Copy of Provider Portal and B2B Payer List_updated

Copy of Provider Portal and B2B Payer List_updated

Updated: 12/14/2006
Provider Portal and B2B Payer List
Payer Name
Aetna
Anthem Blue Cross Blue Shield
Blue Cross Blue Shield CO -Coming Soon!
Blue Cross Blue Shield CT -Coming Soon!
Blue Cross Blue Shield IN -Coming Soon!
Blue Cross Blue Shield KY -Coming Soon!
Blue Cross Blue Shield ME -Coming Soon!
Blue Cross Blue Shield NH -Coming Soon!
Blue Cross Blue Shield NV -Coming Soon!
Blue Cross Blue Shield OH -Coming Soon!
Blue Cross Blue Shield TX -Coming Soon!
Blue Cross CA*
CHA Health Plan
Cigna Healthcare
Connecticare
Coventry Of Georgia
DMERC - Region A
DMERC - Region B
DMERC - Region C
DMERC - Region D
Georgia BCBS*
Glassman- Directors Guild
Glassman- Writers Guild
Great West Life
Harvard Pilgrim
HealthNet of CA
Humana
Independence Blue of PA
Inland Empire Health Plan
InterValley Health Plan
Kaiser Permanente Of Georgia
MA BCBS
Medicaids
CA Medicaid-MediCal
CT Medicaid
Pass
Payer ID Par/NonPar Through Eligibility
Fee*
Claims
Status
B2B Custom
Referral
(Envision
Portal
Eligibility Payer Search Options
Only)
60054
Non Par
N
Y
Y
00050
00060
00130
00160
52618
53759
00265
00332
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
N
N
N
N
N
N
N
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Anthem Eligibility
Anthem Eligibility
Anthem Eligibility
Anthem Eligibility
Anthem Eligibility
Anthem Eligibility
Anthem Eligibility
Anthem Eligibility
00540
1056
62308
06105
25127
MR030
MR031
MR032
MR024
00601
97003
97007
80705
04271
95567
95885
54704
1081
1052
21313
BS059
Non Par
Non Par
Non Par
Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Par
Non Par
Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
N
Y
N
N
Y
N
N
N
N
Y
Y
Y
N
N
N
Y
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
N
Y
Y
N
N
N
N
N
N
N
N
Y
N
N
N
N
N
N
N
N
Blue Cross CA Eligibility
CHA Health Plan Eligibility
Cigna Eligibility
Connecticare Eligibility
Coventry of GA Eligibility
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
Georgia BCBS Eligibility
Glassman- Directors Guild Eligibility
Glassman- Writers Guild Eligibility
Great West Eligibility
Harvard Pilgram Eligibility
HealthNet of CA Eligibility
Humana Eligibility
Independence Blue of PA Eligibility
Inland Empire Eligibility
InterValley Search Eligibility
Kaiser Permanente Of GA Eligibility
MA BCBS Eligibility
72727
00032
Non Par
Non Par
Y
Y
Y
Y
N
N
CA Medicaid Eligibility
CT Medicaid Eligibility
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Y
Aetna Eligibility
Updated: 12/14/2006
Provider Portal and B2B Payer List
Payer Name
Florida Medicaid
GA Medicaid
Kentucky Medicaid
MA Medicaid
Mississippi
Missouri
Ohio
Oklahoma
Pennsylvania
Texas
VA Medicaid
WA Medicaid
Medicare
Medicare - Alabama
Medicare - Alaska
Medicare - Arizona
Medicare - Arkansas
Medicare - Colorado
Medicare - Connecticut
Medicare - Delaware
Medicare - Florida
Medicare - Georgia
Medicare - Hawaii
Medicare - Idaho
Medicare - Illinois (WPS)
Medicare - Indiana
Medicare - Iowa
Medicare - Kansas
Medicare - Kentucky
Medicare - Louisiana
Medicare - Maine
Medicare - Maryland
Medicare - Massachusetts
Medicare - Michigan (WPS)
Medicare - Minnesota (WPS)
Medicare - Mississippi
Pass
Payer ID Par/NonPar Through Eligibility
Fee*
Claims
Status
Referral
(Envision
Portal
Eligibility Payer Search Options
Only)
77027
77034
00043
00014
77032
72728
87728
00023
97001
00066
00024
77045
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
N
N
N
N
N
N
N
N
N
N
N
N
FL Medicaid Eligibility
GA Medicaid Eligibility
KY Medicaid Eligibility
MA Medicaid Eligibility
MS Medicaid Eligibility
MO Medicaid Eligibility
OH Medicaid Eligibility
OK Medicaid Eligibility
PA Medicaid Eligibility
TX Medicaid Eligibility
VA Medicaid Eligibility
WA Medicaid Eligibility
MR054
MR010
MR008
MR055
MR004
MR049
MR039
MR025
MR015
MR057
MR003
MR023
MR041
MR036
MR060
MR052
MR048
MR043
MR038
MR061
MR017
MR019
MR050
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
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Updated: 12/14/2006
Provider Portal and B2B Payer List
Payer Name
Medicare - Missouri (BCBS Arkansas)
Medicare - Missouri (Kansas City)
Medicare - Montana
Medicare - Nebraska
Medicare - Nevada
Medicare - New Hampshire
Medicare - New Jersey
Medicare - New Mexico
Medicare - New York (Empire)
Medicare - New York (Ghi-Queens Cty)
Medicare - North Carolina
Medicare - North Dakota
Medicare - Northern California
Medicare - Ohio
Medicare - Oklahoma
Medicare - Oregon
Medicare - Pennsylvania
Medicare - Rhode Island
Medicare - South Carolina
Medicare - South Dakota
Medicare - Southern California
Medicare - Tennessee
Medicare - Texas
Medicare - Upstate New York
Medicare - Utah
Medicare - Vermont
Medicare - Virginia (TrailBlazer)
Medicare - Washington
Medicare - Washington DC
Medicare - West Virginia
Medicare - Wisconsin
Medicare - Wyoming
Railroad Medicare/ Palmetto GBA
Molina
Molina CA
Molina MI
Pass
Payer ID Par/NonPar Through Eligibility
Fee*
Claims
Status
Referral
(Envision
Portal
Eligibility Payer Search Options
Only)
MR094
MR044
MR047
MR092
MR007
MR051
MR035
MR076
MR042
MR045
MR020
MR083
MR002
MR033
MR013
MR011
MR027
MR075
MR028
MR084
MR001
MR034
MR005
MR059
MR046
MR062
MR022
MR006
MR040
MR056
MR053
MR074
MR018
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
Non Par
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
CMS Search Options & Enroll Form
97006
52630
Non Par
Non Par
Y
Y
Y
Y
N
N
Molina Eligibility
Molina Eligibility
3of 8
Updated: 12/14/2006
Provider Portal and B2B Payer List
Payer Name
Molina UT
Molina WA
Oxford Health Plans, Inc.
Pacificare
Pacificare CA
Pacificare OK
Pacificare OR
Pacificare TX
Pacificare WA
San Joaquin Health Plan
SCAN HMO
Stanislaus County MIA
United Healthcare
Western Health Advantage
Pass
Payer ID Par/NonPar Through Eligibility
Fee*
95502
Non Par
38336
Non Par
06111 Transitional
Y
Y
N
Y
Y
Y
Claims
Status
N
N
Y
Referral
(Envision
Portal
Eligibility Payer Search Options
Only)
Y
Molina Eligibility
Molina Eligibility
Oxford Eligibility
95959
Non Par
N
Y
Y
Pacificare Eligibility
96903
Non Par
N
Y
Y
Pacificare Eligibility
95893
Non Par
N
Y
Y
Pacificare Eligibility
95174
Non Par
N
Y
Y
Pacificare Eligibility
48038
Non Par
N
Y
Y
Pacificare Eligibility
1046
Non Par
Y
Y
N
San Joaquin Health Plan Eligibility
97002
Non Par
Y
Y
N
SCAN HMO Eligibility
1045
Non Par
Y
Y
N
Stanislaus County MIA Eligibility
87726 Transitional
N
Y
Y
UHC Eligibility
Western Health Advantage Eligibility
1043
Non Par
Y
Y
N
* Pass Through Fee varies by payer. Please speak to your account representative for details.
* These Payers require enrollment. Please request Enrollment Forms from: [email protected]:
Anthem Blue Cross Blue Shield Payers- CSI only
Blue Cross of CA- Eligibility and CSI
Georgia BCBS- Eligibility only
Par = Payers which participate with MedAvant in efforts to increase EDI volumes by subsidizing all, or a significant portion, of the cost of electronic transmiss
Non Par = Payers which do not participate with MedAvant in programs to increase EDI volumes by subsidizing the cost of electronic transmission.
Transitional = Payers which participate with MedAvant in efforts to increase EDI volume, but do not fully subsidize the cost of electronic transmission.
4of 8
Updated: 12/14/2006
Provider Portal and B2B Payer List
mers
CSI Payer Search
Options
Aetna CSI
Anthem CSI
Anthem CSI
Anthem CSI
Anthem CSI
Anthem CSI
Anthem CSI
Anthem CSI
Anthem CSI
Blue Cross CA CSI
Cigna CSI
Connecticare CSI
Great West CSI
5of 8
Updated: 12/14/2006
Provider Portal and B2B Payer List
CSI Payer Search
Options
6of 8
Updated: 12/14/2006
Provider Portal and B2B Payer List
CSI Payer Search
Options
7of 8
Updated: 12/14/2006
Provider Portal and B2B Payer List
CSI Payer Search
Options
Oxford CSI
Pacificare CSI
Pacificare CSI
Pacificare CSI
Pacificare CSI
Pacificare CSI
UHC CSI
ion.
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