Birmingham, AL 35238, 2023 American Benefit Administrators. 0 Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. MAILING ADDRESS: American Insurance Administrators P O BOX 17908 LOS ANGELES, CA 90017-0908. For further information, please contact the precertification number located on the members identification card. Ple ase send all c orrespondence and non-claim inquiries to the TPA addresses below. Submitthe request via email to PAI Provider Maintenance at paiprovmtn@paisc.com. Email: sales@americanbenefitadministrators.com, American Benefit Administrators ABA is committed and confident it will provide the same level of service. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. By Mail Sana Benefits Claims P.O. Phone: 800-777-3575 3333 Hesper Road 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 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. Both American Benefit Plan Administrators and Zenith Administrators were strong TPA's prior to the merger, but by combining . New User?Please click here to register. Prior authorization varies from group to group. 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. P.O. 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. Claim Number Email Date of Service Phone Your Message Additional Contact Information Phone 1-888-627-5880 Business Hours 8 am - 5 pm CT, Monday - Friday Email AMA Insurance claims@amainsure.com Claims Mailing Address AMA Insurance Agency, Inc. PO Box 804238 Chicago, IL 60680-4104 %PDF-1.6 % Receiving illegal calls claiming to be from American Benefits Group? As a health care provider, you are an integral part of our team. 1229 0 obj <> endobj endstream endobj startxref We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. Employees. As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. Log in to your account to confirm your specific . 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. First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday All rights reserved. Toll Free: 866.742.4900 Hours: 7:00 a.m. - 6:00 p.m CST. If you are a participating CompNet provider seeking to manage addresses and . Zenith Insurance Company Please forward your refund repayments to: o Each card also includes the paper and electronic claims submission addresses. PRAC Bulletin. Benefits administration is a difficult, increasingly complex business. Contact the Customer Service number on the member ID card if you need assistance. 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. To request reimbursement, please complete and sign the itemized claim form. Columbia, SC 29260. LOS ANGELES, CA 90017-1906. 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 was very impressed with American Benefits Group after separation from my employer. ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK PAI P.O. This is nothing new; however, this is a good time to remind everyone of the feature. All Rights Reserved. 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. These tools focus on quality and ensuring the best possible end result for each and every user. Electronically Electronic/Payor ID: 50114. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network, CompNet. Box 6927 Need answers now? 2009-2023 Zenith Insurance Company. 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. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k hbbd```b`` `>"@``rXd."#;H)`'`y f\"y7A$g-Xd2#7mVXD]"MAD = G`$C 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. HCP Login. (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . 0 Please let us know if you experience any trouble or if you need help using the AMA Insurance Verification of Benefits Portal. You will need an Employer ID when you register. Need answers now? Try taking a look at our. 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 Claims paid under PSIP Program are subject to county audit. 1200 WILSHIRE BLVD-5TH FLOOR. PO Box 804238 . Please use the form below to contact AMA Insurance. American Plan Administrators. Cigna. 83 0 obj <> endobj 2023 Planned Administrators Inc. All rights reserved. Chattanooga, TN 37422-7223. Or you can request a meeting on a specific topic, CLICK HERE to schedule. Take control of your benefits. Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. PSIP Reimbursement Rates for 2020/ . P.O. Cigna. The original entity of Zenith American Solutions has been in business since 1944. (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. 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 Billings MT 59102 Cigna shares the administration of the plan with a third party. Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . Several payers that DO receive claims electronically have been placed on this list for having poor services available. . 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. 6:00 a.m. 8:00 p.m. MST, Corporate Office This team is diligent and kind. AMERICAN INSURANCE ADMINISTRATORS. View contact profiles from American Plan Administrators Popular Searches American Plan Administrators American Plan Administrators LLC 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. The new PAI provider portal is going live. Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: 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 Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson 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. If you use the EDGE portal, additional login information can be found on theEDGE Hub. As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. 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 Changes made will not be reflected on all impacted systems for up to 2 business days. Toll Free: 1.800.854.3643 Local: 1.714.250.3000. Please refer to the members identification card to determine the applicable network. I respect a service team that does what they say theyre going to do with quality! 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 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. We appreciate hearing from you. %PDF-1.6 % 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. 152 0 obj <>stream The team uses PMI standards and project management tools along with IT industry best practices. Fax: 406-652-5380. We strive to provide service excellence and a smooth experience to all our health care providers as they navigate our system to provide care. Hours: 7:00 a.m. 6:00 p.m CST. Box 1558 Its almost here! Try taking a look at our Frequently Asked Questions page. PAI will not require that you repay the refund until PAI has concluded its review. remington pro1 flat iron; out-of-state broker commission texas; July 7, 2022. american plan administrators claim mailing address Home; About; Advantages; Solutions/Services; Resources; Contact us Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com. 2023 American Benefits Group. 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. hb```f``Z`qA2l,1`c(.`Wb4kE/'fLBmlm>x2faTn`9w]B@/.Se~i Ip2) iF r,`qRf`@ 1 Participant Support:support@americanbenefitadministrators.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. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. 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 Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. Van Nuys, CA 91409-9055, Other States: P.O. Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. 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) 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. American Plan Administrators - Contact us. Box 380844 Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. You would need to reimburse yourself and then pay your provider directly. 18 Heyward St. Brooklyn, NY 11249. View the drug lists thatapply to members with PAIs pharmacy benefit coverage with OptumRx. M-F endstream endobj startxref Return the completed form and your itemized paid receipts to: First American Administrators, Inc. Attn: OON Claims P.O. For questions concerning your online portal, including login information, please email:helpdesk@zenith-american.com. Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit The original entity of Zenith American Solutions has been in business since 1944. Driving Directions. %%EOF 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 . To all our customers and vendors, please note that American Benefit Administrators will continue to provide you with continued support and continue our operations. As may vary by group, please call the phone number listed on the member ID card. Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) Dental Claims. There are two easy ways to submit claims to Sana. 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. 1268 0 obj <>stream 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. Medical Claims. About Us; Contact; Helpful Links; Online Forms; Coordination of . 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. P.O. Copyright 2016 AMA Insurance, Inc. All rights reserved. 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. 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. support@americanbenefitadministrators.com, clientservices@americanbenefitadministrators.com. View Map, Employee BenefitManagement Services Phone Number. 1 (800) 244-6224. We are proud to offer our own unique Claims processing and Benefit administration solutions. You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. 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 2023 Planned Administrators Inc. All rights reserved. This field is for validation purposes and should be left unchanged. 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. Helping You Provide The Best Possible Care. endstream endobj 1230 0 obj <. megamenu1. Staff Photography by Jessica Marie Photography Inc. 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. The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. Please Be Advised. 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 Sarasota, FL 34230-1558, Report a Property, Liability, or Auto Claim, Agent & Broker Resources, Support & Online Tools. Provider Address Change Fax an updated W-9 to (803) 264-9089 The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. *Out-of-network form submission deadlines may vary by plan. This team was incredibly patient, kind, and helpful. 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. As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. Login to your account. The cost of healthcare continues to grow at an unsustainable pace. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. You will receive a response within 2 business days. SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. Box 9055 *As part of our effort in achieving a 100% paperless office we encourage you to receive your reimbursements directly into your bank account. Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. Participant Inquiries: cobra@americanbenefitadministrators.com For group-specific prior authorization information, please log in to the MyPAI Provider Portal above and review the members health benefit plan document. Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. Please contact the TPA with questions on these topics. Corporate Headquarters. o ID Cards include the TPA or insurer's telephone number and address(es), for eligibility, benefits, claim status and payment inquiry. Also, customers and vendors may be requested to provide electronic payment options for invoices. 1.800.426.9786. Title Claims Contact. (888) 505-7724 updates@sbmamec.com Toll Free: 866.742.4900 Box 855 Arnold, MD 21012 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. Access your online portal usingthis form. For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. %%EOF d '7y[ f| m x06w a>g For general assistance, please call your Client Services representative or your Customer Care team. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. There you will find answers to common questions, details about your plan, and much more. If youre interested in improving your benefit plan and improving lives, drop us a line. Phonee: 718-625-6300. 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: December 2020. 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 will quickly get back to you with the information you need. Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. 2022 Employee Benefit Management Services, LLC. Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. 2018 Zenith American Solutions, Inc. All Rights Reserved. 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. PAI will not require that you repay the refund until PAI has concluded its review. Chicago, IL 60680-4104. Fill out our Request for Proposal Form. Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. 24 hours a day, 365 days a year. Employees. Client/Employer Support:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: 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. We offer a state-of-the art member portal to help you make the most of your health benefits. Toll Free: 866.742.4900 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 Attention: Refund Analyst PO Box 182223. Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. 7:00 a.m. 8:00 p.m. MST, Monday-Thursday CareFirst contracts with Third Party Administrators to the Network claims product. PO Box 21367 Billings, MT 59104 Local Phone: 406-245-3575 Phone: 800-777-3575 Fax: 406-652-5380 Contact Us 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 Our online tools will give you all the information access you need to utilize patients health benefits to support their care. Preferred Network Arrangements. Media Relations Contact. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. If you currentlyparticipate with the Preferred Blue Network, then you are already set up with PAI as a participating provider. Notice of Privacy. Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. Authorized to administer business in all 50 states, hundreds of employers across the country and their covered employees rely on PAI. 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. PAI 1-800-303-5242. 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? American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. Its a stark contrast from the individuals I spoke to at carriers when following up on enrollments. 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. Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more. 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 Toll Free: 718-834-1256. Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. Its almost here! The long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. 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. First American Financial Corporation 1 First American Way Santa Ana, California 92707. For assistance with portal registration or portal password assistance, please call 877-777-0031. Contact; Log In; Hit enter to search or ESC to close. They are web-based or Internet-accessible solutions that facilitate seamless front office and back office operations.
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