We are proud to offer our own unique Claims processing and Benefit administration solutions. PAI will not require that you repay the refund until PAI has concluded its review. For general inquiries or to file a claim, visit our Submitting a Claim page. Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com. American Plan Administrators. Try taking a look at our. P.O. Please contact the TPA with questions on these topics. 2023 American Benefits Group. How To File A Claim - American Benefits Group - amben.com Chattanooga, TN 37422-7223. 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. hbbd```b`` `>"@``rXd."#;H)`'`y f\"y7A$g-Xd2#7mVXD]"MAD = G`$C (888) 505-7724 updates@sbmamec.com You will receive a response within 2 business days. Van Nuys, CA 91409-9055, Other States: This team is diligent and kind. Cigna. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. Fax: 406-652-5380. Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . Contact Us | AMA Insurance Provider Portal 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. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k Please forward your refund repayments to: Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more. You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. Birmingham, AL 35238, 2023 American Benefit Administrators. 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. The team uses PMI standards and project management tools along with IT industry best practices. 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 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 Locations: For a full list of Zenith American Solutions office locations: Click Here Corporate Headquarters: Zenith American Solutions, Inc. Two Harbor Place 302 Knights Run Avenue, Suite 1100 Tampa, FL 33602 (813) 666-6900 Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) 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 83 0 obj <> endobj 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. American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. %%EOF 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. Copyright 2016 AMA Insurance, Inc. All rights reserved. Its almost here! Ple ase send all c orrespondence and non-claim inquiries to the TPA addresses below. Email: sales@americanbenefitadministrators.com, American Benefit Administrators Box 9055 Home; About; Advantages; Solutions/Services; Resources; Contact us Columbia, SC 29260. Box 380844 CHCP - Resources - Active Accounts - Cigna 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 Helping You Provide The Best Possible Care. As a health care provider, you are an integral part of our team. Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . Electronically Electronic/Payor ID: 50114. American Plan Administrators - Contact us. endstream endobj startxref Submitthe request via email to PAI Provider Maintenance at paiprovmtn@paisc.com. 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. Claims paid under PSIP Program are subject to county audit. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. Please refer to the members identification card to determine the applicable network. 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 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. Please let us know if you experience any trouble or if you need help using the AMA Insurance Verification of Benefits Portal. 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) Our online tools will give you all the information access you need to utilize patients health benefits to support their care. Employees. For assistance with portal registration or portal password assistance, please call 877-777-0031. 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. Employees. Out of network claims - EyeMed Vision Benefits P.O. Contact; Log In; Hit enter to search or ESC to close. Please use the form below to contact AMA Insurance. ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK Chicago, IL 60680-4104. Take control of your benefits. 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 Return the completed form and your itemized paid receipts to: First American Administrators, Inc. Attn: OON Claims P.O. This field is for validation purposes and should be left unchanged. Authorized to administer business in all 50 states, hundreds of employers across the country and their covered employees rely on PAI. support@americanbenefitadministrators.com, clientservices@americanbenefitadministrators.com. endstream endobj 1230 0 obj <. Participant Support:support@americanbenefitadministrators.com American Insurance Administrators About Us; Contact; Helpful Links; Online Forms; Coordination of . The new PAI provider portal is going live. 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. American Plan Administrators - Overview, News & Competitors - ZoomInfo Phone: 800-777-3575 If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. 24 hours a day, 365 days a year. If youre interested in improving your benefit plan and improving lives, drop us a line. 1268 0 obj <>stream 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. Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. Log in to your account to confirm your specific . Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. Sarasota, FL 34230-1558, Report a Property, Liability, or Auto Claim, Agent & Broker Resources, Support & Online Tools. Zenith Insurance Company As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. There are two easy ways to submit claims to Sana. To all our customers and vendors, please note that American Benefit Administrators will continue to provide you with continued support and continue our operations. Changes made will not be reflected on all impacted systems for up to 2 business days. 152 0 obj <>stream PDF Cigna Payer Solutions Active Accounts Update - MemberClicks Provider Claim Submission to APWU Health Plan - apwuhp.com December 2020. Its almost here! SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. Toll Free: 866.742.4900 Its a stark contrast from the individuals I spoke to at carriers when following up on enrollments. 18 Heyward St. Brooklyn, NY 11249. For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. %%EOF 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 General Assistance - Zenith American You would need to reimburse yourself and then pay your provider directly. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. Toll Free: 1.800.854.3643 Local: 1.714.250.3000. Staff Photography by Jessica Marie Photography Inc. Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit If you currentlyparticipate with the Preferred Blue Network, then you are already set up with PAI as a participating provider. 0 Corporate Headquarters. Providers | EBPA If you are a participating CompNet provider seeking to manage addresses and . The new PAI provider portal is going live. For general assistance, please call your Client Services representative or your Customer Care team. The long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. Prior authorization varies from group to group. 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. Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson PRAC Bulletin. View contact profiles from American Plan Administrators Popular Searches American Plan Administrators American Plan Administrators LLC P.O. Hours: 7:00 a.m. 6:00 p.m CST. The cost of healthcare continues to grow at an unsustainable pace. 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 . The original entity of Zenith American Solutions has been in business since 1944. 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. 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. Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. Contact Us For Information on Benefit Plan Administration | EBMS 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 2009-2023 Zenith Insurance Company. PAI will not require that you repay the refund until PAI has concluded its review. 1 (800) 244-6224. 2023 Planned Administrators Inc. All rights reserved. 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. First American Financial Corporation 1 First American Way Santa Ana, California 92707. Title Claims Contact. american plan administrators claim mailing address 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: Box 855 Arnold, MD 21012 PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. 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. Receiving illegal calls claiming to be from American Benefits Group? AMA Insurance Agency, Inc. First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday %PDF-1.6 % . PDF Network Prefix List - CareFirst Provider We offer a state-of-the art member portal to help you make the most of your health benefits. Providers | Planned Administrators Inc. (PAI) American Plan Administrators - Contact us HCP Login. There you will find answers to common questions, details about your plan, and much more. As may vary by group, please call the phone number listed on the member ID card. PDF VISION OUT-OF-NETWORK CLAIM FORM Claim submissions made easy They are web-based or Internet-accessible solutions that facilitate seamless front office and back office operations. Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. PAI EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network, CompNet. Access your online portal usingthis form. View Map, Employee BenefitManagement Services 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 Medical Claims. Login to your account. PO Box 804238 1229 0 obj <> endobj 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. If you use the EDGE portal, additional login information can be found on theEDGE Hub. 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 This team was incredibly patient, kind, and helpful. Box 1558 Participant Inquiries: cobra@americanbenefitadministrators.com 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. Please Be Advised. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. I respect a service team that does what they say theyre going to do with quality! Access the link below for easy-to-use claim filing. New User?Please click here to register. LOS ANGELES, CA 90017-1906. 6:00 a.m. 8:00 p.m. MST, Corporate Office Customized Solutions for Third Party Administrators | Cigna We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. You will need an Employer ID when you register. Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. North America Administrators - Lucent Health Client/Employer Support:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: Contact Us | First American 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. Need answers now? Fax an updated W-9 to (803) 264-9089 All rights reserved. Benefits administration is a difficult, increasingly complex business. PAI P.O. 2022 Employee Benefit Management Services, LLC. CareFirst contracts with Third Party Administrators to the Network claims product. Billings MT 59102 %PDF-1.6 % hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; 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. Contact the Customer Service number on the member ID card if you need assistance. endstream endobj startxref By Mail Sana Benefits Claims P.O. Submitting a Claim - Sana Benefits PSIP Reimbursement Rates for 2020/ . Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. Cigna shares the administration of the plan with a third party. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. Preferred Network Arrangements. The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. 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? P.O. 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. Zenith Insurance Company 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. Toll Free: 866.742.4900 d '7y[ f| m x06w a>g *As part of our effort in achieving a 100% paperless office we encourage you to receive your reimbursements directly into your bank account. Cigna. 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. These tools focus on quality and ensuring the best possible end result for each and every user. *Out-of-network form submission deadlines may vary by plan. If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. hb```f``Z`qA2l,1`c(.`Wb4kE/'fLBmlm>x2faTn`9w]B@/.Se~i Ip2) iF r,`qRf`@ 1 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. Notice of Privacy. Provider Contacts and Billing Information - TheZenith Both American Benefit Plan Administrators and Zenith Administrators were strong TPA's prior to the merger, but by combining . 1-800-303-5242. I was very impressed with American Benefits Group after separation from my employer. 0 American Plan Adminstrators | Better Business Bureau Profile View the drug lists thatapply to members with PAIs pharmacy benefit coverage with OptumRx. Planned Administrators Inc. (PAI) Home - Zenith American Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM SBMA Benefits PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. Fill out our Request for Proposal Form. Several payers that DO receive claims electronically have been placed on this list for having poor services available. 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 For questions concerning your online portal, including login information, please email:helpdesk@zenith-american.com.
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