EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network, CompNet. Dental Claims. You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. %%EOF
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You will receive a response within 2 business days. 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 Cigna. Please contact our Provider Relations team at 800-440-5020 (option 3) or by email at providergroup@thezenith.com if you need: Help with finding network physicians or ancillary service providers; Information about our pharmacy benefit management program and other Zenith programs Once logged in,you will have the ability to: EBPA encourages providers to take advantage of the online resources we have made available. 2023 Planned Administrators Inc. All rights reserved. 0
This is nothing new; however, this is a good time to remind everyone of the feature. o ID Cards include the TPA or insurer's telephone number and address(es), for eligibility, benefits, claim status and payment inquiry. Business Profile American Plan Adminstrators Health Savings Administrators Contact Information 18 Heyward Street Brooklyn, NY 11249-9210 Visit Website Email this Business (718) 625-6300. (1) Allegiance Benefit Plan Management is responsible for administering various aspects of this patient's plan, which may include claim processing, utilization management or eligibility verification. First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday This team was incredibly patient, kind, and helpful. View Map, Employee BenefitManagement Services P.O. You would need to reimburse yourself and then pay your provider directly. PAI will not require that you repay the refund until PAI has concluded its review. For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. 2018 Zenith American Solutions, Inc. All Rights Reserved. If youre interested in improving your benefit plan and improving lives, drop us a line. endstream
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General Liability Notice of Occurrence/Claim, Glossary of Health Coverage & Medical Terms, Self Funded Health Benefit Administration, Property and Casualty Administrative Services, Non-Discrimination Statement and Foreign Language Access, CAA Transparency in Coverage + Machine Readable Files, Your Rights and Protections Against Surprise Medical Bills. . PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. Medical Claims. When you incur a reimbursable expense and are ready to file a claim you can do one of the following: Securely Email: claims@amben.com - sendsecure.amben.com. You will need an Employer ID when you register. Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. hb``` eaXm.;
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CareFirst contracts with Third Party Administrators to the Network claims product. Please use the form below to contact AMA Insurance. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. Also, customers and vendors may be requested to provide electronic payment options for invoices. American Plan Administrators. For group-specific prior authorization information, please log in to the MyPAI Provider Portal above and review the members health benefit plan document. If you currentlyparticipate with the Preferred Blue Network, then you are already set up with PAI as a participating provider. Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. Columbia, SC 29260. The new PAI provider portal is going live. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. PSIP Reimbursement Rates for 2020/ . For further information, please contact the precertification number located on the members identification card. Preferred Network Arrangements. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. PO Box 804238 High Option APWU HP is primary payer All states and U.S. Virgin Islands CIGNA HealthCare PO Box 188004 Chattanooga, TN 37422 or Payer ID 62308 High Option APWU HP is primary payer U.S. Virgin Islands Submitthe request via email to PAI Provider Maintenance at paiprovmtn@paisc.com. This team is diligent and kind. Email: sales@americanbenefitadministrators.com, American Benefit Administrators Home; About; Advantages; Solutions/Services; Resources; Contact us Participant Support:support@americanbenefitadministrators.com Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k
Toll Free: 866.742.4900 Hours: 7:00 a.m. - 6:00 p.m CST. Return the completed form and your itemized paid receipts to: First American Administrators, Inc. Attn: OON Claims P.O. 1 (800) 244-6224. PAI will not require that you repay the refund until PAI has concluded its review. Birmingham, AL 35238, 2023 American Benefit Administrators. For questions concerning your online portal, including login information, please email:helpdesk@zenith-american.com. Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. These tools focus on quality and ensuring the best possible end result for each and every user. Take control of your benefits. I was very impressed with American Benefits Group after separation from my employer. American Plan Administrators - Contact us. The original entity of Zenith American Solutions has been in business since 1944. 1200 WILSHIRE BLVD-5TH FLOOR. There are two easy ways to submit claims to Sana. If you receive a request for refund, you have the right to an appeal, if you do so within 30 days of the refund request. 18 Heyward St. Brooklyn, NY 11249. o Each card also includes the paper and electronic claims submission addresses. 1254 0 obj
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As the largest Taft-Hartley third-party administrator in the United States, weve used our industry know-how and resources to develop leading-edge technologies for our own use, as well as for self-administered trust funds. Chicago, IL 60680-4104. Its not easy to accomplish but it has been my experience and I am very grateful.". Both American Benefit Plan Administrators and Zenith Administrators were strong TPAs prior to the merger, but by combining resources, best practices and scale, the new organization is even stronger and better than before. Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. d
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m x06w a>g Login to your account. The original entity of Zenith American Solutions has been in business since 1944. We will quickly get back to you with the information you need. American Benefits Group (ABG) Navigating the Road to Consumer Directed Healthcare 2.0, American Benefits Group (ABG) Upping the Benefits Administration Game, Login to your account and find the Main Menu (top left) choose, Enter your claim information, then either: Upload the receipts via the portal or fax it with supporting documentation to 877-723-0147, Reimbursements for completed eligible claims received in our office by noon on Fridays, typically will be processed and checks sent the following Tuesday (during our busy time your reimbursement may be processed the following week), Claims Submission Including Receipt Upload. December 2020. Dental Claim Form; Medical Claim Form; Vision Claim Form; 953 American Lane, Suite 100 Schaumburg, IL 60173 Phone: (847) 519-1880 Toll-Free: (800) 323-1683 contactus@groupadministrators.com . Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . Helping You Provide The Best Possible Care. We strive to provide service excellence and a smooth experience to all our health care providers as they navigate our system to provide care. 2023 American Benefits Group. Get tools and flyers to share with your clients Dental Network Together, we can build a solution that's right for your clients For more information, email CignaPayerSolutions@cigna.com or call 1 (888) 284-6851. Whether you are a two-person startup group, a 30,000-employee enterprise, a public school system or a labor union, we have products and services that can meet your population needs and group priorities. All Rights Reserved. Participant Inquiries: cobra@americanbenefitadministrators.com Try taking a look at our. Employees. Please note that Credit Card receipts or cancelled checks are not valid documentation, Claims for personal hygiene items and cosmetics are not eligible expenses, Vitamins and supplements are not eligible without a doctors prescription, Massage therapy and weight-loss programs are only allowable to the extent that they are prescribed for a chronic condition or existing disease and supported by a doctors note submitted with the claim, We will keep doctors note on file but they must be renewed at the beginning of each plan year, Click here for a list of qualifying expenses. SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. AMERICAN INSURANCE ADMINISTRATORS. View the drug lists thatapply to members with PAIs pharmacy benefit coverage with OptumRx. Access your online portal usingthis form. Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM Fax an updated W-9 to (803) 264-9089 7:00 a.m. 8:00 p.m. MST, Monday-Thursday Please refer to the members identification card to determine the applicable network. Prior authorization varies from group to group. Box 9055 Toll Free: 866.742.4900 HCP Login. Zenith American Solutions has invested in a world class PMO (Project Management Office) that works to ensure each new implementation, enhancement, or change is managed to ensure a quality on time delivery. By Mail Sana Benefits Claims P.O. Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. Cigna shares the administration of the plan with a third party. PO Box 182223. 1268 0 obj
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To all our customers and vendors, please note that American Benefit Administrators will continue to provide you with continued support and continue our operations. Billings MT 59102 The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. Types of services that generally require precertification: *Any drugs, services, treatment or supplies that the managed care medical staff for PAI determines, with appropriate consultation, to be experimental, investigational or unproven are not covered services. 1.800.426.9786. Electronically Electronic/Payor ID: 50114. Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more. %PDF-1.6
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As may vary by group, please call the phone number listed on the member ID card. Sarasota, FL 34230-1558, Report a Property, Liability, or Auto Claim, Agent & Broker Resources, Support & Online Tools. Changes made will not be reflected on all impacted systems for up to 2 business days. AMA Insurance Agency, Inc. Or you can request a meeting on a specific topic, CLICK HERE to schedule. We appreciate hearing from you. endstream
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<. Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. Corporate Headquarters. 37 Industrial Drive, Exeter, NH 03833 | 800-258-7298 | TTY Number Dial711, 46 Bowdoin Street, South Burlington, VT 05407-2365 | 800-525-8788 | TTY Number Dial711, Security & Terms of Use Its almost here! Receiving illegal calls claiming to be from American Benefits Group? Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson Who is American Plan Administrators Headquarters 18 Heyward St, Brooklyn, New York, 11249, United States Phone Number (718) 625-6300 Website www.apatpa.com Revenue $5.2M Industry Insurance Is this data correct? Access the link below for easy-to-use claim filing. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. *Out-of-network form submission deadlines may vary by plan. PAI's preferred pharmacy benefit manager is OptumRx, a pharmacy care services company that creates smarter health care connections to help more than 65 million Americans realize improved care, lower costs, and a better overall experience. This field is for validation purposes and should be left unchanged. While some groups require prior authorization for all of these services, others may require prior authorization for more or less than the procedures specified below. hb```f``Z`qA2l,1`c(.`Wb4kE/'fLBmlm>x2faTn`9w]B@/.Se~i Ip2) iF r,`qRf`@ 1
Box 8504 Mason, OH 45040-7111 Patient Last Name (Required) Patient First Name (Required) MI Birth Date (MM/DD/YYYY) - - Street Address City State Zip Code About Us; Contact; Helpful Links; Online Forms; Coordination of . Our combined focus is providing the technologies, services, systems and support methodology to self-funded benefit plans so they get the solutions they need for increasingly complex regulatory changes and cost effective solutions. Please contact our Provider Relations team at 800-440-5020 (option 3) or by email at providergroup@thezenith.com if you need: Submit bills, reports, and other medically-related correspondence by mail or fax: California: endstream
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We are proud to offer our own unique Claims processing and Benefit administration solutions. megamenu1. Toll Free: 1.800.854.3643 Local: 1.714.250.3000. hYkO+-*T}B1ha4.$&&v,~SU $g )_xULXI0e21kF&W#q?JNOdilQ1&hWg
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(e?99gayXXrzOOgLk gE7yWM~NaV{a(YSUGwL0f1h6o8^qgNP\4z!n81Ves|\H{kjbBGem>)GW~[4OpW2C3lWp&zgMIj]E6U
__N[O&3_], Y+2-K>..SJ-3aRidtjMK2qT9}QCHAuVf&Iw*SFi*$9waOuoA5D=#9|(4 As the result, many self-administered Taft-Hartley trust funds and third-party administrators like Zenith American need easy-to-use, cost-effective, data-driven systems for a new era of administration. 83 0 obj
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They are web-based or Internet-accessible solutions that facilitate seamless front office and back office operations.
M-F Toll Free: 866.742.4900 The long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. 1229 0 obj
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PRAC Bulletin. LOS ANGELES, CA 90017-1906. As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. The new PAI provider portal is going live. 2023 Planned Administrators Inc. All rights reserved. Please forward your refund repayments to: All rights reserved. Need answers now? Provider Address Change Fax an updated W-9 to (803) 264-9089 PO Box 21367 Billings, MT 59104 Local Phone: 406-245-3575 Phone: 800-777-3575 Fax: 406-652-5380 Contact Us The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. (888) 505-7724 updates@sbmamec.com Please Be Advised. PAI ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK *As part of our effort in achieving a 100% paperless office we encourage you to receive your reimbursements directly into your bank account. Zenith Insurance Company 2009-2023 Zenith Insurance Company. 1-800-303-5242. We offer a state-of-the art member portal to help you make the most of your health benefits. Staff Photography by Jessica Marie Photography Inc. support@americanbenefitadministrators.com, clientservices@americanbenefitadministrators.com. Box 6927 Columbia, SC 29260 Provider's Refund Request Right of Appeal If you receive a request for refund, you have the right to an appeal, if you do so within 30 days of the refund request. For general assistance, please call your Client Services representative or your Customer Care team. To learn more about our customized solutions: If you are a Participant, Employer, Trustee or Provider: For questions concerning your online portal, including login information, please email. Need answers now? Contact the Customer Service number on the member ID card if you need assistance. Client/Employer Support:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: Title Claims Contact. The team uses PMI standards and project management tools along with IT industry best practices. Try taking a look at our Frequently Asked Questions page. Several payers that DO receive claims electronically have been placed on this list for having poor services available. . For assistance with portal registration or portal password assistance, please call 877-777-0031. Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com. endstream
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M-F Email: Login to your Secure Online Access portal and click on Contact Us Benefit Account Administration: Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) I was very impressed with the questions that they asked and their follow through with carriers in what could otherwise have been a very frustrating situation working with insurance companies. hbbd```b`` `>"@``rXd."#;H)`'`y f\"y7A$g-Xd2#7mVXD]"MAD = G`$C
P.O. 6:00 a.m. 8:00 p.m. MST, Corporate Office Enter your claim information, then either: Upload the receipts via the portal or fax it with supporting documentation to 877-723-0147 File a Claim Online using the ABG Smart Mobile App for smart phones and tablets Find out more about our mobile app Securely Email: claims@amben.com - sendsecure.amben.com The Reimbursements Process Both American Benefit Plan Administrators and Zenith Administrators were strong TPA's prior to the merger, but by combining . Benefits administration is a difficult, increasingly complex business. Phone: 800-777-3575 If your employer offers the ability to have reimbursements deposited to your bank account, you can set-up direct deposit by logging-in to your account, click Reimbursement Settings under the Claims tabwithin the WealthCare Portal. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. The cost of healthcare continues to grow at an unsustainable pace. New User?Please click here to register. We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. Hours: 7:00 a.m. 6:00 p.m CST. 3333 Hesper Road Please let us know if you experience any trouble or if you need help using the AMA Insurance Verification of Benefits Portal. Contact; Log In; Hit enter to search or ESC to close. Box 855 Arnold, MD 21012 Register at launch to take advantage of the enhanced functionality launch date will be announced soon. Its almost here! Copyright 2016 AMA Insurance, Inc. All rights reserved. Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. Claims paid under PSIP Program are subject to county audit. 2022 Employee Benefit Management Services, LLC. For general inquiries or to file a claim, visit our Submitting a Claim page. 0
Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit 119 0 obj
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Please contact the TPA with questions on these topics. ABA is committed and confident it will provide the same level of service. Cigna. AllCare Health Plan MRIPA N N/A Address - Some payers have multiple locations, but claims go to the same electronic location *Indicates claim is routed by paper. American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . First American Financial Corporation 1 First American Way Santa Ana, California 92707. Log in to your account to confirm your specific . We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. If you are a Medicare member, you may use the Out-Of-Network claim form or submit a written request with all information listed above and mail to: First American Admisinstrator, Inc. Att: OON Claims, PO Box 8504, Mason OH, 45040-7111. Notice of Privacy. Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: General Liability Notice of Occurrence/Claim, Glossary of Health Coverage & Medical Terms, Self Funded Health Benefit Administration, Property and Casualty Administrative Services, Non-Discrimination Statement and Foreign Language Access, CAA Transparency in Coverage + Machine Readable Files, Your Rights and Protections Against Surprise Medical Bills, Behavioral health services, including substance abuse treatment, Durable medical equipment (DME) over a specified dollar amount (varies), Investigational or experimental procedures*, Procedures considered cosmetic in nature, such as blepheroplasty, reduction mammoplasty or TMJ, A one-time notification when a member is initiating outpatientchemotherapy or radiation therapy. When I would call, I would reach an individual very quickly and they were always very willing to help and get on the phone with me when I called some of the carriers who were not reflecting my coverage. Claim Number Email Date of Service Phone Your Message Additional Contact Information Phone 1-888-627-5880 Business Hours 8 am - 5 pm CT, Monday - Friday Email AMA Insurance claims@amainsure.com Claims Mailing Address AMA Insurance Agency, Inc. PO Box 804238 Chicago, IL 60680-4104 %PDF-1.6
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Together with the TPA, our goal is to educate members so they can make better, more informed health care decisions. Attention: Refund Analyst 152 0 obj
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Chattanooga, TN 37422-7223. Van Nuys, CA 91409-9055, Other States: Our online tools will give you all the information access you need to utilize patients health benefits to support their care.