Professional (Medical) Payer List Payer ID Order

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1 Professional (Medical) Payer List Order Administrative of Kansas Updated August 2015 Administrative of Kansas (ASK) is Blue Cross and Blue Shield of Kansas DBA ASK. ASK 1

2 ASK accepts claims for the payers listed on this page at no charge to the trading partner. Participation in the Commercial Clearinghouse is not required for any transactions submitted for these payers. Additional Payers Available (Free) PAYER NAME Blue Cross and Blue Shield of Kansas Blue Cross and Blue Shield of Kansas City BlueCross and BlueShield of Western New York BlueCross and BlueShield of Western New York BlueShield of Northeastern New York Freedom Network Freedom Network Select Health Partners of Kansas (HPK) HealthNow New York, Inc Mo-Kan Sheet Metal Workers Welfare Fund PHP (Preferred Health Professionals) Preferred Health Professionals PPO (PHP PPO) ASK 2

3 Professional (Medical) Payer List Hill Physicians Medical Group UnitedHealthcare / Spectera Eyecare Networks Healthsource ME American Healthcare Alliance Magellan Health Healthsource NH Healthsource CMHC Healthsource Massachusetts Inc Smith Administrators UnitedHealthcare Community Plan / AZ (formerly AZ Physicians IPA APIPA) Phoenix Health Plan (Medicaid) Phoenix Health Plans (Medicare - Abrazo) Elderwood Health Pan American Life Insurance Group Neighborhood Health Plan (Boston MA) ELDER SERVICE PLAN OF THE NORTH SHORE Network Health Presbyterian (NM) Neighborhood Health Plan of Rhode Island (NHPRI) Gateway Healthy PA Diversified Administration Corporation - CT ConnectiCare Inc AARP MedicareComplete through UnitedHealthcare / Oxford Medicare Network AARP MedicareComplete through UnitedHealthcare / Oxford Mosaic Network UnitedHealthcare / Oxford Healthsource SC ASAGEHA Global Care Inc Physicians Health Plan (PHP) - SC University Family Care University Family Care - Maricopa Health Plan InTotal Health Christus Health Medicare Advantage Metropolitan Health Plan Fitzharris & Company Inc Fidelis Care New York New York Network Management CareCentrix Medical Initiative VA Fee Basis Programs Medica2 ASK 3

4 Professional (Medical) Payer List 128MI Aetna Better Health of Michigan 128MO Aetna Better Health of Missouri Alliance Healthcare/Florida for Stones River Regional IPA National Benefit Fund Montefiore Contract Management Organization Meridian Health Plan Central Reserve Life Ins Co-Medicare Supplement Continental General Ins Co-Medicare Supplement Great American Life Ins. Co-Medicare Supplement Loyal American Life Ins Co-Medicare Supplement Provident American Life & Health Ins Co-Medicare Supplement United Teacher Assoc Ins Co-Medicare Supplement MetroPlus Health Plan PHCS Savility Payers Insurance Design Administrators Hudson Health Plan BMC HealthNet Plan Boston Medical Center Health Plan Inc Boston Medical Center Health Plan Inc. Encounters Well Sense Health Plan Amalgamated Life - PA / Alicare AFTRA Health Fund ODS Health Plan CenterLight Healthcare Orthonet Corporation - CIGNA Orthonet - Uniformed Family Health Plan Orthonet- Aetna USFHP - St. Vincent Catholic Medical Centers of New York ALICARE Amalgamated Life Emblem Health (GHI - New York Group Health Inc.) Farm Family Life MVP Health Plan of NY CareCore National LLC (Aetna Radiology ) CareCore National LLC (Oxford Radiology ) CareCore National CareCore/WCNY RAD Stones River Regional IPA/BCBST Stones River Regional IPA/Windsor Stones River Regional IPA/BHFG Monitor Life Insurance Company RMSCO INC ARAZ Group America's PPO ASK 4

5 Professional (Medical) Payer List SCHC Total Care - Net Aspen Chautauqua County Healthcare Plan (Mayville NY) North Shore - LIJ (Healthfirst) Concentrix Insurance Solutions Agate Resources Inc. (LIPA) Cerner HealthPlan The Health Exchange (Cerner Corporation) Gemcare Health Plan Physicians Health Collaborative P ADMIN MDwise Excel Network Transchoice or TransSmile - First Service Administrator's Inc ESSENCE HEALTHCARE Molina Illinois Christus Health New Mexico HIX Kaiser Permanente of Georgia AIG Educational Markets St. Barnabas System Health Plan AmeriHealth Caritas Pennsylvania Fallon Community Health Plan Horizon NJ Health Maryland Physicians Care AmeriHealth VIP Care PA EGID (Employees Group Insurance Division) HP Administrative LLC OSEEGIB (Oklahoma State and Education Employees Group Ins. Board) NJ Carpenters Health Fund Managed Health Network Waterstone Benefit Administrators (Outside Oklahoma) Medico Life and Health Insurance Company Superior Administrators Inc (Santa Ana CA) First Priority Sentinel Management Significa Benefits Inc UPMC Health Plan Community Care BHO Pittsburgh Care Partnership Inc Keystone First Select Health of South Carolina Intergroup Corporation MFC & HealthPlus Peoria C&O Employees Hospital Association ASK 5

6 Professional (Medical) Payer List SANTA CLARA FAMILY HEALTH PLAN Pinnacle Management Inc Western Grower's Assurance Trust Western Grower's Insurance Company Advantra Savings Altius (Utah) Association Benefit Plan Carelink Medicaid Carenet Coventry Advantra Texas Coventry Health & Life (Oklahoma) Coventry Health Care Coventry Health Care Encounters Coventry Health Care Carelink - West Virginia only Coventry Health Care Carelink Medicaid - West Virginia only Coventry Health Care National Network Coventry Health Care of Florida Coventry Health Care of Florida Inc Coventry Health Care of Georgia Inc Coventry Health Care of Illinois Coventry Health Care of Iowa Inc Coventry Health Care of Kansas Inc Coventry Health Care of Louisiana Inc Coventry Health Care of Missouri Coventry Health Care of Nebraska Inc Coventry Health Care of Nevada Coventry Health Care of Virginia Coventry Health Care of the Carolinas Coventry Health and Life Insurance Company administered by PersonalCare Coventry Health and Life Insureance (Tennessee) Coventry Missouri Coventry Summitt Health Plan Inc Coventry of Health Care Delaware Inc CoventryCares of Kentucky CoventryCares of Michigan CoventryCares of Nebraska CoventryCares of Pennsylvania Diamond Plan (Maryland Medicaid) Foreign Service Benefit Plan Health America Inc./Health Assurance/Advantra Healthcare USA Mail Handlers Benefit Plan Maryland Medicaid ASK 6

7 Professional (Medical) Payer List Rural Carrier Benefit Plan UT- Altius (UHIN) University of Missouri Benefit Coordinators Corporation (Pittsburgh PA) SouthCare/Healthcare Preferred MCA Administrators Inc Gateway Health Plan Medicaid PA UnitedHealthcare Community Plan / SC (formerly Unison) UnitedHealthcare Community Plan/DEFLHILAMDMS CANNMOHPARI TX WA UPMC Vision Advantage 251MS Medstar Select/Medstar Medicare Choice 251PD Piedmont WellStar Health Plan 251PR Premier Health Plan Seven Corners Orthonet-HealthNet Central California Women's Health AllCare PEBB Retiree Health Trust Florida True Health Lifestyle Health Plans Delaware Physicians Care Inc Payer Fusion Gemcare IPA Arizona Priority Care Plus AmeriHealth Caritas Louisiana AMERIGROUP Community Care of New Mexico AMERIGROUP Georgia Amerigroup Community Care Amerigroup Corporation (Ft Worth) HealthPlus Amerigroup Amerigroup Corporation (Houston) Americaid Community Care (New Jersey) Americaid Community Care (Maryland) Amerigroup Illinois Amerigroup Ohio Amerigroup Florida Kern County CDCR Secure Health Plans of Georgia LLC PHYSICIAN'S ACCOUNTABLE CARE ORG Consumers Life Insurance Company Medical Mutual of Ohio Premier Health Systems Inc Galveston County Indigent Health Care ASK 7

8 Professional (Medical) Payer List Heritage Victor Valley Medical Group Sierra Medical Group Individual Health Insurance Companies State Farm Insurance Companies EBMC Employee Benefit Management Corp (EBMC) TPAC/Employee Benefit Management Corp The Physicians Assurance Corp (TPAC) /Employee Benefit Management Corp (EBM CareSource OH Tribute Health Plan Stoner and Associates (Cincinnati OH) Integra Group Integra Group-CHA AHPO (Cleveland OH) Healthsource OH Innovage Total Community Care Total Long Term Care Nationwide Health Plans HealthSpan Inc S & S Healthcare Strategies Family Health Partners - Healthwave of Kansas ElderPlan Inc VNA Homecare Options Better Health Plans of South Carolina Universal Care - California Loma Linda University Health Care Managed Care Dept OptumHealth Behavioral Solutions (formerly Pacificare Behavioral Health) Rady Children's Hospital San Louis Obispo Select Texas HealthSpring Molina Healthcare of California - Encounters Only Encounters Mercy Maricopa Integrated Care 33LGC Life Gift Cards 33LGC Mediphe Multiplan Wisconsin Preferred Provider Network Healthspan Central Reserve Life Self-Funded Plans Inc JP Farley Corporation Klais & Company 3414A Klais & Company (Repricing for HealthSpan Network Only) ASK 8

9 Professional (Medical) Payer List The Health Plan (Massillon Ohio and St. Clairsville Ohio only) Health Design Plus (Hudson OH) E-V Benefits Management Inc (Columbus OH) NABN (Cleveland OH) North American Benefits Network (Cleveland OH) Emerald Health Network Inc. (All PPO Business) Health Preferred (HSP) by Emerald Health Integrated Care Network (ICN) by Emerald Health FrontPath Health Coalition Comp - Ohio (Austintown OH) Ohio Health Choice PPO Mutual Health Apex Benefit Unified Physicians Network Aetna Better Health of NY MORRIS ASSOCIATES Indiana Teamsters Health Benefits Fund (Indianapolis IN) Local 135 Health Benefits Fund (Indianapolis IN) Employee Plans LLC Indiana ProHealth Network Managed Care LLC Sagamore Health Network Qual Choice of Arkansas Dunn and Associates Benefits Administrators Inc COOPERATIVE MANAGED CARE SERVICES St. Anthony Memorial Healthcare Centers - MDWISE St. Catherine Hospital PHO - MDWISE St. Francis Health Network St. Margaret Mercy Healthcare Centers - MDWISE Cornerstone Benefit Adminstrators Encircle PPO Encore Health Network The Healthcare Group North Texas Healthcare Network WellSystems LLC Benefit Administrative Systems Central States Health & Welfare Funds Teamcare AARP Hospital Indemnity Plans insured by UnitedHealthcare Insurance Co AARP Medicare Supplement Plans insured by UnitedHealthcare Insurance Co MANAGED HEALTH CARE ASSOCIATES Central DuPage Physician Group ASK 9

10 Professional (Medical) Payer List Advocate Medical Group - AMG (Legacy AHC) Associates for Health Care Inc. (AHC) Arkansas Managed Care Organization Inc. (AMCO) HFN Inc Physicians Care Network (Rockford IL only) Northwest Suburban IPA (Illinois) Northern Illinois Health Plan Ingalls Provider Group NorthShore University Health System Medical Group Health Options of Illinois American Imaging Management Inc Rush Prudential Health Plans (HMO Only) Senior Care Partners Century PHO INC Trellis Health Partners Oak West Physician Association Preferred Network Access Inc OAK WEST PRIMARY PHYSICIAN ASSOCIATION Swedish Covenant Hospital Centegra Health System Boilermakers National Health & Welfare Fund International Brotherhood of Boilermakers UNITED FOOD & COMM. WORKERS MIDWEST UNIONS Entrust Sage Technologies Lake County Physicians Association Physicians Health Association of Illinois HSHS Medical Group IPA CNIC Health Solutions Inc TR Paul Inc Western Mutual Insurance HealthSmart Benefit Solutions IAA Insurance Administrators of America Inc Select Benefit Administrators of America HealthSmart Benefit Solutions PAI Planned Administrators Inc RightChoice Benefit Administrators Compsych First Choice VIP Care UnitedHealthOne / Golden Rule Total Healthcare Inc Priority Health ASK 10

11 Professional (Medical) Payer List HAP/AHL/Curanet Medical Value Plan - Ohio (MVP) Weyco Inc Northern California Sheet Metal Workers Health Care Plan Sheet Metal Workers Local 104 Health Care Plan (San Ramon CA) Employee Benefit Concepts (Farmington Hills MI) Activa Benefit LLC Automated Benefit ASR ASR Corporation ASR Health Benefits Administration Systems Research Corporation Physicians Care (ASR Corporation) Physicians Care Health Plans (ASR Corporation) Physicians Care Network (ASR Corporation) Health Net of Arizona JOHN MORRELL COMPANY CO. - AHPBA Pro Care Health Plan Inc. (Detroit MI) Molina Healthcare of California ( only) Molina Healthcare of MICHIGAN Cofinity PPOM LLC Sentry Insurance a Mutual Company Sentry Life Insurance Company Sentry Life of New York Security Health Plan Assurant Health (IM & GROUP FULLY-INSURED) Benefit Plan Administrators Co. (Eau Claire WI) Dean Health Plan MercyCare Community Care Inc. (Wisconsin) Physicians Plus Insurance Corporation ARISE Quad Med LLC (Pewaukee WI) Great Lakes PACE Innovation Health INDECS Corporation Federated Mutual Insurance Wilson-McShane John Alden Life Insurance Co Meritain Health Minneapolis Life Trac PreferredOne (MN) ASK 11

12 Professional (Medical) Payer List Health Management Mayo Clinic Health Solutions OptumHealth Physical Health - includes Oxford (formerly ACN & ACNIPA) OptumHealth Physical Health - includes Oxford (formerly ACN & ACNIPA) Optum? Complex Medical Conditions (CMC) (formerly OptumHealth Care Solutio OptumHealth Care Solutions (formerly United Resource Networks) OptumHealth Care Solutions (formerly United Resource Networks) Encounters Ultra Benefits Inc IMCare American Republic Insurance Health Care Network of Wisconsin (HCN) Cenpatico TPA Centene TPA Centurion Butler Benefit Development Corporation American Specialty Health Mercy Health Plans Premier Benefits Inc Premier Health Plans Joplin / Benefit Management Inc Mercy Provider Network Government Employees Health Association (GEHA) Health Plans Inc American Postal Workers Union Health Plan INDEPENDENT LIVING SYSTEMS Meritus Health Partners GEHA (Multiplan) GEHA (PHCS) West Virginia Family Health Plan Oregon's Health CO-OP HealthyCT Inc University Healthcare Marketplace Fallon Total Care Avera Health Plans Crystal Run Health Plans Aspire Health Plan Montefiore HMO North Shore - LIJ CareConnect Insurance Company Inc. ASK 12

13 Professional (Medical) Payer List University Health Care Advantage State Auto Insurance Companies Continuum Health Solutions LLC AFFINITY MEDICAL GROUP Cincinnati Financial Corporation Midlands Choice Inc GMS Inc Highmark BCBSD Health Options Inc ProviDRs Care Network Via Christi HOPE Group and Pension Administrators Community Health Choice VGM Homelink Informed UHC Brokerage Concepts Kaiser Foundation Health Plan of the Mid-Atlantic States Inc National Telecommunications Cooperative Association Johns Hopkins Healthcare (USFHP) OneNet PPO (formerly Alliance PPO / MAPSI) Optimum Choice of the Carolinas Inc. (OCCI) UMWA Health & Retirement Funds MEDICAL DEVELOPMENT INTERNATIONAL Johns Hopkins Healthcare (EHP/PP) OptumHealth Care Solutions (formerly United Resources Networks Bravo Health Bravo Health Star Plus Cigna-Healthspring Conifer (formerly InforMed) Arbor Health Plan Healthscope Benefits - EHC Repricing March Vision Care Inc NALC/Affordable National Association of Letter Carriers National Association of Letter Carriers/NALC Anchor Benefit Consulting Inc Martin's Point Health Care APS Healthcare Inc Virginia Premier Health Plan Conversion Plan-APWU Allegian Choice Conifer Value-Based Care Harbor Choice Phoenix Choice ASK 13

14 Professional (Medical) Payer List VA-Patient-Centered Community Care Program (VAPCCC) Region VA-Patient-Centered Community Care Program (VAPCCC) Region 5A VA-Patient-Centered Community Care Program (VAPCCC) Region 5B VA-Patient-Centered Community Care Program (VAPCCC) Region American Family Medicare Supplement and PPO Policies Administered by Am Rep BENEFIT MANAGEMENT SERVICES Healthgram Inc Healthsource NC (CIGNA) MedCost Inc OptiCare Managed Vision American Trust Administrators Inc First Carolina Care Detroit Medical Center Kanawha HealthCare Solutions Inc Kanawha Insurance Co CWIBENEFITS INC Ware Inc. dba ManageMed Tricare North Region CARE 1ST HEALTH PLAN OF CA Care 1st Health Plan of Arizona OneCare QVI Risk Solutions Inc State of Texas Dental Plan Stones River IPA - Amerivantage Physician Health Cooperative/SRRIPA Aetna Affordable Health Choices (SM) - SRC ADVANCED DATA SOLUTIONS MedAdmin Solutions Coordinated Medical Specialists MedAdmin Solutions Network TPA LLC Physician Associates of Louisiana Physician Care Network LLC Podi Care Managed Care Healthsource GA (CIGNA) Healthways WholeHealth Networks Harbor Advantage (Abrazo Health Care) Assurant Health/ASA (Assurant Health members with ASA PPO Network) ASK 14

15 Professional (Medical) Payer List Memorial Integrated Healthcare/South Florida Community Care Network The National Radiology Network Fringe Benefits Coordinators Heritage Consultants MedCom AvMed Inc AVMED INC Encounters First Service Administrator's Inc Lakeland Florida Advanzeon Solutions Florida Hospital Healthcare Systems PODIATRY NETWORK FL Alpha Health Plan Inc Christian Care Ministry Advantica Benefits Aetna Aetna Encounters Aetna Encounters Encounters Northstar Advantage Preferred Health Systems Insurance Company Preferred Plus of Kansas Interface EAP (IEAP) Community Health Choice-Health Insurance Marketplace Gateway Health Plan - Medicare Assured Community Care Inc. - Family Care (Wisconsin) Humana Emphesys Humana Employers Health Insurance Humana Inc Humana Insurance Company Choice Care Network Humana Inc. Encounters Encounters Preferred Health Plan (Louisville KY) Humana Veterans Healthcare Bluegrass Family Health Humana Military - Tricare South Healthsource KY J. F. Molloy and Associates Inc Principal Financial Group PrimeWest Health Preferred Health Systems A Coventry Health Care Plan American General Healthsource TN (CIGNA) Windsor Medicare Extra Health Partners - Jackson TN Unified Health ASK 15

16 Professional (Medical) Payer List Better Health Plans Inc Unison Health Plan/Better Health Plans CIGNA CIGNA - PPA CIGNA - PPO CIGNA Health Plan - HMO Connecticut General (CIGNA) EQUICOR EQUICOR - PPO Seton Employee Plan TRILOGY NETWORK HealthSpring HMO/HealthSpring Medicare+Choice Great-West Healthcare (formerly American General) Health Plan Management (HPMS) DentaQuest Vision EyeQuest Valir Pace Acclaim Mississippi Physicians Care Network Mississippi Select Health Care Select Administrative (SAS) AmFirst Insurance Company Meritain Health Agency Inc Meritain Health / Agency Pivotal Plan Orange County Health Care Agency CarePlus Health Plans Inc NAA (North America Administrators L.P.) (Nashville TN) CareFlorida Preferred Care Partners Encounters Preferred Care Partners Florida Silver Cross Health Connection Community Medical Group of the West Valley Inc Eastland Medical Group West Covina Medical Group LakeSide Medical Group Verdugo Hills Medical Group Lakeside Comprehensive Healthcare Community Health Group CentraCare Unity Health Insurance Parkland Community Health Plan Sterling Medicare Advantage ASK 16

17 Professional (Medical) Payer List Health Net - VA Patient Centered Community Care Program Health Plan of San Joaquin San Joaquin Health Administrators John Muir Mt. Diablo Health System John Muir Physician Network OMNI/Medicore HP California Health & Wellness Cenpatico - Arizona Cenpatico - FL Cenpatico - Georgia Cenpatico - Indiana Cenpatico - OHIO Cenpatico - WI Cenpatico Behavioral Health Cenpatico Behavioral Health Texas Cenpatico Massachuetts Cenpatico New Hampshire Cenpatico South Carolina Centene Advantage Plans ILCBH KS - Cenpatico Kansas KY - Cenpatico Kentucky MO - Cenpatico Missouri MS - Cenpatico Mississippi Absolute Total Care Advantage by Bridgeway Health Solutions Advantage by Buckeye Community Health Plan Advantage by Managed Health Advantage by Peach State Advantage by Sunshine State Advantage by Superior HealthPlan Ambetter from Buckeye Community Health Plan Ambetter from CeltiCare Health Plan Ambetter from Magnolia Health Ambetter from Managed Health Ambetter from Peach State Health Plan Ambetter from Sunshine Health Ambetter from Superior Health Ambetter of Arkansas Bridgeway Arizona Buckeye Community Health CeltiCare Granite State Health Plan IlliniCare ASK 17

18 Professional (Medical) Payer List KS - Sunflower State Health Kentucky Spirit Health Plan Louisiana Healthcare Connections MO - Missouri Home State Health Care Magnolia Managed Health Indiana (Medicaid HMO) Managed Health Wisconsin Michigan Fidelis Secure Care Peach State Health Plan Sunshine State Health Plan Superior Health Plan Texas WA - Washington Coordinated Care Healthsource Provident Harbor Health Plan Union Security Insurance Company PACE CNY Healthsource AR (Med) (CIGNA) Continental General Insurance Company ExclusiCare Mutual of Omaha Insurance Company Mutually Preferred United of Omaha LifeCircles PACE PHCS (formerly American LIFECARE) Peoples Health Network PPOPlus LLC SCAN Health Plan QuikTrip C. L. Frates & Co - OSMA Health OSMA Health - C. L. Frates Standard Life and Accident Insurance Company Equitable Plan (Oklahoma City OK) Community Care Managed Health Care Plans of Oklahoma Preferred Community Choice/PCCSelect/CompMed Healthcare Solutions Group Waterstone Benefit Administrators (Oklahoma Providers) First Health Network (f.k.a. CCN Managed Care Inc. & PPO Oklahoma) Scan Health Plan Arizona American National Ins. Co. (ANICO) USAA (United Automobile Association) Wisconsin Department of Corrections UnitedHealthcare StudentResources Assured Benefits Administrators ASK 18

19 Professional (Medical) Payer List MHNET MedBen (Newark OH) Medical Benefits Administrators Inc. (Newark OH) Medical Benefits Companies (Newark OH) Medical Benefits Mutual (Newark OH) Medical Benefits Mutual Life Insrance Co Harpeth IPA - Amerivantage AmeriBen Solutions Inc First Choice of Midwest (PPO) AAG-American Administravie Group ( Formerly Icon Benefit Admin) Employers Direct Health Employer's Direct Health - SF Employer's Direct Health - FI Employer's Direct Health - Employee Plan Healthsmart Accel AAG Benefit Plan Administrators Inc American Administrative Group HealthSmart Preferred Care Inc Healthsource N. TX (CIGNA) Verity National Group Geisinger Health Plan IHG Direct Angeles IPA (SynerMed) Bellflower Hospital (Synermed) East LA - APMG Employee Health System Medical Group Fresno - ENH Medical Group Gardena Memorial Medical Center Hollywood Presbyterian (Synermed) Inland Valleys IPA Multicultural Primary Care Medical Group (San Diego) (Synermed) Pacific Alliance Medical Center Pacific Alliance Medical Group and Hospital (Synermed) Redlands IPA (Synermed) Sacramento - Primary Care Practices of Sacramento - EHS Southern CA Children's Network (SynerMed) Temple Community Hospital The City of Odessa SelectCare of Texas (HPN) Heritage Physicians Network Seton CHIP Renaissance Physicians Organization Midwest Health Partners ASK 19

20 Professional (Medical) Payer List Health Plan of Nevada Sierra Health and Life Health Plan of Nevada (Encounters) Encounters Sierra Health and Life (Encounters) Encounters LifePath Hospice Inc Good Sheperd Hospice Inc AmeriHealth Caritas NorthEast Amerihealth Caritas District of Columbia Prestige Health Choice Amerihealth VIP Care- LA Amerihealth VIP Care- DC First Choice VIP Care Plus - SC MidCoast IPA AmeriHealth Caritas VIP Care Plus (Michigan) Ultimate Health Plan Carepoint Health Plans Central Valley Medical Group Sante Health System and Affiliates Kern Health Systems Arcadian Management Inc Keystone Connect (Amerihealth) AmeriHealth Connect (AMERIHEALTH CARITAS) Fidelis Seniorcare VNS CHOICE Medicare WPP-ElderCare Wisconsin Care Improvement Plus (CIP) DELANO IPA Southeastern Indiana Health (SIHO) Clearchoice Health Plan / COIHS Sutter Gould Medical Foundation Sutter Medical Group of the Redwoods Sutter Delta Medical Group Kentucky Health Cooperative Connecticare - Medicare UMR (formerly UMR Onalaska) Amida Care Medicare MSC (Medical Service Company) Group Inc MDI Holdings (Formerly Medical Partners of America) Innovative Physician Associates LLC Healthfirst Health Plan of New Jersey Healthfirst Inc. (New York) Senior Health Partners (SHP) GIC Indemnity Plan UNICARE ASK 20

21 Professional (Medical) Payer List Great-West Healthcare Allegiance Benefit Plan Management Inc UnitedHealthCare / All Savers Alternate Funding UnitedHealthOne / PacifiCare Life and Health Insurance Company Molina Healthcare of Puerto Rico HCS - Health Service (Boise ID) Primary Health Network MBA Benefit Administrators Inc (Salt Lake UT) SENIOR WHOLE HEALTH Advantek Benefit Administrators Health Plan of Michigan Sloans Lake Preferred Health Networks Pinnacol Assurance Denver Health Medical Plan Inc. - Medicare Choice United Medical Alliance Denver Health and Hospital Authority Denver Health and Hospital Authority - Indigent Care Denver Health Medical Plan InterWest Health (Acceptius Gateway payer) CHAMPVA - HAC Children of Women Vietnam Veterans-VA HAC Spina Bifida - VA HAC Keystone VIP Choice Virginia Coordinated Care-VCC Wabash Memorial Hospital Association Ingalls Provider Group Healthcomp Inc UnitedHealthcare Community Plan / NJ UnitedHealthcare Community Plan/NJ (formerly AmeriChoice Personal Care Pl UnitedHealthcare Community Plan / NY (formerly AmeriChoice Personal Care) UnitedHealthcare Community Plan / PA (formerly AmeriChoice Personal Care ) CIGNA Medicare Advantage Mountain States Administrative (Tucson AZ) UnitedHealthcare Community Plan / NJ UnitedHealthcare Community Plan / NY (formerly AmeriChoice NY Medicaid) UnitedHealthcare Community Plan / PA (formerly AmeriChoice PA Medicaid&CHIP Mercy Care Plan (AHCCCS) Ancillary Benefit (ABS) ASK 21

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