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PAI This field is for validation purposes and should be left unchanged. PAI will not require that you repay the refund until PAI has concluded its review. Prior authorization varies from group to group. Provider Address Change Fax an updated W-9 to (803) 264-9089 PRAC Bulletin. Toll Free: 866.742.4900 Or you can request a meeting on a specific topic, CLICK HERE to schedule. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; 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. View contact profiles from American Plan Administrators Popular Searches American Plan Administrators American Plan Administrators LLC LOS ANGELES, CA 90017-1906. remington pro1 flat iron; out-of-state broker commission texas; July 7, 2022. american plan administrators claim mailing address To all our customers and vendors, please note that American Benefit Administrators will continue to provide you with continued support and continue our operations. I was very impressed with American Benefits Group after separation from my employer. Several payers that DO receive claims electronically have been placed on this list for having poor services available. Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more. Box 9055 Media Relations Contact. The new PAI provider portal is going live. December 2020. o Each card also includes the paper and electronic claims submission addresses. Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. Medical Claims. Home; About; Advantages; Solutions/Services; Resources; Contact us 0 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. endstream endobj startxref 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. This team was incredibly patient, kind, and helpful. 2018 Zenith American Solutions, Inc. All Rights Reserved. This team is diligent and kind. 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. PO Box 804238 PAI P.O. Fax an updated W-9 to (803) 264-9089 1268 0 obj <>stream PAI will not require that you repay the refund until PAI has concluded its review. 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 long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. Changes made will not be reflected on all impacted systems for up to 2 business days. They are web-based or Internet-accessible solutions that facilitate seamless front office and back office operations. 2009-2023 Zenith Insurance Company. endstream endobj 1230 0 obj <. The cost of healthcare continues to grow at an unsustainable pace. Chattanooga, TN 37422-7223. Employees. 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 First American Financial Corporation 1 First American Way Santa Ana, California 92707. 24 hours a day, 365 days a year. 1200 WILSHIRE BLVD-5TH FLOOR. Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. Please let us know if you experience any trouble or if you need help using the AMA Insurance Verification of Benefits Portal. Box 380844 Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM 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. Try taking a look at our Frequently Asked Questions page. 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. New User?Please click here to register. You will receive a response within 2 business days. About Us; Contact; Helpful Links; Online Forms; Coordination of . hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k Login to your account. We offer a state-of-the art member portal to help you make the most of your health benefits. For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. 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. Toll Free: 718-834-1256. Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. Access the link below for easy-to-use claim filing. For general assistance, please call your Client Services representative or your Customer Care team. 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 Receiving illegal calls claiming to be from American Benefits Group? 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 Toll Free: 866.742.4900 Hours: 7:00 a.m. - 6:00 p.m CST. Hours: 7:00 a.m. 6:00 p.m CST. The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. Cigna shares the administration of the plan with a third party. 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 . We will quickly get back to you with the information you need. 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. If you currentlyparticipate with the Preferred Blue Network, then you are already set up with PAI as a participating provider. ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK 83 0 obj <> endobj Take control of your benefits. Zenith Insurance Company ABA is committed and confident it will provide the same level of service. For assistance with portal registration or portal password assistance, please call 877-777-0031. Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson Benefits administration is a difficult, increasingly complex business. You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. . 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. PSIP Reimbursement Rates for 2020/ . Employees. megamenu1. Need answers now? 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. American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. 6:00 a.m. 8:00 p.m. MST, Corporate Office P.O. Please refer to the members identification card to determine the applicable network. 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 First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday We appreciate hearing from you. 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. Box 6927 support@americanbenefitadministrators.com, clientservices@americanbenefitadministrators.com. Try taking a look at our. Participant Inquiries: cobra@americanbenefitadministrators.com Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. *As part of our effort in achieving a 100% paperless office we encourage you to receive your reimbursements directly into your bank account. 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. View the drug lists thatapply to members with PAIs pharmacy benefit coverage with OptumRx. Preferred Network Arrangements. %%EOF You will need an Employer ID when you register. *Out-of-network form submission deadlines may vary by plan. CareFirst contracts with Third Party Administrators to the Network claims product. For general inquiries or to file a claim, visit our Submitting a Claim page. PO Box 21367 Billings, MT 59104 Local Phone: 406-245-3575 Phone: 800-777-3575 Fax: 406-652-5380 Contact Us Its almost here! The original entity of Zenith American Solutions has been in business since 1944. Its a stark contrast from the individuals I spoke to at carriers when following up on enrollments. 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 As may vary by group, please call the phone number listed on the member ID card. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. Staff Photography by Jessica Marie Photography Inc. 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 endstream endobj startxref There are two easy ways to submit claims to Sana. Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. Its almost here! Helping You Provide The Best Possible Care. Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit For further information, please contact the precertification number located on the members identification card. 3333 Hesper Road Its not easy to accomplish but it has been my experience and I am very grateful.". 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 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. 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: 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) Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. If you are a participating CompNet provider seeking to manage addresses and . Contact the Customer Service number on the member ID card if you need assistance. 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 2023 Planned Administrators Inc. All rights reserved. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. 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. You would need to reimburse yourself and then pay your provider directly. Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: . 2022 Employee Benefit Management Services, LLC. 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 1229 0 obj <> endobj SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. 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? o ID Cards include the TPA or insurer's telephone number and address(es), for eligibility, benefits, claim status and payment inquiry. Corporate Headquarters. Driving Directions. Fax: 406-652-5380. 2023 Planned Administrators Inc. All rights reserved. Birmingham, AL 35238, 2023 American Benefit Administrators. For group-specific prior authorization information, please log in to the MyPAI Provider Portal above and review the members health benefit plan document. 0 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 MAILING ADDRESS: American Insurance Administrators P O BOX 17908 LOS ANGELES, CA 90017-0908. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. Billings MT 59102 Fill out our Request for Proposal Form. Cigna. We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. The new PAI provider portal is going live. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. Columbia, SC 29260. As a health care provider, you are an integral part of our team. Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. 1 (800) 244-6224. Copyright 2016 AMA Insurance, Inc. All rights reserved. If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. (888) 505-7724 updates@sbmamec.com Box 1558 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. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. P.O. If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. Dental Claims. Client/Employer Support:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: We strive to provide service excellence and a smooth experience to all our health care providers as they navigate our system to provide care. %PDF-1.6 % Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) Electronically Electronic/Payor ID: 50114. AMERICAN INSURANCE ADMINISTRATORS. P.O. Zenith Insurance Company Ple ase send all c orrespondence and non-claim inquiries to the TPA addresses below. Our online tools will give you all the information access you need to utilize patients health benefits to support their care. American Plan Administrators. 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. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. Return the completed form and your itemized paid receipts to: First American Administrators, Inc. Attn: OON Claims P.O. (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. This is nothing new; however, this is a good time to remind everyone of the feature. If youre interested in improving your benefit plan and improving lives, drop us a line. Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. Phonee: 718-625-6300. 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. %PDF-1.6 % Please Be Advised. Toll Free: 1.800.854.3643 Local: 1.714.250.3000. Please forward your refund repayments to: Van Nuys, CA 91409-9055, Other States: Authorized to administer business in all 50 states, hundreds of employers across the country and their covered employees rely on PAI. 2023 American Benefits Group. d '7y[ f| m x06w a>g Log in to your account to confirm your specific . Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. Chicago, IL 60680-4104. 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. Together with the TPA, our goal is to educate members so they can make better, more informed health care decisions. These tools focus on quality and ensuring the best possible end result for each and every user. hb```f``Z`qA2l,1`c(.`Wb4kE/'fLBmlm>x2faTn`9w]B@/.Se~i Ip2) iF r,`qRf`@ 1 Sarasota, FL 34230-1558, Report a Property, Liability, or Auto Claim, Agent & Broker Resources, Support & Online Tools. 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. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. The original entity of Zenith American Solutions has been in business since 1944. Cigna. Contact; Log In; Hit enter to search or ESC to close. 1.800.426.9786. As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. 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. 7:00 a.m. 8:00 p.m. MST, Monday-Thursday All rights reserved. hbbd```b`` `>"@``rXd."#;H)`'`y f\"y7A$g-Xd2#7mVXD]"MAD = G`$C For questions concerning your online portal, including login information, please email:helpdesk@zenith-american.com. P.O. Phone: 800-777-3575 Toll Free: 866.742.4900 We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. Participant Support:support@americanbenefitadministrators.com Also, customers and vendors may be requested to provide electronic payment options for invoices. %%EOF If you use the EDGE portal, additional login information can be found on theEDGE Hub. Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. We are proud to offer our own unique Claims processing and Benefit administration solutions. M-F 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 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. 1-800-303-5242. (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . Please contact the TPA with questions on these topics. View Map, Employee BenefitManagement Services AMA Insurance Agency, Inc. By Mail Sana Benefits Claims P.O. Title Claims Contact. The team uses PMI standards and project management tools along with IT industry best practices. Claims paid under PSIP Program are subject to county audit. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. 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. Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com. PO Box 182223. Both American Benefit Plan Administrators and Zenith Administrators were strong TPA's prior to the merger, but by combining .
