Login to your account. PO Box 182223. Toll Free: 866.742.4900 Hours: 7:00 a.m. - 6:00 p.m CST. Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. Box 9055 Register at launch to take advantage of the enhanced functionality launch date will be announced soon. If you currentlyparticipate with the Preferred Blue Network, then you are already set up with PAI as a participating provider. 152 0 obj <>stream Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. 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 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. PAI 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 If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. Return the completed form and your itemized paid receipts to: First American Administrators, Inc. Attn: OON Claims P.O. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. hb```f``Z`qA2l,1`c(.`Wb4kE/'fLBmlm>x2faTn`9w]B@/.Se~i Ip2) iF r,`qRf`@ 1 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. 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. endstream endobj startxref December 2020. For assistance with portal registration or portal password assistance, please call 877-777-0031. 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. To be complete, a claim must include a claim form that has been signed and dated by the account holder, and the following five pieces of information: Claims must be accompanied with receipts for the services rendered - for HRA claims an Explanation of Benefits (EOB) is required to show that the expense was applied to the insurance deductible. Try taking a look at our Frequently Asked Questions page. You would need to reimburse yourself and then pay your provider directly. 3333 Hesper Road Please forward your refund repayments to: %%EOF Phone: 800-777-3575 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 Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. M-F 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 hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k Try taking a look at our. This field is for validation purposes and should be left unchanged. Van Nuys, CA 91409-9055, Other States: As a health care provider, you are an integral part of our team. Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. 1 (800) 244-6224. 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. For general assistance, please call your Client Services representative or your Customer Care team. 1.800.426.9786. If you are a participating CompNet provider seeking to manage addresses and . 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. We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. 0 Chicago, IL 60680-4104. PAI will not require that you repay the refund until PAI has concluded its review. Together with the TPA, our goal is to educate members so they can make better, more informed health care decisions. 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 Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: There you will find answers to common questions, details about your plan, and much more. 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. Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM Box 1558 Electronically Electronic/Payor ID: 50114. Toll Free: 866.742.4900 P.O. They are web-based or Internet-accessible solutions that facilitate seamless front office and back office operations. Both American Benefit Plan Administrators and Zenith Administrators were strong TPA's prior to the merger, but by combining . Changes made will not be reflected on all impacted systems for up to 2 business days. ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK Birmingham, AL 35238, 2023 American Benefit Administrators. Toll Free: 866.742.4900 The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. 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. All Rights Reserved. Fill out our Request for Proposal Form. 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 original entity of Zenith American Solutions has been in business since 1944. Chattanooga, TN 37422-7223. As a TPA, Zenith American Solutions must keep up with the technology trends and innovations to continue providing best-in-class services to our clients and their members. endstream endobj 1230 0 obj <. View Map, Employee BenefitManagement Services Its not easy to accomplish but it has been my experience and I am very grateful.". Log in to your account to confirm your specific . Benefits administration is a difficult, increasingly complex business. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network, CompNet. Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. The new PAI provider portal is going live. 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. Cigna. Please Be Advised. AMERICAN INSURANCE ADMINISTRATORS. P.O. Contact; Log In; Hit enter to search or ESC to close. Zenith Insurance Company 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 megamenu1. Its been my privilege to work with PAI for a couple decades now PAI has done a good job of making us feel like we are their only client. Driving Directions. Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. Submitthe request via email to PAI Provider Maintenance at paiprovmtn@paisc.com. Toll Free: 1.800.854.3643 Local: 1.714.250.3000. Phone Number. Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. 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. Need answers now? Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. We offer a state-of-the art member portal to help you make the most of your health benefits. 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 meets the requirements and is authorized to administer business in all 50 states and serves all group markets. Dental Claims. 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. Media Relations Contact. PSIP Reimbursement Rates for 2020/ . This team was incredibly patient, kind, and helpful. Ple ase send all c orrespondence and non-claim inquiries to the TPA addresses below. Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson Preferred Network Arrangements. American Plan Administrators - Contact us. 2018 Zenith American Solutions, Inc. All Rights Reserved. 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? Prior authorization varies from group to group. Access the link below for easy-to-use claim filing. Cigna. If you use the EDGE portal, additional login information can be found on theEDGE Hub. As may vary by group, please call the phone number listed on the member ID card. SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. Several payers that DO receive claims electronically have been placed on this list for having poor services available. To all our customers and vendors, please note that American Benefit Administrators will continue to provide you with continued support and continue our operations. Or you can request a meeting on a specific topic, CLICK HERE to schedule. Contact the Customer Service number on the member ID card if you need assistance. 1254 0 obj <>/Filter/FlateDecode/ID[]/Index[1229 40]/Info 1228 0 R/Length 122/Prev 219460/Root 1230 0 R/Size 1269/Type/XRef/W[1 3 1]>>stream Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit By Mail Sana Benefits Claims P.O. 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. Participant Inquiries: cobra@americanbenefitadministrators.com Participant Support:support@americanbenefitadministrators.com remington pro1 flat iron; out-of-state broker commission texas; July 7, 2022. american plan administrators claim mailing address Columbia, SC 29260. Access your online portal usingthis form. 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. (888) 505-7724 updates@sbmamec.com The cost of healthcare continues to grow at an unsustainable pace. %PDF-1.6 % 18 Heyward St. Brooklyn, NY 11249. Box 855 Arnold, MD 21012 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. First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday ABA is committed and confident it will provide the same level of service. 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) You will need an Employer ID when you register. Attention: Refund Analyst 0 If youre interested in improving your benefit plan and improving lives, drop us a line. support@americanbenefitadministrators.com, clientservices@americanbenefitadministrators.com. American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. 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. All rights reserved. The new PAI provider portal is going live. o Each card also includes the paper and electronic claims submission addresses. 2023 Planned Administrators Inc. All rights reserved. PRAC Bulletin. We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. endstream endobj startxref PAI will not require that you repay the refund until PAI has concluded its review. Also, customers and vendors may be requested to provide electronic payment options for invoices. The long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. 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 %PDF-1.6 % Receiving illegal calls claiming to be from American Benefits Group? %%EOF You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. 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. Staff Photography by Jessica Marie Photography Inc. 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 There are two easy ways to submit claims to Sana. Fax an updated W-9 to (803) 264-9089 Authorized to administer business in all 50 states, hundreds of employers across the country and their covered employees rely on PAI. d '7y[ f| m x06w a>g Phonee: 718-625-6300. P.O. If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. 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 Box 380844 For further information, please contact the precertification number located on the members identification card. View the drug lists thatapply to members with PAIs pharmacy benefit coverage with OptumRx. 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. Our online tools will give you all the information access you need to utilize patients health benefits to support their care. First American Financial Corporation 1 First American Way Santa Ana, California 92707. 1268 0 obj <>stream LOS ANGELES, CA 90017-1906. PO Box 21367 Billings, MT 59104 Local Phone: 406-245-3575 Phone: 800-777-3575 Fax: 406-652-5380 Contact Us HCP Login. Claims paid under PSIP Program are subject to county audit. Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . This is nothing new; however, this is a good time to remind everyone of the feature. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. 2009-2023 Zenith Insurance Company. Once logged in,you will have the ability to: EBPA encourages providers to take advantage of the online resources we have made available. For general inquiries or to file a claim, visit our Submitting a Claim page. hbbd```b`` `>"@``rXd."#;H)`'`y f\"y7A$g-Xd2#7mVXD]"MAD = G`$C (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . Provider Address Change Fax an updated W-9 to (803) 264-9089 These tools focus on quality and ensuring the best possible end result for each and every user. 1-800-303-5242. Take control of your benefits. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. 24 hours a day, 365 days a year. 7:00 a.m. 8:00 p.m. MST, Monday-Thursday Its almost here! Please contact the TPA with questions on these topics. 2022 Employee Benefit Management Services, LLC. American Plan Administrators. Need answers now? Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. Employees. I was very impressed with American Benefits Group after separation from my employer. Notice of Privacy. (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. 119 0 obj <>/Filter/FlateDecode/ID[<38C6DB5AA9170743B09053647D1A6BD2>]/Index[83 70]/Info 82 0 R/Length 156/Prev 301728/Root 84 0 R/Size 153/Type/XRef/W[1 3 1]>>stream We are proud to offer our own unique Claims processing and Benefit administration solutions. 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 team uses PMI standards and project management tools along with IT industry best practices. For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. . Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more.
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