Appendix C Most Common Payer ID/Health Plan ID Numbers (NAIC Codes)
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1 Most Common Payer ID/Health Plan ID Numbers ( s) Aetna Better Health, Inc. Medicaid HMO Aetna Health, Inc. HMO Aetna Health, Inc. Medicare HMO Golden Medicare Aetna Health, Inc. Medicare PPO Golden Choice Aetna Life Insurance Company Fee for Service TraditionalChoice Aetna Life Insurance Company POS Aetna Life Insurance Company PPO American Progressive Fee for Service American Progressive Medicare PPO Today's Options PPO AmeriHealth HMO AmeriHealth Medicaid HMO AmeriHealth Mercy AmeriHealth Medicare HMO AmeriHealth 65 AmeriHealth POS AmeriHealth PPO Bravo Health Insurance Co. Inc. Fee for Service Bravo Health Pennsylvania, Inc. Medicare HMO Senior Partners Gold, Classic, Gold, Premier (Formally known as Elder Health) Fee for Service BasicBlue Medicare PPO SeniorBlue PPO POS PPO CustomBlue CIGNA Health and Life Insurance Company Fee for Service
2 Most Common Payer ID/Health Plan ID Numbers ( s) CIGNA Health and Life Insurance Company HMO CIGNA Health and Life Insurance Company POS CIGNA Health and Life Insurance Company PPO Coventry Health Fee for Service Coventry Health Medicaid HMO Coventry Cares Coventry Health PPO Educators Mutual Life Insurance Company Fee for Service Educators Mutual Life Insurance Company PPO First Priority Life Ins. Co. Fee for Service First Priority Life Ins. Co. PPO Blue Care PPO Gateway Health Plan, Inc. Medicaid HMO Gateway Health Plan, Inc. Medicare HMO Medicare Assured Geisinger Health Plan HMO HMO Solutions Geisinger Health Plan Medicaid HMO Geisinger Health Plan Family Geisinger Health Plan Medicare HMO Gold Classic Geisinger Health Plan Medicare PPO Gold Preferred Geisinger Health Plan POS Geisinger Health Plan PPO Selectus Coordinated Care, Selectus Direct Access Geisinger Indemnity Insurance Company Fee for Service Health Partners of Philadelphia, Inc. Medicaid HMO Health Partners of Philadelphia, Inc. Medicare HMO HealthAmerica (Central and Pittsburgh) HMO HealthAmerica HMO, Advantra HMO HealthAmerica (Central and Pittsburgh) Medicare HMO Advantra HMO HealthAssurance Pennsylvania, Inc. Medicare PPO Advantra PPO
3 Most Common Payer ID/Health Plan ID Numbers ( s) HealthAssurance Pennsylvania, Inc. POS HealthAssurance Coordinate Care POS HealthAssurance Pennsylvania, Inc. PPO HealthAssurance PPO Highmark Senior Health Company Medicare PPO FreedomBlue PPO Highmark, Inc. Fee for Service Highmark ClassicBlue Highmark, Inc. POS SelectBlue POS Highmark, Inc. PPO DirectBlue, PPO Blue HMO of Northeastern Pennsylvania HMO Blue Care HMO HMO of Northeastern Pennsylvania POS Blue Care POS Horizon Healthcare PA HMO (Formally known as Medigroup) Horizon Healthcare PA POS Hospital Service Association of Northeastern PA Hospital Service Association of Northeastern PA Fee for Service (Also known as Blue Cross of Northeastern Pennsylvania) PPO (Also known as Blue Cross of Northeastern Pennsylvania) / Access Care II Humana Insurance Company Fee for Service Humana Insurance Company Medicare HMO Gold Plus Humana Insurance Company Medicare PPO Humana Choice PPO Humana Insurance Company PPO Independence Blue Cross (Eastern PA) Fee for Service Keystone Health Plan Central, Inc. HMO Keystone Health Plan Central, Inc. Medicare HMO SeniorBlue HMO Keystone Health Plan East, Inc. HMO Keystone HMO Keystone Health Plan East, Inc. Medicare HMO Keystone 65 Keystone Health Plan East, Inc. POS Keystone Select Keystone Health Plan West, Inc. HMO Keystone Blue or Community Blue HMO
4 Most Common Payer ID/Health Plan ID Numbers ( s) Keystone Health Plan West, Inc. Medicare HMO Security Blue Optimum Choice, Inc. of PA HMO (Also known as OCI-PA) Prudential Companies Fee for Service ( is for Prudential Insurance Company of America) QCC Insurance Company Medicare HMO Keystone 65 Advantage QCC Insurance Company Medicare PPO Personal Choice 65 QCC Insurance Company PPO Personal Choice United Healthcare Medicaid HMO Community Plan of Pennsylvania United Healthcare Medicare HMO Evercare (formally Unison Advantage) United Healthcare Medicare PPO United Healthcare POS United Healthcare PPO UPMC Health Network, Inc. Medicare PPO For Life UPMC Health Network, Inc. POS UPMC Health Network, Inc. PPO UPMC Health Plan, Inc. HMO UPMC Health Plan, Inc. Medicaid HMO UPMC for You, UPMC for Kids UPMC Health Plan, Inc. Medicare HMO For Life UPMC Health Plan, Inc. POS Vista Health Plan, Inc. Medicaid HMO Keystone First (Formerly Keystone Mercy Health Plan) All Automobile Insurers Automobile Behavioral Health Coverage Unknown/Not Listed Government Fee for Service Government PPO
5 Most Common Payer ID/Health Plan ID Numbers ( s) Medical Assistance (Medicaid) Medicaid Use ONLY for Fee for Service Medicaid, Not Managed Care Medicare Part A & B Medicare Use ONLY for Fee for Service Medicare, Not Managed Care Other Federal/State/County Funded Programs Unknown/Not Listed Including Postal Workers, Inmates, Veterans, etc. Out-of-State Blue Cross Fee for Service Out-of-State Blue Cross HMO Out-of-State Blue Cross POS Out-of-State Blue Cross PPO Out-of-State Blue Cross Unknown/Not Listed State-Hospital Funded Psychiatric Care Unknown/Not Listed Third Party Administrators Unknown/Not Listed TPA TriCare HMO (Formally known as CHAMPUS) Uninsured Workers' Compensation Insurers Self Pay or Charity/Indigent Care Workers' Compensation The following table shows other codes that are checked for valid payer types. Payer Type Product Type Full Name of Payer/Insurer Fee for Service Westchester Fire Ins Co Fee for Service Ace Prop & Cas Ins Co Fee for Service Ace Fire Underwriters Ins Co Fee for Service Ace Amer Ins Co
6 Most Common Payer ID/Health Plan ID Numbers ( s) Payer Type Product Type Full Name of Payer/Insurer Fee for Service R&Q Reins Co Fee for Service LM Prop & Cas Ins Co PPO Aetna Ins Co of CT POS Aetna Ins Co of CT Fee for Service Aetna Ins Co of CT Fee for Service LM Gen Ins Co PPO Aetna Life Ins Co POS Aetna Life Ins Co Fee for Service Aetna Life Ins Co Fee for Service Connecticut Gen Life Ins Co Fee for Service Cigna Life Ins Co Of NY Fee for Service Wilton Reassur Co Fee for Service Prudential Ins Co Of Amer PPO Aetna Hlth Ins Co POS Aetna Hlth Ins Co Fee for Service Aetna Hlth Ins Co PPO Aetna Hlth & Life Ins Co POS Aetna Hlth & Life Ins Co Fee for Service Aetna Hlth & Life Ins Co PPO Ing Life Ins & Ann Co POS Ing Life Ins & Ann Co Fee for Service Ing Life Ins & Ann Co Fee for Service Prudential Retirement Ins & Ann Co Fee for Service Prudential Retirement Ins & Ann Co
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