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 PAI will not require that you repay the refund until PAI has concluded its review. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. 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. Several payers that DO receive claims electronically have been placed on this list for having poor services available. Chicago, IL 60680-4104. . 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. This is nothing new; however, this is a good time to remind everyone of the feature. Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. 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. Ple ase send all c orrespondence and non-claim inquiries to the TPA addresses below. You will receive a response within 2 business days. Driving Directions. 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. Client/Employer Support:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. New User?Please click here to register. If youre interested in improving your benefit plan and improving lives, drop us a line. 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. Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. Both American Benefit Plan Administrators and Zenith Administrators were strong TPA's prior to the merger, but by combining . endstream endobj startxref Box 380844 View contact profiles from American Plan Administrators Popular Searches American Plan Administrators American Plan Administrators LLC The original entity of Zenith American Solutions has been in business since 1944. remington pro1 flat iron; out-of-state broker commission texas; July 7, 2022. american plan administrators claim mailing address Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. 24 hours a day, 365 days a year. 3333 Hesper Road Medical Claims. 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. Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. 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 . For group-specific prior authorization information, please log in to the MyPAI Provider Portal above and review the members health benefit plan document. There are two easy ways to submit claims to Sana. Billings MT 59102 Box 9055 1200 WILSHIRE BLVD-5TH FLOOR. HCP Login. 6:00 a.m. 8:00 p.m. MST, Corporate Office Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. 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. 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. PAI will not require that you repay the refund until PAI has concluded its review. 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. 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. I respect a service team that does what they say theyre going to do with quality! The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. Please contact the TPA with questions on these topics. hb```f``Z`qA2l,1`c(.`Wb4kE/'fLBmlm>x2faTn`9w]B@/.Se~i Ip2) iF r,`qRf`@ 1 Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . This field is for validation purposes and should be left unchanged. Toll Free: 718-834-1256. Hours: 7:00 a.m. 6:00 p.m CST. 2023 Planned Administrators Inc. All rights reserved. We offer a state-of-the art member portal to help you make the most of your health benefits. 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. To all our customers and vendors, please note that American Benefit Administrators will continue to provide you with continued support and continue our operations. Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. We strive to provide service excellence and a smooth experience to all our health care providers as they navigate our system to provide care. M-F Access the link below for easy-to-use claim filing. . Chattanooga, TN 37422-7223. Phone: 800-777-3575 Try taking a look at our Frequently Asked Questions page. To request reimbursement, please complete and sign the itemized claim form. 2009-2023 Zenith Insurance Company. Its almost here! Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. 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. Home; About; Advantages; Solutions/Services; Resources; Contact us If you are a participating CompNet provider seeking to manage addresses and . Corporate Headquarters. American Plan Administrators. megamenu1. 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. 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. Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM Birmingham, AL 35238, 2023 American Benefit Administrators. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit (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. Electronically Electronic/Payor ID: 50114. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. By Mail Sana Benefits Claims P.O. About Us; Contact; Helpful Links; Online Forms; Coordination of . We are proud to offer our own unique Claims processing and Benefit administration solutions. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. 2023 Planned Administrators Inc. All rights reserved. This team is diligent and kind. Fax an updated W-9 to (803) 264-9089 We appreciate hearing from you. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; Please Be Advised. 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? 2023 American Benefits Group. For general inquiries or to file a claim, visit our Submitting a Claim page. Together with the TPA, our goal is to educate members so they can make better, more informed health care decisions. December 2020. If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. 2018 Zenith American Solutions, Inc. All Rights Reserved. o ID Cards include the TPA or insurer's telephone number and address(es), for eligibility, benefits, claim status and payment inquiry. For general assistance, please call your Client Services representative or your Customer Care team. AMA Insurance Agency, Inc. Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. 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: Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: Access your online portal usingthis form. P.O. Toll Free: 866.742.4900 (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . Changes made will not be reflected on all impacted systems for up to 2 business days. Participant Inquiries: cobra@americanbenefitadministrators.com ABA is committed and confident it will provide the same level of service. PSIP Reimbursement Rates for 2020/ . Toll Free: 866.742.4900 Sarasota, FL 34230-1558, Report a Property, Liability, or Auto Claim, Agent & Broker Resources, Support & Online Tools. Dental Claims. Or you can request a meeting on a specific topic, CLICK HERE to schedule. 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. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. 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. Login to your account. Email: sales@americanbenefitadministrators.com, American Benefit Administrators Cigna shares the administration of the plan with a third party. Submitthe request via email to PAI Provider Maintenance at paiprovmtn@paisc.com. o Each card also includes the paper and electronic claims submission addresses. 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. If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. Participant Support:support@americanbenefitadministrators.com As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. The original entity of Zenith American Solutions has been in business since 1944. The new PAI provider portal is going live. Once logged in,you will have the ability to: EBPA encourages providers to take advantage of the online resources we have made available. Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com. 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. 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. Fill out our Request for Proposal Form. *As part of our effort in achieving a 100% paperless office we encourage you to receive your reimbursements directly into your bank account. MAILING ADDRESS: American Insurance Administrators P O BOX 17908 LOS ANGELES, CA 90017-0908. Columbia, SC 29260. As may vary by group, please call the phone number listed on the member ID card. 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. *Out-of-network form submission deadlines may vary by plan. First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday Its a stark contrast from the individuals I spoke to at carriers when following up on enrollments. 1229 0 obj <> endobj Notice of Privacy. 7:00 a.m. 8:00 p.m. MST, Monday-Thursday View Map, Employee BenefitManagement Services Box 1558 You would need to reimburse yourself and then pay your provider directly. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. 0 For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. Log in to your account to confirm your specific . 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. Contact the Customer Service number on the member ID card if you need assistance. Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) CareFirst contracts with Third Party Administrators to the Network claims product. Staff Photography by Jessica Marie Photography Inc. 1-800-303-5242. 1.800.426.9786. Provider Address Change Fax an updated W-9 to (803) 264-9089 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 If you use the EDGE portal, additional login information can be found on theEDGE Hub. As a health care provider, you are an integral part of our team. 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. PAI 2022 Employee Benefit Management Services, LLC. Need answers now? American Plan Administrators - Contact us. 1268 0 obj <>stream 1 (800) 244-6224. We will quickly get back to you with the information you need. PRAC Bulletin. All rights reserved. Copyright 2016 AMA Insurance, Inc. All rights reserved. support@americanbenefitadministrators.com, clientservices@americanbenefitadministrators.com. 152 0 obj <>stream PO Box 182223. They are web-based or Internet-accessible solutions that facilitate seamless front office and back office operations. Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. Need answers now? 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 Employees. Please forward your refund repayments to: Employees. Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. Helping You Provide The Best Possible Care. Take control of your benefits. Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson I was very impressed with American Benefits Group after separation from my employer. Media Relations Contact. The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. All Rights Reserved. Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. Phone Number. Zenith Insurance Company AMERICAN INSURANCE ADMINISTRATORS. You will need an Employer ID when you register. PO Box 21367 Billings, MT 59104 Local Phone: 406-245-3575 Phone: 800-777-3575 Fax: 406-652-5380 Contact Us As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. For further information, please contact the precertification number located on the members identification card. Prior authorization varies from group to group. Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. This team was incredibly patient, kind, and helpful.