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) endstream endobj startxref 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. Driving Directions. remington pro1 flat iron; out-of-state broker commission texas; July 7, 2022. american plan administrators claim mailing address 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. 1200 WILSHIRE BLVD-5TH FLOOR. PAI will not require that you repay the refund until PAI has concluded its review. 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. Cigna shares the administration of the plan with a third party. If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. Phone: 800-777-3575 For assistance with portal registration or portal password assistance, please call 877-777-0031. 2022 Employee Benefit Management Services, LLC. You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. For questions concerning your online portal, including login information, please email:helpdesk@zenith-american.com. 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. Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. Phonee: 718-625-6300. 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. We will quickly get back to you with the information you need. For further information, please contact the precertification number located on the members identification card. 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 Access your online portal usingthis form. 6:00 a.m. 8:00 p.m. MST, Corporate Office The original entity of Zenith American Solutions has been in business since 1944. ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK To request reimbursement, please complete and sign the itemized claim form. 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. Medical Claims. %%EOF As may vary by group, please call the phone number listed on the member ID card. Changes made will not be reflected on all impacted systems for up to 2 business days. We are proud to offer our own unique Claims processing and Benefit administration solutions. ABA is committed and confident it will provide the same level of service. Chicago, IL 60680-4104. 3333 Hesper Road 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: Preferred Network Arrangements. Hours: 7:00 a.m. 6:00 p.m CST. Return the completed form and your itemized paid receipts to: First American Administrators, Inc. Attn: OON Claims P.O. Columbia, SC 29260. Please refer to the members identification card to determine the applicable network. 0 Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. Once logged in,you will have the ability to: EBPA encourages providers to take advantage of the online resources we have made available. I was very impressed with American Benefits Group after separation from my employer. Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: d '7y[ f| m x06w a>g 1-800-303-5242. *Out-of-network form submission deadlines may vary by plan. Provider Address Change Fax an updated W-9 to (803) 264-9089 Prior authorization varies from group to group. Birmingham, AL 35238, 2023 American Benefit Administrators. Log in to your account to confirm your specific . Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson Please Be Advised. 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. Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. AMERICAN INSURANCE ADMINISTRATORS. All Rights Reserved. Electronically Electronic/Payor ID: 50114. 83 0 obj <> endobj Login to your account. (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. 2023 American Benefits Group. support@americanbenefitadministrators.com, clientservices@americanbenefitadministrators.com. 18 Heyward St. Brooklyn, NY 11249. Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM Box 855 Arnold, MD 21012 As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. Chattanooga, TN 37422-7223. For group-specific prior authorization information, please log in to the MyPAI Provider Portal above and review the members health benefit plan document. Claims paid under PSIP Program are subject to county audit. The new PAI provider portal is going live. Our online tools will give you all the information access you need to utilize patients health benefits to support their care. Employees. 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 (888) 505-7724 updates@sbmamec.com 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. Try taking a look at our Frequently Asked Questions page. M-F Participant Inquiries: cobra@americanbenefitadministrators.com Access the link below for easy-to-use claim filing. P.O. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network, CompNet. Notice of Privacy. American Plan Administrators. Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . 2023 Planned Administrators Inc. All rights reserved. PAI The cost of healthcare continues to grow at an unsustainable pace. 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. 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. Cigna. P.O. PRAC Bulletin. View the drug lists thatapply to members with PAIs pharmacy benefit coverage with OptumRx. This team is diligent and kind. endstream endobj 1230 0 obj <. Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) Box 6927 Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit 1 (800) 244-6224. Home; About; Advantages; Solutions/Services; Resources; Contact us You would need to reimburse yourself and then pay your provider directly. Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. The team uses PMI standards and project management tools along with IT industry best practices. Box 380844 Its almost here! Need answers now? Its not easy to accomplish but it has been my experience and I am very grateful.". Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. MAILING ADDRESS: American Insurance Administrators P O BOX 17908 LOS ANGELES, CA 90017-0908. 1229 0 obj <> endobj Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. The new PAI provider portal is going live. o Each card also includes the paper and electronic claims submission addresses. 152 0 obj <>stream Register at launch to take advantage of the enhanced functionality launch date will be announced soon. We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. Sarasota, FL 34230-1558, Report a Property, Liability, or Auto Claim, Agent & Broker Resources, Support & Online Tools. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. PAI will not require that you repay the refund until PAI has concluded its review. 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 These tools focus on quality and ensuring the best possible end result for each and every user. LOS ANGELES, CA 90017-1906. 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. PO Box 182223. This is nothing new; however, this is a good time to remind everyone of the feature. Contact the Customer Service number on the member ID card if you need assistance. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. 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 %%EOF 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. For general inquiries or to file a claim, visit our Submitting a Claim page. American Plan Administrators - Contact us. I respect a service team that does what they say theyre going to do with quality! o ID Cards include the TPA or insurer's telephone number and address(es), for eligibility, benefits, claim status and payment inquiry. PAI P.O. As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. . The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. There you will find answers to common questions, details about your plan, and much more. Also, customers and vendors may be requested to provide electronic payment options for invoices. 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 Together with the TPA, our goal is to educate members so they can make better, more informed health care decisions. The long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. P.O. Its a stark contrast from the individuals I spoke to at carriers when following up on enrollments. Several payers that DO receive claims electronically have been placed on this list for having poor services available. American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. First American Financial Corporation 1 First American Way Santa Ana, California 92707. 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. Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. 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 %PDF-1.6 % Dental Claims. There are two easy ways to submit claims to Sana. 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 Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. 2009-2023 Zenith Insurance Company. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. Benefits administration is a difficult, increasingly complex business. First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday 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. Try taking a look at our. 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. %PDF-1.6 % 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.
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