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. 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. For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. Chicago, IL 60680-4104. Box 9055 You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. The team uses PMI standards and project management tools along with IT industry best practices. Cigna shares the administration of the plan with a third party. 24 hours a day, 365 days a year. hb```f``Z`qA2l,1`c(.`Wb4kE/'fLBmlm>x2faTn`9w]B@/.Se~i Ip2) iF r,`qRf`@ 1 These tools focus on quality and ensuring the best possible end result for each and every user. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. 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. 0 Submitthe request via email to PAI Provider Maintenance at paiprovmtn@paisc.com. Media Relations Contact. For further information, please contact the precertification number located on the members identification card. Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. Billings MT 59102 The long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . The cost of healthcare continues to grow at an unsustainable pace. Employees. o ID Cards include the TPA or insurer's telephone number and address(es), for eligibility, benefits, claim status and payment inquiry. This team was incredibly patient, kind, and helpful. Its not easy to accomplish but it has been my experience and I am very grateful.". 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 Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. This field is for validation purposes and should be left unchanged. Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. December 2020. PAI will not require that you repay the refund until PAI has concluded its review. Columbia, SC 29260. Preferred Network Arrangements. AMERICAN INSURANCE ADMINISTRATORS. This is nothing new; however, this is a good time to remind everyone of the feature. 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. The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. Driving Directions. 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 . PRAC Bulletin. 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 (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. Zenith Insurance Company 2022 Employee Benefit Management Services, LLC. 1.800.426.9786. Box 380844 Copyright 2016 AMA Insurance, Inc. All rights reserved. endstream endobj startxref Access the link below for easy-to-use claim filing. Phone: 800-777-3575 First American Financial Corporation 1 First American Way Santa Ana, California 92707. Notice of Privacy. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. Return the completed form and your itemized paid receipts to: First American Administrators, Inc. Attn: OON Claims P.O. The new PAI provider portal is going live. endstream endobj 1230 0 obj <. We offer a state-of-the art member portal to help you make the most of your health benefits. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. (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. Please forward your refund repayments to: Toll Free: 718-834-1256. To all our customers and vendors, please note that American Benefit Administrators will continue to provide you with continued support and continue our operations. Staff Photography by Jessica Marie Photography Inc. We strive to provide service excellence and a smooth experience to all our health care providers as they navigate our system to provide care. 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 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. Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. %PDF-1.6 % Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. Sarasota, FL 34230-1558, Report a Property, Liability, or Auto Claim, Agent & Broker Resources, Support & Online Tools. 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. All Rights Reserved. Birmingham, AL 35238, 2023 American Benefit Administrators. Toll Free: 866.742.4900 1-800-303-5242. 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 The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. Participant Support:support@americanbenefitadministrators.com Please let us know if you experience any trouble or if you need help using the AMA Insurance Verification of Benefits Portal. SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. 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 (888) 505-7724 updates@sbmamec.com Participant Inquiries: cobra@americanbenefitadministrators.com endstream endobj startxref Contact the Customer Service number on the member ID card if you need assistance. Our online tools will give you all the information access you need to utilize patients health benefits to support their care. View contact profiles from American Plan Administrators Popular Searches American Plan Administrators American Plan Administrators LLC Register at launch to take advantage of the enhanced functionality launch date will be announced soon. 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 PAI P.O. . Zenith Insurance Company Van Nuys, CA 91409-9055, Other States: Or you can request a meeting on a specific topic, CLICK HERE to schedule. HCP Login. Dental Claims. You will need an Employer ID when you register. Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more. Prior authorization varies from group to group. If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. 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. 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. P.O. %PDF-1.6 % Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson Both American Benefit Plan Administrators and Zenith Administrators were strong TPA's prior to the merger, but by combining . CareFirst contracts with Third Party Administrators to the Network claims product. Its almost here! hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; Attention: Refund Analyst 7:00 a.m. 8:00 p.m. MST, Monday-Thursday Login to your account. As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. 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 Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. For assistance with portal registration or portal password assistance, please call 877-777-0031. PAI will not require that you repay the refund until PAI has concluded its review. 1268 0 obj <>stream Fax an updated W-9 to (803) 264-9089 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. Helping You Provide The Best Possible Care. Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. Please use the form below to contact AMA Insurance. Fax: 406-652-5380. 1 (800) 244-6224. Cigna. Contact; Log In; Hit enter to search or ESC to close. If your employer offers the ability to have reimbursements deposited to your bank account, you can set-up direct deposit by logging-in to your account, click Reimbursement Settings under the Claims tabwithin the WealthCare Portal. 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. If youre interested in improving your benefit plan and improving lives, drop us a line. As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. Also, customers and vendors may be requested to provide electronic payment options for invoices. Email: sales@americanbenefitadministrators.com, American Benefit Administrators Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) 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. 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 We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. Box 855 Arnold, MD 21012 American Plan Administrators. Need answers now? Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. For general inquiries or to file a claim, visit our Submitting a Claim page. AMA Insurance Agency, Inc. Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. Receiving illegal calls claiming to be from American Benefits Group? 152 0 obj <>stream If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. 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. 83 0 obj <> endobj 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. Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. Please refer to the members identification card to determine the applicable network. ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK 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 Hours: 7:00 a.m. 6:00 p.m CST. Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com. You would need to reimburse yourself and then pay your provider directly. 1200 WILSHIRE BLVD-5TH FLOOR. As may vary by group, please call the phone number listed on the member ID card. Access your online portal usingthis form. If you use the EDGE portal, additional login information can be found on theEDGE Hub. There are two easy ways to submit claims to Sana. View the drug lists thatapply to members with PAIs pharmacy benefit coverage with OptumRx. %%EOF Phonee: 718-625-6300. Its almost here! hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k 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. Fill out our Request for Proposal Form. We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. 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. The new PAI provider portal is going live.
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