMMERCIAL N
Located in St. Joseph MO. Service
area includes NW Missouri NE
Kansas SW Iowa and SE Nebraska.Community Health Plan Washington SB613 COMMERCIAL NCommunity Health Plan Washington SB613 COMMERCIAL NCommunity Medical Group of the West Valley Inc. 66121 COMMERCIAL NCommunity Medical Group of the West Valley Inc. 66121 COMMERCIAL NComp - Ohio (Austintown OH) 34177 COMMERCIAL NComp - Ohio (Austintown OH) 34177 COMMERCIAL N
Comp One (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Comp One (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.CompBenefits Corporation 37297 COMMERCIAL NCompBenefits Corporation 37297 COMMERCIAL N
CompManagement Health Systems Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
CompManagement Health Systems Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
CompManagement/Integrated Comp (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
CompManagement/Integrated Comp (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Complimentary Health Plan Call COMMERCIAL NComplimentary Health Plan Call COMMERCIAL NComprehensive Behavioral Care 59314 COMMERCIAL NComprehensive Behavioral Care 59314 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 31
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Comprehensive Medical Care (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Comprehensive Medical Care (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.ConnectiCare Inc 6105 COMMERCIAL NConnectiCare Inc 6105 COMMERCIAL NConnecticare - Medicare 78375 COMMERCIAL NConnecticare - Medicare 78375 COMMERCIAL NConnecticut Carpenters Health Fund 37307 COMMERCIAL NConnecticut Carpenters Health Fund 37307 COMMERCIAL NConnecticut General (CIGNA) 62308 COMMERCIAL NConnecticut General (CIGNA) 62308 COMMERCIAL NConsociate Group 37135 COMMERCIAL NConsociate Group 37135 COMMERCIAL NConsolidated Associates Railroad 75284 COMMERCIAL NConsolidated Associates Railroad 75284 COMMERCIAL NConsolidated Health Plans 87843 COMMERCIAL NConsolidated Health Plans 87843 COMMERCIAL N
Consumers Life Insurance Company 29076 COMMERCIAL N
Consumers Life insurance
Company is part of the Medical
Mutual Family of Companies.
Consumers Life Insurance Company 29076 COMMERCIAL N
Consumers Life insurance
Company is part of the Medical
Mutual Family of Companies.Continental General Insurance Company 71404 COMMERCIAL N Non Medicare SupplementContinental General Insurance Company 71404 COMMERCIAL N Non Medicare SupplementContinental Key Family 35315 COMMERCIAL NContinental Key Family 35315 COMMERCIAL NContractors Laborers Teamsters & Engineers 47046 COMMERCIAL NContractors Laborers Teamsters & Engineers 47046 COMMERCIAL N
Conversion Plan-APWU 55544 COMMERCIAL N
Claims are printed and mailed to
the payer.; For conversion plan
members only. If filing a claim for
a federal plan member please use
payer ID 44444.
Conversion Plan-APWU 55544 COMMERCIAL N
Claims are printed and mailed to
the payer.; For conversion plan
members only. If filing a claim for
a federal plan member please use
payer ID 44444.Cook Children's Health Group TH104 COMMERCIAL NCook Children's Health Group TH104 COMMERCIAL NCook Group Health Plan 35149 COMMERCIAL NCook Group Health Plan 35149 COMMERCIAL NCooperative Benefit Administrators (CBA) 52132 COMMERCIAL NCooperative Benefit Administrators (CBA) 52132 COMMERCIAL NCoordinated Medical Specialists 58204 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 32
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationCoordinated Medical Specialists 58204 COMMERCIAL NCore Administrative Services 58231 COMMERCIAL NCore Administrative Services 58231 COMMERCIAL N
CoreSource AZ MN 35182 COMMERCIAL N For assistance 800-689-0106
CoreSource AZ MN 35182 COMMERCIAL N For assistance 800-689-0106
CoreSource Little Rock 75136 COMMERCIAL N
Only for claims where the "submit
claims to address" on the medical
ID card is a CoreSource address in
Little Rock Arkansas. For
assistance call 800-689-0106.
CoreSource Little Rock 75136 COMMERCIAL N
Only for claims where the "submit
claims to address" on the medical
ID card is a CoreSource address in
Little Rock Arkansas. For
assistance call 800-689-0106.CoreSource MD PA IL 35182 COMMERCIAL N For assistance 800-689-0106CoreSource MD PA IL 35182 COMMERCIAL N For assistance 800-689-0106CoreSource NC IN 35182 COMMERCIAL N For assistance 800-689-0106CoreSource NC IN 35182 COMMERCIAL N For assistance 800-689-0106
CoreSource OH 35183 COMMERCIAL N
Only for claims where the "submit
claims to address" on the medical
ID card is a CoreSource address in
the state of Ohio. For assistance
call 800-689-0106.
CoreSource OH 35183 COMMERCIAL N
Only for claims where the "submit
claims to address" on the medical
ID card is a CoreSource address in
the state of Ohio. For assistance
call 800-689-0106.CoreSource-Internal 35187 COMMERCIAL NCoreSource-Internal 35187 COMMERCIAL NCornerstone Benefit Adminstrators 35202 COMMERCIAL NCornerstone Benefit Adminstrators 35202 COMMERCIAL N
Corporate Benefits Service Inc. (NC) 56116 COMMERCIAL N
Payer ID valid only for claims with
a claims submission address of
P.O. Box 12953 Charlotte NC
28220.
Corporate Benefits Service Inc. (NC) 56116 COMMERCIAL N
Payer ID valid only for claims with
a claims submission address of
P.O. Box 12953 Charlotte NC
28220.Corporate Systems Administration 37246 COMMERCIAL NCorporate Systems Administration 37246 COMMERCIAL NCorrectional Medical Services 43160 COMMERCIAL NCorrectional Medical Services 43160 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 33
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Corvel Corporation (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Corvel Corporation (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Country Life Insurance Company 62553 COMMERCIAL NCountry Life Insurance Company 62553 COMMERCIAL NCovenant Administrators Inc. (Atlanta GA) 58102 COMMERCIAL NCovenant Administrators Inc. (Atlanta GA) 58102 COMMERCIAL NCovenant Management Systems TH108 COMMERCIAL NCovenant Management Systems TH108 COMMERCIAL NCoventry Advantra Texas 25133 COMMERCIAL NCoventry Advantra Texas 25133 COMMERCIAL N
Coventry Health & Life (Oklahoma) 25133 COMMERCIAL N
Now part of Coventry
Consolidated payer IDCoventry Health & Life (Oklahoma) 25133 COMMERCIAL NCoventry Health & Life (Oklahoma) 25133 COMMERCIAL N
Coventry Health & Life (Oklahoma) 25133 COMMERCIAL N
Now part of Coventry
Consolidated payer ID
Coventry Health Care 25133 COMMERCIAL N
Coventry's consolidated payer ID.
Claims for all of these legacy
payer IDs may now be submitted
to this payer ID. 25126 25127
25128 25129 25130 25132 25135
25136 25139 25141 25146 25149
25152 62413 87043.
Coventry Health Care 25133 COMMERCIAL N
Coventry's consolidated payer ID.
Claims for all of these legacy
payer IDs may now be submitted
to this payer ID. 25126 25127
25128 25129 25130 25132 25135
25136 25139 25141 25146 25149
25152 62413 87043.
Coventry Health Care National Network 25133 COMMERCIAL N
Formerly payer ID 87043. Now
part of Coventry consolidated
payer ID.
Coventry Health Care National Network 25133 COMMERCIAL N
Formerly payer ID 87043 Now
part of Coventry Consolidated
payer ID.
Coventry Health Care National Network 25133 COMMERCIAL N
Formerly payer ID 87043. Now
part of Coventry consolidated
payer ID.
Coventry Health Care National Network 25133 COMMERCIAL N
Formerly payer ID 87043 Now
part of Coventry Consolidated
payer ID.
Coventry Health Care Nevada 25133 COMMERCIAL N
Formerly Payer ID 25149. Now
part of the Consolidated payer ID.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 34
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Coventry Health Care Nevada 25133 COMMERCIAL N
Formerly Payer ID 25149. Now
part of the Consolidated payer ID.
Coventry Health Care of Florida Inc. 25133 COMMERCIAL N
Formerly Vista Health Plan Inc.
Now part of Coventry
Consolidated Payer ID.
Coventry Health Care of Florida Inc. 25133 COMMERCIAL N
Formerly Vista Health Plan Inc.
Now part of Coventry
Consolidated Payer ID.
Coventry Health Care of Georgia Inc. 25133 COMMERCIAL N
Formerly payer ID 25127. Now
part of Coventry Consolidated
payer ID.
Coventry Health Care of Georgia Inc. 25133 COMMERCIAL N
Formerly payer ID 25127. Now
part of Coventry Consolidated
payer ID.
Coventry Health Care of Iowa Inc. 25133 COMMERCIAL N
Formerly payer ID 25132. Now
part of Coventry Consolidated
payer ID.
Coventry Health Care of Iowa Inc. 25133 COMMERCIAL N
Formerly payer ID 25132. Now
part of Coventry Consolidated
payer ID.
Coventry Health Care of Kansas Inc. 25133 COMMERCIAL N
Now part of Coventry
Consolidated payer ID
Coventry Health Care of Kansas Inc. 25133 COMMERCIAL N
Now part of Coventry
Consolidated payer IDCoventry Health Care of Kansas Inc. 25133 COMMERCIAL NCoventry Health Care of Kansas Inc. 25133 COMMERCIAL N
Coventry Health Care of Louisiana Inc. 25133 COMMERCIAL N
Formerly payer ID 25135. Now
part of Coventry Consolidated
payer ID.
Coventry Health Care of Louisiana Inc. 25133 COMMERCIAL N
Formerly payer ID 25135. Now
part of Coventry Consolidated
payer ID.
Coventry Health Care of Nebraska Inc. 25133 COMMERCIAL N
Formerly payer ID 25136. Now
part of Coventry Consolidated
payer ID.
Coventry Health Care of Nebraska Inc. 25133 COMMERCIAL N
Formerly payer ID 25136. Now
part of Coventry Consolidated
payer ID.
Coventry Health Plan of Florida 25133 COMMERCIAL N
Formerly Vista Health Plan of
South Florida Inc. Now part of
Coventry Consolidated Payer ID.
Coventry Health Plan of Florida 25133 COMMERCIAL N
Formerly Vista Health Plan of
South Florida Inc. Now part of
Coventry Consolidated Payer ID.Coventry Health and Life Insurance Company administered by PersonalCare25133 COMMERCIAL NCoventry Health and Life Insurance Company administered by PersonalCare25133 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 35
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Coventry Health and Life Insureance (Tennessee) 25133 COMMERCIAL N
Formerly payer ID 25141 Now
part of Coventry Consolidated
payer ID.
Coventry Health and Life Insureance (Tennessee) 25133 COMMERCIAL N
Formerly payer ID 25141 Now
part of Coventry Consolidated
payer ID.
Coventry Missouri 25133 COMMERCIAL N
Formerly payer ID 87043 Now
part of Coventry Consolidated
payer ID.
Coventry Missouri 25133 COMMERCIAL N
Formerly payer ID 87043 Now
part of Coventry Consolidated
payer ID.Coventry Nebraska 25133 COMMERCIAL NCoventry Nebraska 25133 COMMERCIAL N
Coventry Summitt Health Plan Inc. 25133 COMMERCIAL N
Formerly Summitt Health Plan
Inc. Now part of Coventry
Consolidated Payer ID.
Coventry Summitt Health Plan Inc. 25133 COMMERCIAL N
Formerly Summitt Health Plan
Inc. Now part of Coventry
Consolidated Payer ID.
Coventry of Health Care Delaware Inc. 25133 COMMERCIAL N
Formerly payer ID 25130. Now
part of Coventry Consolidated
payer ID.
Coventry of Health Care Delaware Inc. 25133 COMMERCIAL N
Formerly payer ID 25130. Now
part of Coventry Consolidated
payer ID.
CoventryCares 25133 COMMERCIAL N
Now part of Coventry
Consolidated payer ID
CoventryCares 25133 COMMERCIAL N
Now part of Coventry
Consolidated payer ID
Crawford & Company (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Crawford & Company (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Creative Medical Systems 64068 COMMERCIAL NCreative Medical Systems 64068 COMMERCIAL NCreative Plan Administrators 37320 COMMERCIAL NCreative Plan Administrators 37320 COMMERCIAL N
Croy-Hall Mgmt. Inc. 37266 COMMERCIAL N
Please enter the unique policy
number or ID card when
submitting claims. Payer ID valid
only for claims with a billing
submission address of PO Box
982005 Ft. Worth TX 76182.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 36
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Croy-Hall Mgmt. Inc. 37266 COMMERCIAL N
Please enter the unique policy
number or ID card when
submitting claims. Payer ID valid
only for claims with a billing
submission address of PO Box
982005 Ft. Worth TX 76182.Custom Benefit Administrators 39170 COMMERCIAL NCustom Design Benefits Inc. 82056 COMMERCIAL NCustom Design Benefits Inc. 82056 COMMERCIAL N
D.H. EVANS & ASSOC. Call COMMERCIAL N
Call Jessica Picarde @ 410-349-
3222 for Payer id.
D.H. EVANS & ASSOC. Call COMMERCIAL N
Call Jessica Picarde @ 410-349-
3222 for Payer id.
DC Chartered Health Plan Inc. (Medicaid & Alliance) 95748 COMMERCIAL N
PLEASE CONTACT Ronald Gray at
202-408-2229 TO JOIN
CHARTERED HEALTH PLANS EDI
NETWORK
DC Chartered Health Plan Inc. (Medicaid & Alliance) 95748 COMMERCIAL N
PLEASE CONTACT Ronald Gray at
202-408-2229 TO JOIN
CHARTERED HEALTH PLANS EDI
NETWORKDELANO IPA 77124 COMMERCIAL NDELANO IPA 77124 COMMERCIAL NDRISCOLL CHILDREN'S HEALTH PLAN 74284 COMMERCIAL NDRISCOLL CHILDREN'S HEALTH PLAN 74284 COMMERCIAL NDart Container Corporation DARTC COMMERCIAL NDart Container Corporation DARTC COMMERCIAL NDart Container Corporation TH073 COMMERCIAL NDart Container Corporation TH073 COMMERCIAL NDart Management Corporation 6172 COMMERCIAL NDart Management Corporation 6172 COMMERCIAL NDean Health Plan 39113 COMMERCIAL NDean Health Plan 39113 COMMERCIAL NDefinity Health 64159 COMMERCIAL NDefinity Health 64159 COMMERCIAL NDelaware Physicians Care Inc. 27009 COMMERCIAL NDelaware Physicians Care Inc. 27009 COMMERCIAL NDelta Health Systems 94235 COMMERCIAL NDelta Health Systems 94235 COMMERCIAL NDenver Health - Indigent 84134 COMMERCIAL NDenver Health - Indigent 84134 COMMERCIAL NDenver Health Medical Plan 84135 COMMERCIAL NDenver Health Medical Plan 84135 COMMERCIAL NDenver Health Medical Plan Inc. - Medicare Choice 84131 COMMERCIAL NDenver Health Medical Plan Inc. - Medicare Choice 84131 COMMERCIAL NDenver Health and Hospital Authority 84133 COMMERCIAL NDenver Health and Hospital Authority 84133 COMMERCIAL NDeseret Mutual SX105 COMMERCIAL RDeseret Mutual SX105 COMMERCIAL RDesert Medical Group DESRT COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 37
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationDesert Medical Group DESRT COMMERCIAL NDestiny Health 36436 COMMERCIAL NDestiny Health 36436 COMMERCIAL NDetroit Medical Center 56240 COMMERCIAL NDetroit Medical Center 56240 COMMERCIAL NDiaTri LLC 36439 COMMERCIAL NDiaTri LLC 36439 COMMERCIAL N
Diamond Plan 25131 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Diamond Plan 25131 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Diamond Plan 25131 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Diamond Plan 25131 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Diamond Plan (Maryland Medicaid) 25133 COMMERCIAL N
Formerly Payer ID 25131. Now
part of Coventry Consolidated
payer ID.
Diamond Plan (Maryland Medicaid) 25133 COMMERCIAL N
Formerly Payer ID 25131. Now
part of Coventry Consolidated
payer ID.Directors Guild of America - Producer Health Plan 23706 COMMERCIAL NDirectors Guild of America - Producer Health Plan 23706 COMMERCIAL N
Diversified Administration Corporation 6102 COMMERCIAL N
Please verify the Payer ID on the
Member ID card in addition to
the Payer City and State before
submitting claims to Diversified
Admin (Payer ID 06102)
Diversified Administration Corporation 6102 COMMERCIAL N
Please verify the Payer ID on the
Member ID card in addition to
the Payer City and State before
submitting claims to Diversified
Admin (Payer ID 06102)Downey Select IPA (Applecare Medical Managment) APP01 COMMERCIAL NDowney Select IPA (Applecare Medical Managment) APP01 COMMERCIAL N
Dr. Rivera Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected]
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 38
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Dr. Rivera Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected] and Associates Benefits Administrators Inc. 35186 COMMERCIAL NDunn and Associates Benefits Administrators Inc. 35186 COMMERCIAL N
E-V Benefits Management Inc (Columbus OH) 34159 COMMERCIAL N Now known as Meritain Health.
E-V Benefits Management Inc (Columbus OH) 34159 COMMERCIAL N Now known as Meritain Health.
EBC Mid-America Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
EBC Mid-America Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
EBC Inc. Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
EBC Inc. Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.EBMC 31074 COMMERCIAL NEBMC 31074 COMMERCIAL NEBMS SX182 COMMERCIAL NEBMS SX182 COMMERCIAL N
EBS OF OHIO 34166 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box
2568 Mansfield OH 44906.
EBS OF OHIO 34166 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box
2568 Mansfield OH 44906.EMI-KP Ambulance Claims 59299 COMMERCIAL NEMI-KP Ambulance Claims 59299 COMMERCIAL NEQUICOR 62308 COMMERCIAL NEQUICOR 62308 COMMERCIAL NEQUICOR - PPO 62308 COMMERCIAL NEQUICOR - PPO 62308 COMMERCIAL NERISA TH110 COMMERCIAL NERISA TH110 COMMERCIAL NES Beveridge and Associates 34108 COMMERCIAL NES Beveridge and Associates 34108 COMMERCIAL NESSENCE HEALTHCARE 20818 COMMERCIAL NESSENCE HEALTHCARE 20818 COMMERCIAL NEarly Intervention Central TH084 COMMERCIAL NEarly Intervention Central TH084 COMMERCIAL N
East Bay Medical Network Call COMMERCIAL P
Network ID required on all claims.
Call Sutter Connect EDI
Department at (800) 611-5191 to
obtain Network ID prior to first
submission.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 39
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
East Bay Medical Network Call COMMERCIAL P
Network ID required on all claims.
Call Sutter Connect EDI
Department at (800) 611-5191 to
obtain Network ID prior to first
submission.Eastland Medical Group 66122 COMMERCIAL NEastland Medical Group 66122 COMMERCIAL NEducators Mutual (EMIA) SX110 COMMERCIAL NEducators Mutual (EMIA) SX110 COMMERCIAL NEl Paso First - Chip TH090 COMMERCIAL NEl Paso First - Chip TH090 COMMERCIAL N
ElderPlan Inc. 31625 COMMERCIAL N
Elderplan no longer requires
enrollment & individual provider
testing; However Elderplan
Provider ID is necessary on all
claim submissions. If you do not
know your provider Id contact
(718) 921-7979.
ElderPlan Inc. 31625 COMMERCIAL N
Elderplan no longer requires
enrollment & individual provider
testing; However Elderplan
Provider ID is necessary on all
claim submissions. If you do not
know your provider Id contact
(718) 921-7979.Elmcare LLC 36399 COMMERCIAL NElmcare LLC 36399 COMMERCIAL NElmco 37253 COMMERCIAL NElmco 37253 COMMERCIAL NEmerald Health Network Inc. (All PPO Business) 34167 COMMERCIAL NEmerald Health Network Inc. (All PPO Business) 34167 COMMERCIAL NEmergency Medical Services Fund (EMSF) AMM03 COMMERCIAL NEmergency Medical Services Fund (EMSF) AMM03 COMMERCIAL NEmpire Physician's Medical Group EMP01 COMMERCIAL NEmpire Physician's Medical Group EMP01 COMMERCIAL NEmployee Benefit Administration & Management CorporationPilot COMMERCIAL NEmployee Benefit Administration & Management CorporationPilot COMMERCIAL N
Employee Benefit Claims - Mid-America Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
Employee Benefit Claims - Mid-America Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
Employee Benefit Claims of WI Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
Employee Benefit Claims of WI Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
Employee Benefit Claims of Wisconsin Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 40
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Employee Benefit Claims of Wisconsin Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.Employee Benefit Concepts (Farmington Hills MI) 38241 COMMERCIAL NEmployee Benefit Concepts (Farmington Hills MI) 38241 COMMERCIAL N
Employee Benefit Consultants Inc. Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.
Employee Benefit Consultants Inc. Call COMMERCIAL N
To obtain the payer ID please call
(440) 262-1160.Employee Benefit Corporation 37215 COMMERCIAL NEmployee Benefit Corporation 37215 COMMERCIAL NEmployee Benefit Management Corp (EBMC) 31074 COMMERCIAL NEmployee Benefit Management Corp (EBMC) 31074 COMMERCIAL N
Employee Benefit Services (Ft. Mill SC) 37216 COMMERCIAL N
MUST VERIFY ALL CLAIMS
SHOULD GO TO PAYER IN FT. MILL
SC
Employee Benefit Services (Ft. Mill SC) 37216 COMMERCIAL N
MUST VERIFY ALL CLAIMS
SHOULD GO TO PAYER IN FT. MILL
SCEmployee Benefit Services of Louisiana Inc (EBS) 41198 COMMERCIAL NEmployee Benefit Services of Louisiana Inc (EBS) 41198 COMMERCIAL NEmployee Benefit Services of San Antonio TH109 COMMERCIAL NEmployee Benefit Services of San Antonio TH109 COMMERCIAL NEmployee Benefit Systems 42149 COMMERCIAL NEmployee Benefit Systems 42149 COMMERCIAL NEmployee Benefits Administration and Management Corp.22262 COMMERCIAL NEmployee Benefits Administration and Management Corp.22262 COMMERCIAL NEmployee Benefits Plan Administration Inc. (E.B.P.A.) 3036 COMMERCIAL NEmployee Benefits Plan Administration Inc. (E.B.P.A.) 3036 COMMERCIAL NEmployee Health System SYMED COMMERCIAL NEmployee Health System SYMED COMMERCIAL NEmployee Plans LLC 35112 COMMERCIAL NEmployee Plans LLC 35112 COMMERCIAL NEmployer Plan Services 74212 COMMERCIAL NEmployer Plan Services 74212 COMMERCIAL NEmployer's Direct Health - Employee Plan 75236 COMMERCIAL NEmployer's Direct Health - Employee Plan 75236 COMMERCIAL NEmployer's Direct Health - FI 75235 COMMERCIAL NEmployer's Direct Health - FI 75235 COMMERCIAL NEmployer's Direct Health - SF 75233 COMMERCIAL NEmployer's Direct Health - SF 75233 COMMERCIAL NEmployers Direct Health 75232 COMMERCIAL NEmployers Direct Health 75232 COMMERCIAL NEmployers Mutual Inc (Jacksonville Florida) 59298 COMMERCIAL NEmployers Mutual Inc (Jacksonville Florida) 59298 COMMERCIAL N
Employers Mutual Inc. (Stuart Florida) 59331 COMMERCIAL N
For plan and claim requirements
please contact the Employers
Mutual Inc. (Stuart FL) Customer
Service Department at (772) 287-
7650 ext. 4052.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 41
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Employers Mutual Inc. (Stuart Florida) 59331 COMMERCIAL N
For plan and claim requirements
please contact the Employers
Mutual Inc. (Stuart FL) Customer
Service Department at (772) 287-
7650 ext. 4052.Encircle PPO 35206 COMMERCIAL NEncircle PPO 35206 COMMERCIAL NEncore Health Network 35206 COMMERCIAL NEncore Health Network 35206 COMMERCIAL N
Enstar Natural Gas 91136 COMMERCIAL N
Please enter Group Number (P61)
when submitting claims.
Enstar Natural Gas 91136 COMMERCIAL N
Please enter Group Number (P61)
when submitting claims.Entrust 36878 COMMERCIAL NEntrust 36878 COMMERCIAL N
Equitable Plan Services (Oklahoma City OK) 73126 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
P.O. Box 720460 Oklahoma City
OK 73172.
Equitable Plan Services (Oklahoma City OK) 73126 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
P.O. Box 720460 Oklahoma City
OK 73172.Evercare 87726 COMMERCIAL NEvercare 87726 COMMERCIAL NEvergreen Health Plan 58233 COMMERCIAL NEvergreen Health Plan 58233 COMMERCIAL N
Evolutions Healthcare Systems (New Port Richey FL) 59313 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box
5001 New Port Richey FL 34656.
Evolutions Healthcare Systems (New Port Richey FL) 59313 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box
5001 New Port Richey FL 34656.Excel MSO EXC01 COMMERCIAL NExcel MSO EXC01 COMMERCIAL NExclusiCare 71412 COMMERCIAL NExclusiCare 71412 COMMERCIAL NF40 Alaska Carpenters Trust 91136 COMMERCIAL NF40 Alaska Carpenters Trust 91136 COMMERCIAL N
FABOH (CHP/RPU) Call COMMERCIAL N
Payer ID rendering provider and
location number required to
submit claims. Please call Dave
Sell at (608) 210-6656 to obtain.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 42
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
FABOH (CHP/RPU) Call COMMERCIAL N
Payer ID rendering provider and
location number required to
submit claims. Please call Dave
Sell at (608) 210-6656 to obtain.FACS Group 37300 COMMERCIAL NFACS Group 37300 COMMERCIAL NFAMILY CARE 60995 COMMERCIAL NFAMILY CARE 60995 COMMERCIAL NFCE Benefit Administrators 33033 COMMERCIAL NFCE Benefit Administrators 33033 COMMERCIAL NFIRST ADMINISTRATORS INC FAMR1 COMMERCIAL NFIRST ADMINISTRATORS INC FAMR1 COMMERCIAL N
FMH Benefit Services Inc. 48117 COMMERCIAL N
For assistance send email to
FMH Benefit Services Inc. 48117 COMMERCIAL N
For assistance send email to
[email protected] BENEFIT ADMINISTRATORS/CONTRACTOR EMPLOYEE BENEFITS ADMINBOONG COMMERCIAL NFOUNDATION BENEFIT ADMINISTRATORS/CONTRACTOR EMPLOYEE BENEFITS ADMINBOONG COMMERCIAL NFacey Medical Foundation 95432 COMMERCIAL NFacey Medical Foundation 95432 COMMERCIAL NFallon Community Health Plan 22254 COMMERCIAL NFallon Community Health Plan 22254 COMMERCIAL NFamily Health Partners - Healthwave of Kansas 31472 COMMERCIAL NFamily Health Partners - Healthwave of Kansas 31472 COMMERCIAL NFamily Health Partners/MC+ Missouri 43173 COMMERCIAL NFamily Health Partners/MC+ Missouri 43173 COMMERCIAL NFamily Health Plan TH045 COMMERCIAL NFamily Health Plan TH045 COMMERCIAL N
Family Health Plan (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Family Health Plan (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Farm Family Life 14140 COMMERCIAL NFarm Family Life 14140 COMMERCIAL NFederated Benefits 37300 COMMERCIAL NFederated Benefits 37300 COMMERCIAL NFederated HR Services 37300 COMMERCIAL NFederated HR Services 37300 COMMERCIAL NFederated Mutual Insurance 41041 COMMERCIAL NFederated Mutual Insurance 41041 COMMERCIAL NFidelis Care New York 11315 COMMERCIAL NFidelis Care New York 11315 COMMERCIAL NFidelis Secure Care 77054 COMMERCIAL NFidelis Secure Care 77054 COMMERCIAL NFirst Carolina Care 56196 COMMERCIAL NFirst Carolina Care 56196 COMMERCIAL NFirst Choice Health Administrators 91131 COMMERCIAL NFirst Choice Health Administrators 91131 COMMERCIAL NFirst Choice Health Network 91131 COMMERCIAL NFirst Choice Health Network 91131 COMMERCIAL NFirst Choice HealthPlans of Connecticut 14162 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 43
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationFirst Choice HealthPlans of Connecticut 14162 COMMERCIAL NFirst Choice of Midwest (PPO) 75138 COMMERCIAL NFirst Choice of Midwest (PPO) 75138 COMMERCIAL NFirst Health Network (f.k.a. CCN Managed Care Inc. & PPO Oklahoma)73159 COMMERCIAL NFirst Health Network (f.k.a. CCN Managed Care Inc. & PPO Oklahoma)73159 COMMERCIAL NFirst Health Network (f.k.a. CCN Managed Care Inc. & PPO Oklahoma)73159 COMMERCIAL NFirst Health Network (f.k.a. CCN Managed Care Inc. & PPO Oklahoma)73159 COMMERCIAL N
First Medical Network (FMN) - Atlanta GA 29076 COMMERCIAL N
1st Medical Network is part of the
Medical Mutual Family of
Companies. Former payer ID
58203.
First Medical Network (FMN) - Atlanta GA 29076 COMMERCIAL N
1st Medical Network is part of the
Medical Mutual Family of
Companies. Former payer ID
58203.First Service Administrators Inc 59276 COMMERCIAL N Also known as Florida 1stFirst Service Administrators Inc 59276 COMMERCIAL N Also known as Florida 1stFirst Sevice Admin - Limited Medical 20807 COMMERCIAL NFirst Sevice Admin - Limited Medical 20807 COMMERCIAL NFirstCare TH003 COMMERCIAL NFirstCare TH003 COMMERCIAL NFitzharris & Company Inc. 11244 COMMERCIAL NFitzharris & Company Inc. 11244 COMMERCIAL NFlorida Health Care Plan 59322 COMMERCIAL NFlorida Health Care Plan 59322 COMMERCIAL N
Florida Hospital Healthcare Systems 59321 COMMERCIAL N
If Bill Prov NPI not present Render
Prov NPI required -or- If Render
Prov NPI is not present either
Render Prov Network ID (REF*N5)
or Commercial Num (REF*G2) is
required. FHHS member ID must
be 11 digits.
Florida Hospital Healthcare Systems 59321 COMMERCIAL N
If Bill Prov NPI not present Render
Prov NPI required -or- If Render
Prov NPI is not present either
Render Prov Network ID (REF*N5)
or Commercial Num (REF*G2) is
required. FHHS member ID must
be 11 digits.
Florida Hospital Waterman 48116 COMMERCIAL N
For assistance send email to
Florida Hospital Waterman 48116 COMMERCIAL N
For assistance send email to
[email protected] League of Cities Inc. 59698 COMMERCIAL NFlorida League of Cities Inc. 59698 COMMERCIAL N
Foreign Service Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry Consolidated
payer ID. Including AFSPA Staff
Plan
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 44
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Foreign Service Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry Consolidated
payer ID. Including AFSPA Staff
PlanFoundation for Medical Care of Tulare & Kings CountyTKFMC COMMERCIAL NFoundation for Medical Care of Tulare & Kings CountyTKFMC COMMERCIAL NFox-Everett Inc. 64069 COMMERCIAL NFox-Everett Inc. 64069 COMMERCIAL NFreedom First 31313 COMMERCIAL NFreedom First 31313 COMMERCIAL NFreedom Health Plan 41212 COMMERCIAL NFreedom Health Plan 41212 COMMERCIAL NFresenius Medical Care 23130 COMMERCIAL NFresenius Medical Care 23130 COMMERCIAL NFriant Water Users TKFMC COMMERCIAL NFriant Water Users TKFMC COMMERCIAL NFringe Benefit Management 59069 COMMERCIAL NFringe Benefit Management 59069 COMMERCIAL NFringe Benefits Coordinators 59204 COMMERCIAL NFringe Benefits Coordinators 59204 COMMERCIAL NFrontPath Health Coalition 34171 COMMERCIAL NFrontPath Health Coalition 34171 COMMERCIAL N
GATES MCDONALD HEALTH PLUS INC 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
GATES MCDONALD HEALTH PLUS INC 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.GBA 37283 COMMERCIAL NGBA 37283 COMMERCIAL NGEMCare (Golden Empire Managed Care System) MCS01 COMMERCIAL NGEMCare (Golden Empire Managed Care System) MCS01 COMMERCIAL N
GENEX Care of Ohio (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
GENEX Care of Ohio (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.GHI - Medicare Private Fee for Service 22937 COMMERCIAL NGHI - Medicare Private Fee for Service 22937 COMMERCIAL NGHI - New York (Group Health Inc.) 13551 COMMERCIAL NGHI - New York (Group Health Inc.) 13551 COMMERCIAL NGHI HMO 25531 COMMERCIAL NGHI HMO 25531 COMMERCIAL N
GHP (Group Health Plan) 25133 COMMERCIAL N
Formerly payer ID 25141 Now
part of Coventry Consolidated
payer ID.
GHP (Group Health Plan) 25133 COMMERCIAL N
Formerly payer ID 25141 Now
part of Coventry Consolidated
payer ID.GIC Indemnity Plan 80314 COMMERCIAL NGIC Indemnity Plan 80314 COMMERCIAL NGMS Inc. 47083 COMMERCIAL NGMS Inc. 47083 COMMERCIAL NGalveston County Indigent Health Care 30005 COMMERCIAL NGalveston County Indigent Health Care 30005 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 45
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Gates McDonald Health Plus Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Gates McDonald Health Plus Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Gateway Health Plan - Medicare Assured 60550 COMMERCIAL N
Gateway Health Plan - Medicare
Assured; 60550 (Yellow Card).
Please check the ID card to verify
the Payer ID before submitting
claims. If you have questions
please contact Gateway Provider
Servicing Department at 1-800-
685-5205.
Gateway Health Plan - Medicare Assured 60550 COMMERCIAL N
Gateway Health Plan - Medicare
Assured; 60550 (Yellow Card).
Please check the ID card to verify
the Payer ID before submitting
claims. If you have questions
please contact Gateway Provider
Servicing Department at 1-800-
685-5205.
Gateway Health Plan Medicaid PA 25169 COMMERCIAL N
Caution: Gateway Health Plan has
several different Payer ID
numbers please look for the
Payer ID on the ID card before
submitting. PA Medicaid
25169(Green Card). If you have
questions contact Gateway
Provider Servicing Department at
1-800-685-5205.
Gateway Health Plan Medicaid PA 25169 COMMERCIAL N
Caution: Gateway Health Plan has
several different Payer ID
numbers please look for the
Payer ID on the ID card before
submitting. PA Medicaid
25169(Green Card). If you have
questions contact Gateway
Provider Servicing Department at
1-800-685-5205.
Gateway Health Plan OH- Medicare Assured 91741 COMMERCIAL N
Please check the ID card to verify
the Payer ID before submitting
claims. If you have questions
please contact Gateway Provider
Servicing @ 1-800-685-5205
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 46
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Gateway Health Plan OH- Medicare Assured 91741 COMMERCIAL N
Please check the ID card to verify
the Payer ID before submitting
claims. If you have questions
please contact Gateway Provider
Servicing @ 1-800-685-5205Gateway IPA (Pinnacle Health Resources) (Prospect Medical Group)PROSP COMMERCIAL NGateway IPA (Pinnacle Health Resources) (Prospect Medical Group)PROSP COMMERCIAL N
Geisinger Health Plan 75273 COMMERCIAL P
Prior enrollment required. Please
contact Geisinger Health Plan at 1-
888-281-5338 option 3 to obtain
an enrollment form; or download
a PDF enrollment form at
www.thehealthplan.com.
Geisinger Health Plan 75273 COMMERCIAL P
Prior enrollment required. Please
contact Geisinger Health Plan at 1-
888-281-5338 option 3 to obtain
an enrollment form; or download
a PDF enrollment form at
www.thehealthplan.com.Gemcare Health Plan 20376 COMMERCIAL NGemcare Health Plan 20376 COMMERCIAL NGemcare Health Plan MCS03 COMMERCIAL NGemcare Health Plan MCS03 COMMERCIAL NGemcare IPA 27133 COMMERCIAL NGemcare IPA 27133 COMMERCIAL NGenerations Healthcare 46050 COMMERCIAL NGenerations Healthcare 46050 COMMERCIAL NGenerations-Hillcrest 46051 COMMERCIAL NGenerations-Hillcrest 46051 COMMERCIAL NGenesis Healthcare PROSP COMMERCIAL NGenesis Healthcare PROSP COMMERCIAL NGilsbar 88053 COMMERCIAL NGilsbar 88053 COMMERCIAL NGilsbar Inc. 7205 COMMERCIAL NGilsbar Inc. 7205 COMMERCIAL NGlendale Physician's Alliance AMM02 COMMERCIAL NGlendale Physician's Alliance AMM02 COMMERCIAL NGlobal Care Inc. 7689 COMMERCIAL NGlobal Care Inc. 7689 COMMERCIAL NGolden Rule Insurance Company 37602 COMMERCIAL NGolden Rule Insurance Company 37602 COMMERCIAL NGolden State Medical Group MBA01 COMMERCIAL NGolden State Medical Group MBA01 COMMERCIAL NGolden Triangle Physician Alliance/SelectCare of Texas (GTPA)72189 COMMERCIAL NGolden Triangle Physician Alliance/SelectCare of Texas (GTPA)72189 COMMERCIAL NGood Samaritan Medical Practice Association AMM01 COMMERCIAL NGood Samaritan Medical Practice Association AMM01 COMMERCIAL NGovernment Employees Hospital Association (GEHA) 44054 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 47
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationGovernment Employees Hospital Association (GEHA) 44054 COMMERCIAL NGreat Lakes Health Plan 95467 COMMERCIAL NGreat Lakes Health Plan 95467 COMMERCIAL NGreat-West Healthcare 80705 COMMERCIAL NGreat-West Healthcare 80705 COMMERCIAL NGreat-West Healthcare (formerly American General) 63665 COMMERCIAL NGreat-West Healthcare (formerly American General) 63665 COMMERCIAL NGreater Orange County Medical Group NMM01 COMMERCIAL NGreater Orange County Medical Group NMM01 COMMERCIAL NGreater San Gabriel Med Grp NMM01 COMMERCIAL NGreater San Gabriel Med Grp NMM01 COMMERCIAL NGroup Administrators Ltd. 36338 COMMERCIAL NGroup Administrators Ltd. 36338 COMMERCIAL N
Group Health Cooperative - WA State 91051 COMMERCIAL N
All GHC products; GHC Group
Individual Medicare + Choice and
Healthy Options can be submitted
electronically
Group Health Cooperative - WA State 91051 COMMERCIAL N
All GHC products; GHC Group
Individual Medicare + Choice and
Healthy Options can be submitted
electronicallyGroup Health Cooperative of Eau Claire 95192 COMMERCIAL NGroup Health Cooperative of Eau Claire 95192 COMMERCIAL NGroup Health Cooperative of South Central Wisconsin39167 COMMERCIAL NGroup Health Cooperative of South Central Wisconsin39167 COMMERCIAL NGroup Health Cooperative of South Central Wisconsin39168 COMMERCIAL NGroup Health Cooperative of South Central Wisconsin39168 COMMERCIAL NGroup Health Inc. 22937 COMMERCIAL NGroup Health Inc. 22937 COMMERCIAL NGroup Health Managers 38194 COMMERCIAL NGroup Health Managers 38194 COMMERCIAL N
Group Health Options - WA State 91051 COMMERCIAL N
All GHO products; Options and
Alliant can be submitted
electronically
Group Health Options - WA State 91051 COMMERCIAL N
All GHO products; Options and
Alliant can be submitted
electronicallyGroup Insurance Service Center Inc. 37276 COMMERCIAL NGroup Insurance Service Center Inc. 37276 COMMERCIAL NGroup Practice Affiliates 68046 COMMERCIAL NGroup Practice Affiliates 68046 COMMERCIAL NGroup and Pension Administrators 48143 COMMERCIAL NGroup and Pension Administrators 48143 COMMERCIAL NGuardian Healthcare INC. (SC) 77010 COMMERCIAL NGuardian Healthcare INC. (SC) 77010 COMMERCIAL NGuardian Life Insurance Company of America 64246 COMMERCIAL NGuardian Life Insurance Company of America 64246 COMMERCIAL NH.E.R.E.I.U Welfare Pension Funds 37114 COMMERCIAL NH.E.R.E.I.U Welfare Pension Funds 37114 COMMERCIAL NHAA Preferred Partners 65101 COMMERCIAL NHAA Preferred Partners 65101 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 48
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationHAP/AHL/Curanet 38224 COMMERCIAL NHAP/AHL/Curanet 38224 COMMERCIAL NHCH Administration (Illinois) 37111 COMMERCIAL NHCH Administration (Illinois) 37111 COMMERCIAL N
HCH Administration Inc. 37215 COMMERCIAL N Formerly John P. Pearl Associates
HCH Administration Inc. 37215 COMMERCIAL N Formerly John P. Pearl AssociatesHCHA Albq-Self Funded 37329 COMMERCIAL NHCHA Albq-Self Funded 37329 COMMERCIAL NHCS - Health Claims Service (Boise ID) 82018 COMMERCIAL NHCS - Health Claims Service (Boise ID) 82018 COMMERCIAL NHDM Benefit Solutions TH070 COMMERCIAL NHDM Benefit Solutions TH070 COMMERCIAL NHDPC - Premier Healthcare 90023 COMMERCIAL NHDPC - Premier Healthcare 90023 COMMERCIAL NHDPC/Alliance Physicians 20257 COMMERCIAL NHDPC/Alliance Physicians 20257 COMMERCIAL NHEALTHY PALM BEACHES Call COMMERCIAL NHEALTHY PALM BEACHES Call COMMERCIAL NHFN Inc. 36335 COMMERCIAL NHFN Inc. 36335 COMMERCIAL NHIP - Health Insurance Plan of Greater New York 55247 COMMERCIAL NHIP - Health Insurance Plan of Greater New York 55247 COMMERCIAL NHMA Administrators LLC 39044 COMMERCIAL NHMA Administrators LLC 39044 COMMERCIAL NHMA Hawaii 86066 COMMERCIAL NHMA Hawaii 86066 COMMERCIAL NHPS Paradigm Inc. 58227 COMMERCIAL NHPS Paradigm Inc. 58227 COMMERCIAL NHarmony Health Plan of Illinois 36406 COMMERCIAL NHarmony Health Plan of Illinois 36406 COMMERCIAL NHarmony Health Plan of Indiana 36405 COMMERCIAL NHarmony Health Plan of Indiana 36405 COMMERCIAL N
Harrington Health-Kansas (formerly known as Fiserv Health-Kansas)62061 COMMERCIAL N
(Formerly Willis Administrative
Services Corporation)
Harrington Health-Kansas (formerly known as Fiserv Health-Kansas)62061 COMMERCIAL N
(Formerly Willis Administrative
Services Corporation)Harvard Pilgrim Health Care 4271 COMMERCIAL NHarvard Pilgrim Health Care 4271 COMMERCIAL NHawaii Medical Assurance Association (HMAA) 99208 COMMERCIAL NHawaii Medical Assurance Association (HMAA) 99208 COMMERCIAL NHealth Alliance Medical Plans 77950 COMMERCIAL NHealth Alliance Medical Plans 77950 COMMERCIAL N
Health America Inc./Health Assurance/Advantra 25133 COMMERCIAL N
Formerly payer ID 25126. Now
part of Coventry Consolidated
payer ID.
Health America Inc./Health Assurance/Advantra 25133 COMMERCIAL N
Formerly payer ID 25126. Now
part of Coventry Consolidated
payer ID.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 49
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationHealth Care Network of Wisconsin (HCN) 42102 COMMERCIAL NHealth Care Network of Wisconsin (HCN) 42102 COMMERCIAL NHealth Choice Arizona 62179 COMMERCIAL NHealth Choice Arizona 62179 COMMERCIAL NHealth Choice Generations 62180 COMMERCIAL NHealth Choice Generations 62180 COMMERCIAL NHealth Cost Solutions 62111 COMMERCIAL NHealth Cost Solutions 62111 COMMERCIAL NHealth Design Plus (Hudson OH) 34158 COMMERCIAL NHealth Design Plus (Hudson OH) 34158 COMMERCIAL NHealth Future LLC. 30946 COMMERCIAL NHealth Future LLC. 30946 COMMERCIAL NHealth Management Administrators (HMA) TH049 COMMERCIAL NHealth Management Administrators (HMA) TH049 COMMERCIAL N
Health Management Solutions (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Health Management Solutions (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Health Market Care Assured 62295 COMMERCIAL NHealth Market Care Assured 62295 COMMERCIAL NHealth Net Pearl SX185 COMMERCIAL NHealth Net Pearl SX185 COMMERCIAL NHealth Net of Arizona 38309 COMMERCIAL N Payer requires NPIHealth Net of Arizona 38309 COMMERCIAL N Payer requires NPIHealth Net of California and Oregon - Claims 95567 COMMERCIAL NHealth Net of California and Oregon - Claims 95567 COMMERCIAL NHealth Net of the Northeast Inc. 6108 COMMERCIAL N Payer requires NPI.Health Net of the Northeast Inc. 6108 COMMERCIAL N Payer requires NPI.Health Network America 20199 COMMERCIAL NHealth Network America 20199 COMMERCIAL NHealth Network One 65062 COMMERCIAL NHealth Network One 65062 COMMERCIAL N
Health New England Call COMMERCIAL N
To obtain payer id please contact
Joanne Shaw 413-233-3444
[email protected] or Joanne
Walton-Bicknell 413-233-3456
Health New England Call COMMERCIAL N
To obtain payer id please contact
Joanne Shaw 413-233-3444
[email protected] or Joanne
Walton-Bicknell 413-233-3456
[email protected] Options of Florida SX030 COMMERCIAL NHealth Options of Florida SX030 COMMERCIAL NHealth Options of Illinois 36368 COMMERCIAL NHealth Options of Illinois 36368 COMMERCIAL NHealth Partners - Jackson TN 62157 COMMERCIAL NHealth Partners - Jackson TN 62157 COMMERCIAL NHealth Partners PA 80142 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 50
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationHealth Partners PA 80142 COMMERCIAL NHealth Payment Systems Inc. 20270 COMMERCIAL NHealth Payment Systems Inc. 20270 COMMERCIAL NHealth Plan of Michigan 83253 COMMERCIAL NHealth Plan of Michigan 83253 COMMERCIAL NHealth Plan of San Joaquin 68035 COMMERCIAL NHealth Plan of San Joaquin 68035 COMMERCIAL N
Health Plan of San Mateo Call COMMERCIAL N
CONTACT PAYER FOR
REGISTRATION AND PAYER ID.
Endry Lo: 650-616-2017 or Ken
Cottrell: 650-616-2021
Health Plan of San Mateo Call COMMERCIAL N
CONTACT PAYER FOR
REGISTRATION AND PAYER ID.
Endry Lo: 650-616-2017 or Ken
Cottrell: 650-616-2021Health Plans Inc. 44273 COMMERCIAL NHealth Plans Inc. 44273 COMMERCIAL N
Health Plus PHSP (Brooklyn NY) 11324 COMMERCIAL P
Providers must contact Health
Plus at 718-491-8355 prior to
submitting claims.
Health Plus PHSP (Brooklyn NY) 11324 COMMERCIAL P
Providers must contact Health
Plus at 718-491-8355 prior to
submitting claims.Health Right 52201 COMMERCIAL NHealth Right 52201 COMMERCIAL NHealth Services Consulting Group Inc. 20896 COMMERCIAL NHealth Services Consulting Group Inc. 20896 COMMERCIAL NHealth Services Management 41150 COMMERCIAL RHealth Services Management 41150 COMMERCIAL RHealth Services Preferred (HSP) by Emerald Health 34167 COMMERCIAL NHealth Services Preferred (HSP) by Emerald Health 34167 COMMERCIAL NHealth Services for Children with Special Needs 37290 COMMERCIAL NHealth Services for Children with Special Needs 37290 COMMERCIAL NHealth Strategies SX044 COMMERCIAL NHealth Strategies SX044 COMMERCIAL N
HealthCare Partners IPA 11328 COMMERCIAL N
Formerly Heritage New York
Medical Group.
HealthCare Partners IPA 11328 COMMERCIAL N
Formerly Heritage New York
Medical Group.HealthEZ 41178 COMMERCIAL NHealthEZ 41178 COMMERCIAL NHealthFirst TPA (Houston TX) 34185 COMMERCIAL NHealthFirst TPA (Houston TX) 34185 COMMERCIAL NHealthGroup Limited 23274 COMMERCIAL NHealthGroup Limited 23274 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 51
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
HealthPartners MN SX009 COMMERCIAL R
Payer must be requested via the
Provider Setup Form and Payer
Reqistration completed prior to
electronic claims submission.
Provider Forms can be found:
www.emdeon.com/enrollment
HealthPartners MN SX009 COMMERCIAL R
Payer must be requested via the
Provider Setup Form and Payer
Reqistration completed prior to
electronic claims submission.
Provider Forms can be found:
www.emdeon.com/enrollmentHealthPlan Services 59140 COMMERCIAL NHealthPlan Services 59140 COMMERCIAL N
HealthPlus of Michigan 38216 COMMERCIAL R
HealthPlus requires a Trading
Partner Agreement. Providers
should contact the EDI
department at (810-230-2084)
upon billing via Emdeon to
request a TPA form.
HealthPlus of Michigan 38216 COMMERCIAL R
HealthPlus requires a Trading
Partner Agreement. Providers
should contact the EDI
department at (810-230-2084)
upon billing via Emdeon to
request a TPA form.HealthSCOPE Benefits Inc. 71063 COMMERCIAL NHealthSCOPE Benefits Inc. 71063 COMMERCIAL NHealthSmart -Noble Mid Orange HSM01 COMMERCIAL NHealthSmart -Noble Mid Orange HSM01 COMMERCIAL NHealthSmart Preferred Care Inc. 75250 COMMERCIAL NHealthSmart Preferred Care Inc. 75250 COMMERCIAL N
HealthSpring HMO/HealthSpring Medicare+Choice 63092 COMMERCIAL N
It is no longer necessary to notify
HealthSpring before submitting
claims electronically.
HealthSpring encourages
electronic submission of all
claims. Be sure to submit only
the HealthSpring
subscriber/member ID number
found on the HealthSpring ID card
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 52
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
HealthSpring HMO/HealthSpring Medicare+Choice 63092 COMMERCIAL N
It is no longer necessary to notify
HealthSpring before submitting
claims electronically.
HealthSpring encourages
electronic submission of all
claims. Be sure to submit only
the HealthSpring
subscriber/member ID number
found on the HealthSpring ID cardHealthStar Inc. 36332 COMMERCIAL NHealthStar Inc. 36332 COMMERCIAL NHealthcare Partners HCP01 COMMERCIAL NHealthcare Partners HCP01 COMMERCIAL NHealthcare Resources NW 56731 COMMERCIAL NHealthcare Resources NW 56731 COMMERCIAL NHealthcare Solutions Group 73147 COMMERCIAL NHealthcare Solutions Group 73147 COMMERCIAL N
Healthcare Transaction Processing Inc (HTP) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Healthcare Transaction Processing Inc (HTP) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Healthcare USA 25133 COMMERCIAL N
Formerly Payer ID 25141. Now
part of Coventry Consolidated
payer ID.
Healthcare USA 25133 COMMERCIAL N
Formerly Payer ID 25141. Now
part of Coventry Consolidated
payer ID.Healthcare USA 25143 COMMERCIAL NHealthcare USA 25143 COMMERCIAL NHealthcare USA 25143 COMMERCIAL NHealthcare USA 25143 COMMERCIAL NHealthcomp Inc. 85729 COMMERCIAL NHealthcomp Inc. 85729 COMMERCIAL NHealthfirst Health Plan of New Jersey 80141 COMMERCIAL NHealthfirst Health Plan of New Jersey 80141 COMMERCIAL NHealthfirst TPA (Tyler TX) 75234 COMMERCIAL NHealthfirst TPA (Tyler TX) 75234 COMMERCIAL NHealthfirst of Austin 75289 COMMERCIAL NHealthfirst of Austin 75289 COMMERCIAL NHealthfirst Inc. (New York) 80141 COMMERCIAL NHealthfirst Inc. (New York) 80141 COMMERCIAL N
Healthlink HMO 96475 COMMERCIAL N
Please call Provider Relations
Dept at (800) 624-2356 for
unique provider number.
Healthlink HMO 96475 COMMERCIAL N
Please call Provider Relations
Dept at (800) 624-2356 for
unique provider number.
Healthlink PPO 90001 COMMERCIAL N
Customer Service phone number:
(800 624-2356)
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 53
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Healthlink PPO 90001 COMMERCIAL N
Customer Service phone number:
(800 624-2356)
Healthnow Division 55204 COMMERCIAL R
Provider id = 12 digits with G2
qualifier
Healthnow Division 55204 COMMERCIAL R
Provider id = 12 digits with G2
qualifierHealthscope Benefits - EHC Repricing 52429 COMMERCIAL NHealthscope Benefits - EHC Repricing 52429 COMMERCIAL NHealthsmart Accel 75237 COMMERCIAL NHealthsmart Accel 75237 COMMERCIAL NHealthsource CMHC 2041 COMMERCIAL NHealthsource CMHC 2041 COMMERCIAL NHealthsource Massachusetts Inc. 2041 COMMERCIAL NHealthsource Massachusetts Inc. 2041 COMMERCIAL N
Healthsource Provident 68195 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.
Healthsource Provident 68195 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.
Healthsource AR (Med) (CIGNA) 71075 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.
Healthsource AR (Med) (CIGNA) 71075 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.
Healthsource GA (CIGNA) 58210 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.
Healthsource GA (CIGNA) 58210 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.Healthsource KY 61127 COMMERCIAL NHealthsource KY 61127 COMMERCIAL NHealthsource ME 1041 COMMERCIAL PHealthsource ME 1041 COMMERCIAL P
Healthsource N. TX (CIGNA) 75255 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.
Healthsource N. TX (CIGNA) 75255 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.
Healthsource NC (CIGNA) 56147 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.
Healthsource NC (CIGNA) 56147 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.Healthsource NH 2038 COMMERCIAL NHealthsource NH 2038 COMMERCIAL NHealthsource OH 31141 COMMERCIAL NHealthsource OH 31141 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 54
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Healthsource SC 6119 COMMERCIAL N
Healthsource Network Providers
Only
Healthsource SC 6119 COMMERCIAL N
Healthsource Network Providers
Only
Healthsource TN (CIGNA) 62129 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.
Healthsource TN (CIGNA) 62129 COMMERCIAL N
Claims are edited under CIGNA's
payer specific edits Payer ID
62308.Healthways WholeHealth Networks 58213 COMMERCIAL NHealthways WholeHealth Networks 58213 COMMERCIAL N
Heritage Consultants 59230 COMMERCIAL N
For faster payment please be sure
to use only the 9-digit subscriber
ID on all claims.
Heritage Consultants 59230 COMMERCIAL N
For faster payment please be sure
to use only the 9-digit subscriber
ID on all claims.Heritage Physician Network TH011 COMMERCIAL NHeritage Physician Network TH011 COMMERCIAL NHeritage Provider Network DESRT COMMERCIAL NHeritage Provider Network DESRT COMMERCIAL NHeritage Provider Network REGAL COMMERCIAL NHeritage Provider Network REGAL COMMERCIAL NHewittt Coleman 88051 COMMERCIAL NHewittt Coleman 88051 COMMERCIAL NHigh Desert Primary Care 33069 COMMERCIAL NHigh Desert Primary Care 33069 COMMERCIAL NHighmark- Key Family 35145 COMMERCIAL NHighmark- Key Family 35145 COMMERCIAL NHill Physicians Medical Group 46 COMMERCIAL NHill Physicians Medical Group 46 COMMERCIAL NHinsdale Physician Healthcare 36385 COMMERCIAL NHinsdale Physician Healthcare 36385 COMMERCIAL NHispanic Physicians IPA HPIPA COMMERCIAL NHispanic Physicians IPA HPIPA COMMERCIAL NHollywood Presbyterian (Synermed) SYMED COMMERCIAL NHollywood Presbyterian (Synermed) SYMED COMMERCIAL NHoly Cross Health Partners 36412 COMMERCIAL NHoly Cross Health Partners 36412 COMMERCIAL NHometown Health Plan Nevada 88023 COMMERCIAL NHometown Health Plan Nevada 88023 COMMERCIAL NHometown Health Providers 88537 COMMERCIAL NHometown Health Providers 88537 COMMERCIAL NHorizon HealthCare Admin (HHA) 22304 COMMERCIAL NHorizon HealthCare Admin (HHA) 22304 COMMERCIAL N
Horizon NJ Health 22326 COMMERCIAL N
Medicaid managed care. For EDI
support please e-mail
Formerly Horizon Mercy Health
Plan
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 55
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Horizon NJ Health 22326 COMMERCIAL N
Medicaid managed care. For EDI
support please e-mail
Formerly Horizon Mercy Health
PlanHospital Benefits Inc. 37274 COMMERCIAL NHospital Benefits Inc. 37274 COMMERCIAL N
Hotel Employees & Restaurant Employees Health Trust91136 COMMERCIAL N
Please enter Group Number (F19)
when submitting claims.
Hotel Employees & Restaurant Employees Health Trust91136 COMMERCIAL N
Please enter Group Number (F19)
when submitting claims.Hudson Health Plan 13335 COMMERCIAL RHudson Health Plan 13335 COMMERCIAL RHumana Dermatology - New Century Health NCH02 COMMERCIAL NHumana Dermatology - New Century Health NCH02 COMMERCIAL NHumana Emphesys 61101 COMMERCIAL NHumana Emphesys 61101 COMMERCIAL NHumana Employers Health Insurance 61101 COMMERCIAL NHumana Employers Health Insurance 61101 COMMERCIAL NHumana Inc. 61101 COMMERCIAL NHumana Inc. 61101 COMMERCIAL N
Humana Insurance Company Choice Care Network 61101 COMMERCIAL N
Does not include Humana
ChoiceCare of Cincinnati -
(Humana Health Plans of Ohio)
Humana Insurance Company Choice Care Network 61101 COMMERCIAL N
Does not include Humana
ChoiceCare of Cincinnati -
(Humana Health Plans of Ohio)Humana Veterans Healthcare Services 61160 COMMERCIAL NHumana Veterans Healthcare Services 61160 COMMERCIAL NHumboldt-Del Norte Foundation for Medical Care 94154 COMMERCIAL NHumboldt-Del Norte Foundation for Medical Care 94154 COMMERCIAL NI'Mcare 41600 COMMERCIAL NI'Mcare 41600 COMMERCIAL NI. E. Shaffer (West Trenton NJ) 22175 COMMERCIAL NI. E. Shaffer (West Trenton NJ) 22175 COMMERCIAL NIAA 37279 COMMERCIAL NIAA 37279 COMMERCIAL N
IHG Direct 75274 COMMERCIAL N
Valid for claims with the following
mailing address: P.O. Box 2388
Stow OH 44224
IHG Direct 75274 COMMERCIAL N
Valid for claims with the following
mailing address: P.O. Box 2388
Stow OH 44224
IHS Networks - 1 Call COMMERCIAL N
Call Jessica Picarde at Provider
relations (410) 349-3222 to
acquire payer id information.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 56
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
IHS Networks - 1 Call COMMERCIAL N
Call Jessica Picarde at Provider
relations (410) 349-3222 to
acquire payer id information.IMS Management Services TH099 COMMERCIAL NIMS Management Services TH099 COMMERCIAL NIMX Easy 86070 COMMERCIAL NIMX Easy 86070 COMMERCIAL NINDECS Corporation 40585 COMMERCIAL NINDECS Corporation 40585 COMMERCIAL NINETICO INC. 43471 COMMERCIAL NINTERNATIONAL FUNDING LTD 39182 COMMERCIAL NINTERNATIONAL FUNDING LTD 39182 COMMERCIAL N
INTGRITAS BENEFIT GROUP 20435 COMMERCIAL N
Claims are printed and mailed to
Payer.IU Medical Group Primary Care SX172 COMMERCIAL NIU Medical Group Primary Care SX172 COMMERCIAL NIllinois Health Solutions 86069 COMMERCIAL NIllinois Health Solutions 86069 COMMERCIAL N
Imperial County Physicians Medical Group Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected]
Imperial County Physicians Medical Group Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected] Medical Group MHM01 COMMERCIAL NIndependence Medical Group MHM01 COMMERCIAL NIndependence Medical Group - Tulare 26274 COMMERCIAL NIndependence Medical Group - Tulare 26274 COMMERCIAL NIndependent Health SX073 COMMERCIAL PIndependent Health SX073 COMMERCIAL P
Indian Health Services SX171 COMMERCIAL N
Enrollment is required. Providers
should contact BCBSNM
Customer Service Department at
1-800-225-0241
Indian Health Services SX171 COMMERCIAL N
Enrollment is required. Providers
should contact BCBSNM
Customer Service Department at
1-800-225-0241Indiana Department of Health - Children's Health - Claims35600 COMMERCIAL RIndiana Department of Health - Children's Health - Claims35600 COMMERCIAL RIndiana ProHealth Network 35161 COMMERCIAL NIndiana ProHealth Network 35161 COMMERCIAL N
Indiana Teamsters Health Benefits Fund (Indianapolis IN)35107 COMMERCIAL N
Formerly known as Local 135
Health Benefits Fund
(Indianapolis IN)
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 57
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Indiana Teamsters Health Benefits Fund (Indianapolis IN)35107 COMMERCIAL N
Formerly known as Local 135
Health Benefits Fund
(Indianapolis IN)
Individual Health Insurance Companies 31053 COMMERCIAL N
Payer ID 31053 is for State Farm -
Health line of business.
Individual Health Insurance Companies 31053 COMMERCIAL N
Payer ID 31053 is for State Farm -
Health line of business.Informed LLC 52196 COMMERCIAL NInformed LLC 52196 COMMERCIAL NIngalls Provider Group 36348 COMMERCIAL NIngalls Provider Group 36348 COMMERCIAL N
Injured Workers Insurance Fund 52212 COMMERCIAL N
Injured Workers Insurance Fund
requires first time submitters to
contact Grace Sobrio at (410) 494-
2045 prior to submitting claims.
Injured Workers Insurance Fund 52212 COMMERCIAL N
Injured Workers Insurance Fund
requires first time submitters to
contact Grace Sobrio at (410) 494-
2045 prior to submitting claims.Inland Empire Health Plan IEHP1 COMMERCIAL NInland Empire Health Plan IEHP1 COMMERCIAL NInnovante Benefit Administrators 31172 COMMERCIAL NInnovante Benefit Administrators 31172 COMMERCIAL N
Innovative Healthware Services Call COMMERCIAL N
Before submitting please contact
Jessica Picarde at (410) 349-3222
to obtain Payer ID
Innovative Healthware Services Inc. Call COMMERCIAL N
Before submitting contact Jessica
Picarde at (410) 349-3222
Innovative Healthware Services Inc. Call COMMERCIAL N
Before submitting contact Jessica
Picarde at (410) 349-3222Insurance Administrators of America Inc. 37279 COMMERCIAL NInsurance Administrators of America Inc. 37279 COMMERCIAL NInsurance Design Administrators 13315 COMMERCIAL NInsurance Design Administrators 13315 COMMERCIAL N
Insurance Management Services (Amarillo TX) 15688 COMMERCIAL N
This Payer ID is only valid for
claims with submission address of
P.O. Box 15688; Amarillo TX
79105
Insurance Management Services (Amarillo TX) 15688 COMMERCIAL N
This Payer ID is only valid for
claims with submission address of
P.O. Box 15688; Amarillo TX
79105Insurance Services of Lubbock TH012 COMMERCIAL NInsurance Services of Lubbock TH012 COMMERCIAL NInsurdata/Insurnational SX011 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 58
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationInsurdata/Insurnational SX011 COMMERCIAL N
Insurers Administrative Corp. 86304 COMMERCIAL N
Please visit website prior to
submitting claims:
edihelp.iacusa.com
Insurers Administrative Corp. 86304 COMMERCIAL N
Please visit website prior to
submitting claims:
edihelp.iacusa.com
Integra Administrative Group (Seaford DE) 51020 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
110 S. Shipley Street Seaford DE
19973.
Integra Administrative Group (Seaford DE) 51020 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
110 S. Shipley Street Seaford DE
19973.Integra Group 31127 COMMERCIAL NIntegra Group 31127 COMMERCIAL NIntegra Group-CHA 31129 COMMERCIAL NIntegra Group-CHA 31129 COMMERCIAL NIntegrated Care Network (ICN) by Emerald Health 34167 COMMERCIAL NIntegrated Care Network (ICN) by Emerald Health 34167 COMMERCIAL N
Integrated Mental Health Services 68053 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
800-716-5650 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Integrated Mental Health Services 68053 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
800-716-5650 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.InterCare Health Plans Inc. 37227 COMMERCIAL NInterCare Health Plans Inc. 37227 COMMERCIAL NInterWest Health (Acceptius Gateway payer) 84137 COMMERCIAL NInterWest Health (Acceptius Gateway payer) 84137 COMMERCIAL NInterface EAP (IEAP) 60280 COMMERCIAL NInterface EAP (IEAP) 60280 COMMERCIAL NIntergroup Services Corporation 23287 COMMERCIAL NIntergroup Services Corporation 23287 COMMERCIAL NInternational Brotherhood of Boilermakers 36609 COMMERCIAL NInternational Brotherhood of Boilermakers 36609 COMMERCIAL NInternational Brotherhood of Boilermakers Employee Health Care Plan(IBBEHC)48603 COMMERCIAL NInternational Brotherhood of Boilermakers Employee Health Care Plan(IBBEHC)48603 COMMERCIAL NInternational Educational Exchange Services Inc. (IEES)16158 COMMERCIAL NInternational Educational Exchange Services Inc. (IEES)16158 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 59
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationInternational Medical Group TH105 COMMERCIAL NInternational Medical Group TH105 COMMERCIAL NIowa Health Solutions 86068 COMMERCIAL NIowa Health Solutions 86068 COMMERCIAL NJ. F. Molloy and Associates Inc. 61271 COMMERCIAL NJ. F. Molloy and Associates Inc. 61271 COMMERCIAL NJ. Smith Lanier & Co. Administrators 37272 COMMERCIAL NJ. Smith Lanier & Co. Administrators 37272 COMMERCIAL NJI Specialties TH033 COMMERCIAL NJI Specialties TH033 COMMERCIAL NJMH - SFCCN PHT (PSN CMSN) 9822 COMMERCIAL NJMH - SFCCN PHT (PSN CMSN) 9822 COMMERCIAL NJMH HEALTH PLAN COMMERCIAL HMO 5014 COMMERCIAL NJMH HEALTH PLAN COMMERCIAL HMO 5014 COMMERCIAL NJOHN MORRELL COMPANY CO. - AHPBA 38310 COMMERCIAL NJOHN MORRELL COMPANY CO. - AHPBA 38310 COMMERCIAL N
JOHN MUIR TRAUMA PHYSICIANS Call COMMERCIAL N
Please contact John Muir Trauma
Physicians at 925-947-5288 for
Payer id information.
JOHN MUIR TRAUMA PHYSICIANS Call COMMERCIAL N
Please contact John Muir Trauma
Physicians at 925-947-5288 for
Payer id information.JP Farley Corporation 34136 COMMERCIAL NJP Farley Corporation 34136 COMMERCIAL NJSL Administrators 37272 COMMERCIAL NJSL Administrators 37272 COMMERCIAL NJohn Alden Life Insurance Co. 41099 COMMERCIAL NJohn Alden Life Insurance Co. 41099 COMMERCIAL N
John Muir Mt. Diablo Health System 68036 COMMERCIAL N
Providers who have never
submitted claims to John Muir
are required to register Tax ID
prior to initial claims submission.
Please fax W-9 along with contact
name and number to the
attention of Patty Kan at (925)
941-2026. Allow 2 days for
processing bef
John Muir Mt. Diablo Health System 68036 COMMERCIAL N
Providers who have never
submitted claims to John Muir
are required to register Tax ID
prior to initial claims submission.
Please fax W-9 along with contact
name and number to the
attention of Patty Kan at (925)
941-2026. Allow 2 days for
processing bef
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 60
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
John Muir Physician Network 68036 COMMERCIAL N
Providers who have never
submitted claims to John Muir
are required to register Tax ID
prior to initial claims submission.
Please fax W-9 along with contact
name and number to the
attention of Patty Kan at (925)
941-2026. Allow 2 days for
processing bef
John Muir Physician Network 68036 COMMERCIAL N
Providers who have never
submitted claims to John Muir
are required to register Tax ID
prior to initial claims submission.
Please fax W-9 along with contact
name and number to the
attention of Patty Kan at (925)
941-2026. Allow 2 days for
processing bef
Johns Hopkins Healthcare (EHP/PP) 52189 COMMERCIAL P
New submitters should send in
their Billing NPI and
Rending/Servicing NPI.
Johns Hopkins Healthcare (EHP/PP) 52189 COMMERCIAL P
New submitters should send in
their Billing NPI and
Rending/Servicing NPI.
Johns Hopkins Healthcare (USFHP) 52123 COMMERCIAL N
New submitters should send in
their Billing NPI and
Rending/Servicing NPI.
Johns Hopkins Healthcare (USFHP) 52123 COMMERCIAL N
New submitters should send in
their Billing NPI and
Rending/Servicing NPI.
Jopari Careworks J1410 COMMERCIAL N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 61
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Jopari Careworks J1410 COMMERCIAL N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify theJoplin Claims 43178 COMMERCIAL NJoplin Claims 43178 COMMERCIAL NKEY GAP 35317 COMMERCIAL NKEY GAP 35317 COMMERCIAL NKPS-Kitsap Physician Services KPS01 COMMERCIAL NKPS-Kitsap Physician Services KPS01 COMMERCIAL NKaiser CSI-California Select for Individuals (formerly known as Kaiser PPO)94320 COMMERCIAL NKaiser CSI-California Select for Individuals (formerly known as Kaiser PPO)94320 COMMERCIAL NKaiser Foundation Health Plan of Colorado 91617 COMMERCIAL NKaiser Foundation Health Plan of Colorado 91617 COMMERCIAL N
Kaiser Foundation Health Plan of Northern CA Region94135 COMMERCIAL N
Please call (510) 987-4639 for
approval prior to submitting
Northern California referral
claims.
Kaiser Foundation Health Plan of Northern CA Region94135 COMMERCIAL N
Please call (510) 987-4639 for
approval prior to submitting
Northern California referral
claims.
Kaiser Foundation Health Plan of Ohio 34092 COMMERCIAL N
Kaiser Ohio will be receiving
Extend Content. E-tactic Billing
Service participating in Pilot.
Kaiser Foundation Health Plan of Ohio 34092 COMMERCIAL N
Kaiser Ohio will be receiving
Extend Content. E-tactic Billing
Service participating in Pilot.
Kaiser Foundation Health Plan of Southern CA Region94134 COMMERCIAL N
For more information please call
(866) 285-0361
Kaiser Foundation Health Plan of Southern CA Region94134 COMMERCIAL N
For more information please call
(866) 285-0361
Kaiser Foundation Health Plan of the Mid-Atlantic States Inc.52095 COMMERCIAL N
For more information please
contact Kenya Neal at Kaiser at
(301) 625-2264.
Kaiser Foundation Health Plan of the Mid-Atlantic States Inc.52095 COMMERCIAL N
For more information please
contact Kenya Neal at Kaiser at
(301) 625-2264.
Kaiser Foundation of the Northwest 93079 COMMERCIAL N
This payer id can only be used to
submit claims for Oregon and
Washington Kaiser Permanente
members.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 62
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Kaiser Foundation of the Northwest 93079 COMMERCIAL N
This payer id can only be used to
submit claims for Oregon and
Washington Kaiser Permanente
members.Kaiser Permanente of Georgia 21313 COMMERCIAL NKaiser Permanente of Georgia 21313 COMMERCIAL NKanawha HealthCare Solutions Inc. 57038 COMMERCIAL NKanawha HealthCare Solutions Inc. 57038 COMMERCIAL NKanawha Insurance Co. 57038 COMMERCIAL NKanawha Insurance Co. 57038 COMMERCIAL NKaty Medical Claims 81812 COMMERCIAL NKaty Medical Claims 81812 COMMERCIAL NKaweah Delta TKFMC COMMERCIAL NKaweah Delta TKFMC COMMERCIAL NKempton Company 73100 COMMERCIAL NKempton Company 73100 COMMERCIAL NKempton Group Administrators 73100 COMMERCIAL NKempton Group Administrators 73100 COMMERCIAL NKern County CDCR 28021 COMMERCIAL NKern County CDCR 28021 COMMERCIAL NKern Health Systems 77039 COMMERCIAL NKern Health Systems 77039 COMMERCIAL N
Key Benefit Administrators (Indianapolis IN) 37217 COMMERCIAL N
MUST VERIFY AL CLAIMS SHOULD
GO TO PAYER IN INDIANAPOLIS IN
Key Benefit Administrators (Indianapolis IN) 37217 COMMERCIAL N
MUST VERIFY AL CLAIMS SHOULD
GO TO PAYER IN INDIANAPOLIS INKey Health Pilot COMMERCIAL NKey Health Pilot COMMERCIAL NKey Medical Group IP082 COMMERCIAL NKey Medical Group IP082 COMMERCIAL NKey Select 37321 COMMERCIAL NKey Select 37321 COMMERCIAL N
Keystone Mercy Health Plan 23284 COMMERCIAL N
Medicaid managed care. For EDI
support please e-mail
Keystone Mercy Health Plan 23284 COMMERCIAL N
Medicaid managed care. For EDI
support please e-mail
[email protected] & Company 34145 COMMERCIAL NKlais & Company 34145 COMMERCIAL N
Klais & Company (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Klais & Company (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Korean American Medical Group 66123 COMMERCIAL NLA Care Health Plan LACAR COMMERCIAL NLA Care Health Plan LACAR COMMERCIAL NLBA Health Plans 52193 COMMERCIAL NLBA Health Plans 52193 COMMERCIAL NLHP Claims Unit 37248 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 63
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationLHP Claims Unit 37248 COMMERCIAL NLIPA/Agate Resources TH106 COMMERCIAL NLIPA/Agate Resources TH106 COMMERCIAL NLake County Physicians Association 37116 COMMERCIAL NLake County Physicians Association 37116 COMMERCIAL NLakeside Comprehensive Healthcare 66127 COMMERCIAL NLakeside Comprehensive Healthcare 66127 COMMERCIAL NLakeside Health Services LMG11 COMMERCIAL NLakeside Health Services LMG11 COMMERCIAL N
Lancaster General Health Group - Preferred Health Care (IHS Payer)Call COMMERCIAL N
Contact Sherry Wolgemuth Vice
President of Claims Operations
for Preferred Health Care at (717)
560-9290 ext. 124 for approval
and the Payer ID.
Lancaster General Health Group - Preferred Health Care (IHS Payer)Call COMMERCIAL N
Contact Sherry Wolgemuth Vice
President of Claims Operations
for Preferred Health Care at (717)
560-9290 ext. 124 for approval
and the Payer ID.Landmark Healthcare Inc LNDMK COMMERCIAL NLandmark Healthcare Inc LNDMK COMMERCIAL NLawndale Christian Health Center 36333 COMMERCIAL NLawndale Christian Health Center 36333 COMMERCIAL NLeon Medical Center Health Plan 37316 COMMERCIAL NLeon Medical Center Health Plan 37316 COMMERCIAL NLiberty Health Advantage 87071 COMMERCIAL NLiberty Health Advantage 87071 COMMERCIAL NLiberty Union 37281 COMMERCIAL NLiberty Union 37281 COMMERCIAL NLife Assurance Company 37281 COMMERCIAL NLife Assurance Company 37281 COMMERCIAL NLife Investors Insurance TH120 COMMERCIAL NLife Investors Insurance TH120 COMMERCIAL NLife Investors of America - Long Term Care TH093 COMMERCIAL NLife Investors of America - Long Term Care TH093 COMMERCIAL NLife Trac 41136 COMMERCIAL NLife Trac 41136 COMMERCIAL N
LifeWise Healthplan of Oregon 93093 COMMERCIAL R
Payer EDI agreement must be
processed thru Emdeon's
Enrollment Dpt. Do not send EDI
Agreement to Payer. Applies to all
providers (including those adding
site id's) enrolling for Electronic
submission thru WebMD.
Questions: (800) 845-6592
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 64
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
LifeWise Healthplan of Oregon 93093 COMMERCIAL R
Payer EDI agreement must be
processed thru Emdeon's
Enrollment Dpt. Do not send EDI
Agreement to Payer. Applies to all
providers (including those adding
site id's) enrolling for Electronic
submission thru WebMD.
Questions: (800) 845-6592
Lifewise Health Plan of Arizona 91155 COMMERCIAL R
Payer EDI agreement must be
processed thru Emdeons
Enrollment Dpt. Do not send EDI
Agreement to Payer. Applies to all
providers (incl. those adding site
ids) enrolling for Electronic
submission thru WebMD.
Questions: (800) 845-6592
Lifewise Health Plan of Arizona 91155 COMMERCIAL R
Payer EDI agreement must be
processed thru Emdeons
Enrollment Dpt. Do not send EDI
Agreement to Payer. Applies to all
providers (incl. those adding site
ids) enrolling for Electronic
submission thru WebMD.
Questions: (800) 845-6592Local 135 Health Benefits Fund (Indianapolis IN) 35107 COMMERCIAL NLocal 135 Health Benefits Fund (Indianapolis IN) 35107 COMMERCIAL NLoma Linda University Adventist Health Sciences Center Employee Health Plan37267 COMMERCIAL NLoma Linda University Adventist Health Sciences Center Employee Health Plan37267 COMMERCIAL NLoma Linda University Adventist Health Sciences Centers37267 COMMERCIAL NLoma Linda University Adventist Health Sciences Centers37267 COMMERCIAL NLoma Linda University Behavioral Medicine Center Employee Health Plan37267 COMMERCIAL NLoma Linda University Behavioral Medicine Center Employee Health Plan37267 COMMERCIAL NLoma Linda University Employee Health Plan 37267 COMMERCIAL NLoma Linda University Employee Health Plan 37267 COMMERCIAL NLoma Linda University Health Care Employee Health Plan37267 COMMERCIAL NLoma Linda University Health Care Employee Health Plan37267 COMMERCIAL N
Loma Linda University Healthcare - ManagedCare Claims33036 COMMERCIAL N
Claims are printed and mailed to
the payer.
Loma Linda University Healthcare - ManagedCare Claims33036 COMMERCIAL N
Claims are printed and mailed to
the payer.Loma Linda University Medical Center Employee Health Plan37267 COMMERCIAL NLoma Linda University Medical Center Employee Health Plan37267 COMMERCIAL NLoma Linda University Medical Center Residents Health Plan37267 COMMERCIAL NLoma Linda University Medical Center Residents Health Plan37267 COMMERCIAL NLoma Linda University Student Health Plan 37267 COMMERCIAL NLoma Linda University Student Health Plan 37267 COMMERCIAL NLovelace Salud SX159 COMMERCIAL NLovelace Salud SX159 COMMERCIAL NLovelace Sandia Health Plan 90328 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 65
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationLovelace Sandia Health Plan 90328 COMMERCIAL NMAMSI Life and Health Insurance Co. (MLH) 52148 COMMERCIAL NMAMSI Life and Health Insurance Co. (MLH) 52148 COMMERCIAL NMBA Benefit Administrators Inc. 83028 COMMERCIAL NMBA Benefit Administrators Inc. 83028 COMMERCIAL N
MBA Benefit Administrators Inc. (Salt Lake City UT) 87065 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box
651109 Salt Lake City UT 84115
MBA Benefit Administrators Inc. (Salt Lake City UT) 87065 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box
651109 Salt Lake City UT 84115
MBA of Wyoming (Worland WY) 87065 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box 98
Worland WY 82401
MBA of Wyoming (Worland WY) 87065 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box 98
Worland WY 82401MBS 56205 COMMERCIAL N Formerly Payer ID 56151MBS 56205 COMMERCIAL N Formerly Payer ID 56151MCA ADMINISTRATORS 25160 COMMERCIAL NMCA ADMINISTRATORS 25160 COMMERCIAL NMCOA 88054 COMMERCIAL NMCOA 88054 COMMERCIAL NMD - Individual Practice Association Inc. (M.D. IPA) 52148 COMMERCIAL NMD - Individual Practice Association Inc. (M.D. IPA) 52148 COMMERCIAL NMDWise Hoosier Alliance 20475 COMMERCIAL NMDWise Hoosier Alliance 20475 COMMERCIAL NMEDICA HEALTH CARE PLAN INC. 78857 COMMERCIAL NMEDICA HEALTH CARE PLAN INC. 78857 COMMERCIAL NMEDICAL DEVELOPMENT INTERNATIONAL 52181 COMMERCIAL NMEDICAL DEVELOPMENT INTERNATIONAL 52181 COMMERCIAL NMEMIC 1047 COMMERCIAL NMEMIC 1047 COMMERCIAL N
MEMORIAL INTEGRATED HEALTHCARE Call COMMERCIAL N
PLEASE EMAIL TRACY HARSWICK
AT [email protected] FOR
PAYER ID INFORMATION
MEMORIAL INTEGRATED HEALTHCARE Call COMMERCIAL N
PLEASE EMAIL TRACY HARSWICK
AT [email protected] FOR
PAYER ID INFORMATIONMFC & HealthPlus Peoria 23550 COMMERCIAL NMFC & HealthPlus Peoria 23550 COMMERCIAL NMHP Systems 64068 COMMERCIAL NMHP Systems 64068 COMMERCIAL NMIPS 5018 COMMERCIAL NMIPS 5018 COMMERCIAL NMMA 35316 COMMERCIAL NMMA 35316 COMMERCIAL N
MMAC (Managed Medical Assurance Co. Ltd.) (Ohio BWC)31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 66
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
MMAC (Managed Medical Assurance Co. Ltd.) (Ohio BWC)31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
MMSI 41154 COMMERCIAL N Mayo Management Services Inc.
MMSI 41154 COMMERCIAL N Mayo Management Services Inc.MORRIS ASSOCIATES 35092 COMMERCIAL NMORRIS ASSOCIATES 35092 COMMERCIAL NMPA-Custom Provider Network 80900 COMMERCIAL NMPA-Custom Provider Network 80900 COMMERCIAL NMPE Services Inc. 37233 COMMERCIAL NMPE Services Inc. 37233 COMMERCIAL NMPEEBT 37233 COMMERCIAL NMPEEBT 37233 COMMERCIAL NMVP Health Plan of NY 14165 COMMERCIAL NMVP Health Plan of NY 14165 COMMERCIAL N
MVP Health Rochester SX089 COMMERCIAL N
Formerly known as Preferred
Care NY
MVP Health Rochester SX089 COMMERCIAL N
Formerly known as Preferred
Care NYMacNeal Health Providers- CHS 36334 COMMERCIAL NMacNeal Health Providers- CHS 36334 COMMERCIAL NMagellan Health Services 1260 COMMERCIAL NMagellan Health Services 1260 COMMERCIAL NMagnacare 11303 COMMERCIAL NMagnacare 11303 COMMERCIAL N
Mail Handlers Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry Consolidated
payer ID. Including AFSPA Staff
Plan. a.k.a. Mailhandlers CAC.
Mail Handlers Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry Consolidated
payer ID. Including AFSPA Staff
Plan. a.k.a. Mailhandlers CAC.Maksin Management Corporation 22195 COMMERCIAL NMaksin Management Corporation 22195 COMMERCIAL NManaged Care Services LLC 35162 COMMERCIAL NManaged Care Services LLC 35162 COMMERCIAL NManaged Care Systems (Delano Regional Medical Group)MCS02 COMMERCIAL NManaged Care Systems (Delano Regional Medical Group)MCS02 COMMERCIAL NManaged Care Systems (Gemcare) MCS01 COMMERCIAL NManaged Care Systems (Gemcare) MCS01 COMMERCIAL NManaged Health Network 22771 COMMERCIAL NManaged Health Network 22771 COMMERCIAL N
Managed Health Services Indiana (Medicaid HMO) 39186 COMMERCIAL P
Prior to submitting claims please
call Provider Relations Dept at
877.647.4848 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 67
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Managed Health Services Indiana (Medicaid HMO) 39186 COMMERCIAL P
Prior to submitting claims please
call Provider Relations Dept at
877.647.4848 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Managed Health Services Wisconsin 39187 COMMERCIAL P
Prior to submitting claims please
call Provider Relations Dept at 1-
800-547-1647 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Managed Health Services Wisconsin 39187 COMMERCIAL P
Prior to submitting claims please
call Provider Relations Dept at 1-
800-547-1647 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.Managed Physical Network 41159 COMMERCIAL NManaged Physical Network 41159 COMMERCIAL NManatee Service Center (Bradenton FL) 41555 COMMERCIAL NManatee Service Center (Bradenton FL) 41555 COMMERCIAL NManulife W. J. Sutton Company 98010 COMMERCIAL NManulife W. J. Sutton Company 98010 COMMERCIAL NMarquette Life Insurance Company 48055 COMMERCIAL NMarquette Life Insurance Company 48055 COMMERCIAL NMarsh Advantage 13310 COMMERCIAL NMarsh Advantage 13310 COMMERCIAL NMaryland Medicaid SKMD0 COMMERCIAL AMaryland Medicaid SKMD0 COMMERCIAL A
Maryland Physicians Care 22348 COMMERCIAL N
Rendering provider id must
contain 1D qualifier. Payer
accepts zero dollar service line
charges. Payer Registration not
required. Autoenroll payer.
Maryland Physicians Care 22348 COMMERCIAL N
Rendering provider id must
contain 1D qualifier. Payer
accepts zero dollar service line
charges. Payer Registration not
required. Autoenroll payer.Mashantucket Pequot Tribal Nation 37121 COMMERCIAL NMashantucket Pequot Tribal Nation 37121 COMMERCIAL NMaster Mates & Pilots Program TH111 COMMERCIAL NMaster Mates & Pilots Program TH111 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 68
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationMcKinley Medical Group MHM02 COMMERCIAL NMcKinley Medical Group MHM02 COMMERCIAL NMdwis-HIP MDWIS COMMERCIAL NMdwis-HIP MDWIS COMMERCIAL NMedAdmin Solutions 58202 COMMERCIAL NMedAdmin Solutions 58202 COMMERCIAL NMedAdmin Solutions 58204 COMMERCIAL NMedAdmin Solutions 58204 COMMERCIAL NMedBen (Newark OH) 74323 COMMERCIAL NMedBen (Newark OH) 74323 COMMERCIAL NMedCom 59231 COMMERCIAL NMedCom 59231 COMMERCIAL N
MedCost Inc. 56162 COMMERCIAL N
For questions on claim
submission please contact
Customer Service 800-824-7406
MedCost Inc. 56162 COMMERCIAL N
For questions on claim
submission please contact
Customer Service 800-824-7406MedDirect 38353 COMMERCIAL NMedDirect 38353 COMMERCIAL NMedPartners 35205 COMMERCIAL NMedPartners Administrative Services 35205 COMMERCIAL NMedSolutions Inc 62160 COMMERCIAL NMedSolutions Inc 62160 COMMERCIAL NMedfocus 95321 COMMERCIAL NMedfocus 95321 COMMERCIAL NMedica 94265 COMMERCIAL NMedica 94265 COMMERCIAL NMedicaid Hawaii Waivers 77059 COMMERCIAL RMedicaid Hawaii Waivers 77059 COMMERCIAL R
Medical Administrators Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Medical Administrators Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Medical Benefit Administrators Inc/dba MBA of MD Inc37298 COMMERCIAL NMedical Benefit Administrators Inc/dba MBA of MD Inc37298 COMMERCIAL NMedical Benefits Administration MBA01 COMMERCIAL NMedical Benefits Administration MBA01 COMMERCIAL NMedical Benefits Administrators Inc. (Newark OH) 74323 COMMERCIAL NMedical Benefits Administrators Inc. (Newark OH) 74323 COMMERCIAL NMedical Benefits Companies (Newark OH) 74323 COMMERCIAL NMedical Benefits Companies (Newark OH) 74323 COMMERCIAL NMedical Benefits Mutual (Newark OH) 74323 COMMERCIAL NMedical Benefits Mutual (Newark OH) 74323 COMMERCIAL NMedical Benefits Mutual Life Insrance Co. 74323 COMMERCIAL NMedical Benefits Mutual Life Insrance Co. 74323 COMMERCIAL NMedical Claims Service Inc. 4258 COMMERCIAL NMedical Claims Service Inc. 4258 COMMERCIAL NMedical Mutual of Ohio 29076 COMMERCIAL NMedical Mutual of Ohio 29076 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 69
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationMedical Network of Colorado Springs 84600 COMMERCIAL NMedical Network of Colorado Springs 84600 COMMERCIAL NMedical Partners of America 80026 COMMERCIAL NMedical Partners of America 80026 COMMERCIAL NMedical Reimbursements of America 62177 COMMERCIAL NMedical Reimbursements of America 62177 COMMERCIAL NMedical Services Initiative 12057 COMMERCIAL NMedical Services Initiative 12057 COMMERCIAL NMedical Value Plan - Ohio (MVP) 38224 COMMERCIAL NMedical Value Plan - Ohio (MVP) 38224 COMMERCIAL N
Mega Life & Health Insurance Company - Insurance Center59221 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
the following: P.O. Box 982009
North Richland Hills TX 76182.
Mega Life & Health Insurance Company - Insurance Center59221 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
the following: P.O. Box 982009
North Richland Hills TX 76182.Memorial Clinical Associates/ SelectCare of Texas (MCA)62181 COMMERCIAL NMemorial Clinical Associates/ SelectCare of Texas (MCA)62181 COMMERCIAL NMemorial Herman Health Network Providers TH092 COMMERCIAL NMemorial Herman Health Network Providers TH092 COMMERCIAL N
Memorial PSN/CMS Call COMMERCIAL N
Please contact Memorial
Enrollment department at 954-
276-3176 for payer ID
information.
Memorial PSN/CMS Call COMMERCIAL N
Please contact Memorial
Enrollment department at 954-
276-3176 for payer ID
information.Mennonite Mutual Aid Association and Affiliates (MMA)35605 COMMERCIAL NMennonite Mutual Aid Association and Affiliates (MMA)35605 COMMERCIAL NMercer Administrators 13310 COMMERCIAL NMercer Administrators 13310 COMMERCIAL NMercy Care Plan (AHCCCS) 86052 COMMERCIAL NMercy Care Plan (AHCCCS) 86052 COMMERCIAL NMercy Health Plans 43166 COMMERCIAL NMercy Health Plans 43166 COMMERCIAL N
MercyCare Call COMMERCIAL N
Please call 608-758-7739 for
payer id.
MercyCare Call COMMERCIAL N
Please call 608-758-7739 for
payer id.Meridian Health Plan 13189 COMMERCIAL NMeridian Health Plan 13189 COMMERCIAL N
Meritain Health / Agency Services 64158 COMMERCIAL N
Formerly know as Agency Services
Inc.
Meritain Health / Agency Services 64158 COMMERCIAL N
Formerly know as Agency Services
Inc.Meritain Health Minneapolis 41124 COMMERCIAL NMeritain Health Minneapolis 41124 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 70
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Meritain Health/North American Administrators 64157 COMMERCIAL N
Formerly know as North
American Administrators Inc.
Meritain Health/North American Administrators 64157 COMMERCIAL N
Formerly know as North
American Administrators Inc.Mesa Mental Health 85035 COMMERCIAL NMesa Mental Health 85035 COMMERCIAL NMethodist Associate Health Plan Pilot COMMERCIAL NMethodist Associate Health Plan Pilot COMMERCIAL N
MetroPlus Health Plan 13265 COMMERCIAL N
Registration and submission of
the Billing Provider's NPI is
required. If you have not
registered please contact MHP
Customer Service at (800) 303-
9626. Claims will reject if the NPI
is not registered and/or
submitted on claims sent
electronically.
MetroPlus Health Plan 13265 COMMERCIAL N
Registration and submission of
the Billing Provider's NPI is
required. If you have not
registered please contact MHP
Customer Service at (800) 303-
9626. Claims will reject if the NPI
is not registered and/or
submitted on claims sent
electronically.Metropolitan Health Plan 10850 COMMERCIAL NMetropolitan Health Plan 10850 COMMERCIAL NMetrowest HealthPlan TH068 COMMERCIAL NMetrowest HealthPlan TH068 COMMERCIAL NMetrowest Star Medicaid TH069 COMMERCIAL NMetrowest Star Medicaid TH069 COMMERCIAL NMichael Reese Physicians Group 37127 COMMERCIAL NMichael Reese Physicians Group 37127 COMMERCIAL NMid Atlantic Psychiatric Services Inc. (MAPSI) 52149 COMMERCIAL NMid Atlantic Psychiatric Services Inc. (MAPSI) 52149 COMMERCIAL NMid-America Associates Inc. 37281 COMMERCIAL NMid-America Associates Inc. 37281 COMMERCIAL NMid-County Physicians Medical Group (San Diego) (Synermed)SYMED COMMERCIAL NMid-County Physicians Medical Group (San Diego) (Synermed)SYMED COMMERCIAL N
Mid-West National Life Insurance Co. of Tennessee - Insurance Center59224 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
the following: P.O. Box 982017
North Richland Hills TX 76182.
Mid-West National Life Insurance Co. of Tennessee - Insurance Center59224 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
the following: P.O. Box 982017
North Richland Hills TX 76182.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 71
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Mid-West National Life Insurance Co. of Tennessee - Student Insurance74227 COMMERCIAL N
Payer ID only valid if the P.O. Box
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 890025 809067 809079
809066 809036 809081 Dallas Tx
75380-9025.
Mid-West National Life Insurance Co. of Tennessee - Student Insurance74227 COMMERCIAL N
Payer ID only valid if the P.O. Box
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 890025 809067 809079
809066 809036 809081 Dallas Tx
75380-9025.MidCoast IPA 77012 COMMERCIAL NMidCoast IPA 77012 COMMERCIAL NMidlands Choice Inc. 47080 COMMERCIAL NMidlands Choice Inc. 47080 COMMERCIAL NMidwest Health Partners 76079 COMMERCIAL NMidwest Health Partners 76079 COMMERCIAL N
Midwest Health Plans Inc. TH074 COMMERCIAL P
Accepts NPI only. Require the
billing NPI to be the group NPI if
using a Business Tax id. Service
provider NPI required in servicing
provider loop. No longer require
6 digit provider identifier.
Provider must complete
enrollment form on payers
website.
Midwest Health Plans Inc. TH074 COMMERCIAL P
Accepts NPI only. Require the
billing NPI to be the group NPI if
using a Business Tax id. Service
provider NPI required in servicing
provider loop. No longer require
6 digit provider identifier.
Provider must complete
enrollment form on payers
website.Mills Peninsula Health Services MPHS1 COMMERCIAL NMills Peninsula Health Services MPHS1 COMMERCIAL NMills Peninsula Medical Group MPMG1 COMMERCIAL NMills Peninsula Medical Group MPMG1 COMMERCIAL NMission (St. Joseph Heritage Healthcare) STJOE COMMERCIAL NMission (St. Joseph Heritage Healthcare) STJOE COMMERCIAL NMississippi Health Partners 64068 COMMERCIAL NMississippi Health Partners 64068 COMMERCIAL NMississippi Medicaid SKMS0 COMMERCIAL AMississippi Medicaid SKMS0 COMMERCIAL AMississippi Physicians Care Network 64084 COMMERCIAL NMississippi Physicians Care Network 64084 COMMERCIAL NMississippi Public Entity Employee Benefit Trust 37233 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 72
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationMississippi Public Entity Employee Benefit Trust 37233 COMMERCIAL N
Mississippi Select Health Care 64088 COMMERCIAL N
Also doing business as Select
Administrative Services (SAS).
Mississippi Select Health Care 64088 COMMERCIAL N
Also doing business as Select
Administrative Services (SAS).Missoula County Medical Benefits Plan 37275 COMMERCIAL NMissoula County Medical Benefits Plan 37275 COMMERCIAL NMissouri Care/MC 43179 COMMERCIAL NMissouri Care/MC 43179 COMMERCIAL NMolina Healthcare Utah (aka: American Family Care) SX109 COMMERCIAL NMolina Healthcare Utah (aka: American Family Care) SX109 COMMERCIAL NMolina Healthcare of CALIFORNIA 38333 COMMERCIAL NMolina Healthcare of CALIFORNIA 38333 COMMERCIAL NMolina Healthcare of Florida 51062 COMMERCIAL NMolina Healthcare of Florida 51062 COMMERCIAL NMolina Healthcare of MICHIGAN 38334 COMMERCIAL NMolina Healthcare of MICHIGAN 38334 COMMERCIAL N
Molina Healthcare of Missouri 71079 COMMERCIAL N
Please note the payer name
changed effective 4/1/10. For
questions please contact Molina
Healthcare of Missouri. Please
refer to the Member ID cards for
payer contact information.
Molina Healthcare of Missouri 71079 COMMERCIAL N
Please note the payer name
changed effective 4/1/10. For
questions please contact Molina
Healthcare of Missouri. Please
refer to the Member ID cards for
payer contact information.Molina Healthcare of Nevada 20676 COMMERCIAL NMolina Healthcare of Nevada 20676 COMMERCIAL NMolina Healthcare of New Mexico - Salud 9824 COMMERCIAL NMolina Healthcare of New Mexico - Salud 9824 COMMERCIAL NMolina Healthcare of New Mexico -SCI 4423 COMMERCIAL NMolina Healthcare of New Mexico -SCI 4423 COMMERCIAL NMolina Healthcare of Ohio 20149 COMMERCIAL NMolina Healthcare of Ohio 20149 COMMERCIAL NMolina Healthcare of Texas 20554 COMMERCIAL NMolina Healthcare of Texas 20554 COMMERCIAL NMolina Healthcare of WASHINGTON 38336 COMMERCIAL NMolina Healthcare of WASHINGTON 38336 COMMERCIAL NMolina Healthcare of Washington ASO 91128 COMMERCIAL NMolina Healthcare of Washington ASO 91128 COMMERCIAL NMonarch IPA IP095 COMMERCIAL NMonarch IPA IP095 COMMERCIAL NMontefiore Contract Management Organization 13174 COMMERCIAL PMontefiore Contract Management Organization 13174 COMMERCIAL PMonumental Life Insurance Company TH094 COMMERCIAL NMonumental Life Insurance Company TH094 COMMERCIAL NMonumental Life Insurance Company TH121 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 73
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationMonumental Life Insurance Company TH121 COMMERCIAL NMosaic IPA Medical Group IP083 COMMERCIAL NMosaic IPA Medical Group IP083 COMMERCIAL NMotion Pictures Industry 99282 COMMERCIAL NMotion Pictures Industry 99282 COMMERCIAL NMountain States Administrative Services (Tucson AZ) 86040 COMMERCIAL NMountain States Administrative Services (Tucson AZ) 86040 COMMERCIAL NMulticultural Primary Care Medical Group (San Diego) (Synermed)SYMED COMMERCIAL NMulticultural Primary Care Medical Group (San Diego) (Synermed)SYMED COMMERCIAL NMultiplan Wisconsin Preferred Provider Network 34080 COMMERCIAL NMultiplan Wisconsin Preferred Provider Network 34080 COMMERCIAL NMunicipal Health Benefit Fund 81883 COMMERCIAL NMunicipal Health Benefit Fund 81883 COMMERCIAL NMutual Assurance Administrators 37256 COMMERCIAL NMutual Assurance Administrators 37256 COMMERCIAL NMutual Group (The) (US) 59140 COMMERCIAL NMutual Group (The) (US) 59140 COMMERCIAL NMutual of Omaha Insurance Company 71412 COMMERCIAL NMutual of Omaha Insurance Company 71412 COMMERCIAL NMutually Preferred 71412 COMMERCIAL NMutually Preferred 71412 COMMERCIAL N
N.W. Ironworkers Health & Security Trust Fund 91136 COMMERCIAL N
Please enter Group Number (F15)
when submitting claims.
N.W. Ironworkers Health & Security Trust Fund 91136 COMMERCIAL N
Please enter Group Number (F15)
when submitting claims.
N.W. Roofers & Employers Health & Security Trust Fund91136 COMMERCIAL N
Please enter Group Number (F26)
when submitting claims.
N.W. Roofers & Employers Health & Security Trust Fund91136 COMMERCIAL N
Please enter Group Number (F26)
when submitting claims.
N.W. Textile Processors 91136 COMMERCIAL N
Please enter Group Number (F14)
when submitting claims.
N.W. Textile Processors 91136 COMMERCIAL N
Please enter Group Number (F14)
when submitting claims.NAA (North America Administrators L.P.) (Nashville TN)65085 COMMERCIAL NNAA (North America Administrators L.P.) (Nashville TN)65085 COMMERCIAL N
NABN (Cleveland OH) 34159 COMMERCIAL N
Now known as Meritain Health.
Payer ID valid only for claims with
billing submission address of P.O.
Box 94928 Cleveland OH 44101-
4928 or P.O. Box 89476 Cleveland
OH 44101-5476.
NABN (Cleveland OH) 34159 COMMERCIAL N
Now known as Meritain Health.
Payer ID valid only for claims with
billing submission address of P.O.
Box 94928 Cleveland OH 44101-
4928 or P.O. Box 89476 Cleveland
OH 44101-5476.NALC/Affordable 53011 COMMERCIAL NNALC/Affordable 53011 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 74
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationNCAS - Fairfax VA 75190 COMMERCIAL NNCAS - Fairfax VA 75190 COMMERCIAL NNGS American Inc 38225 COMMERCIAL NNGS American Inc 38225 COMMERCIAL NNHBC 01 88049 COMMERCIAL NNHBC 01 88049 COMMERCIAL NNHBCAUX 88050 COMMERCIAL NNHBCAUX 88050 COMMERCIAL NNHP/SHP (Neighborhood Health Providers and Suffolk Health Plan)11325 COMMERCIAL PNHP/SHP (Neighborhood Health Providers and Suffolk Health Plan)11325 COMMERCIAL PNJ Carpenters Health Fund 22603 COMMERCIAL NNJ Carpenters Health Fund 22603 COMMERCIAL NNMCI Pilot COMMERCIAL NNMCI Pilot COMMERCIAL NNORTHWEST COMMUNITY HEALTH PARTNERS 36234 COMMERCIAL NNORTHWEST COMMUNITY HEALTH PARTNERS 36234 COMMERCIAL NNaperville Healthcare TH088 COMMERCIAL NNaperville Healthcare TH088 COMMERCIAL NNational Association of Letter Carriers 53011 COMMERCIAL NNational Association of Letter Carriers 53011 COMMERCIAL NNational Association of Letter Carriers/NALC 53011 COMMERCIAL NNational Association of Letter Carriers/NALC 53011 COMMERCIAL NNational Benefit Administrators - New Jersey 56175 COMMERCIAL NNational Benefit Administrators - New Jersey 56175 COMMERCIAL NNational Benefit Administrators - North Carolina 56176 COMMERCIAL NNational Benefit Administrators - North Carolina 56176 COMMERCIAL N
National Capital Preferred Provider Organization (NCPPO)90001 COMMERCIAL N
Customer Service phone number:
(800 272-5911)
National Capital Preferred Provider Organization (NCPPO)90001 COMMERCIAL N
Customer Service phone number:
(800 272-5911)National Imaging Associates SX190 COMMERCIAL NNational Imaging Associates SX190 COMMERCIAL NNational Rural Electric Coop (NRECA) 52132 COMMERCIAL NNational Rural Electric Coop (NRECA) 52132 COMMERCIAL NNational Telecommunications Cooperative Association (NTCA - Staff)52104 COMMERCIAL NNational Telecommunications Cooperative Association (NTCA - Staff)52104 COMMERCIAL NNational Telecommunications Cooperative Association (NTCA)52103 COMMERCIAL NNational Telecommunications Cooperative Association (NTCA)52103 COMMERCIAL NNationwide Health Plans 31417 COMMERCIAL NNationwide Health Plans 31417 COMMERCIAL N
Neighborhood Health Partnership of Florida 96107 COMMERCIAL N
Payer ID is valid for claims
submission address PO Box
025680 Miami FL 33102-5680.
Any questions should be directed
to (305)715-4334.
Neighborhood Health Partnership of Florida 96107 COMMERCIAL N
Payer ID is valid for claims
submission address PO Box
025680 Miami FL 33102-5680.
Any questions should be directed
to (305)715-4334.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 75
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationNeighborhood Health Plan (Boston MA) 4293 COMMERCIAL NNeighborhood Health Plan (Boston MA) 4293 COMMERCIAL N
Neighborhood Health Plan of Rhode Island (NHPRI) 5047 COMMERCIAL N
Please call NHPRI at 1-401-459-
6020 to obtain or confirm your
provider and vendor number
prior to your initial claims
submission.
Neighborhood Health Plan of Rhode Island (NHPRI) 5047 COMMERCIAL N
Please call NHPRI at 1-401-459-
6020 to obtain or confirm your
provider and vendor number
prior to your initial claims
submission.Nesika Health Group 37255 COMMERCIAL NNesika Health Group 37255 COMMERCIAL NNetcare Life and Health Insurance (Hagatna Guam) 66055 COMMERCIAL NNetcare Life and Health Insurance (Hagatna Guam) 66055 COMMERCIAL N
Network Health 4332 COMMERCIAL P
Before initiating submissions
please go to www.network-
health.org and go to the
Providers Tab then forms then
Claims Forms then EDI setup
forms or email edi@network-
health.org for an EDI setup form
or call Gary Evans @ 781-393-
7487 or Bob Williams
2111,,04332,Network
Health,,COMMERCIAL,M,B,N,P,0,
Claims,1,,Y,,,http://transact.emde
on.com/factsheets/edi_fact_shee
t_04332.php,Before initiating
submissions please go to
www.network-health.org and go
to the Providers Tab then forms
then Claims Forms then EDI setup
forms or email edi@network-
health.org for an EDI setup form
or call Gary Evans @ 781-393-
7487 or Bob Williams Network Health Insurance Corp-Medicare 77076 COMMERCIAL NNetwork Health Insurance Corp-Medicare 77076 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 76
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Network Health Plan of Wisconsin Inc. 39144 COMMERCIAL N
Use for Network Health Plan
HMO and POS claims only. Payer
Id valid only if the send claims to
address on the back of the
member's card is PO Box 568
Menasha WI 54952. DO NOT USE
this payer id for Network
Platinum Plus Network Premier
Plus or Managed
Network Health Plan of Wisconsin Inc. 39144 COMMERCIAL N
Payer id is valid only if the claim
submission address on the back
of the member's card is PO Box
568 Menasha WI 54952.Network Medical Management NMM01 COMMERCIAL NNetwork Medical Management NMM01 COMMERCIAL NNetwork TPA LLC 58204 COMMERCIAL NNetwork TPA LLC 58204 COMMERCIAL NNevadaCare 86067 COMMERCIAL NNevadaCare 86067 COMMERCIAL NNew Century Health - IEHP Oncology NCH11 COMMERCIAL NNew Century Health - IEHP Oncology NCH11 COMMERCIAL NNew Century Health - Vista Cardiology NCH09 COMMERCIAL NNew Century Health - Vista Cardiology NCH09 COMMERCIAL NNew Era Employee Welfare Benefit Plan Trust 76031 COMMERCIAL NNew Era Employee Welfare Benefit Plan Trust 76031 COMMERCIAL NNew Era Life Insurance Company 75281 COMMERCIAL NNew Era Life Insurance Company 75281 COMMERCIAL NNew Market Dimensions 65056 COMMERCIAL NNew Market Dimensions 65056 COMMERCIAL NNew West Health Services SX164 COMMERCIAL NNew West Health Services SX164 COMMERCIAL NNew York Life TH122 COMMERCIAL NNew York Life TH122 COMMERCIAL NNew York Network Management 11334 COMMERCIAL NNew York Network Management 11334 COMMERCIAL NNew York Presbyterian System Select Health 24819 COMMERCIAL NNew York Presbyterian System Select Health 24819 COMMERCIAL NNippon Life Insurance Company of America 81264 COMMERCIAL NNippon Life Insurance Company of America 81264 COMMERCIAL NNoble AMA Select IPA PDT01 COMMERCIAL NNoble AMA Select IPA PDT01 COMMERCIAL N
North American Administrators Inc. 64157 COMMERCIAL N Now known as Meritain Health
North American Administrators Inc. 64157 COMMERCIAL N Now known as Meritain Health
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 77
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
North American Benefits Network (Cleveland OH) 34159 COMMERCIAL N
Now known as Meritain Health.
Payer ID valid only for claims with
billing submission address of P.O.
Box 94928 Cleveland OH 44101-
4928 or P.O. Box 89476 Cleveland
OH 44101-5476.
North American Benefits Network (Cleveland OH) 34159 COMMERCIAL N
Now known as Meritain Health.
Payer ID valid only for claims with
billing submission address of P.O.
Box 94928 Cleveland OH 44101-
4928 or P.O. Box 89476 Cleveland
OH 44101-5476.
North American Health Plan 64157 COMMERCIAL N Now known as Meritain Health
North American Health Plan 64157 COMMERCIAL N Now known as Meritain Health
North American Medical Management (NAMM) - Northern CaliforniaE3510 COMMERCIAL P
Please contact the EDI Dept for
North American Medical
Management (NAMM) - Northern
California Lead/Supervisor at 1-
800-956-8000 prior to initial
submission of claims.
North American Medical Management (NAMM) - Northern CaliforniaE3510 COMMERCIAL P
Please contact the EDI Dept for
North American Medical
Management (NAMM) - Northern
California Lead/Supervisor at 1-
800-956-8000 prior to initial
submission of claims.North American Medical Management (NAMM) - Southern CaliforniaE3510 COMMERCIAL PNorth American Medical Management (NAMM) - Southern CaliforniaE3510 COMMERCIAL P
North American Preferred 64157 COMMERCIAL N Now known as Meritain Health
North American Preferred 64157 COMMERCIAL N Now known as Meritain HealthNorth Broward Hospital District 37314 COMMERCIAL NNorth Broward Hospital District 37314 COMMERCIAL N
North County Health Services Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected]
North County Health Services Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected] Suburban Associated Physicians 36392 COMMERCIAL NNorth Suburban Associated Physicians 36392 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 78
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationNorth Texas Healthcare Network 35212 COMMERCIAL NNorth Texas Healthcare Network 35212 COMMERCIAL NNorth West Orange County Medical Group PROSP COMMERCIAL NNorth West Orange County Medical Group PROSP COMMERCIAL NNorthShore University Health System Medical Group 36364 COMMERCIAL NNorthShore University Health System Medical Group 36364 COMMERCIAL NNorthStar Advantage NSA01 COMMERCIAL NNorthStar Advantage NSA01 COMMERCIAL N
Northern California Sheet Metal Workers Health Care Plan38238 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box
1138 San Ramon CA 94583.
Northern California Sheet Metal Workers Health Care Plan38238 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box
1138 San Ramon CA 94583.Northern Illinois Health Plan 36347 COMMERCIAL NNorthern Illinois Health Plan 36347 COMMERCIAL N
Northern Nevada Trust Fund 88027 COMMERCIAL N
Please call (775) 826-7200 to
verfiy if you should be sending
claims to Northern Nevada Trust
Fund.
Northern Nevada Trust Fund 88027 COMMERCIAL N
Please call (775) 826-7200 to
verfiy if you should be sending
claims to Northern Nevada Trust
Fund.Northridge Medical Group NMG01 COMMERCIAL NNorthridge Medical Group NMG01 COMMERCIAL NNorthstar Advantage 60058 COMMERCIAL NNorthstar Advantage 60058 COMMERCIAL NNorthwest Diagnostic Clinic/SelectCare of Texas (NWDC)62119 COMMERCIAL NNorthwest Diagnostic Clinic/SelectCare of Texas (NWDC)62119 COMMERCIAL NNorthwest Suburban IPA (Illinois) 36346 COMMERCIAL NNorthwest Suburban IPA (Illinois) 36346 COMMERCIAL NNova Casualty Company 16114 COMMERCIAL NNova Casualty Company 16114 COMMERCIAL NNovanet 6226 COMMERCIAL NNovanet 6226 COMMERCIAL NNovasys Health Network 71080 COMMERCIAL NNovasys Health Network 71080 COMMERCIAL NNuestra Familia Medical Group (Prospect Medical Group)PROSP COMMERCIAL NNuestra Familia Medical Group (Prospect Medical Group)PROSP COMMERCIAL NNyhart 37299 COMMERCIAL NNyhart 37299 COMMERCIAL NOAK WEST PRIMARY PHYSICIAN ASSOCIATION 36402 COMMERCIAL NOAK WEST PRIMARY PHYSICIAN ASSOCIATION 36402 COMMERCIAL NODS Health Plan 13350 COMMERCIAL NODS Health Plan 13350 COMMERCIAL NOK State Employees & Educators (EDS) 22521 COMMERCIAL NOK State Employees & Educators (EDS) 22521 COMMERCIAL NOMNI/Medicore HP 68037 COMMERCIAL NOMNI/Medicore HP 68037 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 79
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationOSF Health Plans 62171 COMMERCIAL NOSF Health Plans 62171 COMMERCIAL NOSMA Health - C. L. Frates 73071 COMMERCIAL NOSMA Health - C. L. Frates 73071 COMMERCIAL N
OSNA Cigna Commercial SX193 COMMERCIAL N
Claims submitted with a DOS on
or after May 1 2010 will be
rejected while claims with a DOS
prior to May 1 2010 will
continued to be accepted and
processed.
OSNA Cigna Commercial SX193 COMMERCIAL N
Claims submitted with a DOS on
or after May 1 2010 will be
rejected while claims with a DOS
prior to May 1 2010 will
continued to be accepted and
processed.
OSNA Cigna Medicare SX194 COMMERCIAL N
Claims submitted with a DOS on
or after May 1 2010 will be
rejected while claims with a DOS
prior to May 1 2010 will
continued to be accepted and
processed.
OSNA Cigna Medicare SX194 COMMERCIAL N
Claims submitted with a DOS on
or after May 1 2010 will be
rejected while claims with a DOS
prior to May 1 2010 will
continued to be accepted and
processed.
OSNA United Health Care SX195 COMMERCIAL N
Claims submitted with a DOS on
or after May 1 2010 will be
rejected while claims with a DOS
prior to May 1 2010 will
continued to be accepted and
processed.
OSNA United Health Care SX195 COMMERCIAL N
Claims submitted with a DOS on
or after May 1 2010 will be
rejected while claims with a DOS
prior to May 1 2010 will
continued to be accepted and
processed.Oasis IPA DESRT COMMERCIAL NOasis IPA DESRT COMMERCIAL N
Occupational Health Mgmt Inc. (HealthManage) (Ohio BWC)31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Occupational Health Mgmt Inc. (HealthManage) (Ohio BWC)31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 80
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Office of Group Benefits- Louisiana 72087 COMMERCIAL N
Office of Group Benefits is located
in the state of Louisiana. This
payer is currently not sending
997's. Syntax errors will be
worked on with payer tech.
Office of Group Benefits- Louisiana 72087 COMMERCIAL N
Office of Group Benefits is located
in the state of Louisiana. This
payer is currently not sending
997's. Syntax errors will be
worked on with payer tech.Ohana Health Plan 14163 COMMERCIAL NOhana Health Plan 14163 COMMERCIAL N
Ohio BWC 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Ohio BWC 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Ohio Comp Choice Inc. (HMS) (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Ohio Comp Choice Inc. (HMS) (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Ohio Employee Health Partnership (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Ohio Employee Health Partnership (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Ohio Health Choice PPO 34189 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of PO
Box 3619 Akron OH 44309-3619
or PO Box 93538
Ohio Health Choice PPO 34189 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of PO
Box 3619 Akron OH 44309-3619
or PO Box 93538Ohio Health Group 95435 COMMERCIAL NOhio Health Group 95435 COMMERCIAL N
Omnicare 25133 COMMERCIAL N
Formerly Payer ID 25150. Now
part of Coventry Consolidated
payer ID.
Omnicare 25133 COMMERCIAL N
Formerly Payer ID 25150. Now
part of Coventry Consolidated
payer ID.Omnicare Medical Group (OMNI) OMN02 COMMERCIAL NOmnicare Medical Group (OMNI) OMN02 COMMERCIAL N
Omnicare A Coventry Health Plan 25150 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 81
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Omnicare A Coventry Health Plan 25150 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Omnicare A Coventry Health Plan 25150 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.
Omnicare A Coventry Health Plan 25150 COMMERCIAL N
The go forward payer ID for this
plan is 25133. Please see new
entry under that ID on the payer
list.One Call Medical 22321 COMMERCIAL NOne Call Medical 22321 COMMERCIAL N
OneNet PPO LLC. 52149 COMMERCIAL N
Name effective from 9/1/2006.
Previous name Alliance PPO LLC.
OneNet PPO LLC. 52149 COMMERCIAL N
Name effective from 9/1/2006.
Previous name Alliance PPO LLC.
Operating Engineers Locals 302 & 612 Health & Security Fund91136 COMMERCIAL N
Please enter Group Number (F12)
when submitting claims.
Operating Engineers Locals 302 & 612 Health & Security Fund91136 COMMERCIAL N
Please enter Group Number (F12)
when submitting claims.OptiCare Managed Vision 56190 COMMERCIAL NOptiCare Managed Vision 56190 COMMERCIAL N
Optima Health Plan 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is reqd.
Field must be 5-7 chars positions
1-5 must be numeric only and
positions 6&7 (if applicable) must
be alpha only. Please contact
Ydsia Slagle-Provider Relations at
(757) 552-7477.
Optima Health Plan 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is reqd.
Field must be 5-7 chars positions
1-5 must be numeric only and
positions 6&7 (if applicable) must
be alpha only. Please contact
Ydsia Slagle-Provider Relations at
(757) 552-7477.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 82
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Optima Insurance Company 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is reqd.
Field must be 5-7 chars positions
1-5 must be numeric only and
positions 6&7 (if applicable) must
be alpha only. Please contact
Ydsia Slagle-Provider Relations at
(757) 552-7477.
Optima Insurance Company 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is reqd.
Field must be 5-7 chars positions
1-5 must be numeric only and
positions 6&7 (if applicable) must
be alpha only. Please contact
Ydsia Slagle-Provider Relations at
(757) 552-7477.Optimum Choice of the Carolinas Inc. (OCCI) 52152 COMMERCIAL NOptimum Choice of the Carolinas Inc. (OCCI) 52152 COMMERCIAL NOptimum Choice Inc. (OCI) 52148 COMMERCIAL NOptimum Choice Inc. (OCI) 52148 COMMERCIAL NOptumHealth - CMC 41194 COMMERCIAL NOptumHealth - CMC 41194 COMMERCIAL N
Orthonet - Uniformed Services Family Health Plan 13382 COMMERCIAL N
Claims are printed and mailed to
the payer. For Payable USFHP (NY
& NJ) outpatient therapy claims
only. Contact Theresa Malgioglio
at (914) 681-8800.
Orthonet - Uniformed Services Family Health Plan 13382 COMMERCIAL N
Claims are printed and mailed to
the payer. For Payable USFHP (NY
& NJ) outpatient therapy claims
only. Contact Theresa Malgioglio
at (914) 681-8800.Orthonet Corporation - CIGNA 13381 COMMERCIAL NOrthonet Corporation - CIGNA 13381 COMMERCIAL NOrthonet- Aetna 13383 COMMERCIAL NOrthonet- Aetna 13383 COMMERCIAL NOrthonet-HealthNet 25681 COMMERCIAL NOrthonet-HealthNet 25681 COMMERCIAL NOxford Health Plans 6111 COMMERCIAL NOxford Health Plans 6111 COMMERCIAL NP5 Health Plan Solutions of Utah 87068 COMMERCIAL NP5 Health Plan Solutions of Utah 87068 COMMERCIAL NPAI 37287 COMMERCIAL NPAI 37287 COMMERCIAL N
PEHP - Utah Public Employee Health Plan Call COMMERCIAL P
Call EDI at 801-366-7544 or email
[email protected] to obtain
the payer id.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 83
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
PEHP - Utah Public Employee Health Plan Call COMMERCIAL P
Call EDI at 801-366-7544 or email
[email protected] to obtain
the payer id.PHCS Savility Payers 13306 COMMERCIAL NPHCS Savility Payers 13306 COMMERCIAL N
PHP - Physicians Health Plan of Northern Indiana (Fort Wayne IN)12399 COMMERCIAL N
Contracted Providers: All claims
require NPI. Contact (260) 432-
6690 x549 with questions.
Corrected/adjustment claims -
submit via paper. Anesthesia
claims - submit with ASA/AA
modifiers and billed with minutes
PHP - Physicians Health Plan of Northern Indiana (Fort Wayne IN)12399 COMMERCIAL N
Contracted Providers: All claims
require NPI. Contact (260) 432-
6690 x549 with questions.
Corrected/adjustment claims -
submit via paper. Anesthesia
claims - submit with ASA/AA
modifiers and billed with minutesPHP of South Michigan 87726 COMMERCIAL NPHP of South Michigan 87726 COMMERCIAL NPHP of Southwest Michigan 87726 COMMERCIAL NPHP of Southwest Michigan 87726 COMMERCIAL NPHP of West Michigan 87726 COMMERCIAL NPHP of West Michigan 87726 COMMERCIAL NPIMA Health 9861 COMMERCIAL RPIMA Health 9861 COMMERCIAL RPODIATRY NETWORK FL 59324 COMMERCIAL NPODIATRY NETWORK FL 59324 COMMERCIAL NPOMCO 16111 COMMERCIAL NPOMCO 16111 COMMERCIAL NPPOM LLC 38335 COMMERCIAL NPPOM LLC 38335 COMMERCIAL NPPOPlus LLC 72148 COMMERCIAL NPPOPlus LLC 72148 COMMERCIAL NPSYCHCARE LLC 51052 COMMERCIAL NPSYCHCARE LLC 51052 COMMERCIAL NPUGET SOUND HEALTH PARTNERS INC. 42172 COMMERCIAL NPUGET SOUND HEALTH PARTNERS INC. 42172 COMMERCIAL NPacifiCare Behavioral Health 33053 COMMERCIAL NPacifiCare Behavioral Health 33053 COMMERCIAL N
PacifiCare PPO - All States 95999 COMMERCIAL N
For payable PPO claims only. NOT
for Pacificare/Secure Horizons
HMO claims. For further
questions you may inquire via
email at
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 84
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
PacifiCare PPO - All States 95999 COMMERCIAL N
For payable PPO claims only. NOT
for Pacificare/Secure Horizons
HMO claims. For further
questions you may inquire via
email at
PacifiCare of Arizona - Claims 95964 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS claims
only. Not for PPO claims. For
further questions you may inquire
via email at
PacifiCare of Arizona - Claims 95964 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS claims
only. Not for PPO claims. For
further questions you may inquire
via email at
PacifiCare of California - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
PacifiCare of California - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
PacifiCare of Colorado - Claims 95962 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS claims
only. Not for PPO claims. For
further questions you may inquire
via email at
PacifiCare of Colorado - Claims 95962 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS claims
only. Not for PPO claims. For
further questions you may inquire
via email at
PacifiCare of Oklahoma - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 85
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
PacifiCare of Oklahoma - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
PacifiCare of Oregon - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
PacifiCare of Oregon - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
PacifiCare of Texas - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
PacifiCare of Texas - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
PacifiCare of Washington - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
PacifiCare of Washington - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected] Alliance Medical Group and Hospital (Synermed)SYMED COMMERCIAL NPacific Alliance Medical Group and Hospital (Synermed)SYMED COMMERCIAL NPacific IPA PCFCI COMMERCIAL NPacific IPA PCFCI COMMERCIAL N
PacificSource Health Plans 93029 COMMERCIAL N
Payer does not accept COB claims
electronically
PacificSource Health Plans 93029 COMMERCIAL N
Payer does not accept COB claims
electronicallyParagon Benefits Inc. 58174 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 86
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationParagon Benefits Inc. 58174 COMMERCIAL NParamount SX158 COMMERCIAL NParamount SX158 COMMERCIAL N
Paramount Preferred Network (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Paramount Preferred Network (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Park Terrace/Encompass Medical Group Call COMMERCIAL N
To obtain Payer ID and enroll with
payer please contact Tristin
Rausche 858-824-7100
Park Terrace/Encompass Medical Group Call COMMERCIAL N
To obtain Payer ID and enroll with
payer please contact Tristin
Rausche 858-824-7100
[email protected] Community Health Plan 66917 COMMERCIAL NParkland Community Health Plan 66917 COMMERCIAL N
Passport Advantage 76569 COMMERCIAL N
Only claims with a DOS and/or
Admit Date on or after 1/1/2010
shall be submitted to this new
Payer ID.
Passport Advantage 76569 COMMERCIAL N
Only claims with a DOS and/or
Admit Date on or after 1/1/2010
shall be submitted to this new
Payer ID.
Passport Health Plan 61129 COMMERCIAL N
Medicaid managed care. For EDI
support please e-mail
Passport Health Plan 61129 COMMERCIAL N
Medicaid managed care. For EDI
support please e-mail
[email protected] Advocates LLC 10525 COMMERCIAL NPatient Advocates LLC 10525 COMMERCIAL N
Peach State Health Plan 68049 COMMERCIAL P
Prior to submitting claims please
call Provider Relations Dept at 1-
866-874-0633 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Peach State Health Plan 68049 COMMERCIAL P
Prior to submitting claims please
call Provider Relations Dept at 1-
866-874-0633 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.Pegasus Medical Group PROSP COMMERCIAL NPegasus Medical Group PROSP COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 87
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Pennsylvania's Preferred Health Network Call COMMERCIAL N
Call Jessica Picarde Manager of
PPHN Claims Operations(410) 349-
3222
Pennsylvania's Preferred Health Network Call COMMERCIAL N
Call Jessica Picarde Manager of
PPHN Claims Operations(410) 349-
3222Peoples Health Network 72126 COMMERCIAL NPeoples Health Network 72126 COMMERCIAL N
PerformCare-Select Health MH/SA 25176 COMMERCIAL N
For Behavioral Health EDI support
please e-mail [email protected]
PerformCare-Select Health MH/SA 25176 COMMERCIAL N
For Behavioral Health EDI support
please e-mail [email protected] Insurance Administrators Inc. (Agoura Hills CA)95397 COMMERCIAL NPersonal Insurance Administrators Inc. (Agoura Hills CA)95397 COMMERCIAL N
PersonalCare 25133 COMMERCIAL N
Formerly payer ID 25146 Now
part of Coventry Consolidated
payer ID.
PersonalCare 25133 COMMERCIAL N
Formerly payer ID 25146 Now
part of Coventry Consolidated
payer ID.Phoenix Health Plan 3440 COMMERCIAL NPhoenix Health Plan 3440 COMMERCIAL NPhyicians Health Plan (PHP) Mid-Michigan 37330 COMMERCIAL NPhyicians Health Plan (PHP) Mid-Michigan 37330 COMMERCIAL NPhysician Associates of Louisiana 58204 COMMERCIAL NPhysician Associates of Louisiana 58204 COMMERCIAL N
Physician Associates of the Greater San Gabriel Valley Call COMMERCIAL N
Please call David McGee 626-817-
8354 or Art Tarin 626-817-8318
to obtain the Payer Id
Physician Associates of the Greater San Gabriel Valley Call COMMERCIAL N
Please call David McGee 626-817-
8354 or Art Tarin 626-817-8318
to obtain the Payer IdPhysician Associates of the Greater San Gabriel ValleyPA513 COMMERCIAL NPhysician Associates of the Greater San Gabriel ValleyPA513 COMMERCIAL NPhysician Care Network LLC 58204 COMMERCIAL NPhysician Care Network LLC 58204 COMMERCIAL NPhysician's Data Trust PDT01 COMMERCIAL NPhysician's Data Trust PDT01 COMMERCIAL NPhysicians Alliance/Stones River Regional IPA 15749 COMMERCIAL NPhysicians Alliance/Stones River Regional IPA 15749 COMMERCIAL N
Physicians Care (ASR Corporation) 38265 COMMERCIAL N
Note: This is Physicians Care
Network located in Michigan
Physicians Care (ASR Corporation) 38265 COMMERCIAL N
Note: This is Physicians Care
Network located in Michigan
Physicians Care Health Plans (ASR Corporation) 38265 COMMERCIAL N
Note: This is Physicians Care
Network located in Michigan
Physicians Care Health Plans (ASR Corporation) 38265 COMMERCIAL N
Note: This is Physicians Care
Network located in Michigan
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 88
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Physicians Care Network (ASR Corporation) 38265 COMMERCIAL N
Note: This is Physicians Care
Network located in Michigan
Physicians Care Network (ASR Corporation) 38265 COMMERCIAL N
Note: This is Physicians Care
Network located in MichiganPhysicians Care Network (Rockford IL only) 36345 COMMERCIAL NPhysicians Care Network (Rockford IL only) 36345 COMMERCIAL NPhysicians Health Association of Illinois 37136 COMMERCIAL NPhysicians Health Association of Illinois 37136 COMMERCIAL NPhysicians Health Choice - Encounters TH114 COMMERCIAL NPhysicians Health Choice - Encounters TH114 COMMERCIAL NPhysicians Health Claims - Claims TH113 COMMERCIAL NPhysicians Health Claims - Claims TH113 COMMERCIAL NPhysicians Health Collaborative 20398 COMMERCIAL NPhysicians Health Collaborative 20398 COMMERCIAL NPhysicians Health Network MHM03 COMMERCIAL NPhysicians Health Network MHM03 COMMERCIAL NPhysicians Health Plan (PHP) - SC 9173 COMMERCIAL NPhysicians Health Plan (PHP) - SC 9173 COMMERCIAL NPhysicians Health Plan PHP South Michigan 37330 COMMERCIAL NPhysicians Health Plan PHP South Michigan 37330 COMMERCIAL NPhysicians Medical Group of San Jose EXC01 COMMERCIAL NPhysicians Medical Group of San Jose EXC01 COMMERCIAL N
Physicians Mutual Insurance Company 47027 COMMERCIAL N
Please send all PPO and dental
claims to the address on the back
of the insured's ID Card
Physicians Mutual Insurance Company 47027 COMMERCIAL N
Please send all PPO and dental
claims to the address on the back
of the insured's ID CardPhysicians Plus Insurance Corporation 39156 COMMERCIAL NPhysicians Plus Insurance Corporation 39156 COMMERCIAL NPhysicians United Plan TH131 COMMERCIAL NPhysicians United Plan TH131 COMMERCIAL NPiedmont Behavioral Health 6607 COMMERCIAL NPiedmont Behavioral Health 6607 COMMERCIAL NPinnacle Claims Management Inc. 24735 COMMERCIAL NPinnacle Claims Management Inc. 24735 COMMERCIAL NPinnacle Health Resources (Prospect Medical Group) PROSP COMMERCIAL NPinnacle Health Resources (Prospect Medical Group) PROSP COMMERCIAL NPinnacle Physician Management ORG 45985 COMMERCIAL NPinnacle Physician Management ORG 45985 COMMERCIAL NPinnacol Assurance 84109 COMMERCIAL NPinnacol Assurance 84109 COMMERCIAL NPioneer Medical Group PIONR COMMERCIAL NPioneer Medical Group PIONR COMMERCIAL NPittman & Associates 37224 COMMERCIAL NPittman & Associates 37224 COMMERCIAL NPivotal Plan 64160 COMMERCIAL NPivotal Plan 64160 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 89
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Planned Administrators Inc. 37287 COMMERCIAL N
Providers submitting claims as a
Preferred Blue provider should
not submit claims using payer ID
37287
Planned Administrators Inc. 37287 COMMERCIAL N
Providers submitting claims as a
Preferred Blue provider should
not submit claims using payer ID
37287Podi Care Managed Care 58204 COMMERCIAL NPodi Care Managed Care 58204 COMMERCIAL NPoly America Medical & Dental Benefits Plan 32680 COMMERCIAL NPoly America Medical & Dental Benefits Plan 32680 COMMERCIAL NPomona Valley Medical Group IP057 COMMERCIAL NPomona Valley Medical Group IP057 COMMERCIAL NPracticare Inc 4334 COMMERCIAL NPracticare Inc 4334 COMMERCIAL NPrairie States Enterprises Inc. 36373 COMMERCIAL NPrairie States Enterprises Inc. 36373 COMMERCIAL NPreferred Benefits Administrator 61665 COMMERCIAL N E6-14 Required on MedicalPreferred Benefits Administrator 61665 COMMERCIAL N E6-14 Required on Medical
Preferred Care Partners Florida 65088 COMMERCIAL N
We process claims for Florida
members only. Please check the
member address on the ID card
before submitting claims to
Preferred Care Partners.
Preferred Care Partners Florida 65088 COMMERCIAL N
We process claims for Florida
members only. Please check the
member address on the ID card
before submitting claims to
Preferred Care Partners.Preferred Community Choice/PCCSelect/CompMed 73145 COMMERCIAL NPreferred Community Choice/PCCSelect/CompMed 73145 COMMERCIAL N
Preferred Health Care - PPO Lancaster PA (IHS Gateway Payer)Call COMMERCIAL N
Contact Sherry Wolgemuth Vice
President of Claims Operations
for Preferred Health Care at (717)
560-9290 ext. 124 for approval
and the Payer ID.
Preferred Health Care - PPO Lancaster PA (IHS Gateway Payer)Call COMMERCIAL N
Contact Sherry Wolgemuth Vice
President of Claims Operations
for Preferred Health Care at (717)
560-9290 ext. 124 for approval
and the Payer ID.Preferred Health Plan (Louisville KY) 61106 COMMERCIAL NPreferred Health Plan (Louisville KY) 61106 COMMERCIAL NPreferred Health Professionals 31478 COMMERCIAL NPreferred Health Professionals 31478 COMMERCIAL NPreferred Health Systems Insurance Company 60110 COMMERCIAL NPreferred Health Systems Insurance Company 60110 COMMERCIAL NPreferred IPA PFIPA COMMERCIAL NPreferred IPA PFIPA COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 90
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationPreferred Network Access Inc. 36401 COMMERCIAL NPreferred Network Access Inc. 36401 COMMERCIAL NPreferred Plus of Kansas 60110 COMMERCIAL NPreferred Plus of Kansas 60110 COMMERCIAL NPreferredOne (MN) 41147 COMMERCIAL NPreferredOne (MN) 41147 COMMERCIAL NPremier Benefits Inc. 43166 COMMERCIAL NPremier Benefits Inc. 43166 COMMERCIAL N
Premier Comp of Hometown Health Network (Ohio BWC)31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Premier Comp of Hometown Health Network (Ohio BWC)31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Premier Health Plans 43166 COMMERCIAL NPremier Health Plans 43166 COMMERCIAL N
Premier Health Systems Inc 90440 COMMERCIAL N
Premier Health Systems Inc. is
part of the Medical Mutual Family
of Companies. For claims with
DOS prior to 4/1/09 use payer ID
90440. Claims with DOS 4/1/09
and after use their new payer ID
29076.
Premier Health Systems Inc 90440 COMMERCIAL N
Premier Health Systems Inc. is
part of the Medical Mutual Family
of Companies. For claims with
DOS prior to 4/1/09 use payer ID
90440. Claims with DOS 4/1/09
and after use their new payer ID
29076.
Premier Health Systems Inc. 29076 COMMERCIAL N
Premier Health Systems Inc. is
part of the Medical Mutual Family
of Companies. Former payer ID
90040. Use Payer ID 20976 for
claims with DOS 4/1/09 and after.
For claims with DOS prior to
4/1/09 use former payer ID
90440.
Premier Health Systems Inc. 29076 COMMERCIAL N
Premier Health Systems Inc. is
part of the Medical Mutual Family
of Companies. Former payer ID
90040. Use Payer ID 20976 for
claims with DOS 4/1/09 and after.
For claims with DOS prior to
4/1/09 use former payer ID
90440.
Premier Managed Care Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Premier Managed Care Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 91
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationPresbyterian (NM) 5003 COMMERCIAL NPresbyterian (NM) 5003 COMMERCIAL NPrestige Health Choice 45056 COMMERCIAL NPrestige Health Choice 45056 COMMERCIAL NPrevea Health Plan 39185 COMMERCIAL NPrevea Health Plan 39185 COMMERCIAL NPrima Health IPA IP096 COMMERCIAL NPrima Health IPA IP096 COMMERCIAL NPrimary Health Network 82048 COMMERCIAL NPrimary Health Network 82048 COMMERCIAL NPrimary PhysicianCare Inc. 56144 COMMERCIAL NPrimary PhysicianCare Inc. 56144 COMMERCIAL NPrime West Health Plan 61604 COMMERCIAL NPrime West Health Plan 61604 COMMERCIAL N
PrimeSource Health Network (PSHN) - PPO Harrisburg PA (IHS Gateway Payer)Call COMMERCIAL N
Before submitting contact Jessica
Picarde at (410) 349-3222
PrimeSource Health Network (PSHN) - PPO Harrisburg PA (IHS Gateway Payer)Call COMMERCIAL N
Before submitting contact Jessica
Picarde at (410) 349-3222Principal Financial Group 61271 COMMERCIAL NPrincipal Financial Group 61271 COMMERCIAL NPriority Health 38217 COMMERCIAL NPriority Health 38217 COMMERCIAL NPrism Network Inc. 37268 COMMERCIAL NPrism Network Inc. 37268 COMMERCIAL NPrism Network Inc. 37296 COMMERCIAL NPrism Network Inc. 37296 COMMERCIAL NPrism-First Health 37303 COMMERCIAL NPrism-First Health 37303 COMMERCIAL NPrism-Univera 37315 COMMERCIAL NPrism-Univera 37315 COMMERCIAL N
Pro Care Health Plan Inc. (Detroit MI) 38329 COMMERCIAL N
Payer ID valid for claims with the
following submission addresses:
PO Box 3160 Detroit MI 48203
AND PO Box 3590 Detroit MI
48203.
Pro Care Health Plan Inc. (Detroit MI) 38329 COMMERCIAL N
Payer ID valid for claims with the
following submission addresses:
PO Box 3160 Detroit MI 48203
AND PO Box 3590 Detroit MI
48203.ProCare (Prospect) PROSP COMMERCIAL NProCare (Prospect) PROSP COMMERCIAL NProCare Health Plan Medicaid 70259 COMMERCIAL NProCare Health Plan Medicaid 70259 COMMERCIAL NProMed HealthCare Administrators IP057 COMMERCIAL NProMed HealthCare Administrators IP057 COMMERCIAL NProfessional Benefit Administrators (Winter Park FL) 59296 COMMERCIAL NProfessional Benefit Administrators (Winter Park FL) 59296 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 92
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Professional Benefit Administrators Inc. (Oak Brook IL)36331 COMMERCIAL N
Payer ID is valid only for claims
with billing submission name city
and state of Professional Benefit
Administrators Inc. Oak Brook IL.
Professional Benefit Administrators Inc. (Oak Brook IL)36331 COMMERCIAL N
Payer ID is valid only for claims
with billing submission name city
and state of Professional Benefit
Administrators Inc. Oak Brook IL.Professional Risk Management 34134 COMMERCIAL NProfessional Risk Management 34134 COMMERCIAL NProspect Health Network PROSP COMMERCIAL NProspect Health Network PROSP COMMERCIAL NProspect Medical Group PROSP COMMERCIAL NProspect Medical Group PROSP COMMERCIAL NProspect Sherman Oaks Medical Group (Prospect Medical Group)PROSP COMMERCIAL NProspect Sherman Oaks Medical Group (Prospect Medical Group)PROSP COMMERCIAL NProtective Life Insurance Company 37309 COMMERCIAL NProtective Life Insurance Company 37309 COMMERCIAL N
Protegrity Services (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Protegrity Services (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Providence PPO SX187 COMMERCIAL N
For Claims Status please contact
Susan Naanes @ 503-574-7441 or
Debra Wallenstein at 503-574-
7450 .
Providence PPO SX187 COMMERCIAL N
For Claims Status please contact
Susan Naanes @ 503-574-7441 or
Debra Wallenstein at 503-574-
7450 .
Providence of Oregon Health Plan SX133 COMMERCIAL N
For Claims Status please contact
Susan Naanes @ 503-574-7441 or
Debra Wallenstein at 503-574-
7450.
Providence of Oregon Health Plan SX133 COMMERCIAL N
For Claims Status please contact
Susan Naanes @ 503-574-7441 or
Debra Wallenstein at 503-574-
7450.
Puget Sound Benefits Trust 91136 COMMERCIAL N
Please enter Group Number (F25)
when submitting claims.
Puget Sound Benefits Trust 91136 COMMERCIAL N
Please enter Group Number (F25)
when submitting claims.
Puget Sound Electrical Workers Trust 91136 COMMERCIAL N
Please enter Group Number (F33)
when submitting claims.
Puget Sound Electrical Workers Trust 91136 COMMERCIAL N
Please enter Group Number (F33)
when submitting claims.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 93
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationPyramid Life Insurance Company 48055 COMMERCIAL NPyramid Life Insurance Company 48055 COMMERCIAL NQVI Risk Solutions Inc. 57117 COMMERCIAL NQVI Risk Solutions Inc. 57117 COMMERCIAL NQuad Med LLC (Pewaukee WI) 39197 COMMERCIAL NQuad Med LLC (Pewaukee WI) 39197 COMMERCIAL NQual Choice of Arkansas 35174 COMMERCIAL NQual Choice of Arkansas 35174 COMMERCIAL N
QualCare Inc. 23342 COMMERCIAL P
New Providers must enroll with
QualCare at (800) 992-6613
option 5.
QualCare Inc. 23342 COMMERCIAL P
New Providers must enroll with
QualCare at (800) 992-6613
option 5.
QuikTrip 73067 COMMERCIAL N
E-print address: QuikTrip P.O. Box
733 Buckeystown MD 21717
QuikTrip 73067 COMMERCIAL N
E-print address: QuikTrip P.O. Box
733 Buckeystown MD 21717R&N Market TKFMC COMMERCIAL NR&N Market TKFMC COMMERCIAL N
RADCON INC. Call COMMERCIAL N
Please contact Kathy King @ (856)
608-1350 for Payer Id
information.
RADCON INC. Call COMMERCIAL N
Please contact Kathy King @ (856)
608-1350 for Payer Id
information.RBMS LLC 91176 COMMERCIAL NRBMS LLC 91176 COMMERCIAL NRIVERSIDE SAN BERNARDINO COUNTY INDIAN HEALTH INC.Call COMMERCIAL NRIVERSIDE SAN BERNARDINO COUNTY INDIAN HEALTH INC.Call COMMERCIAL NRMSCO INC. 16117 COMMERCIAL NRMSCO INC. 16117 COMMERCIAL NRWDSU BENEFIT FUND 63070 COMMERCIAL NRWDSU BENEFIT FUND 63070 COMMERCIAL NRedlands IPA (Synermed) SYMED COMMERCIAL NRedlands IPA (Synermed) SYMED COMMERCIAL NRegal Medical Group REGAL COMMERCIAL NRegal Medical Group REGAL COMMERCIAL NRegency Employee Benefits 38221 COMMERCIAL NRegency Employee Benefits 38221 COMMERCIAL NRegional Care Inc. 47076 COMMERCIAL NRegional Care Inc. 47076 COMMERCIAL NRenaissance Physicians Organization 76066 COMMERCIAL NRenaissance Physicians Organization 76066 COMMERCIAL N
Reserve National Insurance 73066 COMMERCIAL N
For claims rejections please
contact Reserve National
Customer Service at (405) 848-
7931
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 94
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Reserve National Insurance 73066 COMMERCIAL N
For claims rejections please
contact Reserve National
Customer Service at (405) 848-
7931ResourceOne Administrators 37278 COMMERCIAL NResourceOne Administrators 37278 COMMERCIAL N
Resurrection Health Care Preferred/FKA Family Medical Network36396 COMMERCIAL N
Please call (773) 572-8311 or(
773) 572-8309 prior to your first
submission of claims
Resurrection Health Care Preferred/FKA Family Medical Network36396 COMMERCIAL N
Please call (773) 572-8311 or(
773) 572-8309 prior to your first
submission of claimsRetiree Health Trust 26316 COMMERCIAL NRetiree Health Trust 26316 COMMERCIAL NRightChoice Benefit Administrators 37331 COMMERCIAL NRightChoice Benefit Administrators 37331 COMMERCIAL NRocky Mountain Health Plan - Grand Junction SX141 COMMERCIAL RRocky Mountain Health Plan - Grand Junction SX141 COMMERCIAL RRooney Life Inc. 37602 COMMERCIAL NRooney Life Inc. 37602 COMMERCIAL N
Rural Carrier Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry Consolidated
payer ID. Including NRLCA Staff
Plan.
Rural Carrier Benefit Plan 25133 COMMERCIAL N
Formerly payer ID 62413 Now
part of Coventry Consolidated
payer ID. Including NRLCA Staff
Plan.Rush Health Association 36339 COMMERCIAL NRush Health Association 36339 COMMERCIAL NRush Prudential Health Plans (HMO Only) 36389 COMMERCIAL NRush Prudential Health Plans (HMO Only) 36389 COMMERCIAL NRyan White Network AMM03 COMMERCIAL NRyan White Network AMM03 COMMERCIAL NS & S Healthcare Strategies 31441 COMMERCIAL NS & S Healthcare Strategies 31441 COMMERCIAL NSAINT MARY'S HEALTH PLAN 88029 COMMERCIAL NSAINT MARY'S HEALTH PLAN 88029 COMMERCIAL NSANTA CLARA FAMILY HEALTH PLAN 24077 COMMERCIAL NSANTA CLARA FAMILY HEALTH PLAN 24077 COMMERCIAL NSCAN ENCOUNTERS 99157 COMMERCIAL N Diversified Data Design (DDD)SCAN ENCOUNTERS 99157 COMMERCIAL N Diversified Data Design (DDD)SCAN Health Plan 72261 COMMERCIAL NSCAN Health Plan 72261 COMMERCIAL NSCAN Long Term Care 20460 COMMERCIAL NSCAN Long Term Care 20460 COMMERCIAL NSCHC Total Care Inc. (Acceptius Gateway payer) 16146 COMMERCIAL NSCHC Total Care Inc. (Acceptius Gateway payer) 16146 COMMERCIAL NSENIOR WHOLE HEALTH 83035 COMMERCIAL NSENIOR WHOLE HEALTH 83035 COMMERCIAL NSagamore Health Network 35164 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 95
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationSagamore Health Network 35164 COMMERCIAL NSage Technologies 37105 COMMERCIAL NSage Technologies 37105 COMMERCIAL NSage Technologies - PBS 37137 COMMERCIAL NSage Technologies - PBS 37137 COMMERCIAL NSan Diego County Coverage Initiative (CI) MSO77 COMMERCIAL NSan Diego County Coverage Initiative (CI) MSO77 COMMERCIAL NSan Diego County Medical Services (CMS) MSO11 COMMERCIAL NSan Diego County Medical Services (CMS) MSO11 COMMERCIAL NSan Diego County Ryan White Care Act MSO33 COMMERCIAL NSan Diego County Ryan White Care Act MSO33 COMMERCIAL N
San Diego Physicians Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected]
San Diego Physicians Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected]
San Diego Physicians Medical Group Central Region Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected]
San Diego Physicians Medical Group Central Region Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected] Joaquin Health Administrators 68035 COMMERCIAL NSan Joaquin Health Administrators 68035 COMMERCIAL NSan Judas Medical Group IPA HSM01 COMMERCIAL NSan Judas Medical Group IPA HSM01 COMMERCIAL NSan Louis Obispo Select 33072 COMMERCIAL NSan Louis Obispo Select 33072 COMMERCIAL NSanford Health Plan 91184 COMMERCIAL NSanford Health Plan 91184 COMMERCIAL NSante Health System 77024 COMMERCIAL NSante Health System 77024 COMMERCIAL NSante Health System and Affiliates 77038 COMMERCIAL NSante Health System and Affiliates 77038 COMMERCIAL NScan Health Plan Arizona 73172 COMMERCIAL NScan Health Plan Arizona 73172 COMMERCIAL NScott & White TH002 COMMERCIAL NScott & White TH002 COMMERCIAL NSeabury & Smith 13310 COMMERCIAL NSeabury & Smith 13310 COMMERCIAL NSeaview IPA SVIPA COMMERCIAL NSeaview IPA SVIPA COMMERCIAL NSecure Health Plans of Georgia LLC 28530 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 96
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationSecure Health Plans of Georgia LLC 28530 COMMERCIAL N
Secure Horizons Arizona - Claims 95964 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS claims
only. Not for PPO claims. For
further questions you may inquire
via email at
Secure Horizons Arizona - Claims 95964 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS claims
only. Not for PPO claims. For
further questions you may inquire
via email at
Secure Horizons California - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
Secure Horizons California - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
Secure Horizons Colorado - Claims 95962 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS claims
only. Not for PPO claims. For
further questions you may inquire
via email at
Secure Horizons Colorado - Claims 95962 COMMERCIAL N
For payable PacifiCare/Secure
Horizons HMO and POS claims
only. Not for PPO claims. For
further questions you may inquire
via email at
Secure Horizons Washington - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 97
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Secure Horizons Washington - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
Secure Horizons of Oklahoma - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
Secure Horizons of Oklahoma - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
Secure Horizons of Oregon - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
Secure Horizons of Oregon - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
Secure Horizons of Texas - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected].
Secure Horizons of Texas - Claims 95959 COMMERCIAL N
For Payable Pacificare/Secure
Horizon HMO claims only. NOT
for PPO claims. For further
questions you may inquire via
email at [email protected] Health Plan 39045 COMMERCIAL NSecurity Health Plan 39045 COMMERCIAL N
Select Administrative Services (SAS) 64088 COMMERCIAL N
Also known as Mississippi Select
Health Care.
Select Administrative Services (SAS) 64088 COMMERCIAL N
Also known as Mississippi Select
Health Care.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 98
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Select Benefit Administrators of America 37282 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
P.O. Box 440 Ashland WI 54806.
Select Benefit Administrators of America 37282 COMMERCIAL N
Payer ID valid only for claims with
a billing submission address of
P.O. Box 440 Ashland WI 54806.Select Benefit Administrators Inc. 93031 COMMERCIAL NSelect Benefit Administrators Inc. 93031 COMMERCIAL N
Select Health of South Carolina 23285 COMMERCIAL N
For EDI support please e-mail
Select Health of South Carolina 23285 COMMERCIAL N
For EDI support please e-mail
[email protected] Senior Clinic 20415 COMMERCIAL NSelect Senior Clinic 20415 COMMERCIAL NSelectCare 14 COMMERCIAL NSelectCare 14 COMMERCIAL NSelectCare of Texas (HPN) Heritage Physicians Network76045 COMMERCIAL NSelectCare of Texas (HPN) Heritage Physicians Network76045 COMMERCIAL NSelectCare of Texas (Kelsey-Seybold) 61225 COMMERCIAL NSelectCare of Texas (Kelsey-Seybold) 61225 COMMERCIAL N
SelectHealth SX107 COMMERCIAL N
SelectHealth was formerly
Intermountain Healthcare (IHC)
SelectHealth SX107 COMMERCIAL N
SelectHealth was formerly
Intermountain Healthcare (IHC)
Self Insured Benefit Administrators (Clearwater FL) 59111 COMMERCIAL N
Payer ID valid only for claims with
a submission address of 18167 US
Highway 19 North Suite 300
Clearwater FL 33764.
Self Insured Benefit Administrators (Clearwater FL) 59111 COMMERCIAL N
Payer ID valid only for claims with
a submission address of 18167 US
Highway 19 North Suite 300
Clearwater FL 33764.
Self Insured Plans (Naples FL) 36404 COMMERCIAL N
Payer ID valid only for claims with
a submission address of 1016
Collier Center Way Suite 200
Naples FL 34110. Please call
Customer Service at (239) 403-
7884 to verify claims submission
to Self Insured Plans - Payer ID
36404 (Naples FL).
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 99
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Self Insured Plans (Naples FL) 36404 COMMERCIAL N
Payer ID valid only for claims with
a submission address of 1016
Collier Center Way Suite 200
Naples FL 34110. Please call
Customer Service at (239) 403-
7884 to verify claims submission
to Self Insured Plans - Payer ID
36404 (Naples FL).Self-Funded Plans Inc. 34131 COMMERCIAL NSelf-Funded Plans Inc. 34131 COMMERCIAL NSenior Care Partners 36390 COMMERCIAL NSenior Care Partners 36390 COMMERCIAL N
Sentara Family Care 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is reqd.
Field must be 5-7 chars positions
1-5 must be numeric only and
positions 6&7 (if applicable) must
be alpha only. Please contact
Ydsia Slagle-Provider Relations at
(757) 552-7477.
Sentara Family Care 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is reqd.
Field must be 5-7 chars positions
1-5 must be numeric only and
positions 6&7 (if applicable) must
be alpha only. Please contact
Ydsia Slagle-Provider Relations at
(757) 552-7477.
Sentara Health Management 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is reqd.
Field must be 5-7 chars positions
1-5 must be numeric only and
positions 6&7 (if applicable) must
be alpha only. Please contact
Ydsia Slagle-Provider Relations at
(757) 552-7477.
Sentara Health Management 54154 COMMERCIAL N
Note: Rendering Provider
Network ID (E6-14) field is reqd.
Field must be 5-7 chars positions
1-5 must be numeric only and
positions 6&7 (if applicable) must
be alpha only. Please contact
Ydsia Slagle-Provider Relations at
(757) 552-7477.Sentinel Management Services 23249 COMMERCIAL NSentinel Management Services 23249 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 100
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Sentry Insurance a Mutual Company 39033 COMMERCIAL N
Claims must have the Sentry Life
Insurance Co. Group and
Subscriber Numbers. To verify
you are using the correct number
you may contact Sentry's
Customer Service Department at
1-800-426-7234
Sentry Insurance a Mutual Company 39033 COMMERCIAL N
Claims must have the Sentry Life
Insurance Co. Group and
Subscriber Numbers. To verify
you are using the correct number
you may contact Sentry's
Customer Service Department at
1-800-426-7234
Sentry Life Insurance Company 39033 COMMERCIAL N
Claims must have the Sentry Life
Insurance Co. Group and
Subscriber Numbers. To verify
you are using the correct number
you may contact Sentry's
Customer Service Department at
1-800-426-7234
Sentry Life Insurance Company 39033 COMMERCIAL N
Claims must have the Sentry Life
Insurance Co. Group and
Subscriber Numbers. To verify
you are using the correct number
you may contact Sentry's
Customer Service Department at
1-800-426-7234
Sentry Life of New York 39033 COMMERCIAL N
Claims must have the Sentry Life
Insurance Co. Group and
Subscriber Numbers. To verify
you are using the correct number
you may contact Sentry's
Customer Service Department at
1-800-426-7234
Sentry Life of New York 39033 COMMERCIAL N
Claims must have the Sentry Life
Insurance Co. Group and
Subscriber Numbers. To verify
you are using the correct number
you may contact Sentry's
Customer Service Department at
1-800-426-7234Sequoia Beverage TKFMC COMMERCIAL NSequoia Beverage TKFMC COMMERCIAL NSeton CHIP 76056 COMMERCIAL NSeton CHIP 76056 COMMERCIAL NSeton Employee Plan TH080 COMMERCIAL NSeton Employee Plan TH080 COMMERCIAL NSeton Health Plan - Exclusive TH079 COMMERCIAL NSeton Health Plan - Exclusive TH079 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 101
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationSeton MAP Program TH081 COMMERCIAL NSeton MAP Program TH081 COMMERCIAL NSeven Corners 25404 COMMERCIAL NSeven Corners 25404 COMMERCIAL NShasta Administrative Services 75280 COMMERCIAL N Jeld-Wen Claims OnlyShasta Administrative Services 75280 COMMERCIAL N Jeld-Wen Claims Only
Sheakley UNICOMP (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Sheakley UNICOMP (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Sheet Metal Workers Local 104 Health Care Plan (San Ramon CA)38238 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box
1618 San Ramon CA 94583.
Sheet Metal Workers Local 104 Health Care Plan (San Ramon CA)38238 COMMERCIAL N
Payer ID valid for claims with a
submission address of PO Box
1618 San Ramon CA 94583.
Sheffield Olson & McQueen Inc Call COMMERCIAL N
Please contact Cate Ahlquist at
Sheffield Olson & McQueen Inc.
prior to submitting claims
electronically. Phone number is
651-695-2602
Sheffield Olson & McQueen Inc Call COMMERCIAL N
Please contact Cate Ahlquist at
Sheffield Olson & McQueen Inc.
prior to submitting claims
electronically. Phone number is
651-695-2602Sierra Family Network (Prospect Medical Group) PROSP COMMERCIAL NSierra Family Network (Prospect Medical Group) PROSP COMMERCIAL NSierra Health Services 76342 COMMERCIAL NSierra Health Services 76342 COMMERCIAL NSierra Nevada Medical Association MBA01 COMMERCIAL NSierra Nevada Medical Association MBA01 COMMERCIAL N
Signature Health Alliance 62159 COMMERCIAL N
Valid only for HCFA-1500 claims
currently mailed to Signature
Health Alliance P.O. Box 22419
Nashville TN 37202-2419.
Signature Health Alliance 62159 COMMERCIAL N
Valid only for HCFA-1500 claims
currently mailed to Signature
Health Alliance P.O. Box 22419
Nashville TN 37202-2419.Significa Benefits Services Inc. 23250 COMMERCIAL NSignifica Benefits Services Inc. 23250 COMMERCIAL NSilver Cross Managed Care Organization 36387 COMMERCIAL NSilver Cross Managed Care Organization 36387 COMMERCIAL NSinclair Health Plan 84076 COMMERCIAL NSinclair Health Plan 84076 COMMERCIAL NSloans Lake Preferred Health Networks 84096 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 102
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationSloans Lake Preferred Health Networks 84096 COMMERCIAL NSmith Administrators 2057 COMMERCIAL NSmith Administrators 2057 COMMERCIAL N
Solano Regional Medical Group Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID.
Solano Regional Medical Group Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID.
Solidarity Managed Care Organization (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Solidarity Managed Care Organization (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Sound Health (now known as First Choice Health Network)91131 COMMERCIAL NSound Health (now known as First Choice Health Network)91131 COMMERCIAL N
South Central Preferred - PPO York PA (IHS Gateway Payer)Call COMMERCIAL N
Call Jane Grove at Provider
Relations for South Central
Preferred (717) 851-6715
South Central Preferred - PPO York PA (IHS Gateway Payer)Call COMMERCIAL N
Call Jane Grove at Provider
Relations for South Central
Preferred (717) 851-6715
South Dakota Medicaid SKSD0 COMMERCIAL R
Secondary claims note: Only
accepts Medicare Crossover
claims
South Dakota Medicaid SKSD0 COMMERCIAL R
Secondary claims note: Only
accepts Medicare Crossover
claimsSouth FL Community Care Network - NBHD 37314 COMMERCIAL NSouth FL Community Care Network - NBHD 37314 COMMERCIAL NSouth Haven Community Hospital Call COMMERCIAL NSouth Haven Community Hospital Call COMMERCIAL NSouth Indiana Health Operations - HMO SX142 COMMERCIAL NSouth Indiana Health Operations - HMO SX142 COMMERCIAL NSouth Indiana Health Options - Prime Care Choice SX143 COMMERCIAL NSouth Indiana Health Options - Prime Care Choice SX143 COMMERCIAL NSouth Indiana Health Options - TPA SX144 COMMERCIAL NSouth Indiana Health Options - TPA SX144 COMMERCIAL NSouth Point Hotel & Casino 35227 COMMERCIAL NSouth Point Hotel & Casino 35227 COMMERCIAL NSouthCare/Healthcare Preferred 25147 COMMERCIAL NSouthCare/Healthcare Preferred 25147 COMMERCIAL NSouthCare/Healthcare Preferred 25147 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 103
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationSouthCare/Healthcare Preferred 25147 COMMERCIAL NSoutheast Texas Govt Employees Benefit Pool TH116 COMMERCIAL NSoutheast Texas Govt Employees Benefit Pool TH116 COMMERCIAL N
Southern Benefit Services 37318 COMMERCIAL N
Southern Benefit Services will no
longer process claims from the
following Provider Groups:
Brockman Enterprises and SPS
International.
Southern Benefit Services 37318 COMMERCIAL N
Southern Benefit Services will no
longer process claims from the
following Provider Groups:
Brockman Enterprises and SPS
International.Southern CA Children's Network (SynerMed) SYMED COMMERCIAL NSouthern CA Children's Network (SynerMed) SYMED COMMERCIAL NSouthern Cal Physicians Managed Care Services SCP01 COMMERCIAL NSouthern Cal Physicians Managed Care Services SCP01 COMMERCIAL N
Southern Health Service Inc. 25133 COMMERCIAL N
Formerly payer ID 25128. Now
part of Coventry Consolidated
payer ID.
Southern Health Service Inc. 25133 COMMERCIAL N
Formerly payer ID 25128. Now
part of Coventry Consolidated
payer ID.Southwest Administrators California SWSTA COMMERCIAL NSouthwest Administrators California SWSTA COMMERCIAL NSouthwest Administrators Nevada SWSTA COMMERCIAL NSouthwest Administrators Nevada SWSTA COMMERCIAL N
Southwest Service Life 37266 COMMERCIAL N
Please enter the unique policy
number or ID card when
submitting claims. Payer ID valid
only for claims with a billing
submission address of PO Box
982005 Ft. Worth TX 76182.
Southwest Service Life 37266 COMMERCIAL N
Please enter the unique policy
number or ID card when
submitting claims. Payer ID valid
only for claims with a billing
submission address of PO Box
982005 Ft. Worth TX 76182.Special Risk International 52190 COMMERCIAL NSpecial Risk International 52190 COMMERCIAL NSpectrum Administrators Inc. - TPA Allentown PA (IHS Gateway Payer)23253 COMMERCIAL NSpectrum Administrators Inc. - TPA Allentown PA (IHS Gateway Payer)23253 COMMERCIAL NSpina Bifida - VA HAC 84146 COMMERCIAL NSpina Bifida - VA HAC 84146 COMMERCIAL NSpohn Health TH100 COMMERCIAL NSpohn Health TH100 COMMERCIAL NSt Francis IPA APP01 COMMERCIAL NSt Francis IPA APP01 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 104
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationSt Joseph IPA STJOE COMMERCIAL NSt Joseph IPA STJOE COMMERCIAL NSt Jude Yorba Linda STJOE COMMERCIAL NSt Jude Yorba Linda STJOE COMMERCIAL N
St. Anthony Memorial Healthcare Centers - MDWISE 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502
St. Anthony Memorial Healthcare Centers - MDWISE 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502St. Barnabas System Health Plan 22240 COMMERCIAL NSt. Barnabas System Health Plan 22240 COMMERCIAL N
St. Catherine Hospital PHO - MDWISE 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502
St. Catherine Hospital PHO - MDWISE 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502
St. Francis Health Network 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502
St. Francis Health Network 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502St. John's Claims Administration 37264 COMMERCIAL NSt. John's Claims Administration 37264 COMMERCIAL NSt. Joseph Heritage Healthcare STJOE COMMERCIAL NSt. Joseph Heritage Healthcare STJOE COMMERCIAL NSt. Jude (St. Joseph Heritage Healthcare) STJOE COMMERCIAL NSt. Jude (St. Joseph Heritage Healthcare) STJOE COMMERCIAL N
St. Margaret Mercy Healthcare Centers - MDWISE 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502
St. Margaret Mercy Healthcare Centers - MDWISE 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502St. Vincent IPA PDT01 COMMERCIAL NSt. Vincent IPA PDT01 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 105
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Star HRG 59225 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 55270 30870 30888
54150 30069 55400 Phoenix AZ
85270-5270.
Star HRG 59225 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 55270 30870 30888
54150 30069 55400 Phoenix AZ
85270-5270.Starmark 61425 COMMERCIAL NStarmark 61425 COMMERCIAL NStarmark 61425 COMMERCIAL NStarmark 61425 COMMERCIAL NState Auto Insurance Companies 46450 COMMERCIAL NState Auto Insurance Companies 46450 COMMERCIAL N
State Farm (Casualty & Property Claims) 31059 COMMERCIAL N
State Farm - Property & Casualty
line of business is Payer ID 31059.
State Farm (Casualty & Property Claims) 31059 COMMERCIAL N
State Farm - Property & Casualty
line of business is Payer ID 31059.
State Farm Insurance Companies 31053 COMMERCIAL N
Payer ID 31053 is for State Farm -
Health line of business.
State Farm Insurance Companies 31053 COMMERCIAL N
Payer ID 31053 is for State Farm -
Health line of business.State of Texas Dental Plan 57254 COMMERCIAL NState of Texas Dental Plan 57254 COMMERCIAL NStates General Life Insurance 75087 COMMERCIAL NStates General Life Insurance 75087 COMMERCIAL NStaywell Health Plan 14163 COMMERCIAL NStaywell Health Plan 14163 COMMERCIAL N
Sterling Option 1 91151 COMMERCIAL N
To register for ERA (sent directly
from Sterling to the provider)
please go to
https://providernet.adminisource
.com/. If you have any questions
support is available by phone at
877-389-1160.
Sterling Option 1 91151 COMMERCIAL N
To register for ERA (sent directly
from Sterling to the provider)
please go to
https://providernet.adminisource
.com/. If you have any questions
support is available by phone at
877-389-1160.Stoner and Associates (Cincinnati OH) 31121 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 106
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationStoner and Associates (Cincinnati OH) 31121 COMMERCIAL NStones River Regional IPA- Windsor 15752 COMMERCIAL NStones River Regional IPA- Windsor 15752 COMMERCIAL N
Student Insurance - Mid-West National Life Insurance Co. of Tenessee74227 COMMERCIAL N
Payer ID only valid if the P.O. Box
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 890025 809067 809079
809066 809036 809081 Dallas Tx
75380-9025.
Student Insurance - Mid-West National Life Insurance Co. of Tenessee74227 COMMERCIAL N
Payer ID only valid if the P.O. Box
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 890025 809067 809079
809066 809036 809081 Dallas Tx
75380-9025.
Student Insurance - The MEGA Life & Health Insurance Company74227 COMMERCIAL N
Payer ID only valid if the P.O. Box
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 890025 809067 809079
809066 809036 809081 Dallas Tx
75380-9025.
Student Insurance - The MEGA Life & Health Insurance Company74227 COMMERCIAL N
Payer ID only valid if the P.O. Box
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 890025 809067 809079
809066 809036 809081 Dallas Tx
75380-9025.
Suburban Health Organization 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502
Suburban Health Organization 35199 COMMERCIAL N
To obtain the payer ID for this
payer please contact CMCS
Customer Service at (800) 352-
7502SummaCare Health Plan 95202 COMMERCIAL NSummaCare Health Plan 95202 COMMERCIAL NSummerlin Life & Health Insurance 86071 COMMERCIAL NSummerlin Life & Health Insurance 86071 COMMERCIAL N
Summit America Insurance Services Inc. 37301 COMMERCIAL N
Student Accident and Sickness
College Sports and NASCC claims
only
Summit America Insurance Services Inc. 37301 COMMERCIAL N
Student Accident and Sickness
College Sports and NASCC claims
only
SummitCorp (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 107
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
SummitCorp (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Sunshine State Health Plan 68057 COMMERCIAL NSunshine State Health Plan 68057 COMMERCIAL N
Superior Administrators Inc (Santa Ana CA) 23218 COMMERCIAL N
Payer ID valid for claims with a
submission address of P.O. Box
27730 Santa Ana CA 92799-7730
Superior Administrators Inc (Santa Ana CA) 23218 COMMERCIAL N
Payer ID valid for claims with a
submission address of P.O. Box
27730 Santa Ana CA 92799-7730
Superior Health Plan Texas 39188 COMMERCIAL P
Prior to submitting claims please
call Provider Relations Dept at 1-
800-218-7453 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Superior Health Plan Texas 39188 COMMERCIAL P
Prior to submitting claims please
call Provider Relations Dept at 1-
800-218-7453 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
Sutter Delta Medical Group Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID.
Sutter Delta Medical Group Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID.Sutter East Bay Medical Foundation Call COMMERCIAL NSutter East Bay Medical Foundation Call COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 108
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Sutter Gould Medical Foundation Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID.
Sutter Gould Medical Foundation Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID.
Sutter Independent Physicians Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID
Sutter Independent Physicians Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID
Sutter Medical Foundation Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID.
Sutter Medical Foundation Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 109
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Sutter Medical Group of the Redwoods Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID.
Sutter Medical Group of the Redwoods Call COMMERCIAL P
Sutter Connect requires the
providers to complete an
application & get approval from
us prior to sending claims to a
clearinghouse. Contact Sutter
Connect EDI Dept @ (800)611-
5191 for payer ID.Swedish Covenant Hospital 36411 COMMERCIAL NSwedish Covenant Hospital 36411 COMMERCIAL NSynermed SYMED COMMERCIAL NSynermed SYMED COMMERCIAL NTASEBA TKFMC COMMERCIAL NTASEBA TKFMC COMMERCIAL NTBT 94304 COMMERCIAL NTBT 94304 COMMERCIAL NTEXAS CHILDRENS HEALTH TXCSM COMMERCIAL NTEXAS CHILDRENS HEALTH TXCSM COMMERCIAL N
TN IPA 15750 COMMERCIAL N
This Payer ID should be used for
Stones River Regional IPA - BC/BS
Tennessee claims.
TN IPA 15750 COMMERCIAL N
This Payer ID should be used for
Stones River Regional IPA - BC/BS
Tennessee claims.TOUCHSTONE HEALTH/HEALTH NET SMART CHOICE 13402 COMMERCIAL NTOUCHSTONE HEALTH/HEALTH NET SMART CHOICE 13402 COMMERCIAL NTPAC/Employee Benefit Management Corp 31074 COMMERCIAL NTPAC/Employee Benefit Management Corp 31074 COMMERCIAL NTR Paul Inc. 37230 COMMERCIAL NTR Paul Inc. 37230 COMMERCIAL N
TRIHEALTH PHYSICIAN SOLUTIONS 31144 COMMERCIAL R
Payer registration is required
prior to claims submission. Forms
are located at
www.emdeon.com/enrollment.
TRIHEALTH PHYSICIAN SOLUTIONS 31144 COMMERCIAL R
Payer registration is required
prior to claims submission. Forms
are located at
www.emdeon.com/enrollment.TRIHEALTH PHYSICIAN SOLUTIONS - CONCERN 31143 COMMERCIAL NTRIHEALTH PHYSICIAN SOLUTIONS - CONCERN 31143 COMMERCIAL NTRLHN/AS 98514 COMMERCIAL NTRLHN/AS 98514 COMMERCIAL NTRLHN/EB 62777 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 110
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationTRLHN/EB 62777 COMMERCIAL NTalbert Medical Group TALMG COMMERCIAL NTalbert Medical Group TALMG COMMERCIAL NTall Tree Administrators 88067 COMMERCIAL NTall Tree Administrators 88067 COMMERCIAL NTarrant Health Services 37228 COMMERCIAL NTarrant Health Services 37228 COMMERCIAL NTeachers Health Trust 88019 COMMERCIAL NTeachers Health Trust 88019 COMMERCIAL NTeam Choice Gold 75139 COMMERCIAL NTeam Choice Gold 75139 COMMERCIAL NTeam Choice PNS 75133 COMMERCIAL NTeam Choice PNS 75133 COMMERCIAL NTeam Choice UMC 75134 COMMERCIAL NTeam Choice UMC 75134 COMMERCIAL NTeamcare 36215 COMMERCIAL NTeamcare 36215 COMMERCIAL NTeamsters Benefit Trust 94304 COMMERCIAL NTeamsters Benefit Trust 94304 COMMERCIAL NTethys Health Ventures 20212 COMMERCIAL NTethys Health Ventures 20212 COMMERCIAL NTexas Children's Health Plan 76048 COMMERCIAL NTexas Children's Health Plan 76048 COMMERCIAL N
Texas Children's Star Call COMMERCIAL N
Provider ID required for all THIN
payers.
Texas Children's Star Call COMMERCIAL N
Provider ID required for all THIN
payers.Texas Childrens Health Plan (Medicaid) 75228 COMMERCIAL NTexas Childrens Health Plan (Medicaid) 75228 COMMERCIAL NTexas HealthSpring 33104 COMMERCIAL NTexas HealthSpring 33104 COMMERCIAL NTexas Premier Plan TH089 COMMERCIAL NTexas Premier Plan TH089 COMMERCIAL NTexas True Choice TH055 COMMERCIAL NTexas True Choice TH055 COMMERCIAL NTexasFirst Health Plan (NTX) 13185 COMMERCIAL NTexasFirst Health Plan (NTX) 13185 COMMERCIAL N
The Chesapeake Life Insurance Company - Student Insurance74227 COMMERCIAL N
Payer ID only valid if the P.O. Box
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 890025 809067 809079
809066 809036 809081 Dallas Tx
75380-9025.
The Chesapeake Life Insurance Company - Student Insurance74227 COMMERCIAL N
Payer ID only valid if the P.O. Box
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 890025 809067 809079
809066 809036 809081 Dallas Tx
75380-9025.The City of Odessa 75600 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 111
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationThe City of Odessa 75600 COMMERCIAL NThe Ford Meter Box Company Inc. 37305 COMMERCIAL NThe Ford Meter Box Company Inc. 37305 COMMERCIAL NThe Health Exchange (Cerner Corporation) 20356 COMMERCIAL NThe Health Exchange (Cerner Corporation) 20356 COMMERCIAL N
The Health Plan (Massillon Ohio and St. Clairsville Ohio only)34150 COMMERCIAL N
Services ordered by outside
provider require referring
provider on a HCFA and attending
physician on a UB. Pease provide
physician name and UPIN if
available.
The Health Plan (Massillon Ohio and St. Clairsville Ohio only)34150 COMMERCIAL N
Services ordered by outside
provider require referring
provider on a HCFA and attending
physician on a UB. Pease provide
physician name and UPIN if
available.
The Health Plan (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
The Health Plan (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.The Healthcare Group 35206 COMMERCIAL NThe Healthcare Group 35206 COMMERCIAL NThe Integrity Benefit Group Inc. 58200 COMMERCIAL NThe Integrity Benefit Group Inc. 58200 COMMERCIAL NThe Loomis Company - TPA Wyomissing PA (IHS Gateway Payer)23223 COMMERCIAL NThe Loomis Company - TPA Wyomissing PA (IHS Gateway Payer)23223 COMMERCIAL N
The MEGA Life & Health Insurance Company - Insurance Center59221 COMMERCIAL N
Payer ID valid only if the P.O. Box
on the Health ID card matches
the following P.O. Box: P.O. Box
982009 North Richland Hills TX
76182
The MEGA Life & Health Insurance Company - Insurance Center59221 COMMERCIAL N
Payer ID valid only if the P.O. Box
on the Health ID card matches
the following P.O. Box: P.O. Box
982009 North Richland Hills TX
76182
The MEGA Life & Health Insurance Company - Starbridge StarHRG59225 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 55270 30870 30888
54150 30069 55400 Phoenix AZ
85270-5270.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 112
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
The MEGA Life & Health Insurance Company - Starbridge StarHRG59225 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 55270 30870 30888
54150 30069 55400 Phoenix AZ
85270-5270.
The MEGA Life & Health Insurance Company - Student Insurance74227 COMMERCIAL N
Payer ID only valid if the P.O. Box
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 890025 809067 809079
809066 809036 809081 Dallas Tx
75380-9025.
The MEGA Life & Health Insurance Company - Student Insurance74227 COMMERCIAL N
Payer ID only valid if the P.O. Box
on the Health ID Card matches
one of the following P.O. Boxes:
P.O. Box 890025 809067 809079
809066 809036 809081 Dallas Tx
75380-9025.
The MEGA Life & Health Insurance Company-OKC 59227 COMMERCIAL N
If the P.O. Box on the health ID
card matches the following P.O.
Box: P.O. Box 548801 Oklahoma
City OK 73154
The MEGA Life & Health Insurance Company-OKC 59227 COMMERCIAL N
If the P.O. Box on the health ID
card matches the following P.O.
Box: P.O. Box 548801 Oklahoma
City OK 73154
The National Radiology Network 59087 COMMERCIAL N
Electronic Payer ID for Claims
printed and mailed to payer
The National Radiology Network 59087 COMMERCIAL N
Electronic Payer ID for Claims
printed and mailed to payerThe Perfect Health Insurance Co. 13522 COMMERCIAL NThe Perfect Health Insurance Co. 13522 COMMERCIAL NThe Physicians Assurance Corp (TPAC) /Employee Benefit Management Corp (EBM31074 COMMERCIAL NThe Physicians Assurance Corp (TPAC) /Employee Benefit Management Corp (EBM31074 COMMERCIAL N
The Preferred Healthcare System (TPHS) - PPO Altoona PA (IHS GatewayPayer)Call COMMERCIAL N
Before submitting contact Jessica
Picarde at (410) 349-3222
The Preferred Healthcare System (TPHS) - PPO Altoona PA (IHS GatewayPayer)Call COMMERCIAL N
Before submitting contact Jessica
Picarde at (410) 349-3222
Therapy Review Systems 75305 COMMERCIAL N
This payer id is valid for
contracted Therapy Review
Systems Georgia providers only.
Therapy Review Systems 75305 COMMERCIAL N
This payer id is valid for
contracted Therapy Review
Systems Georgia providers only.Thomas H. Cooper SX160 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 113
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationThomas H. Cooper SX160 COMMERCIAL N
Three Rivers Health Plans Inc 25175 COMMERCIAL N
Now known as Unison Health
Plan
Three Rivers Health Plans Inc 25175 COMMERCIAL N
Now known as Unison Health
PlanTime Insurance Company 39065 COMMERCIAL NTime Insurance Company 39065 COMMERCIAL NToday's Health Wisconsin 20081 COMMERCIAL NToday's Health Wisconsin 20081 COMMERCIAL NToday's Options (American Progressive and Pyramid Life)48055 COMMERCIAL NToday's Options (American Progressive and Pyramid Life)48055 COMMERCIAL NToday's Options powered by CCRX 48055 COMMERCIAL NToday's Options powered by CCRX 48055 COMMERCIAL NTongass Timber Trust 92620 COMMERCIAL NTongass Timber Trust 92620 COMMERCIAL NTooling & Manufacturing Association 61425 COMMERCIAL NTooling & Manufacturing Association 61425 COMMERCIAL NTorrance Hospital IPA THIPA COMMERCIAL NTorrance Hospital IPA THIPA COMMERCIAL NTotal Claims Administration 37314 COMMERCIAL NTotal Claims Administration 37314 COMMERCIAL NTotal Community Care 31182 COMMERCIAL NTotal Community Care 31182 COMMERCIAL N
Total Health Management - PBM (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Total Health Management - PBM (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Total Healthcare Inc. 38201 COMMERCIAL NTotal Healthcare Inc. 38201 COMMERCIAL NTouchpoint Health Plan HMO 97910 COMMERCIAL NTouchpoint Health Plan HMO 97910 COMMERCIAL NTouchstone Health PSO 23856 COMMERCIAL NTouchstone Health PSO 23856 COMMERCIAL NTower Life Insurance Co. 69493 COMMERCIAL NTower Life Insurance Co. 69493 COMMERCIAL NTown & Country TKFMC COMMERCIAL NTown & Country TKFMC COMMERCIAL NTransAmerica Assurance Company (TLIN3) TH127 COMMERCIAL NTransAmerica Assurance Company (TLIN3) TH127 COMMERCIAL NTransAmerica Assurance Company (TLINS) TH126 COMMERCIAL NTransAmerica Assurance Company (TLINS) TH126 COMMERCIAL NTransAmerica Assurance Company (TSAA2) TH124 COMMERCIAL NTransAmerica Assurance Company (TSAA2) TH124 COMMERCIAL NTransAmerica Assurance Company (TSAAC) TH125 COMMERCIAL NTransAmerica Assurance Company (TSAAC) TH125 COMMERCIAL N
TransAmerica Life Insurance Company 59222 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
the following: P.O. Box 982009
North Richland Hills TX 76182.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 114
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
TransAmerica Life Insurance Company 59222 COMMERCIAL N
Payer ID valid only if the address
on the Health ID Card matches
the following: P.O. Box 982009
North Richland Hills TX 76182.TransAmerica Occidental Life Insurance (TOLIC) TH128 COMMERCIAL NTransAmerica Occidental Life Insurance (TOLIC) TH128 COMMERCIAL NTransChoice-Key Benefit Administrators 37284 COMMERCIAL NTransChoice-Key Benefit Administrators 37284 COMMERCIAL NTrellis Health Partners 36397 COMMERCIAL NTrellis Health Partners 36397 COMMERCIAL NTriCities IPA PDT01 COMMERCIAL NTriCities IPA PDT01 COMMERCIAL NTribute /SelectCare of Oklahoma 73117 COMMERCIAL NTribute /SelectCare of Oklahoma 73117 COMMERCIAL NTrue Choice USA 54210 COMMERCIAL NTrue Choice USA 54210 COMMERCIAL NTrue Choice USA TH083 COMMERCIAL NTrue Choice USA TH083 COMMERCIAL NTrusteed Plans Service Corporation 91078 COMMERCIAL NTrusteed Plans Service Corporation 91078 COMMERCIAL NTrustmark Insurance Company 61425 COMMERCIAL NTrustmark Insurance Company 61425 COMMERCIAL N
Tufts Health Plan Call COMMERCIAL P
Please contact the Tufts Health
Plan EDI Operations Department
at 888-880-8699 ext. 4042. for
payer id.
Tufts Health Plan Call COMMERCIAL P
Please contact the Tufts Health
Plan EDI Operations Department
at 888-880-8699 ext. 4042. for
payer id.UBH - United Behavioral Health (Health Plan - HMO) 87726 COMMERCIAL NUBH - United Behavioral Health (Health Plan - HMO) 87726 COMMERCIAL NUBH - United Behavioral Health (former MetraHealth - UNET)87726 COMMERCIAL NUBH - United Behavioral Health (former MetraHealth - UNET)87726 COMMERCIAL NUCARE of Minnesota SX178 COMMERCIAL NUCARE of Minnesota SX178 COMMERCIAL N
UHP of New Jersey 22329 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
800-780-2438 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 115
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
UHP of New Jersey 22329 COMMERCIAL N
Prior to submitting claims please
call Provider Relations Dept at 1-
800-780-2438 to verify your
provider info is on file in the claim
system. This will prevent
rejections and allow payments to
be made in a timely manner.
UICI - Administrators - State of Nevada 74223 COMMERCIAL N
Accepting claims only for the
State of Nevada.
UICI - Administrators - State of Nevada 74223 COMMERCIAL N
Accepting claims only for the
State of Nevada.UMC HEALTH PLAN 75130 COMMERCIAL NUMC HEALTH PLAN 75130 COMMERCIAL N
UMR - Cincinnati (formerly known as United Medical Resources)31107 COMMERCIAL N
This Payer ID is valid for all claims
addresses on UMR Member ID
cards with a listed Payer ID of
31107.
UMR - Cincinnati (formerly known as United Medical Resources)31107 COMMERCIAL N
This Payer ID is valid for all claims
addresses on UMR Member ID
cards with a listed Payer ID of
31107.UMR - Harrington (formerly known as Harrington Benefit Services-Columbus)95266 COMMERCIAL N Harrington; RE HarringtonUMR - Harrington (formerly known as Harrington Benefit Services-Columbus)95266 COMMERCIAL N Harrington; RE HarringtonUMR - Lexington (formerly known as CommonWealth Administrative Group)37237 COMMERCIAL NUMR - Lexington (formerly known as CommonWealth Administrative Group)37237 COMMERCIAL NUMR - Onalaska (formerly known as Midwest Security of WI)79480 COMMERCIAL NUMR - Onalaska (formerly known as Midwest Security of WI)79480 COMMERCIAL NUMR - Wausau/UHIS (formerly Fiserv Health - Wausau Benefits/Benesight)39026 COMMERCIAL NUMR - Wausau/UHIS (formerly Fiserv Health - Wausau Benefits/Benesight)39026 COMMERCIAL N
UMR -Harrington (formerly known as Harrington Benefit Services-Westerville)75196 COMMERCIAL N Centra; Centra Benefit Services
UMR -Harrington (formerly known as Harrington Benefit Services-Westerville)75196 COMMERCIAL N Centra; Centra Benefit ServicesUMWA Health & Retirement Funds 52180 COMMERCIAL NUMWA Health & Retirement Funds 52180 COMMERCIAL NUNICARE 80314 COMMERCIAL NUNICARE 80314 COMMERCIAL NUNION PACIFIC RAILROAD EMPLOYES Health Systems87042 COMMERCIAL NUNION PACIFIC RAILROAD EMPLOYES Health Systems87042 COMMERCIAL NUNITED FOOD & COMM. WORKERS MIDWEST UNIONS36659 COMMERCIAL NUNITED FOOD & COMM. WORKERS MIDWEST UNIONS36659 COMMERCIAL N
UNIVERSITY OF MIAMI BEHAVIORAL HEALTH Call COMMERCIAL N
All submitters call for detailed
information and payer id prior to
sending claims. Contact UMBH
Provider Relations (305) 243-7270
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 116
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
UNIVERSITY OF MIAMI BEHAVIORAL HEALTH Call COMMERCIAL N
All submitters call for detailed
information and payer id prior to
sending claims. Contact UMBH
Provider Relations (305) 243-7270UPMC Health Plan 23281 COMMERCIAL NUPMC Health Plan 23281 COMMERCIAL NUS Benefits 93092 COMMERCIAL NUS Benefits 93092 COMMERCIAL NUS Family Health Plan (USFHP) TH103 COMMERCIAL NUS Family Health Plan (USFHP) TH103 COMMERCIAL N
USAA (United Services Automobile Association) 74095 COMMERCIAL N
Property and Casualty Division
Only
USAA (United Services Automobile Association) 74095 COMMERCIAL N
Property and Casualty Division
OnlyUSC Health Services TH021 COMMERCIAL NUSC Health Services TH021 COMMERCIAL N
USFHP - St. Vincent Catholic Medical Centers of New York13407 COMMERCIAL N
Serving parts of New York NYC all
of New Jersey Southeastern
Pennsylvania and Western
Connecticut. For member
eligibility call 1-800-241-4848
USFHP - St. Vincent Catholic Medical Centers of New York13407 COMMERCIAL N
Serving parts of New York NYC all
of New Jersey Southeastern
Pennsylvania and Western
Connecticut. For member
eligibility call 1-800-241-4848
UT- Altius (UHIN) 25133 COMMERCIAL N
Formerly Payer ID 12X38. Now
part of the Consolidated payer ID.
UT- Altius (UHIN) 25133 COMMERCIAL N
Formerly Payer ID 12X38. Now
part of the Consolidated payer ID.Unified Group Services 35198 COMMERCIAL NUnified Group Services 35198 COMMERCIAL N
Unified Health Services 62170 COMMERCIAL N
Worker's Compensation Claims
Only.
Unified Health Services 62170 COMMERCIAL N
Worker's Compensation Claims
Only.
Uniform Medical Plan/Harrington Benefit Services 75243 COMMERCIAL N
Harrington; Uniform Medical
Plan; Centra
Uniform Medical Plan/Harrington Benefit Services 75243 COMMERCIAL N
Harrington; Uniform Medical
Plan; Centra
Union Pacific IPA Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected]
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 117
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Union Pacific IPA Call COMMERCIAL N
To obtain Payer ID and enroll with
payer California providers should
contact Tristin Rausche 858-824-
7100 [email protected] Security Insurance Company 70408 COMMERCIAL NUnion Security Insurance Company 70408 COMMERCIAL NUnison Health Plan/Better Health Plans 62183 COMMERCIAL NUnison Health Plan/Better Health Plans 62183 COMMERCIAL NUnison Health Plan/Three Rivers 25175 COMMERCIAL NUnison Health Plan/Three Rivers 25175 COMMERCIAL NUnited Agriculture Benefit Trust UAGBT COMMERCIAL NUnited Agriculture Benefit Trust UAGBT COMMERCIAL NUnited Healthcare Ovations Insurance Solutions (AARP)36273 COMMERCIAL NUnited Healthcare Ovations Insurance Solutions (AARP)36273 COMMERCIAL N
United Healthcare of River Valley 95378 COMMERCIAL P
Prior to initial submission
provider must first contact John
Deere at (309) 765-1593 - toll free
(866) 509-1593 - to verify NPI
registration is complete
United Healthcare of River Valley 95378 COMMERCIAL P
Prior to initial submission
provider must first contact John
Deere at (309) 765-1593 - toll free
(866) 509-1593 - to verify NPI
registration is completeUnited Medical Alliance 84132 COMMERCIAL NUnited Medical Alliance 84132 COMMERCIAL N
United Security Life & Health Ins Co 36362 COMMERCIAL N
Please do not submit claims on or
after 1/1/2011 using payer ID
36362. Claims will need to be
submitted on paper to United
Security Life and Health PO Box
24655 Seattle WA 98124-0655.
For questions call 1-800-875-
4422.United Security Life & Health Ins Co 36362 COMMERCIAL NUnited of Omaha 71412 COMMERCIAL NUnited of Omaha 71412 COMMERCIAL NUnitedHealthcare 87726 COMMERCIAL N
UnitedHealthcare 87726 COMMERCIAL N
[former MetraHealth Healthcare
Network PPO New York State
Employees (Empire) Travelers Ins
Co Travelers Plan Administrators]
UnitedHealthcare 87726 COMMERCIAL N
[former The Travelers Travelers
Health Network (HMO & Care
Option Travelers/CGT - PPO
MetraHealth - UNET]
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 118
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
UnitedHealthcare 87726 COMMERCIAL N
[former MetraHealth Healthcare
Network PPO New York State
Employees (Empire) Travelers Ins
Co Travelers Plan Administrators]
UnitedHealthcare 87726 COMMERCIAL N
[former The Travelers Travelers
Health Network (HMO & Care
Option Travelers/CGT - PPO
MetraHealth - UNET]UnitedHealthcare 87726 COMMERCIAL NUnitedHealthcare Plans of Puerto Rico 87726 COMMERCIAL NUnitedHealthcare Plans of Puerto Rico 87726 COMMERCIAL NUnitedHealthcare of Alabama 87726 COMMERCIAL NUnitedHealthcare of Alabama 87726 COMMERCIAL NUnitedHealthcare of Arizona Inc. 87726 COMMERCIAL NUnitedHealthcare of Arizona Inc. 87726 COMMERCIAL NUnitedHealthcare of Arkansas 87726 COMMERCIAL NUnitedHealthcare of Arkansas 87726 COMMERCIAL NUnitedHealthcare of California - Northern California 87726 COMMERCIAL NUnitedHealthcare of California - Northern California 87726 COMMERCIAL NUnitedHealthcare of California - Southern California 87726 COMMERCIAL NUnitedHealthcare of California - Southern California 87726 COMMERCIAL NUnitedHealthcare of Colorado Inc. 87726 COMMERCIAL NUnitedHealthcare of Colorado Inc. 87726 COMMERCIAL NUnitedHealthcare of Florida 87726 COMMERCIAL NUnitedHealthcare of Florida 87726 COMMERCIAL NUnitedHealthcare of Georgia 87726 COMMERCIAL NUnitedHealthcare of Georgia 87726 COMMERCIAL NUnitedHealthcare of Illinois 87726 COMMERCIAL NUnitedHealthcare of Illinois 87726 COMMERCIAL NUnitedHealthcare of Kentucky Ltd. 87726 COMMERCIAL NUnitedHealthcare of Kentucky Ltd. 87726 COMMERCIAL NUnitedHealthcare of Louisiana 87726 COMMERCIAL NUnitedHealthcare of Louisiana 87726 COMMERCIAL NUnitedHealthcare of Mississippi 87726 COMMERCIAL NUnitedHealthcare of Mississippi 87726 COMMERCIAL NUnitedHealthcare of New England 87726 COMMERCIAL NUnitedHealthcare of New England 87726 COMMERCIAL NUnitedHealthcare of New York (includes New York and New Jersey)87726 COMMERCIAL NUnitedHealthcare of New York (includes New York and New Jersey)87726 COMMERCIAL NUnitedHealthcare of North Carolina Inc. 87726 COMMERCIAL NUnitedHealthcare of North Carolina Inc. 87726 COMMERCIAL NUnitedHealthcare of Ohio 87726 COMMERCIAL NUnitedHealthcare of Ohio 87726 COMMERCIAL NUnitedHealthcare of Tennessee 87726 COMMERCIAL NUnitedHealthcare of Tennessee 87726 COMMERCIAL NUnitedHealthcare of Texas - Dallas 87726 COMMERCIAL NUnitedHealthcare of Texas - Dallas 87726 COMMERCIAL NUnitedHealthcare of Texas - Houston 87726 COMMERCIAL NUnitedHealthcare of Texas - Houston 87726 COMMERCIAL NUnitedHealthcare of Upstate New York 87726 COMMERCIAL NUnitedHealthcare of Upstate New York 87726 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 119
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January 2011
Payer ID State Model Enroll Additional InformationUnitedHealthcare of Utah 87726 COMMERCIAL NUnitedHealthcare of Utah 87726 COMMERCIAL NUnitedHealthcare of Virginia 87726 COMMERCIAL NUnitedHealthcare of Virginia 87726 COMMERCIAL NUnitedHealthcare of Wisconsin Inc. 87726 COMMERCIAL NUnitedHealthcare of Wisconsin Inc. 87726 COMMERCIAL NUnitedHealthcare of the Mid-Atlantic 87726 COMMERCIAL NUnitedHealthcare of the Mid-Atlantic 87726 COMMERCIAL NUnitedHealthcare of the Midlands - HMO (Choice Select)87726 COMMERCIAL NUnitedHealthcare of the Midlands - HMO (Choice Select)87726 COMMERCIAL NUnitedHealthcare of the Midlands - PPO(Choice PlusSelect PlusSelf Funded)87726 COMMERCIAL NUnitedHealthcare of the Midlands - PPO(Choice PlusSelect PlusSelf Funded)87726 COMMERCIAL NUnitedHealthcare of the Midwest - Choice Choice Plus Select Select Plus87726 COMMERCIAL NUnitedHealthcare of the Midwest - Choice Choice Plus Select Select Plus87726 COMMERCIAL NUnitedHealthcare of the Midwest - Medicare Complete87726 COMMERCIAL NUnitedHealthcare of the Midwest - Medicare Complete87726 COMMERCIAL N
Unity Health Insurance 66705 COMMERCIAL N
Before submitting claims please
go to
http://www.unityhealth.com/Pro
viders/AdminResources/EDI/inde
x.htm and complete EDI Sign Up
Form and NPI Appendix A
documents.
Unity Health Insurance 66705 COMMERCIAL N
Before submitting claims please
go to
http://www.unityhealth.com/Pro
viders/AdminResources/EDI/inde
x.htm and complete EDI Sign Up
Form and NPI Appendix A
documents.Univera - Health Care Plan/ChoiceCare Buffalo SX087 COMMERCIAL RUnivera - Health Care Plan/ChoiceCare Buffalo SX087 COMMERCIAL RUnivera - Pre Paid Health Plan of NY SX086 COMMERCIAL RUnivera - Pre Paid Health Plan of NY SX086 COMMERCIAL RUnivera - Univera Health Southern Tier SX088 COMMERCIAL RUnivera - Univera Health Southern Tier SX088 COMMERCIAL RUnivera SSA ENY SX090 COMMERCIAL RUnivera SSA ENY SX090 COMMERCIAL RUnivera SSA WNY SX091 COMMERCIAL RUnivera SSA WNY SX091 COMMERCIAL RUniversal Care - California 33001 COMMERCIAL NUniversal Care - California 33001 COMMERCIAL N
Universal Health Care Inc 50528 COMMERCIAL N
The payer ID's of the TH057 and
12t36 will no longer be active
please use the new payer ID of
the 50528 for all EDI submissions
to Emdeon.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 120
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Universal Health Care Inc 50528 COMMERCIAL N
The payer ID's of the TH057 and
12t36 will no longer be active
please use the new payer ID of
the 50528 for all EDI submissions
to Emdeon.
University Comp Care (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
University Comp Care (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.University Family Care 9830 COMMERCIAL NUniversity Family Care 9830 COMMERCIAL NUniversity Family Care - Healthcare Group 7503 COMMERCIAL NUniversity Family Care - Healthcare Group 7503 COMMERCIAL NUniversity Family Care - Maricopa Health Plan 9908 COMMERCIAL NUniversity Family Care - Maricopa Health Plan 9908 COMMERCIAL N
University Health Alliance 99026 COMMERCIAL R
Payer Registration is required. EDI
Enrollment form is available at
www.emdeon.com
University Health Alliance 99026 COMMERCIAL R
Payer Registration is required. EDI
Enrollment form is available at
www.emdeon.comUniversity of Illinois at Chicago Div of Specialized Care for Children37601 COMMERCIAL NUniversity of Illinois at Chicago Div of Specialized Care for Children37601 COMMERCIAL N
University of Missouri 25133 COMMERCIAL N
Formerly payer ID 87043 Now
part of Coventry Consolidated
payer ID.
University of Missouri 25133 COMMERCIAL N
Formerly payer ID 87043 Now
part of Coventry Consolidated
payer ID.University of Utah Health Plans SX155 COMMERCIAL NUniversity of Utah Health Plans SX155 COMMERCIAL NUpland Medical Group IP056 COMMERCIAL NUpland Medical Group IP056 COMMERCIAL NUpper Peninsula Health Group (TPA) 37324 COMMERCIAL NUpper Peninsula Health Group (TPA) 37324 COMMERCIAL NUpper Peninsula Health Plan (Medicaid) 38337 COMMERCIAL NUpper Peninsula Health Plan (Medicaid) 38337 COMMERCIAL NVA Fee Basis Programs 12115 COMMERCIAL NVA Fee Basis Programs 12115 COMMERCIAL NVHAMA-WATERSTONE BENEFITS Call COMMERCIAL NVHAMA-WATERSTONE BENEFITS Call COMMERCIAL N
VNS CHOICE Medicare 77073 COMMERCIAL N
Formerly listed as Visiting Nurses
Service
VNS CHOICE Medicare 77073 COMMERCIAL N
Formerly listed as Visiting Nurses
ServiceVOLUSIA HEALTH NETWORK 59266 COMMERCIAL NVOLUSIA HEALTH NETWORK 59266 COMMERCIAL NValley Baptist Health Plan TH022 COMMERCIAL NValley Baptist Health Plan TH022 COMMERCIAL NValley Care IPA VCIPA COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 121
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January 2011
Payer ID State Model Enroll Additional InformationValley Care IPA VCIPA COMMERCIAL NValley Mental Health 94293 COMMERCIAL NValley Mental Health 94293 COMMERCIAL NValley Preferred - PPO Allentown PA (IHS Gateway Payer)23253 COMMERCIAL NValley Preferred - PPO Allentown PA (IHS Gateway Payer)23253 COMMERCIAL N
Value Options - Commercial SX173 COMMERCIAL R
Enrollment is required and forms
can be located on
www.emdeon.com/enrollment
Value Options - Commercial SX173 COMMERCIAL R
Enrollment is required and forms
can be located on
www.emdeon.com/enrollmentVantage Health Plan Inc. 72128 COMMERCIAL NVantage Health Plan Inc. 72128 COMMERCIAL N
Vantage Health Plan Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.
Vantage Health Plan Inc. (Ohio BWC) 31147 COMMERCIAL N
For Ohio Worker's Comp Claims
ONLY.Vantage Medical Group PPM01 COMMERCIAL NVantage Medical Group PPM01 COMMERCIAL NVentureNet Healthcare 86062 COMMERCIAL NVentureNet Healthcare 86062 COMMERCIAL NVerdugo Hills Medical Group 66126 COMMERCIAL NVerdugo Hills Medical Group 66126 COMMERCIAL NVerity National Group 75256 COMMERCIAL NVerity National Group 75256 COMMERCIAL NVictor Valley IPA VVIPA COMMERCIAL NVictor Valley IPA VVIPA COMMERCIAL NVictor Valley IPA VVMG1 COMMERCIAL NVictor Valley IPA VVMG1 COMMERCIAL NVillage Family Practice 73743 COMMERCIAL NVillage Family Practice 73743 COMMERCIAL NVirginia Medicaid CVAK1 COMMERCIAL NVirginia Medicaid CVAK1 COMMERCIAL N
Virginia Premier Health Plan 54176 COMMERCIAL R
Virginia Premier enrollment forms
located on
www.emdeon.com/enrollment
Virginia Premier Health Plan 54176 COMMERCIAL R
Virginia Premier enrollment forms
located on
www.emdeon.com/enrollmentVison Care Incorporated 37297 COMMERCIAL NVison Care Incorporated 37297 COMMERCIAL N
Vista Health Plan 25133 COMMERCIAL N
Formerly payer ID 55248. Now
part of Coventry Consolidated
payer ID. Plan name is now
Coventry Health Care of Florida
Inc.
Vista Health Plan 25133 COMMERCIAL N
Formerly payer ID 55248. Now
part of Coventry Consolidated
payer ID. Plan name is now
Coventry Health Care of Florida
Inc.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 122
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January 2011
Payer ID State Model Enroll Additional InformationVista Oncology - New Century Infusion Solutions NCH08 COMMERCIAL NVista Oncology - New Century Infusion Solutions NCH08 COMMERCIAL N
Viva Health Plan 63114 COMMERCIAL N
VIVA Health requires a complete
member ID number including
suffix on all claim submissions. Pls
use the following site to verify
member information:
https://estepp.cschcg.com/TRI_pr
ovider/doEntry.jsp
Viva Health Plan 63114 COMMERCIAL N
VIVA Health requires a complete
member ID number including
suffix on all claim submissions. Pls
use the following site to verify
member information:
https://estepp.cschcg.com/TRI_pr
ovider/doEntry.jspVytra Healthcare 22264 COMMERCIAL NVytra Healthcare 22264 COMMERCIAL NWEA Insurance Group 39151 COMMERCIAL NWEA Insurance Group 39151 COMMERCIAL NWPP-ElderCare Wisconsin 77080 COMMERCIAL NWPP-ElderCare Wisconsin 77080 COMMERCIAL NWPS - Tricare for Life SX176 COMMERCIAL PWPS - Tricare for Life SX176 COMMERCIAL P
WPS Commercial SX022 COMMERCIAL R
Subscriber id = 9 digits Provider id
qualifier = G2
WPS Commercial SX022 COMMERCIAL R
Subscriber id = 9 digits Provider id
qualifier = G2WRHN BEECHSTREET COMMERCIAL NWRHN BEECHSTREET COMMERCIAL NWabash Memorial Hospital Association 85256 COMMERCIAL NWabash Memorial Hospital Association 85256 COMMERCIAL NWashington Labor & Industry SX063 COMMERCIAL RWashington Labor & Industry SX063 COMMERCIAL RWaterstone Benefit Administrators 73155 COMMERCIAL NWaterstone Benefit Administrators 73155 COMMERCIAL NWeiss Health Providers 36337 COMMERCIAL NWeiss Health Providers 36337 COMMERCIAL NWellCare of Ohio Inc 14163 COMMERCIAL NWellCare of Ohio Inc 14163 COMMERCIAL NWellMed TH023 COMMERCIAL NWellMed TH023 COMMERCIAL N
WellPath 25133 COMMERCIAL N
Formerly payer ID 25129. Now
part of Coventry Consolidated
payer ID.
WellPath 25133 COMMERCIAL N
Formerly payer ID 25129. Now
part of Coventry Consolidated
payer ID.Wellcare HMO Inc. 14163 COMMERCIAL NWellcare HMO Inc. 14163 COMMERCIAL N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 123
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January 2011
Payer ID State Model Enroll Additional InformationWellcare Private Fee for Service Plans 77072 COMMERCIAL NWellcare Private Fee for Service Plans 77072 COMMERCIAL NWellcare of CT 14164 COMMERCIAL NWellcare of CT 14164 COMMERCIAL NWellcare of Florida 59608 COMMERCIAL NWellcare of Florida 59608 COMMERCIAL NWellcare of Georgia 14163 COMMERCIAL NWellcare of Georgia 14163 COMMERCIAL NWellcare of Louisiana 14163 COMMERCIAL NWellcare of Louisiana 14163 COMMERCIAL NWellcare of New York 14163 COMMERCIAL NWellcare of New York 14163 COMMERCIAL NWells Fargo Third Party Administrators Inc. 87815 COMMERCIAL NWells Fargo Third Party Administrators Inc. 87815 COMMERCIAL NWells Fargo Third Party Administrators Inc. (Formerly JSL Administrators)37272 COMMERCIAL N Newnan GA & Fayetteville NCWells Fargo Third Party Administrators Inc. (Formerly JSL Administrators)37272 COMMERCIAL N Newnan GA & Fayetteville NCWenatchee Valley Medical Center 91064 COMMERCIAL NWenatchee Valley Medical Center 91064 COMMERCIAL NWest Covina Medical Group 66124 COMMERCIAL NWest Covina Medical Group 66124 COMMERCIAL NWestLake Financial Group Inc. 90560 COMMERCIAL NWestLake Financial Group Inc. 90560 COMMERCIAL NWestern Grower's Assurance Trust 24735 COMMERCIAL NWestern Grower's Assurance Trust 24735 COMMERCIAL NWestern Grower's Insurance Company 24735 COMMERCIAL NWestern Grower's Insurance Company 24735 COMMERCIAL NWestern Health Advantage 68039 COMMERCIAL NWestern Health Advantage 68039 COMMERCIAL NWestern Health Inc 37306 COMMERCIAL NWestern Health Inc 37306 COMMERCIAL NWestern Mutual Insurance 37247 COMMERCIAL NWestern Mutual Insurance 37247 COMMERCIAL NWestern Southern Financial Group (Cincinnati OH) 31048 COMMERCIAL NWestern Southern Financial Group (Cincinnati OH) 31048 COMMERCIAL NWestlake Financial Group TH101 COMMERCIAL NWestlake Financial Group TH101 COMMERCIAL NWeyco Inc. 38232 COMMERCIAL NWeyco Inc. 38232 COMMERCIAL NWilliam C. Earhart 93050 COMMERCIAL NWilliam C. Earhart 93050 COMMERCIAL NWilson-McShane 41095 COMMERCIAL NWilson-McShane 41095 COMMERCIAL NWindsor Medicare Extra 62153 COMMERCIAL NWindsor Medicare Extra 62153 COMMERCIAL NWisconsin Auto and Truck Dealers 39200 COMMERCIAL NWisconsin Auto and Truck Dealers 39200 COMMERCIAL NWisconsin Department of Corrections 74101 COMMERCIAL RWisconsin Department of Corrections 74101 COMMERCIAL RWisconsin Physicians Service - Third Party Pricing SX162 COMMERCIAL NWisconsin Physicians Service - Third Party Pricing SX162 COMMERCIAL NWomen's Integrated Network Inc. (WIN Fertility) 13413 COMMERCIAL N WIN HealthcareWomen's Integrated Network Inc. (WIN Fertility) 13413 COMMERCIAL N WIN Healthcare
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 124
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January 2011
Payer ID State Model Enroll Additional InformationWorkers Comp of West Virginia SX067 COMMERCIAL AWorkers Comp of West Virginia SX067 COMMERCIAL AWorksite Benefit Services LLC 20333 COMMERCIAL NWorksite Benefit Services LLC 20333 COMMERCIAL NWorld Insurance Company 75276 COMMERCIAL NWorld Insurance Company 75276 COMMERCIAL NWriters' Guild - Industry Health Plan 23710 COMMERCIAL NWriters' Guild - Industry Health Plan 23710 COMMERCIAL NWyoming Medicaid SKWY0 COMMERCIAL RWyoming Medicaid SKWY0 COMMERCIAL RYale University Heath Plan 60646 COMMERCIAL NYale University Heath Plan 60646 COMMERCIAL NYavapai County 9829 COMMERCIAL NYavapai County 9829 COMMERCIAL NYorba Park STJOE COMMERCIAL NYorba Park STJOE COMMERCIAL NYorba Park (St. Joseph Heritage HealthCare) STJOE COMMERCIAL NYorba Park (St. Joseph Heritage HealthCare) STJOE COMMERCIAL NYoung Life 75285 COMMERCIAL NwebTPA/Community Health Electronic Claims/CHEC 75261 COMMERCIAL NwebTPA/Community Health Electronic Claims/CHEC 75261 COMMERCIAL NAmeriHealth - Delaware (Non-HMO Claims) SX074 DE BLUE CROSS/BLUE SHIELD NAmeriHealth - Delaware (Non-HMO Claims) SX074 DE BLUE CROSS/BLUE SHIELD NAmeriHealth - New Jersey (Non-HMO Claims) SX075 NJ BLUE CROSS/BLUE SHIELD NAmeriHealth - New Jersey (Non-HMO Claims) SX075 NJ BLUE CROSS/BLUE SHIELD N
Anthem Blue Cross 47198 CA BLUE CROSS/BLUE SHIELD N
California License number
required.
Anthem Blue Cross 47198 CA BLUE CROSS/BLUE SHIELD N
California License number
required.Anthem Blue Cross Blue Shield of Connecticut SB560 CT BLUE CROSS/BLUE SHIELD NAnthem Blue Cross Blue Shield of Connecticut SB560 CT BLUE CROSS/BLUE SHIELD N
Anthem Blue Cross and Blue Shield (Virginia) SB923 VA BLUE CROSS/BLUE SHIELD N
Always bill with type 1 npi
however there are some
exceptions. Please refer back to
credentialing with Anthem.
Please call Provider enrollment
for credentialing @ 800-533-
1120.
Anthem Blue Cross and Blue Shield (Virginia) SB923 VA BLUE CROSS/BLUE SHIELD N
Always bill with type 1 npi
however there are some
exceptions. Please refer back to
credentialing with Anthem.
Please call Provider enrollment
for credentialing @ 800-533-
1120.
Anthem Blue Cross and Blue Shield - Indiana SB630 IN BLUE CROSS/BLUE SHIELD N
This is for secondary Claim
volume
Anthem Blue Cross and Blue Shield - Indiana SB630 IN BLUE CROSS/BLUE SHIELD N
This is for secondary Claim
volume
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 125
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Anthem Blue Cross and Blue Shield - Kentucky SB660 KY BLUE CROSS/BLUE SHIELD N
This is for secondary Claim
volume
Anthem Blue Cross and Blue Shield - Kentucky SB660 KY BLUE CROSS/BLUE SHIELD N
This is for secondary Claim
volumeAnthem Blue Cross and Blue Shield of Ohio SB338 OH BLUE CROSS/BLUE SHIELD NAnthem Blue Cross and Blue Shield of Ohio SB338 OH BLUE CROSS/BLUE SHIELD NArkansas Blue Cross and Blue Shield SB520 AR BLUE CROSS/BLUE SHIELD RArkansas Blue Cross and Blue Shield SB520 AR BLUE CROSS/BLUE SHIELD R
BCBS SC - Instil Health PFFS SX161 SC BLUE CROSS/BLUE SHIELD N
Non par payer that requires 1B
qualifier with provider id.
Requires 2010 AA REF 01 = 1B
BCBS SC - Instil Health PFFS SX161 SC BLUE CROSS/BLUE SHIELD N
Non par payer that requires 1B
qualifier with provider id.
Requires 2010 AA REF 01 = 1B
BCBSPA - BlueCard Par Point of Service (POS) SX168 BLUE CROSS/BLUE SHIELD R
No special enrollment required
on Synaptek but must have the
BCBSPA step in production in
provider's enrollment for claims
to go electronically. This payer id
is to be used for member id alpha
prefixes of:AMS ATS NJP NRG or
YHF.
BCBSPA - BlueCard Par Point of Service (POS) SX168 BLUE CROSS/BLUE SHIELD R
No special enrollment required
on Synaptek but must have the
BCBSPA step in production in
provider's enrollment for claims
to go electronically. This payer id
is to be used for member id alpha
prefixes of:AMS ATS NJP NRG or
YHF.BLUE CARE NETWORK (BLUE CROSS BLUE SHIELD OF MICHIGAN)SB711 MI BLUE CROSS/BLUE SHIELD RBLUE CARE NETWORK (BLUE CROSS BLUE SHIELD OF MICHIGAN)SB711 MI BLUE CROSS/BLUE SHIELD RBlue CHiP of Rhode Island SB871 RI BLUE CROSS/BLUE SHIELD ABlue CHiP of Rhode Island SB871 RI BLUE CROSS/BLUE SHIELD ABlue Care Family/Anthem Medicaid SB562 CT BLUE CROSS/BLUE SHIELD NBlue Care Family/Anthem Medicaid SB562 CT BLUE CROSS/BLUE SHIELD NBlue Choice Network SB900 TX BLUE CROSS/BLUE SHIELD NBlue Choice Network SB900 TX BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield - Montana SB751 MT BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield - Montana SB751 MT BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield Mississippi State and Teacher EmployeesSB731 MS BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield Mississippi State and Teacher EmployeesSB731 MS BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield NC BlueMedicare HMO/PPO Call NC BLUE CROSS/BLUE SHIELD P
This is Blue Cross Blue Shield NC
Medicare Advantage Plan. Please
call BCBSNC BlueMedicare
HMO/PPO Provider Services
Department at (888)296-9790
option 2 for electronic claims set
up.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 126
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January 2011
Payer ID State Model Enroll Additional Information
Blue Cross Blue Shield NC BlueMedicare HMO/PPO Call NC BLUE CROSS/BLUE SHIELD P
This is Blue Cross Blue Shield NC
Medicare Advantage Plan. Please
call BCBSNC BlueMedicare
HMO/PPO Provider Services
Department at (888)296-9790
option 2 for electronic claims set
up.Blue Cross Blue Shield Wyoming SB960 WY BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield Wyoming SB960 WY BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Alabama SB510 AL BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Alabama SB510 AL BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Arizona SB530 AZ BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Arizona SB530 AZ BLUE CROSS/BLUE SHIELD N
Blue Cross Blue Shield of Colorado SB550 CO BLUE CROSS/BLUE SHIELD N
Secondary claims accepted
electronically only when
Medicare is primary.
Blue Cross Blue Shield of Colorado SB550 CO BLUE CROSS/BLUE SHIELD N
Secondary claims accepted
electronically only when
Medicare is primary.Blue Cross Blue Shield of Connecticut SB563 CT BLUE CROSS/BLUE SHIELD N (FEP Product)Blue Cross Blue Shield of Connecticut SB563 CT BLUE CROSS/BLUE SHIELD N (FEP Product)Blue Cross Blue Shield of Delaware SB570 DE BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Delaware SB570 DE BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Florida SB590 FL BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Florida SB590 FL BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Georgia (Atlanta) SB600 GA BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Georgia (Atlanta) SB600 GA BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Illinois SB621 IL BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Illinois SB621 IL BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Kansas SB650 KS BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Kansas SB650 KS BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Kansas City SB740 MO BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Kansas City SB740 MO BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Kansas HMO FEP SB651 KS BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Kansas HMO FEP SB651 KS BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Kansas HMO Regular SB652 KS BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Kansas HMO Regular SB652 KS BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Kansas HMO Senior Plan SB653 KS BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Kansas HMO Senior Plan SB653 KS BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Louisiana 23738 LA BLUE CROSS/BLUE SHIELD P
For enrollment information call
(225) 295-2427.
Blue Cross Blue Shield of Louisiana 23738 LA BLUE CROSS/BLUE SHIELD P
For enrollment information call
(225) 295-2427.Blue Cross Blue Shield of Maine SB680 ME BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Maine SB680 ME BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Massachusetts SB700 MA BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Massachusetts SB700 MA BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Michigan SB710 MI BLUE CROSS/BLUE SHIELD ABlue Cross Blue Shield of Michigan SB710 MI BLUE CROSS/BLUE SHIELD ABlue Cross Blue Shield of Minnesota SB720 MN BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Minnesota SB720 MN BLUE CROSS/BLUE SHIELD N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 127
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January 2011
Payer ID State Model Enroll Additional InformationBlue Cross Blue Shield of Mississippi SB730 MS BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Mississippi SB730 MS BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Missouri SB741 MO BLUE CROSS/BLUE SHIELD N
NPI only is required when
submitting claims to BCBSMO.
Emdeon requires a provider set
up form to be completed before
initial claims submission.
Blue Cross Blue Shield of Missouri SB741 MO BLUE CROSS/BLUE SHIELD N
NPI only is required when
submitting claims to BCBSMO.
Emdeon requires a provider set
up form to be completed before
initial claims submission.
Blue Cross Blue Shield of Missouri (Blue Choice) SB742 MO BLUE CROSS/BLUE SHIELD N
NPI only is required when
submitting claims to BCBSMO.
Emdeon requires a provider set
up form to be completed before
initial claims submission.
Blue Cross Blue Shield of Missouri (Blue Choice) SB742 MO BLUE CROSS/BLUE SHIELD N
NPI only is required when
submitting claims to BCBSMO.
Emdeon requires a provider set
up form to be completed before
initial claims submission.Blue Cross Blue Shield of Nebraska SB760 NE BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Nebraska SB760 NE BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Nevada SB765 NV BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Nevada SB765 NV BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of New Hampshire SB770 NH BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of New Hampshire SB770 NH BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of New Mexico SB790 NM BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of New Mexico SB790 NM BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of North Carolina SB810 NC BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of North Carolina SB810 NC BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of North Dakota SB820 ND BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of North Dakota SB820 ND BLUE CROSS/BLUE SHIELD RBlue Cross Blue Shield of Oklahoma SB840 OK BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Oklahoma SB840 OK BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Rhode Island SB870 RI BLUE CROSS/BLUE SHIELD ABlue Cross Blue Shield of Rhode Island SB870 RI BLUE CROSS/BLUE SHIELD ABlue Cross Blue Shield of South Carolina - Companion HealthcareSX085 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Carolina - Companion HealthcareSX085 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Carolina - Companion TechnologiesSB880 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Carolina - Companion TechnologiesSB880 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Carolina - Consolidated Benefits Inc.SX108 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Carolina - Consolidated Benefits Inc.SX108 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Carolina - Federal Employee Program (FEP)SX084 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Carolina - Federal Employee Program (FEP)SX084 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Carolina - Planned Administrators Inc.SX104 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Carolina - Planned Administrators Inc.SX104 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Carolina - State Health PlanSX103 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Carolina - State Health PlanSX103 SC BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of South Dakota (Sioux Falls) SB889 SD BLUE CROSS/BLUE SHIELD R
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 128
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January 2011
Payer ID State Model Enroll Additional InformationBlue Cross Blue Shield of South Dakota (Sioux Falls) SB889 SD BLUE CROSS/BLUE SHIELD R
Blue Cross Blue Shield of Tennessee (Chattanooga HMO Plans)SB891 TN BLUE CROSS/BLUE SHIELD R
Multiple plans. Please call (423)
755-5717 for plan code
information. Single Enrollment
with BCBSTN enables electronic
claim submission for all BCBSTN
payer ID's listed (enrollment is
not 'plan specific').
Blue Cross Blue Shield of Tennessee (Chattanooga HMO Plans)SB891 TN BLUE CROSS/BLUE SHIELD R
Multiple plans. Please call (423)
755-5717 for plan code
information. Single Enrollment
with BCBSTN enables electronic
claim submission for all BCBSTN
payer ID's listed (enrollment is
not 'plan specific').
Blue Cross Blue Shield of Tennessee (Chattanooga) SB890 TN BLUE CROSS/BLUE SHIELD R
Single Enrollment with BCBSTN
enables electronic claim
submission for all BCBSTN payer
ID's listed (enrollment is not 'plan
specific').
Blue Cross Blue Shield of Tennessee (Chattanooga) SB890 TN BLUE CROSS/BLUE SHIELD R
Single Enrollment with BCBSTN
enables electronic claim
submission for all BCBSTN payer
ID's listed (enrollment is not 'plan
specific').
Blue Cross Blue Shield of Tennessee (Memphis) SB892 TN BLUE CROSS/BLUE SHIELD R
Single Enrollment with BCBSTN
enables electronic claim
submission for all BCBSTN payer
ID's listed (enrollment is not 'plan
specific').
Blue Cross Blue Shield of Tennessee (Memphis) SB892 TN BLUE CROSS/BLUE SHIELD R
Single Enrollment with BCBSTN
enables electronic claim
submission for all BCBSTN payer
ID's listed (enrollment is not 'plan
specific').Blue Cross Blue Shield of Texas SB900 TX BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Texas SB900 TX BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Vermont SB915 VT BLUE CROSS/BLUE SHIELD NBlue Cross Blue Shield of Vermont SB915 VT BLUE CROSS/BLUE SHIELD NBlue Cross and Blue Shield United of Wisconsin/Comp CareSB950 WI BLUE CROSS/BLUE SHIELD NBlue Cross and Blue Shield United of Wisconsin/Comp CareSB950 WI BLUE CROSS/BLUE SHIELD NBlue Cross of Idaho Health Services Inc SB612 ID BLUE CROSS/BLUE SHIELD RBlue Cross of Idaho Health Services Inc SB612 ID BLUE CROSS/BLUE SHIELD R
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 129
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Blue Shield of California 94036 CA BLUE CROSS/BLUE SHIELD P
Group number is required.;
Please contact Blue Shield of CA
EDI Customer Service at (800) 480-
1221 to verify correct provider
information prior to sending
claims.
Blue Shield of California 94036 CA BLUE CROSS/BLUE SHIELD P
Group number is required.;
Please contact Blue Shield of CA
EDI Customer Service at (800) 480-
1221 to verify correct provider
information prior to sending
claims.Capital Blue Cross - Facility 24705 PA BLUE CROSS/BLUE SHIELD PCapital Blue Cross - Facility 24705 PA BLUE CROSS/BLUE SHIELD PCapital Blue Cross/CAIC 23045 PA BLUE CROSS/BLUE SHIELD NCapital Blue Cross/CAIC 23045 PA BLUE CROSS/BLUE SHIELD NCareFirst BlueCross BlueShield MD Region SB690 MD BLUE CROSS/BLUE SHIELD NCareFirst BlueCross BlueShield MD Region SB690 MD BLUE CROSS/BLUE SHIELD N
CareFirst BlueCross BlueShield NCA Region SB580 DC BLUE CROSS/BLUE SHIELD N
Includes coverage for DC and
Northern Virginia.
CareFirst BlueCross BlueShield NCA Region SB580 DC BLUE CROSS/BLUE SHIELD N
Includes coverage for DC and
Northern Virginia.Empire Blue Cross and Blue Shield of New York SB803 NY BLUE CROSS/BLUE SHIELD NEmpire Blue Cross and Blue Shield of New York SB803 NY BLUE CROSS/BLUE SHIELD NExcellus - BCBS Utica Watertown SB806 NY BLUE CROSS/BLUE SHIELD RExcellus - BCBS Utica Watertown SB806 NY BLUE CROSS/BLUE SHIELD RExcellus - Blue Cross Blue Shield of Central New York SB805 NY BLUE CROSS/BLUE SHIELD RExcellus - Blue Cross Blue Shield of Central New York SB805 NY BLUE CROSS/BLUE SHIELD RExcellus - Blue Cross/Blue Shield Rochester Area SB804 NY BLUE CROSS/BLUE SHIELD RExcellus - Blue Cross/Blue Shield Rochester Area SB804 NY BLUE CROSS/BLUE SHIELD R
First Priority 23241 PA BLUE CROSS/BLUE SHIELD P
Beginning 1/8/2007 all new
providers must enroll with First
Priority Health/Blue Cross of
Northeastern PA prior to
submitting electronic claims.
Enrollment form available at:
http://www.bcnepa.com/EDI/regi
strationForm.aspx
First Priority 23241 PA BLUE CROSS/BLUE SHIELD P
Beginning 1/8/2007 all new
providers must enroll with First
Priority Health/Blue Cross of
Northeastern PA prior to
submitting electronic claims.
Enrollment form available at:
http://www.bcnepa.com/EDI/regi
strationForm.aspxFreedom Blue Medicare Advantage Claims SB942 BLUE CROSS/BLUE SHIELD NFreedom Blue Medicare Advantage Claims SB942 BLUE CROSS/BLUE SHIELD NGateway SX078 PA BLUE CROSS/BLUE SHIELD R
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 130
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationGateway SX078 PA BLUE CROSS/BLUE SHIELD R
Hawaii Medical Service Association (HMSA) SB971 HI BLUE CROSS/BLUE SHIELD R
Payer requires provider level
testing.
Hawaii Medical Service Association (HMSA) SB971 HI BLUE CROSS/BLUE SHIELD R
Payer requires provider level
testing.HealthNow - BCBS Northeastern NY SB800 NY BLUE CROSS/BLUE SHIELD RHealthNow - BCBS Northeastern NY SB800 NY BLUE CROSS/BLUE SHIELD RHealthNow - Blue Cross Blue Shield of Western NY SB801 NY BLUE CROSS/BLUE SHIELD RHealthNow - Blue Cross Blue Shield of Western NY SB801 NY BLUE CROSS/BLUE SHIELD RHighmark Blue Cross & Blue Shield of Pennsylvania SB865 PA BLUE CROSS/BLUE SHIELD RHighmark Blue Cross & Blue Shield of Pennsylvania SB865 PA BLUE CROSS/BLUE SHIELD RHorizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ)22099 NY BLUE CROSS/BLUE SHIELD PHorizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ)22099 NY BLUE CROSS/BLUE SHIELD PHorizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ)22099 NJ BLUE CROSS/BLUE SHIELD PHorizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ)22099 NJ BLUE CROSS/BLUE SHIELD P
Horizon Healthcare of NY 22099 NJ BLUE CROSS/BLUE SHIELD P
Participating Payer - see last page
for definition.
Horizon Healthcare of NY 22099 NJ BLUE CROSS/BLUE SHIELD P
Participating Payer - see last page
for definition.
Horizon Healthcare of NY 22099 NY BLUE CROSS/BLUE SHIELD P
Participating Payer - see last page
for definition.
Horizon Healthcare of NY 22099 NY BLUE CROSS/BLUE SHIELD P
Participating Payer - see last page
for definition.IBC Personal Choice SX083 PA BLUE CROSS/BLUE SHIELD NIBC Personal Choice SX083 PA BLUE CROSS/BLUE SHIELD NIndependence Administrators TA720 BLUE CROSS/BLUE SHIELD NIndependence Administrators TA720 BLUE CROSS/BLUE SHIELD NInter-County Health Plan SX079 PA BLUE CROSS/BLUE SHIELD NInter-County Health Plan SX079 PA BLUE CROSS/BLUE SHIELD NKeystone Health Plan East SX055 PA BLUE CROSS/BLUE SHIELD NKeystone Health Plan East SX055 PA BLUE CROSS/BLUE SHIELD NKeystone Health Plan West SX056 PA BLUE CROSS/BLUE SHIELD RKeystone Health Plan West SX056 PA BLUE CROSS/BLUE SHIELD RMedicare Blue SX263 BLUE CROSS/BLUE SHIELD NMedicare Blue SX263 BLUE CROSS/BLUE SHIELD NMedicare Blue Private SX262 BLUE CROSS/BLUE SHIELD NMedicare Blue Private SX262 BLUE CROSS/BLUE SHIELD N
Mountain State Blue Cross and Blue Shield SB941 WV BLUE CROSS/BLUE SHIELD R
Testing Required: 25 Claims. Test
claims should be representative
of production claims.
Mountain State Blue Cross and Blue Shield SB941 WV BLUE CROSS/BLUE SHIELD R
Testing Required: 25 Claims. Test
claims should be representative
of production claims.Regence Blue Cross Blue Shield of Oregon SB850 OR BLUE CROSS/BLUE SHIELD NRegence Blue Cross Blue Shield of Oregon SB850 OR BLUE CROSS/BLUE SHIELD NRegence Blue Cross Blue Shield of Utah SB910 UT BLUE CROSS/BLUE SHIELD RRegence Blue Cross Blue Shield of Utah SB910 UT BLUE CROSS/BLUE SHIELD RRegence Blue Shield of Idaho SB611 ID BLUE CROSS/BLUE SHIELD NRegence Blue Shield of Idaho SB611 ID BLUE CROSS/BLUE SHIELD NRegence Blue Shield of Washington SB931 WA BLUE CROSS/BLUE SHIELD N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 131
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationRegence Blue Shield of Washington SB931 WA BLUE CROSS/BLUE SHIELD NSelect Advantage SA704 BLUE CROSS/BLUE SHIELD NSelect Advantage SA704 BLUE CROSS/BLUE SHIELD NTexas Health Insurance Risk Pool SB900 TX BLUE CROSS/BLUE SHIELD NTexas Health Insurance Risk Pool SB900 TX BLUE CROSS/BLUE SHIELD NTrigon Blue Cross and Blue Shield (Virginia) SB924 VA BLUE CROSS/BLUE SHIELD NTrigon Blue Cross and Blue Shield (Virginia) SB924 VA BLUE CROSS/BLUE SHIELD N
Triple-S Inc. SB980 BLUE CROSS/BLUE SHIELD P
Payer requires enrollment via
forms or by calling 1-787-479-
4067.
Triple-S Inc. SB980 BLUE CROSS/BLUE SHIELD P
Payer requires enrollment via
forms or by calling 1-787-479-
4067.
WA - Premera Blue Cross SB930 WA BLUE CROSS/BLUE SHIELD R
Payer Enrollment form is listed
under the Alaska BCBS
http://www.emdeon.com/enroll
ment/MED/SB930CLMP_2.pdf
WA - Premera Blue Cross SB930 AK BLUE CROSS/BLUE SHIELD R
Payer Enrollment form is listed
under the Alaska BCBS
http://www.emdeon.com/enroll
ment/MED/SB930CLMP_2.pdf
WA - Premera Blue Cross SB930 AK BLUE CROSS/BLUE SHIELD R
Payer Enrollment form is listed
under the Alaska BCBS
http://www.emdeon.com/enroll
ment/MED/SB930CLMP_2.pdf
WA - Premera Blue Cross SB930 WA BLUE CROSS/BLUE SHIELD R
Payer Enrollment form is listed
under the Alaska BCBS
http://www.emdeon.com/enroll
ment/MED/SB930CLMP_2.pdfWellChoice of NJ SB803 NY BLUE CROSS/BLUE SHIELD NWellChoice of NJ SB803 NY BLUE CROSS/BLUE SHIELD N
Wellmark BCBS - Medicare COB SB645 BLUE CROSS/BLUE SHIELD N
Use payer id when Medicare has
processed as Primary
Wellmark BCBS - Medicare COB SB645 BLUE CROSS/BLUE SHIELD N
Use payer id when Medicare has
processed as PrimaryWellmark Blue Cross and Blue Shield of Iowa (IASD) SB640 IA BLUE CROSS/BLUE SHIELD RWellmark Blue Cross and Blue Shield of Iowa (IASD) SB640 IA BLUE CROSS/BLUE SHIELD RAetna Better Health - PA Medicaid 23228 MEDICAID NAetna Better Health - PA Medicaid 23228 MEDICAID NAetna Better Health Connecticut Medicaid 23225 MEDICAID NAetna Better Health Connecticut Medicaid 23225 MEDICAID NAetna TX Medicaid & CHIP 38692 MEDICAID NAetna TX Medicaid & CHIP 38692 MEDICAID NAlabama Medicaid SKAL0 AL MEDICAID NAlabama Medicaid SKAL0 AL MEDICAID NAlaska Medicaid SKAK0 AK MEDICAID RAlaska Medicaid SKAK0 AK MEDICAID RArizona Medicaid SKAZ0 AZ MEDICAID NArizona Medicaid SKAZ0 AZ MEDICAID NArkansas Medicaid SKAR0 AR MEDICAID NArkansas Medicaid SKAR0 AR MEDICAID N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 132
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationAzeros Health Plans Inc. 16644 NY MEDICAID NAzeros Health Plans Inc. 16644 NY MEDICAID N
Better Health Plan of Florida 20488 MEDICAID N
Please note for claims rejections
please contact Better Health of
Florida at 1-800-514-4561 and
select the provider services
option.
Better Health Plan of Florida 20488 MEDICAID N
Please note for claims rejections
please contact Better Health of
Florida at 1-800-514-4561 and
select the provider services
option.Blue Choice Medicaid Managed Care 403 MEDICAID NBlue Choice Medicaid Managed Care 403 MEDICAID N
California Medicaid SKCA0 CA MEDICAID R
Additional Enrollment
Requirement for Providers in LA
County. Please call (916) 636-
1000 and ask for LA County Unit.
California Medicaid SKCA0 CA MEDICAID R
Additional Enrollment
Requirement for Providers in LA
County. Please call (916) 636-
1000 and ask for LA County Unit.
Central California Alliance for Health SX169 CA MEDICAID N
Alliance EDI Support Unit - 831-
430-5510
Central California Alliance for Health SX169 CA MEDICAID N
Alliance EDI Support Unit - 831-
430-5510Colorado Medicaid SKCO0 CO MEDICAID RColorado Medicaid SKCO0 CO MEDICAID RConnecticut Medicaid SKCT0 CT MEDICAID RConnecticut Medicaid SKCT0 CT MEDICAID RDC Medicaid SKDC0 DC MEDICAID ADC Medicaid SKDC0 MD MEDICAID ADC Medicaid SKDC0 DC MEDICAID ADC Medicaid SKDC0 MD MEDICAID ADelaware Medicaid SKDE0 DE MEDICAID RDelaware Medicaid SKDE0 DE MEDICAID RFlorida Medicaid SKFL0 FL MEDICAID RFlorida Medicaid SKFL0 FL MEDICAID RFlorida NetPass 65063 MEDICAID NFlorida NetPass 65063 MEDICAID NGeorgia Medicaid SKGA0 GA MEDICAID RGeorgia Medicaid SKGA0 GA MEDICAID RHawaii Medicaid SKHI0 HI MEDICAID RHawaii Medicaid SKHI0 HI MEDICAID RIdaho Medicaid SKID0 ID MEDICAID PIdaho Medicaid SKID0 ID MEDICAID PIllinois Medicaid SKIL0 IL MEDICAID NIllinois Medicaid SKIL0 IL MEDICAID NIndiana Medicaid SKIN0 IN MEDICAID NIndiana Medicaid SKIN0 IN MEDICAID N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 133
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January 2011
Payer ID State Model Enroll Additional InformationIntegral Quality Care 23229 MEDICAID NIntegral Quality Care 23229 MEDICAID NIowa Medicaid SKIA0 IA MEDICAID RIowa Medicaid SKIA0 IA MEDICAID RJMH Health Plan Medicaid HMO 16001 MEDICAID NJMH Health Plan Medicaid HMO 16001 MEDICAID NKansas Medicaid SKKS0 KS MEDICAID NKansas Medicaid SKKS0 KS MEDICAID N
Kentucky Medicaid SKKY0 KY MEDICAID P
Unysis is fiscal agent until
11/30/05. After 12/1/05 fiscl
agent will be EDS.
Kentucky Medicaid SKKY0 KY MEDICAID P
Unysis is fiscal agent until
11/30/05. After 12/1/05 fiscl
agent will be EDS.Louisiana Medicaid SKLA0 LA MEDICAID ALouisiana Medicaid SKLA0 LA MEDICAID A
Louisiana Medicaid - Ambulance claims SKLA2 LA MEDICAID R
Payer Enrollment required utilize
form for SKLA0 to complete
enrollment for SKLA2 and SKLA3
Louisiana Medicaid - Ambulance claims SKLA2 LA MEDICAID R
Payer Enrollment required utilize
form for SKLA0 to complete
enrollment for SKLA2 and SKLA3
Louisiana Medicaid - DME Claims SKLA1 MEDICAID R
Payer Enrollment required utilize
form for SKLA0 to complete
enrollment for SKLA1
Louisiana Medicaid - DME Claims SKLA1 MEDICAID R
Payer Enrollment required utilize
form for SKLA0 to complete
enrollment for SKLA1
Louisiana Medicaid - KidMed Claims SKLA3 LA MEDICAID R
Payer Enrollment required utilize
form for SKLA0 to complete
enrollment for SKLA2 and SKLA3
Louisiana Medicaid - KidMed Claims SKLA3 LA MEDICAID R
Payer Enrollment required utilize
form for SKLA0 to complete
enrollment for SKLA2 and SKLA3
MPlan (Medicaid) 35177 IN MEDICAID N
Edits to mirror current edits
submitted for 1st payer id 95444.
MPlan (Medicaid) 35177 IN MEDICAID N
Edits to mirror current edits
submitted for 1st payer id 95444.
Maine Medicaid SKME0 ME MEDICAID N
MaineCare asks all providers to re-
enroll in MIHMS. Enrollment
forms can be found
at:https://mainecare.maine.gov/
Default.aspx
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 134
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Maine Medicaid SKME0 ME MEDICAID N
MaineCare asks all providers to re-
enroll in MIHMS. Enrollment
forms can be found
at:https://mainecare.maine.gov/
Default.aspxMaryland Public Mental Health SX069 MD MEDICAID AMaryland Public Mental Health SX069 MD MEDICAID A
Massachusetts Medicaid SKMA0 MA MEDICAID A
Providers must email
([email protected]) or
fax (617-988-8971) a letter stating
they would like to submit claims
to payer via Emdeon/WebMD.
They must include their provider
ID and Emdeon's Trading Partner
# of 9900756
Massachusetts Medicaid SKMA0 MA MEDICAID A
Providers must email
([email protected]) or
fax (617-988-8971) a letter stating
they would like to submit claims
to payer via Emdeon/WebMD.
They must include their provider
ID and Emdeon's Trading Partner
# of 9900756MedStar Family Choice 39190 MEDICAID RMedStar Family Choice 39190 MEDICAID RMedi-Cal (Vision) SKCA1 CA MEDICAID NMedi-Cal (Vision) SKCA1 CA MEDICAID N
Medicaid New York (eMedNY Test System) SKNYT MEDICAID N
NY Medicaid offers a provider test
enviroment as a platform to
enable providers to test claims
using the same validation and
adjudication methods as the NY
Medicaid production enviroment.
Medicaid New York (eMedNY Test System) SKNYT MEDICAID N
NY Medicaid offers a provider test
enviroment as a platform to
enable providers to test claims
using the same validation and
adjudication methods as the NY
Medicaid production enviroment.Michigan Medicaid SKMI0 MI MEDICAID AMichigan Medicaid SKMI0 MI MEDICAID AMinnesota Medicaid SKMN0 MN MEDICAID AMinnesota Medicaid SKMN0 MN MEDICAID AMissouri Medicaid SKMO0 MO MEDICAID NMissouri Medicaid SKMO0 MO MEDICAID NMontana Medicaid SKMT0 MT MEDICAID NMontana Medicaid SKMT0 MT MEDICAID N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 135
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationNYS DOH UCP 14142 MEDICAID NNYS DOH UCP 14142 MEDICAID NNebraska Medicaid SKNE0 NE MEDICAID RNebraska Medicaid SKNE0 NE MEDICAID RNevada Medicaid: First Health Services SKNV0 NV MEDICAID ANevada Medicaid: First Health Services SKNV0 NV MEDICAID ANew Hampshire Medicaid SKNH0 NH MEDICAID RNew Hampshire Medicaid SKNH0 NH MEDICAID RNew Jersey Medicaid SKNJ0 NJ MEDICAID RNew Jersey Medicaid SKNJ0 NJ MEDICAID RNew Mexico Medicaid SKNM0 NM MEDICAID NNew Mexico Medicaid SKNM0 NM MEDICAID NNew York Medicaid SKNY0 NY MEDICAID RNew York Medicaid SKNY0 NY MEDICAID RNorth Carolina Medicaid SKNC0 NC MEDICAID PNorth Carolina Medicaid SKNC0 NC MEDICAID PNorth Dakota Medicaid (Medical) SKND0 ND MEDICAID NNorth Dakota Medicaid (Medical) SKND0 ND MEDICAID NOhio Medicaid SKOH0 OH MEDICAID NOhio Medicaid SKOH0 OH MEDICAID NOklahoma Medicaid SKOK0 OK MEDICAID NOklahoma Medicaid SKOK0 OK MEDICAID NOregon Medicaid SKOR0 OR MEDICAID ROregon Medicaid SKOR0 OR MEDICAID R
Partnership Health of California-CAPHP SX140 CA MEDICAID R
NEW PROVIDERS ONLY: Payer
requires EDI enrollment and
testing. Please see the following
link for more information:
www.emdeon.com/enrollment/M
ED/SX140CLMP.pdf
Partnership Health of California-CAPHP SX140 CA MEDICAID R
NEW PROVIDERS ONLY: Payer
requires EDI enrollment and
testing. Please see the following
link for more information:
www.emdeon.com/enrollment/M
ED/SX140CLMP.pdfPennsylvania Medicaid SKPA0 PA MEDICAID NPennsylvania Medicaid SKPA0 PA MEDICAID NRhode Island Medicaid SKRI0 RI MEDICAID RRhode Island Medicaid SKRI0 RI MEDICAID RSouth Carolina Medicaid SKSC0 SC MEDICAID ASouth Carolina Medicaid SKSC0 SC MEDICAID ATennessee Medicaid SKTN2 TN MEDICAID RTennessee Medicaid SKTN2 TN MEDICAID RTexas Medicaid SKTX0 TX MEDICAID NTexas Medicaid SKTX0 TX MEDICAID NUtah Medicaid SKUT0 UT MEDICAID RUtah Medicaid SKUT0 UT MEDICAID RValue Options New Mexico SX177 MEDICAID NValue Options New Mexico SX177 MEDICAID N
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 136
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
ValueOptions/MBHP (MA Behavioral Health Partnership)43307 MEDICAID R
For claims rejections please
contact e-
om or 888-247-9311 (8am-6pm M-
F)
ValueOptions/MBHP (MA Behavioral Health Partnership)43307 MEDICAID R
For claims rejections please
contact e-
om or 888-247-9311 (8am-6pm M-
F)Vermont Medicaid SKVT0 VT MEDICAID AVermont Medicaid SKVT0 VT MEDICAID AVirginia Medicaid SKVA0 VA MEDICAID RVirginia Medicaid SKVA0 VA MEDICAID RWashington Medicaid SKWA0 WA MEDICAID RWashington Medicaid SKWA0 WA MEDICAID RWest Virginia Medicaid SKWV0 WV MEDICAID NWest Virginia Medicaid SKWV0 WV MEDICAID N
Wisconsin Medicaid SKWI0 WI MEDICAID N
Any questions about provider
enrollment should be directed to
the Medicaid WI's provider
helpdesk: 800-947-9627
Wisconsin Medicaid SKWI0 WI MEDICAID N
Any questions about provider
enrollment should be directed to
the Medicaid WI's provider
helpdesk: 800-947-9627ZEPHERELLA 26335 MEDICAID N Pilot Payer currently testingZEPHERELLA 26335 MEDICAID N Pilot Payer currently testingAK Medicare Part B (J2) SMAK0 AK MEDICARE RAK Medicare Part B (J2) SMAK0 AK MEDICARE RAL Medicare Part B (J10 - Cahaba) SMAL0 AL MEDICARE RAL Medicare Part B (J10 - Cahaba) SMAL0 AL MEDICARE RAR Medicare Part B (J7) SMAR0 AR MEDICARE RAR Medicare Part B (J7) SMAR0 AR MEDICARE RAZ Medicare Part B (J3 - Noridian) SMAZ0 AZ MEDICARE RAZ Medicare Part B (J3 - Noridian) SMAZ0 AZ MEDICARE RCA Medicare Part B North (J1 - PGBA) SMCA1 CA MEDICARE RCA Medicare Part B North (J1 - PGBA) SMCA1 CA MEDICARE R
CA Medicare Part B South (J1 - PGBA) SMCA2 CA MEDICARE R
Includes coverage for Southern
CA. Please indicate Southern CA
on the WebMD Envoy Set Up
Form.
CA Medicare Part B South (J1 - PGBA) SMCA2 CA MEDICARE R
Includes coverage for Southern
CA. Please indicate Southern CA
on the WebMD Envoy Set Up
Form.CO Medicare Part B (J4 - Trailblazer) SMCO0 CO MEDICARE RCO Medicare Part B (J4 - Trailblazer) SMCO0 CO MEDICARE RCT Medicare Part B (J13 - NGS) SMCT0 CT MEDICARE RCT Medicare Part B (J13 - NGS) SMCT0 CT MEDICARE R
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 137
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
DC Medicare Part B (J12 - Highmark) SMDC0 DC MEDICARE A
Includes coverage for DC and
Northern Virginia.
DC Medicare Part B (J12 - Highmark) SMDC0 DC MEDICARE A
Includes coverage for DC and
Northern Virginia.DE Medicare Part B (J12 - Highmark) SMDE0 DE MEDICARE ADE Medicare Part B (J12 - Highmark) SMDE0 DE MEDICARE ADME Region D (DMERC D) SDMED US MEDICARE ADME Region D (DMERC D) SDMED US MEDICARE AEducators Mututal Medicare Advantage SX111 MEDICARE NEducators Mututal Medicare Advantage SX111 MEDICARE NFL Medicare Part B (J9 First Coast) SMFL0 FL MEDICARE RFL Medicare Part B (J9 First Coast) SMFL0 FL MEDICARE RFamilyCare Inc 93087 MEDICARE NFamilyCare Inc 93087 MEDICARE NGA Medicare Part B (J10 - Cahaba) SMGA0 GA MEDICARE RGA Medicare Part B (J10 - Cahaba) SMGA0 GA MEDICARE RHI Medicare Part B (J1 - PGBA) SMHI0 HI MEDICARE RHI Medicare Part B (J1 - PGBA) SMHI0 HI MEDICARE RHMSO-Highline Medical Service Organization 91164 MEDICARE NHMSO-Highline Medical Service Organization 91164 MEDICARE NHighline Medical Service Organization - PSHP 91161 MEDICARE NHighline Medical Service Organization - PSHP 91161 MEDICARE NIA Medicare Part B (J5 - WPS) SMIA0 IA MEDICARE RIA Medicare Part B (J5 - WPS) SMIA0 IA MEDICARE RID Medicare Part B (J2) SMID0 ID MEDICARE RID Medicare Part B (J2) SMID0 ID MEDICARE RIL Medicare Part B (J6) SMIL0 IL MEDICARE AIL Medicare Part B (J6) SMIL0 IL MEDICARE AIN Medicare Part B (J8) SMIN0 IN MEDICARE AIN Medicare Part B (J8) SMIN0 IN MEDICARE AJMH Medicare Advantage 59171 MEDICARE NJMH Medicare Advantage 59171 MEDICARE NKS Medicare Part B (J5 - WPS) SMKS0 KS MEDICARE RKS Medicare Part B (J5 - WPS) SMKS0 KS MEDICARE RKY Medicare Part B (J15) SMKY0 KY MEDICARE RKY Medicare Part B (J15) SMKY0 KY MEDICARE RLA Medicare Part B (J7) SMLA0 LA MEDICARE RLA Medicare Part B (J7) SMLA0 LA MEDICARE RMA Medicare Part B (J14 - NHIC) SMMA0 MA MEDICARE RMA Medicare Part B (J14 - NHIC) SMMA0 MA MEDICARE RMD Medicare Part B (J12 - Highmark) SMMD0 MD MEDICARE AMD Medicare Part B (J12 - Highmark) SMMD0 MD MEDICARE AME Medicare Part B (J14 - NHIC) SMME0 ME MEDICARE RME Medicare Part B (J14 - NHIC) SMME0 ME MEDICARE RMI Medicare Part B (J8) SMMI0 MI MEDICARE RMI Medicare Part B (J8) SMMI0 MI MEDICARE RMN Medicare Part B (J6) SMMN0 MN MEDICARE RMN Medicare Part B (J6) SMMN0 MN MEDICARE RMO Medicare Part B East (J5 - WPS) SMMO0 MO MEDICARE RMO Medicare Part B East (J5 - WPS) SMMO0 MO MEDICARE RMO Medicare Part B West (J5 - WPS) SMKC0 KS MEDICARE R
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 138
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
MO Medicare Part B West (J5 - WPS) SMKC0 KS MEDICARE R
New Provider Enrollments please
complete payer enrollment forms
for SMMO0.MO Medicare Part B West (J5 - WPS) SMKC0 MO MEDICARE R
MO Medicare Part B West (J5 - WPS) SMKC0 MO MEDICARE R
New Provider Enrollments please
complete payer enrollment forms
for SMMO0.MS Medicare Part B (J7) SMMS0 MS MEDICARE RMS Medicare Part B (J7) SMMS0 MS MEDICARE RMT Medicare Part B (J3 - Noridian) SMMT0 MT MEDICARE RMT Medicare Part B (J3 - Noridian) SMMT0 MT MEDICARE RMedicare DME (JA - CEDI/NHIC) SDMEA US MEDICARE AMedicare DME (JA - CEDI/NHIC) SDMEA US MEDICARE AMedicare DME (JB - CEDI/NGS) SDMEB US MEDICARE AMedicare DME (JB - CEDI/NGS) SDMEB US MEDICARE AMedicare DME (JC - CEDI/CGS) SDMEC US MEDICARE AMedicare DME (JC - CEDI/CGS) SDMEC US MEDICARE A
Medicare Plus Blue SX170 MI MEDICARE R
Provider enrolls at
https://editest.bcbsm.com/tpaLo
gon.html OR by calling 248-486-
2292 opt 1. Emdeon PSF required.
Medicare Plus Blue SX170 MI MEDICARE R
Provider enrolls at
https://editest.bcbsm.com/tpaLo
gon.html OR by calling 248-486-
2292 opt 1. Emdeon PSF required.NC Medicare Part B (J11) SMNC0 NC MEDICARE RNC Medicare Part B (J11) SMNC0 NC MEDICARE RND Medicare Part B (J3 - Noridian) SMND0 ND MEDICARE RND Medicare Part B (J3 - Noridian) SMND0 ND MEDICARE RNE Medicare Part B (J5 - WPS) SMNE0 NE MEDICARE RNE Medicare Part B (J5 - WPS) SMNE0 NE MEDICARE RNH Medicare Part B (J14 - NHIC) SMNH0 NH MEDICARE RNH Medicare Part B (J14 - NHIC) SMNH0 NH MEDICARE RNJ Medicare Part B (J12 - Highmark) SMNJ0 NJ MEDICARE RNJ Medicare Part B (J12 - Highmark) SMNJ0 NJ MEDICARE RNM Medicare Part B (J4 - Trailblazer) SMNM0 NM MEDICARE RNM Medicare Part B (J4 - Trailblazer) SMNM0 NM MEDICARE RNV Medicare Part B (J1 - PGBA) SMNV0 NV MEDICARE RNV Medicare Part B (J1 - PGBA) SMNV0 NV MEDICARE RNY Medicare Part B Downstate (J13 - NGS) SMNY0 NY MEDICARE ANY Medicare Part B Downstate (J13 - NGS) SMNY0 NY MEDICARE ANY Medicare Part B Queens (J13 - NGS) SMNY2 NY MEDICARE ANY Medicare Part B Queens (J13 - NGS) SMNY2 NY MEDICARE ANY Medicare Part B Upstate (J13 - NGS) SMNY1 NY MEDICARE ANY Medicare Part B Upstate (J13 - NGS) SMNY1 NY MEDICARE AOH Medicare Part B (J15) SMOH0 WV MEDICARE ROH Medicare Part B (J15) SMOH0 OH MEDICARE ROH Medicare Part B (J15) SMOH0 WV MEDICARE ROH Medicare Part B (J15) SMOH0 OH MEDICARE ROK Medicare Part B (J4 - Trailblazer) SMOK0 OK MEDICARE R
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 139
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional InformationOK Medicare Part B (J4 - Trailblazer) SMOK0 OK MEDICARE ROR Medicare Part B (J2 - Noridian) SMOR0 OR MEDICARE ROR Medicare Part B (J2 - Noridian) SMOR0 OR MEDICARE RPA Medicare Part B (J12 - Highmark) SMPA0 PA MEDICARE RPA Medicare Part B (J12 - Highmark) SMPA0 PA MEDICARE R
PR Medicare Part B (J9 - First Coast) SMPR0 MEDICARE R
Payer approval required prior to
submitting claims.
PR Medicare Part B (J9 - First Coast) SMPR0 MEDICARE R
Payer approval required prior to
submitting claims.RI Medicare Part B (J14 - NHIC) SMRI0 RI MEDICARE RRI Medicare Part B (J14 - NHIC) SMRI0 RI MEDICARE RRailroad Medicare (PGBA) SRRGA US MEDICARE R RailRoad MedicareRailroad Medicare (PGBA) SRRGA US MEDICARE R RailRoad MedicareSC Medicare Part B (J11) SMSC0 SC MEDICARE RSC Medicare Part B (J11) SMSC0 SC MEDICARE RSD Medicare Part B (J3 - Noridian) SMSD0 SD MEDICARE RSD Medicare Part B (J3 - Noridian) SMSD0 SD MEDICARE RTN Medicare Part B (J10 - Cahaba) SMTN0 TN MEDICARE RTN Medicare Part B (J10 - Cahaba) SMTN0 TN MEDICARE RTX Medicare Part B and Indian Health Services (J4 - Trailblazer)SMTX0 TX MEDICARE ATX Medicare Part B and Indian Health Services (J4 - Trailblazer)SMTX0 TX MEDICARE AUT Medicare Part B (J3 - Noridian) SMUT0 UT MEDICARE RUT Medicare Part B (J3 - Noridian) SMUT0 UT MEDICARE R
VA Medicare Part B (J11) SMVA0 VA MEDICARE R
Includes coverage for All Regions
(except Northern Virginia).
VA Medicare Part B (J11) SMVA0 VA MEDICARE R
Includes coverage for All Regions
(except Northern Virginia).
VI Medicare Part B (J9 - First Coast) SMVI0 MEDICARE R
Payer approval required prior to
submitting claims.
VI Medicare Part B (J9 - First Coast) SMVI0 MEDICARE R
Payer approval required prior to
submitting claims.VT Medicare Part B (J14 - NHIC) SMVT0 VT MEDICARE RVT Medicare Part B (J14 - NHIC) SMVT0 VT MEDICARE RVirginia Premier Gold SX198 MEDICARE NVirginia Premier Gold SX198 MEDICARE NWA Medicare Part B (J2 - Noridian) SMWA0 WA MEDICARE RWA Medicare Part B (J2 - Noridian) SMWA0 WA MEDICARE RWI Medicare Part B (J6) SMWI0 WI MEDICARE RWI Medicare Part B (J6) SMWI0 WI MEDICARE R
WV Medicare Part B (J11) SMWV0 MEDICARE R
Enrollment is required and forms
and can be located at
www.emdeon.com
WV Medicare Part B (J11) SMWV0 MEDICARE R
Enrollment is required and forms
and can be located at
www.emdeon.comWY Medicare Part B (J3 - Noridian) SMWY0 WY MEDICARE RWY Medicare Part B (J3 - Noridian) SMWY0 WY MEDICARE R
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 140
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Humana Military - Tricare South 61125 US CHAMPUS N
Participating Payer for Tricare
South including AL AR FL GA LA
MS OK SC TN and East TX.
Humana Military - Tricare South 61125 US CHAMPUS N
Participating Payer for Tricare
South including AL AR FL GA LA
MS OK SC TN and East TX.
Tricare North Region 57106 US CHAMPUS N
TRICARE North Region includes -
CT DE IL IN KY MA MD ME MI NC
NH NJ NY OH PA RI VA VT WI WV
and some zip codes in IA/MO/TN -
contact Tricare North at (877) 874-
2273 for details.
Tricare North Region 57106 US CHAMPUS N
TRICARE North Region includes -
CT DE IL IN KY MA MD ME MI NC
NH NJ NY OH PA RI VA VT WI WV
and some zip codes in IA/MO/TN -
contact Tricare North at (877) 874-
2273 for details.WPS Tricare TriWest SCWI0 US CHAMPUS N West RegionWPS Tricare TriWest SCWI0 US CHAMPUS N West Region
Auto Club Association (ACG) 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Auto Club Association (ACG) 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Uvalde CISD J1204 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 141
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Uvalde CISD J1204 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
''Nova Pro Risk Solutions (San Diego) J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
''Nova Pro Risk Solutions (San Diego) J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
'Hortica Florist Mutual Insurance 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
'Hortica Florist Mutual Insurance 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 142
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
AAA Chicago 11983 AUTOMOBILE MEDICAL N
This payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's transact
Website for contacts and
additional informati
AAA Chicago 11983 AUTOMOBILE MEDICAL N
This payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's transact
Website for contacts and
additional informati
AAA Chicago Motor Club 11983 AUTOMOBILE MEDICAL N
This payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's transact
Website for contacts and
additional informati
AAA Chicago Motor Club 11983 AUTOMOBILE MEDICAL N
This payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's transact
Website for contacts and
additional informati
AAA Michigan 11983 AUTOMOBILE MEDICAL N
This payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's transact
Website for contacts and
additional informati
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 143
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
AAA Michigan 11983 AUTOMOBILE MEDICAL N
This payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's transact
Website for contacts and
additional informati
AAA Minnesota/Iowa 11983 AUTOMOBILE MEDICAL N
This payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's transact
Website for contacts and
additional informati
AAA Minnesota/Iowa 11983 AUTOMOBILE MEDICAL N
This payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's transact
Website for contacts and
additional informati
AAA Nebraska 11983 AUTOMOBILE MEDICAL N
This payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's transact
Website for contacts and
additional informati
AAA Nebraska 11983 AUTOMOBILE MEDICAL N
This payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for the Automobile Medical
transaction service (Emdeon
Office customers excluded).
Please visit Emdeon's transact
Website for contacts and
additional informati
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 144
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
AAA North Dakota 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
AAA North Dakota 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
AAA Wisconsin 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
AAA Wisconsin 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical claims Only. You and/or
your vendor must be contracted
for this transaction service
(Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
ACIA 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 145
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
ACIA 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Abilene ISD Run-Off J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Abilene ISD Run-Off J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Abilene ISD Self-Insured J1121 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Abilene ISD Self-Insured J1121 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 146
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Abilene Independent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Abilene Independent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Accuride Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Accuride Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Alamo Heights I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 147
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Alamo Heights I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Aledo I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Aledo I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Allianz Global Risk US Insurance Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Allianz Global Risk US Insurance Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 148
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Alvey Systems (AON Risk) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Alvey Systems (AON Risk) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
American Coin Merchandising Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
American Coin Merchandising Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
American Cyanamid TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 149
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
American Cyanamid TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
American Hardware Mutual Insurance J1203 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
American Hardware Mutual Insurance J1203 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
American National Property and Casualty Company (ANPAC)See Comments AUTOMOBILE MEDICAL N
Please call 1-800-333-2860 if you
would like to submit claims to
ANPAC.
American National Property and Casualty Company (ANPAC)See Comments AUTOMOBILE MEDICAL N
Please call 1-800-333-2860 if you
would like to submit claims to
ANPAC.
American Specialty Companies TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
American Specialty Companies TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 150
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
American Specialty Ins. / MIB TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
American Specialty Ins. / MIB TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Ameriprise Auto & Home Ins. C1004 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Ameriprise Auto & Home Ins. C1004 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Amica 12287 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 151
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Amica 12287 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Atlantic Mutual Insurance 19895 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Atlantic Mutual Insurance 19895 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Auto Club Group 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Auto Club Group 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 152
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Auto Club Group Insurance Company 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Auto Club Group Insurance Company 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Auto Club Property-Casualty Insurance Company 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Auto Club Property-Casualty Insurance Company 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Ayers Trucking J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 153
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Ayers Trucking J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Beall's Inc / Midwest Employers TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Beall's Inc / Midwest Employers TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Bellville I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Bellville I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 154
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Benavides I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Benavides I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Berkley Specialty Underwriters 25224 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Berkley Specialty Underwriters 25224 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Berwind Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 155
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Berwind Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Big Spring I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Big Spring I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Birdville Independendent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 156
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Birdville Independendent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Brackett I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Brackett I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Brady I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 157
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Brady I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Breckenridge ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Breckenridge ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Brooks County I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 158
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Brooks County I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Brownfield I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Brownfield I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Brownfield ISD J1123 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Brownfield ISD J1123 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 159
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Brownyard Group Inc. (Arch Insurance) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Brownyard Group Inc. (Arch Insurance) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Brunswick Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Brunswick Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Burleson County Alternative School J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 160
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Burleson County Alternative School J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Burleson-Milam Special Svcs Co-Op J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Burleson-Milam Special Svcs Co-Op J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Burlington Coat Factory Wareho TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Burlington Coat Factory Wareho TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 161
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
CCMSI J1010 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
CCMSI J1010 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
CNA Insurance 20443 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
CNA Insurance 20443 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
CVS Pharmacy TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
CVS Pharmacy TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 162
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Caldwell I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Caldwell I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Canyon I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Canyon I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 163
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Carrizo Springs CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Carrizo Springs CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Cendant Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Cendant Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Centennial Insurance Company 19895 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 164
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Centennial Insurance Company 19895 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Center Point ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Center Point ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Central Hockey League TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Central Hockey League TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 165
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Charming Shoppes Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Charming Shoppes Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
City Of Arlington J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
City Of Arlington J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
City Of El Paso J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 166
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
City Of El Paso J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
City of Plano 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
City of Plano 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Clarksville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Clarksville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 167
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Classic Residence By Hyatt TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Classic Residence By Hyatt TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Coca-Cola Enterprises Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Coca-Cola Enterprises Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Columbia Sussex Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 168
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Columbia Sussex Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
CompTech 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
CompTech 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Compass Group Usa Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Compass Group Usa Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 169
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Contech Construction Products TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Contech Construction Products TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Continental Airlines TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Continental Airlines TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Convergys Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 170
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Convergys Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Correctional Management Service TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Correctional Management Service TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Corrections Corp of America TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Corrections Corp of America TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 171
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Cotulla ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Cotulla ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Coworx Staffing LLC TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Coworx Staffing LLC TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Crum & Forster Indemnity Company 31348 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 172
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Crum & Forster Indemnity Company 31348 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Crystal City ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Crystal City ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Dalhart ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 173
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Dalhart ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Danaher Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Danaher Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
De Bartolos Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
De Bartolos Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 174
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
De Soto ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
De Soto ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Del Valle ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Del Valle ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 175
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Denver City I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Denver City I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Denver City ISD J1124 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Denver City ISD J1124 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Dilley ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 176
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Dilley ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Directory Distributing Assoc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Directory Distributing Assoc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Discover Re (Burger King) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Discover Re (Burger King) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 177
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Dumas I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Dumas I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Dunn-Edwards Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Dunn-Edwards Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Dustrol 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 178
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Dustrol 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Dynamex Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Dynamex Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
EMC Insurance Companies 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
EMC Insurance Companies 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 179
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
ERMC J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
ERMC J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
ESIS TP043 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
ESIS TP043 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
ESIS (First American Insurance Co) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 180
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
ESIS (First American Insurance Co) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Eagle Mt-Saginaw ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Eagle Mt-Saginaw ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Edinburg CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 181
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Edinburg CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Edwards Claim Administration J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Edwards Claim Administration J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
El Paso Community College (Tx Jur) J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
El Paso Community College (Tx Jur) J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 182
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
El Paso Water Util Tx Jur J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
El Paso Water Util Tx Jur J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Electric Insurance (EIC) 21261 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Electric Insurance (EIC) 21261 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Employers Insurance Group J1232 WORKERS COMPENSATION N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 183
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Employers Insurance Group J1232 WORKERS COMPENSATION N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
Employers Mutual Casualty 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Employers Mutual Casualty 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Envirosource TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Envirosource TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 184
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Esurance Inc. 30210 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Esurance Inc. 30210 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Evolution Insurance Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Evolution Insurance Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
F.A. Richard & Associates (FARA) TP044 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 185
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
F.A. Richard & Associates (FARA) TP044 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
FARMERS INSURANCE C1025 WORKERS COMPENSATION N
Payer id is for Workers Comp MN
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
FARMERS INSURANCE C1025 WORKERS COMPENSATION N
Payer id is for Workers Comp MN
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
FKI Industries Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
FKI Industries Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 186
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Factory 2 U J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Factory 2 U J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Federated Rural Electric (TX) 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Federated Rural Electric (TX) 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Federated Services Insurance Company 13935 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 187
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Federated Services Insurance Company 13935 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Fireman's Fund Insurance Company 21873 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Fireman's Fund Insurance Company 21873 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Fireman's Fund Insurance Company C1019 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Fireman's Fund Insurance Company C1019 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 188
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Firstcomp J1011 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Firstcomp J1011 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Floresville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Floresville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Forney ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 189
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Forney ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Frank Gates Service Company TP056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Frank Gates Service Company TP056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Frenship I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Frenship I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 190
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Frenship ISD J1125 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Frenship ISD J1125 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Frio County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Frio County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Ft Sam Houston ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 191
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Ft Sam Houston ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
GAB Robbins Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
GAB Robbins Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Gainesville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Gainesville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 192
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Gallagher Bassett TP057 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Gallagher Bassett TP057 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Garner I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Garner I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Gates Corp Dba Gates Rubber Co TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 193
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Gates Corp Dba Gates Rubber Co TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Georgetown ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Georgetown ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Godley ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 194
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Godley ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Golden Corral Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Golden Corral Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Graford ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Graford ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 195
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Grange 10322 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Grange 10322 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Graphic Arts Mutual 25984 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Graphic Arts Mutual 25984 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Great American Alliance Ins Co. 26832 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 196
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Great American Alliance Ins Co. 26832 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Great American Assurance Company 26344 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Great American Assurance Company 26344 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Great American Ins. Co. of N.Y. 22136 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Great American Ins. Co. of N.Y. 22136 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 197
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Great American Ins. Company 16691 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Great American Ins. Company 16691 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Great Divide Insurance 25224 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Great Divide Insurance 25224 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Gruver I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 198
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Gruver I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Gse Lining Technology Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Gse Lining Technology Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Health Partners Managed Care 44547 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Health Partners Managed Care 44547 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 199
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Heritage Group TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Heritage Group TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Hidalgo ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Hidalgo ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Holly Farms Corp. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 200
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Holly Farms Corp. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Household Merch Nni TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Household Merch Nni TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Housing Authority El Paso (TX) J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Housing Authority El Paso (TX) J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 201
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Houston Hunters Patrol Inc J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Houston Hunters Patrol Inc J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Howard County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Howard County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Hudspeth County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 202
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Hudspeth County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Huffman ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Huffman ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Hughes Tool Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Hughes Tool Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 203
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
IDS PROPERTY CASUALTY INSURANCE COMPANY 12504 WORKERS COMPENSATION N
Payer id is for Workers Comp MN
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
IDS PROPERTY CASUALTY INSURANCE COMPANY 12504 WORKERS COMPENSATION N
Payer id is for Workers Comp MN
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Insilco Corp TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Insilco Corp TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Integrity Mutual Insurance Company 10322 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 204
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Integrity Mutual Insurance Company 10322 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Irex Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Irex Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Ironworking Contract I.P. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Ironworking Contract I.P. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 205
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
J B Hunt Transport Inc. J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
J B Hunt Transport Inc. J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
JI Specialty Services J1006 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
JI Specialty Services J1006 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Jones Truck LinesInc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 206
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Jones Truck LinesInc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Junction ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Junction ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Juvenile Jail Facility Managem TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Juvenile Jail Facility Managem TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 207
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
KCI Holdings USA TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
KCI Holdings USA TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Karnes City ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Karnes City ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Ken Davis Industries Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 208
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Ken Davis Industries Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Kennedale ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Kennedale ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
La Vernia ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 209
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
La Vernia ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
La Villa ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
La Villa ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Lackland ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 210
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Lackland ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Lago Vista I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Lago Vista I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Landstar Bco Wc Program TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Landstar Bco Wc Program TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 211
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Levelland I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Levelland I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Levelland ISD J1126 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Levelland ISD J1126 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Lewisville ISD Self-Insured J1122 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 212
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Lewisville ISD Self-Insured J1122 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Lewisville Independent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Lewisville Independent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Liberty-Eylau ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 213
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Liberty-Eylau ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Lsg Sky Chefs International TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Lsg Sky Chefs International TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
MCMC LLC J1007 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
MCMC LLC J1007 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 214
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Major League Baseball 8 TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Major League Baseball 8 TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Marble Falls I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Marble Falls I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Marlin ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 215
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Marlin ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Matrix Absence Management TP075 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Matrix Absence Management TP075 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Maxim Crane Works TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Maxim Crane Works TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 216
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Mc Donald'S-Mcopco TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Mc Donald'S-Mcopco TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Member Select Insurance Company 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Member Select Insurance Company 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Mendota Insurance Company 33650 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 217
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Mendota Insurance Company 33650 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Mercedes ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Mercedes ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Metropolitan Property and Casualty Insurance CompanyC1011 AUTOMOBILE MEDICAL N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Metropolitan Property and Casualty Insurance CompanyC1011 AUTOMOBILE MEDICAL N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 218
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Metropolitan Transit Athority J1238 WORKERS COMPENSATION N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
Metropolitan Transit Athority J1238 WORKERS COMPENSATION N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
Mexia I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Mexia I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 219
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Midland County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Midland County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Midwest Drywall 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Midwest Drywall 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Midwest Insurance 10895 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 220
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Midwest Insurance 10895 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Millsap I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Millsap I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Mission CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 221
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Mission CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Mission Consolidated Independent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Mission Consolidated Independent School District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Mitchell Energy & Devel TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Mitchell Energy & Devel TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 222
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Montgomery County Texas J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Montgomery County Texas J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Moody ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Moody ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Morris Material Handling TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 223
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Morris Material Handling TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Morrison Health Care Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Morrison Health Care Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Morton ISD J1127 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Morton ISD J1127 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 224
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Motorist Mutual Insurance J1203 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Motorist Mutual Insurance J1203 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Muleshoe I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Muleshoe I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Muleshoe ISD J1128 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 225
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Muleshoe ISD J1128 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Munford Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Munford Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Nacogdoches ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Nacogdoches ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 226
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Nap Tools 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Nap Tools 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Natalia ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Natalia ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
National Interstate (TX) 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 227
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
National Interstate (TX) 13978 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
National Loss Prevention Inc J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
National Loss Prevention Inc J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
New Caney ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
New Caney ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 228
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
New Caney ISD Self-Insured J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
New Caney ISD Self-Insured J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
New York State Insurance Fund (NYSIF) 45052 WORKERS COMPENSATION N
Payer id is for Workers Comp NY
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
New York State Insurance Fund (NYSIF) 45052 WORKERS COMPENSATION N
Payer id is for Workers Comp NY
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Norwood TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 229
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Norwood TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Nova Pro Risk Solutions J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Nova Pro Risk Solutions J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Old Republic Insurance Co TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Old Republic Insurance Co TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 230
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
One Beacon Insurance 20621 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
One Beacon Insurance 20621 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Orica Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Orica Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Papa John's International Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 231
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Papa John's International Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Paradigm J1001 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Paradigm J1001 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Pearsall ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Pearsall ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 232
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Peg Discover Re TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Peg Discover Re TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Peg Discover Re( Food Merchant) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Peg Discover Re( Food Merchant) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Pegi-Family Dining TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 233
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Pegi-Family Dining TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Perryton I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Perryton I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Phh Fleetamerica TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Phh Fleetamerica TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 234
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Plains I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Plains I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Plemons-Stinnett-Phillips CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Plemons-Stinnett-Phillips CISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 235
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Poolville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Poolville ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Poth ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Poth ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 236
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Potter County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Potter County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Preferred Employers TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Preferred Employers TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Preferred Employers Group TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 237
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Preferred Employers Group TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Providence Property and Casualty 28711 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Providence Property and Casualty 28711 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
RIver Road ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
RIver Road ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 238
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
RSC Insurance Services Ltd. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
RSC Insurance Services Ltd. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
RTW (Return to Work) J1202 WORKERS COMPENSATION N
Payer id is for Workers Comp MN
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
RTW (Return to Work) J1202 WORKERS COMPENSATION N
Payer id is for Workers Comp MN
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Rampart Insurance Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 239
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Rampart Insurance Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Randall County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Randall County J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Recovery & Claim Services AKA Mayo Clinic 41193 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Recovery & Claim Services AKA Mayo Clinic 41193 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 240
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Red Oak Independent School District J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Red Oak Independent School District J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Republic Franklin Insurance 12475 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Republic Franklin Insurance 12475 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Republic Indemnity J1008 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 241
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Republic Indemnity J1008 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Residential Services Group TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Residential Services Group TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Restaurant Reinsurance Limited TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Restaurant Reinsurance Limited TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 242
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Rhone-PoulencInc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Rhone-PoulencInc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Rieth-Riley Construction Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Rieth-Riley Construction Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Risk Transfer Technologies Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 243
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Risk Transfer Technologies Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Roth Staffing Companies J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Roth Staffing Companies J1056 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Ryder Services Inc. J1009 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Ryder Services Inc. J1009 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 244
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
SRS Hilton Worldwide Inc J1237 WORKERS COMPENSATION N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
SRS Hilton Worldwide Inc J1237 WORKERS COMPENSATION N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
SUA Insurance Company 40134 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
SUA Insurance Company 40134 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
SafeCo Insurance 24740 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 245
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
SafeCo Insurance 24740 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Safety-Kleen Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Safety-Kleen Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
San Angelo ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
San Angelo ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 246
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Schlumberger Technology TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Schlumberger Technology TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Scotts Miracle-Gro Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Scotts Miracle-Gro Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Selective 39926 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 247
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Selective 39926 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Seminole I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Seminole I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Silsbee ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 248
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Silsbee ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Slaton I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Slaton I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Snap-On Incorporated TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Snap-On Incorporated TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 249
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Solvay America Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Solvay America Inc TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Somerset ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Somerset ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
South Plains School WC Program J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 250
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
South Plains School WC Program J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Southland ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Southland ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Southside ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 251
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Southside ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Southwest Airlines J1233 WORKERS COMPENSATION N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
Southwest Airlines J1233 WORKERS COMPENSATION N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
Spearman I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 252
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Spearman I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Springtown I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Springtown I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Stant Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Stant Corporation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 253
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Stockdale ISD J1204 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Stockdale ISD J1204 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Stratford I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Stratford I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Summit Health Ltd TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 254
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Summit Health Ltd TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Sunray I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Sunray I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Swift Transportation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Swift Transportation TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 255
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Synder ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Synder ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Tarrant Appraisal District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Tarrant Appraisal District J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 256
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Texas A&M TAMU A0235 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Texas A&M TAMU A0235 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Texas Association of School Boards A0234 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Texas Association of School Boards A0234 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Texas Municipal League IRP A0245 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Texas Municipal League IRP A0245 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 257
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Texas Mutual Insurance Company 22945 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Texas Mutual Insurance Company 22945 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Texas Small Business Pool TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Texas Small Business Pool TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
The Auto Club Group 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 258
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
The Auto Club Group 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
The Beacon Mutual Ins Co J1234 WORKERS COMPENSATION N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
The Beacon Mutual Ins Co J1234 WORKERS COMPENSATION N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
The Scotts Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
The Scotts Company TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 259
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
The Zenith 13269 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
The Zenith 13269 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Total Petroleum Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Total Petroleum Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Triple A 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 260
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Triple A 11983 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
US Foodservice Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
US Foodservice Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
US National Resources (Aigrm) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
US National Resources (Aigrm) TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 261
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
UTICA (C1027) C1027 AUTOMOBILE MEDICAL N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
UTICA (C1027) C1027 AUTOMOBILE MEDICAL N
The above Payer Name(s) may
represent multiple Accounts
(employers). For a complete list
please refer directly to Emdeon's
published Payer List at:
www.emdeon.com/PayerLists/pa
yerlists.php Search the Payer List
using the above Payer ID(s) to
identify the
Underwriters Safety and Claims TP108 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Underwriters Safety and Claims TP108 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Union Insurance Company of Providence 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 262
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Union Insurance Company of Providence 21407 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
United Dominion Realty Trust TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
United Dominion Realty Trust TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
United States Cold Storage TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
United States Cold Storage TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 263
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Unitrin Direct Property & Casualty Company 16063 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Unitrin Direct Property & Casualty Company 16063 AUTOMOBILE MEDICAL N
Payer id is for Automobile
Medical MN claims Only. You
and/or your vendor must be
contracted for this transaction
service (Emdeon Office customers
excluded). Please visit
www.transact.emdeon.com for
info.
Utica Mutual Insurance Company 25976 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Utica Mutual Insurance Company 25976 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Utica National Insurance Co of Texas 43478 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 264
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Utica National Insurance Co of Texas 43478 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Vanliners Insurance Company 21172 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Vanliners Insurance Company 21172 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Vicorp Restaurants Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Vicorp Restaurants Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 265
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
WC Solutions J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
WC Solutions J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Wal-Mart J1004 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Wal-Mart J1004 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Weatherford I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 266
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Weatherford I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Weimer ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Weimer ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
White Deer I.S.D J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 267
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
White Deer I.S.D J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Whiteface C.I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Whiteface C.I.S.D. J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
conta
Wyman-Gordon Companies TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Wyman-Gordon Companies TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 268
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Xl Environmental Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Xl Environmental Inc. TP117 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Yorkstown ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Yorkstown ISD J1204 WORKERS COMPENSATION N
This payer id is for Workers
Compensation claims in the State
of Texas Only. You and/or your
vendor must be contracted for
the Workers Compensation
transaction service (Emdeon
Office customers excluded).
Please visit
http://transact.emdeon.com/ for
contac
Znat Insurance (Zenith National Insurance) 30120 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 269
eClaims Medical Payer List
January 2011
Payer ID State Model Enroll Additional Information
Znat Insurance (Zenith National Insurance) 30120 WORKERS COMPENSATION N
Payer id is for Workers Comp
claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Zurich Farmers J1015 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Zurich Farmers J1015 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Zurich Insurance NA 16535 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
Zurich Insurance NA 16535 WORKERS COMPENSATION N
Payer id is for Workers Comp TX
MN claims Only. You and/or your
vendor must be contracted for
this transaction service (Emdeon
Office customers excluded).
Please visit
www.transact.emdeon.com for
info.
For an updated payer list please visit our website https://pattersonsupport.custhelp.com
Page 270