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 There you will find answers to common questions, details about your plan, and much more. Cigna. *Out-of-network form submission deadlines may vary by plan. Please refer to the members identification card to determine the applicable network. View the drug lists thatapply to members with PAIs pharmacy benefit coverage with OptumRx. Please forward your refund repayments to: Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . SBMA Benefits Its not easy to accomplish but it has been my experience and I am very grateful.". 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. As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. 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: Need answers now? 7:00 a.m. 8:00 p.m. MST, Monday-Thursday December 2020. 3333 Hesper Road 0 18 Heyward St. Brooklyn, NY 11249. The new PAI provider portal is going live. Phonee: 718-625-6300. %PDF-1.6 % Title Claims Contact. Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. PDF Network Prefix List - CareFirst Provider 2023 Planned Administrators Inc. All rights reserved. Toll Free: 718-834-1256. Submitting a Claim - Sana Benefits (888) 505-7724 updates@sbmamec.com hbbd```b`` `>"@``rXd."#;H)`'`y f\"y7A$g-Xd2#7mVXD]"MAD = G`$C This is nothing new; however, this is a good time to remind everyone of the feature. (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. The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. Try taking a look at our. If you are a Medicare member, you may use the Out-Of-Network claim form or submit a written request with all information listed above and mail to: First American Admisinstrator, Inc. Att: OON Claims, PO Box 8504, Mason OH, 45040-7111. Chicago, IL 60680-4104. P.O. PSIP Reimbursement Rates for 2020/ . Zenith Insurance Company 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. 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) PO Box 804238 Van Nuys, CA 91409-9055, Other States: Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: 1-800-303-5242. Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. Contact; Log In; Hit enter to search or ESC to close. 2022 Employee Benefit Management Services, LLC. (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . *As part of our effort in achieving a 100% paperless office we encourage you to receive your reimbursements directly into your bank account. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. 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? 1.800.426.9786. Toll Free: 866.742.4900 Hours: 7:00 a.m. - 6:00 p.m CST. Provider Claim Submission to APWU Health Plan - apwuhp.com All Rights Reserved. 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. 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 Dental Claims. 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. Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) If you currentlyparticipate with the Preferred Blue Network, then you are already set up with PAI as a participating provider. This team was incredibly patient, kind, and helpful. Billings MT 59102 Corporate Headquarters. Chattanooga, TN 37422-7223. M-F We will quickly get back to you with the information you need. PDF Payer Connection Payer List Phone: 800-777-3575 Contact Us | Customer Service | Cigna Its almost here! The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. Medical Claims. Providers | Planned Administrators Inc. (PAI) 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. Employees. Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. Attention: Refund Analyst PRAC Bulletin. 1268 0 obj <>stream 1200 WILSHIRE BLVD-5TH FLOOR. You will need an Employer ID when you register. For assistance with portal registration or portal password assistance, please call 877-777-0031. LOS ANGELES, CA 90017-1906. About Us; Contact; Helpful Links; Online Forms; Coordination of . Need answers now? PDF VISION OUT-OF-NETWORK CLAIM FORM Claim submissions made easy Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. Together with the TPA, our goal is to educate members so they can make better, more informed health care decisions. I was very impressed with American Benefits Group after separation from my employer. endstream endobj startxref Providers | EBPA 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. Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. Or you can request a meeting on a specific topic, CLICK HERE to schedule. 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. Provider Address Change Fax an updated W-9 to (803) 264-9089 Home; About; Advantages; Solutions/Services; Resources; Contact us You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. View contact profiles from American Plan Administrators Popular Searches American Plan Administrators American Plan Administrators LLC For questions concerning your online portal, including login information, please email:helpdesk@zenith-american.com. PO Box 21367 Billings, MT 59104 Local Phone: 406-245-3575 Phone: 800-777-3575 Fax: 406-652-5380 Contact Us Out of network claims - EyeMed Vision Benefits Contact Us For Information on Benefit Plan Administration | EBMS Please Be Advised. Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. Driving Directions. %PDF-1.6 % Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more. Provider Contacts and Billing Information - TheZenith You will receive a response within 2 business days. PDF Cigna Payer Solutions Active Accounts Update - MemberClicks Claims paid under PSIP Program are subject to county audit. Login to your account. PAI P.O. There are two easy ways to submit claims to Sana. 83 0 obj <> endobj Copyright 2016 AMA Insurance, Inc. All rights reserved. The cost of healthcare continues to grow at an unsustainable pace. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; Log in to your account to confirm your specific . Employees. Home - Zenith American Prior authorization varies from group to group. Toll Free: 1.800.854.3643 Local: 1.714.250.3000. Contact Us - American Benefit Administrators As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. o Each card also includes the paper and electronic claims submission addresses. We appreciate hearing from you. 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. 1 (800) 244-6224. Ple ase send all c orrespondence and non-claim inquiries to the TPA addresses below. By Mail Sana Benefits Claims P.O. Also, customers and vendors may be requested to provide electronic payment options for invoices. Email: sales@americanbenefitadministrators.com, American Benefit Administrators 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. Staff Photography by Jessica Marie Photography Inc. Please let us know if you experience any trouble or if you need help using the AMA Insurance Verification of Benefits Portal. Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. Contact | American Insurance Administrators 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. As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. Benefits administration is a difficult, increasingly complex business. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. Both American Benefit Plan Administrators and Zenith Administrators were strong TPA's prior to the merger, but by combining . 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:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: Receiving illegal calls claiming to be from American Benefits Group? 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 SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. Contact Us | AMA Insurance Provider Portal d '7y[ f| m x06w a>g Helping You Provide The Best Possible Care. Authorized to administer business in all 50 states, hundreds of employers across the country and their covered employees rely on PAI. The long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. P.O. 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 Toll Free: 866.742.4900 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 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. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. megamenu1. This field is for validation purposes and should be left unchanged. American Plan Administrators - Contact us Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. Box 9055 American Plan Administrators - Contact us. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit As a health care provider, you are an integral part of our team. 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. CHCP - Resources - Active Accounts - Cigna 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 endstream endobj startxref This team is diligent and kind. PO Box 182223. %%EOF The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. You would need to reimburse yourself and then pay your provider directly. First American Financial Corporation 1 First American Way Santa Ana, California 92707. 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. Cigna shares the administration of the plan with a third party. Several payers that DO receive claims electronically have been placed on this list for having poor services available. If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. 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 ABA is committed and confident it will provide the same level of service. Toll Free: 866.742.4900 Its a stark contrast from the individuals I spoke to at carriers when following up on enrollments. Participant Inquiries: cobra@americanbenefitadministrators.com If you use the EDGE portal, additional login information can be found on theEDGE Hub. 2018 Zenith American Solutions, Inc. All Rights Reserved. endstream endobj 1230 0 obj <. 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. Participant Support:support@americanbenefitadministrators.com Access your online portal usingthis form. 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. These tools focus on quality and ensuring the best possible end result for each and every user. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. 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 Welcome to American Plan Administrators 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. For group-specific prior authorization information, please log in to the MyPAI Provider Portal above and review the members health benefit plan document. Cigna. Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. Once logged in,you will have the ability to: EBPA encourages providers to take advantage of the online resources we have made available. 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. . 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. How To File A Claim - American Benefits Group - amben.com Birmingham, AL 35238, 2023 American Benefit Administrators. We are proud to offer our own unique Claims processing and Benefit administration solutions. Box 1558 Zenith Insurance Company Take control of your benefits. American Plan Administrators. Our online tools will give you all the information access you need to utilize patients health benefits to support their care. Media Relations Contact. AMERICAN INSURANCE ADMINISTRATORS. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k Box 855 Arnold, MD 21012 MAILING ADDRESS: American Insurance Administrators P O BOX 17908 LOS ANGELES, CA 90017-0908. American Plan Adminstrators | Better Business Bureau Profile remington pro1 flat iron; out-of-state broker commission texas; July 7, 2022. american plan administrators claim mailing address If you are a participating CompNet provider seeking to manage addresses and . For general assistance, please call your Client Services representative or your Customer Care team. I respect a service team that does what they say theyre going to do with quality! The original entity of Zenith American Solutions has been in business since 1944. We offer a state-of-the art member portal to help you make the most of your health benefits. Planned Administrators Inc. (PAI) 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 Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. 2009-2023 Zenith Insurance Company. Contact Us | First American 2023 American Benefits Group. To request reimbursement, please complete and sign the itemized claim form. %%EOF 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. AMA Insurance Agency, Inc. Please use the form below to contact AMA Insurance. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday For further information, please contact the precertification number located on the members identification card. They are web-based or Internet-accessible solutions that facilitate seamless front office and back office operations. Preferred Network Arrangements. We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. 0 Customized Solutions for Third Party Administrators | Cigna Access the link below for easy-to-use claim filing. Contact the Customer Service number on the member ID card if you need assistance. 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.