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 Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM 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. Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. Please Be Advised. December 2020. As a health care provider, you are an integral part of our team. Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) For general inquiries or to file a claim, visit our Submitting a Claim page. 18 Heyward St. Brooklyn, NY 11249. Staff Photography by Jessica Marie Photography Inc. They are web-based or Internet-accessible solutions that facilitate seamless front office and back office operations. megamenu1. Return the completed form and your itemized paid receipts to: First American Administrators, Inc. Attn: OON Claims P.O. 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) First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday Claims paid under PSIP Program are subject to county audit. o Each card also includes the paper and electronic claims submission addresses. Cigna. hb```f``Z`qA2l,1`c(.`Wb4kE/'fLBmlm>x2faTn`9w]B@/.Se~i Ip2) iF r,`qRf`@ 1 Prior authorization varies from group to group. Its a stark contrast from the individuals I spoke to at carriers when following up on enrollments. ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. 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. Van Nuys, CA 91409-9055, Other States: Both American Benefit Plan Administrators and Zenith Administrators were strong TPA's prior to the merger, but by combining . Helping You Provide The Best Possible Care. 2018 Zenith American Solutions, Inc. All Rights Reserved. M-F Box 9055 1-800-303-5242. 0 Chicago, IL 60680-4104. Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. 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 Contact the Customer Service number on the member ID card if you need assistance. PSIP Reimbursement Rates for 2020/ . (888) 505-7724 updates@sbmamec.com We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. Title Claims Contact. endstream endobj startxref For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. Please contact the TPA with questions on these topics. Zenith Insurance Company 2023 American Benefits Group. The long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. Toll Free: 866.742.4900 HCP Login. 152 0 obj <>stream About Us; Contact; Helpful Links; Online Forms; Coordination of . Electronically Electronic/Payor ID: 50114. All rights reserved. PAI will not require that you repay the refund until PAI has concluded its review. Chattanooga, TN 37422-7223. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . Login to your account. 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 %%EOF Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson The original entity of Zenith American Solutions has been in business since 1944. %%EOF Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. support@americanbenefitadministrators.com, clientservices@americanbenefitadministrators.com. Submitthe request via email to PAI Provider Maintenance at paiprovmtn@paisc.com. Preferred Network Arrangements. 2009-2023 Zenith Insurance Company. Participant Support:support@americanbenefitadministrators.com 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. ABA is committed and confident it will provide the same level of service. 24 hours a day, 365 days a year. . 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. We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. Fax: 406-652-5380. %PDF-1.6 % Its not easy to accomplish but it has been my experience and I am very grateful.". 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. LOS ANGELES, CA 90017-1906. 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. Its almost here! 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. You will need an Employer ID when you register. This team was incredibly patient, kind, and helpful. MAILING ADDRESS: American Insurance Administrators P O BOX 17908 LOS ANGELES, CA 90017-0908. Toll Free: 866.742.4900 Hours: 7:00 a.m. - 6:00 p.m CST. 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. endstream endobj 1230 0 obj <. Or you can request a meeting on a specific topic, CLICK HERE to schedule. We will quickly get back to you with the information you need. Driving Directions. View Map, Employee BenefitManagement Services If you are a participating CompNet provider seeking to manage addresses and . Participant Inquiries: cobra@americanbenefitadministrators.com 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. Cigna. Access the link below for easy-to-use claim filing. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. AMA Insurance Agency, Inc. Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. AMERICAN INSURANCE ADMINISTRATORS. 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. . 0 PRAC Bulletin. Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. Please use the form below to contact AMA Insurance. Email: sales@americanbenefitadministrators.com, American Benefit Administrators Box 1558 Box 855 Arnold, MD 21012 To all our customers and vendors, please note that American Benefit Administrators will continue to provide you with continued support and continue our operations. For questions concerning your online portal, including login information, please email:helpdesk@zenith-american.com. 1229 0 obj <> endobj The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. 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. PAI We offer a state-of-the art member portal to help you make the most of your health benefits. Receiving illegal calls claiming to be from American Benefits Group? Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. Try taking a look at our. 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. As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. Phone Number. First American Financial Corporation 1 First American Way Santa Ana, California 92707. CareFirst contracts with Third Party Administrators to the Network claims product. 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 Contact; Log In; Hit enter to search or ESC to close. 1.800.426.9786. PAI P.O. Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more. 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. By Mail Sana Benefits Claims P.O. Copyright 2016 AMA Insurance, Inc. All rights reserved. Attention: Refund Analyst Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. I respect a service team that does what they say theyre going to do with quality! EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network, CompNet. Changes made will not be reflected on all impacted systems for up to 2 business days. Notice of Privacy. American Plan Administrators - Contact us. I was very impressed with American Benefits Group after separation from my employer. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. 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. Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. These tools focus on quality and ensuring the best possible end result for each and every user. Provider Address Change Fax an updated W-9 to (803) 264-9089 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. There you will find answers to common questions, details about your plan, and much more. Benefits administration is a difficult, increasingly complex business. 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 Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. 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: Dental Claims. Access your online portal usingthis form. American Plan Administrators. 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. The cost of healthcare continues to grow at an unsustainable pace. 2023 Planned Administrators Inc. All rights reserved. You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. Box 6927 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. Billings MT 59102 If youre interested in improving your benefit plan and improving lives, drop us a line. This team is diligent and kind. P.O. Also, customers and vendors may be requested to provide electronic payment options for invoices. Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. Client/Employer Support:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. Phonee: 718-625-6300. Our online tools will give you all the information access you need to utilize patients health benefits to support their care. Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. *Out-of-network form submission deadlines may vary by plan. For general assistance, please call your Client Services representative or your Customer Care team. P.O. The new PAI provider portal is going live. 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. SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. New User?Please click here to register. If you currentlyparticipate with the Preferred Blue Network, then you are already set up with PAI as a participating provider. Please refer to the members identification card to determine the applicable network. Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com. 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 appreciate hearing from you. 2023 Planned Administrators Inc. All rights reserved. 1200 WILSHIRE BLVD-5TH FLOOR. Once logged in,you will have the ability to: EBPA encourages providers to take advantage of the online resources we have made available. As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. All Rights Reserved. As may vary by group, please call the phone number listed on the member ID card. To request reimbursement, please complete and sign the itemized claim form. 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. 83 0 obj <> endobj American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. 1 (800) 244-6224. Phone: 800-777-3575 You will receive a response within 2 business days. The team uses PMI standards and project management tools along with IT industry best practices. Zenith Insurance Company If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. Employees. Employees. Toll Free: 718-834-1256. 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 3333 Hesper Road Columbia, SC 29260. PAI will not require that you repay the refund until PAI has concluded its review. Its almost here! Media Relations Contact. Take control of your benefits. PO Box 182223. Hours: 7:00 a.m. 6:00 p.m CST. PO Box 21367 Billings, MT 59104 Local Phone: 406-245-3575 Phone: 800-777-3575 Fax: 406-652-5380 Contact Us 2022 Employee Benefit Management Services, LLC. 6:00 a.m. 8:00 p.m. MST, Corporate Office We strive to provide service excellence and a smooth experience to all our health care providers as they navigate our system to provide care. If you use the EDGE portal, additional login information can be found on theEDGE Hub. Several payers that DO receive claims electronically have been placed on this list for having poor services available. For group-specific prior authorization information, please log in to the MyPAI Provider Portal above and review the members health benefit plan document. This field is for validation purposes and should be left unchanged. Birmingham, AL 35238, 2023 American Benefit Administrators. 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 The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. 7:00 a.m. 8:00 p.m. MST, Monday-Thursday 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. 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. Box 380844 *As part of our effort in achieving a 100% paperless office we encourage you to receive your reimbursements directly into your bank account. 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*$9waOuoA5D=#9|(4 Register at launch to take advantage of the enhanced functionality launch date will be announced soon. endstream endobj startxref P.O. hbbd```b`` `>"@``rXd."#;H)`'`y f\"y7A$g-Xd2#7mVXD]"MAD = G`$C Need answers now? P.O. We are proud to offer our own unique Claims processing and Benefit administration solutions. Authorized to administer business in all 50 states, hundreds of employers across the country and their covered employees rely on PAI. This is nothing new; however, this is a good time to remind everyone of the feature. Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured .
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