Need answers now? Claims paid under PSIP Program are subject to county audit. This team was incredibly patient, kind, and helpful. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k View Map, Employee BenefitManagement Services Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. If you currentlyparticipate with the Preferred Blue Network, then you are already set up with PAI as a participating provider. We will quickly get back to you with the information you need. 1268 0 obj <>stream Toll Free: 866.742.4900 PO Box 804238 Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. Take control of your benefits. Once logged in,you will have the ability to: EBPA encourages providers to take advantage of the online resources we have made available. Medical Claims. 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 [email protected] or call 1 (888) 284-6851. 152 0 obj <>stream Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at [email protected]. (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . 7:00 a.m. 8:00 p.m. MST, Monday-Thursday There are two easy ways to submit claims to Sana. 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. To all our customers and vendors, please note that American Benefit Administrators will continue to provide you with continued support and continue our operations. Birmingham, AL 35238, 2023 American Benefit Administrators. 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 Box 380844 Education Campaigns for HSA and Health FSA, Caution: Fradulent Calls Impersonating American Benefits Group, Health Reimbursement Arrangements Answers, How To File A Claim - Spanish (download PDF), How To Add/Edit Direct Deposit Information. PAI P.O. Preferred Network Arrangements. Attention: Refund Analyst Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. There you will find answers to common questions, details about your plan, and much more. This is nothing new; however, this is a good time to remind everyone of the feature. 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. 1229 0 obj <> endobj I respect a service team that does what they say theyre going to do with quality! *Out-of-network form submission deadlines may vary by plan. Cigna shares the administration of the plan with a third party. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; If you use the EDGE portal, additional login information can be found on theEDGE Hub. 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. %PDF-1.6 % Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. 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 For general assistance, please call your Client Services representative or your Customer Care team. Both American Benefit Plan Administrators and Zenith Administrators were strong TPA's prior to the merger, but by combining . Client/Employer Support:[email protected], COBRA/Direct Billing Administration: American Plan Administrators. Box 855 Arnold, MD 21012 Columbia, SC 29260. American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. megamenu1. Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. 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. The cost of healthcare continues to grow at an unsustainable pace. First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. Fax an updated W-9 to (803) 264-9089 We offer a state-of-the art member portal to help you make the most of your health benefits. We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. 1200 WILSHIRE BLVD-5TH FLOOR. If youre interested in improving your benefit plan and improving lives, drop us a line. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. endstream endobj startxref If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. . 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. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. Our online tools will give you all the information access you need to utilize patients health benefits to support their care. Ple ase send all c orrespondence and non-claim inquiries to the TPA addresses below. Log in to your account to confirm your specific . 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. Provider Address Change Fax an updated W-9 to (803) 264-9089 Please forward your refund repayments to: Box 6927 Please contact the TPA with questions on these topics. Toll Free: 866.742.4900 All rights reserved. 2018 Zenith American Solutions, Inc. All Rights Reserved. These tools focus on quality and ensuring the best possible end result for each and every user. Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. endstream endobj 84 0 obj <> endobj 85 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/Properties<>/XObject<>>>/Rotate 0/TrimBox[9.0 9.0 621.0 801.0]/Type/Page>> endobj 86 0 obj <>stream Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. PO Box 182223. AMERICAN INSURANCE ADMINISTRATORS. We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. 2023 Planned Administrators Inc. All rights reserved. PRAC Bulletin. 1.800.426.9786. Driving Directions. 24 hours a day, 365 days a year. 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. hYkO+-*T}B1ha4.$&&v,~SU $g )_xULXI0e21kF&W#q?JNOdilQ1&hWg Jst#nrmMLK{f)g667(8zjdpy'83>AyNG@y}W (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 Please contact our Provider Relations team at 800-440-5020 (option 3) or by email at [email protected] if you need: Help with finding network physicians or ancillary service providers; Information about our pharmacy benefit management program and other Zenith programs Prior authorization varies from group to group. Fax: 406-652-5380. HCP Login. Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . o Each card also includes the paper and electronic claims submission addresses. Access the link below for easy-to-use claim filing. For group-specific prior authorization information, please log in to the MyPAI Provider Portal above and review the members health benefit plan document. Copyright 2016 AMA Insurance, Inc. All rights reserved. Box 9055 Participant Support:[email protected] 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 For further information, please contact the precertification number located on the members identification card. 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: [email protected] - sendsecure.amben.com The Reimbursements Process Benefits administration is a difficult, increasingly complex business. If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. 2023 American Benefits Group. PAI will not require that you repay the refund until PAI has concluded its review. PSIP Reimbursement Rates for 2020/ . Receiving illegal calls claiming to be from American Benefits Group? We are proud to offer our own unique Claims processing and Benefit administration solutions. Employees. Notice of Privacy. Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. 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. Please let us know if you experience any trouble or if you need help using the AMA Insurance Verification of Benefits Portal. Chicago, IL 60680-4104. For questions concerning your online portal, including login information, please email:[email protected]. 1 (800) 244-6224. mZbqEm2dU1 (RtzEowwz{nZ/L++P@,*,&yiPQ9{KYp*GiERa&pS0\,fta1 kptdt 5P#ld[j u4wf;6qpB'Du` C0k&P"78-|;se}[bH&n )f[X2d%?%MQ.#G4ytT"5',i{+Y"+rR]Kk\EA%[X@-F FGlKZ"J8?qpZ?c8GH6*yl'yGw'fk uV{Q"U&!cq=%ib[#h9AH%D"zIA r+OhN#Ztu(O1\\!.irrZ>X_.R-vac92G#ZX>]BR92j]Y;Lu 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.
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