Once logged in,you will have the ability to: EBPA encourages providers to take advantage of the online resources we have made available. %%EOF endstream endobj startxref For questions concerning your online portal, including login information, please email:helpdesk@zenith-american.com. Phonee: 718-625-6300. 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 . CareFirst contracts with Third Party Administrators to the Network claims product. The new PAI provider portal is going live. Title Claims Contact. LOS ANGELES, CA 90017-1906. 18 Heyward St. Brooklyn, NY 11249. 1.800.426.9786. The team uses PMI standards and project management tools along with IT industry best practices. Birmingham, AL 35238, 2023 American Benefit Administrators. PAI will not require that you repay the refund until PAI has concluded its review. 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. Please contact the TPA with questions on these topics. The long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. 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. Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. 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 83 0 obj <> endobj Corporate Headquarters. We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. Dental Claims. Staff Photography by Jessica Marie Photography Inc. I respect a service team that does what they say theyre going to do with quality! Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM 0 Our online tools will give you all the information access you need to utilize patients health benefits to support their care. View contact profiles from American Plan Administrators Popular Searches American Plan Administrators American Plan Administrators LLC Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. There you will find answers to common questions, details about your plan, and much more. Box 380844 Changes made will not be reflected on all impacted systems for up to 2 business days. Access your online portal usingthis form. PRAC Bulletin. Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. Preferred Network Arrangements. Its almost here! Phone: 800-777-3575 Contact; Log In; Hit enter to search or ESC to close. 2022 Employee Benefit Management Services, LLC. AMA Insurance Agency, Inc. 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. Prior authorization varies from group to group. 1-800-303-5242. 1229 0 obj <> endobj Media Relations Contact. . d '7y[ f| m x06w a>g First American Financial Corporation 1 First American Way Santa Ana, California 92707. Try taking a look at our. 0 Submitthe request via email to PAI Provider Maintenance at paiprovmtn@paisc.com. Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. Provider Address Change Fax an updated W-9 to (803) 264-9089 Or you can request a meeting on a specific topic, CLICK HERE to schedule. Please forward your refund repayments to: Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com. PSIP Reimbursement Rates for 2020/ . The new PAI provider portal is going live. 2023 American Benefits Group. Also, customers and vendors may be requested to provide electronic payment options for invoices. %%EOF endstream endobj startxref *As part of our effort in achieving a 100% paperless office we encourage you to receive your reimbursements directly into your bank account. Need answers now? Its almost here! 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 . The original entity of Zenith American Solutions has been in business since 1944. o ID Cards include the TPA or insurer's telephone number and address(es), for eligibility, benefits, claim status and payment inquiry. If you use the EDGE portal, additional login information can be found on theEDGE Hub. Participant Support:support@americanbenefitadministrators.com ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK Please let us know if you experience any trouble or if you need help using the AMA Insurance Verification of Benefits Portal. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; Fill out our Request for Proposal Form. Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson 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. hb```f``Z`qA2l,1`c(.`Wb4kE/'fLBmlm>x2faTn`9w]B@/.Se~i Ip2) iF r,`qRf`@ 1 Billings MT 59102 Authorized to administer business in all 50 states, hundreds of employers across the country and their covered employees rely on PAI. (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . For further information, please contact the precertification number located on the members identification 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. AMERICAN INSURANCE 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, 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. MAILING ADDRESS: American Insurance Administrators P O BOX 17908 LOS ANGELES, CA 90017-0908. We offer a state-of-the art member portal to help you make the most of your health benefits. 1200 WILSHIRE BLVD-5TH FLOOR. The original entity of Zenith American Solutions has been in business since 1944. 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. If you are a participating CompNet provider seeking to manage addresses and . PO Box 804238 There are two easy ways to submit claims to Sana. All rights reserved. Employees. As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. Fax an updated W-9 to (803) 264-9089 To all our customers and vendors, please note that American Benefit Administrators will continue to provide you with continued support and continue our operations. We are proud to offer our own unique Claims processing and Benefit administration solutions. 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? 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 P.O. ABA is committed and confident it will provide the same level of service. Phone Number. We will quickly get back to you with the information you need. Its not easy to accomplish but it has been my experience and I am very grateful.". As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. All Rights Reserved. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. 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. Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. endstream endobj 1230 0 obj <. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. 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 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. Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. Cigna. Helping You Provide The Best Possible Care. 152 0 obj <>stream 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: remington pro1 flat iron; out-of-state broker commission texas; July 7, 2022. american plan administrators claim mailing address 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 For assistance with portal registration or portal password assistance, please call 877-777-0031. Toll Free: 718-834-1256. 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. If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. You will need an Employer ID when you register. Cigna shares the administration of the plan with a third party. Both American Benefit Plan Administrators and Zenith Administrators were strong TPA's prior to the merger, but by combining . 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. Chattanooga, TN 37422-7223. Contact the Customer Service number on the member ID card if you need assistance. Benefits administration is a difficult, increasingly complex business. support@americanbenefitadministrators.com, clientservices@americanbenefitadministrators.com. Toll Free: 866.742.4900 You would need to reimburse yourself and then pay your provider directly. We appreciate hearing from you. Try taking a look at our Frequently Asked Questions page. Box 6927 hbbd```b`` `>"@``rXd."#;H)`'`y f\"y7A$g-Xd2#7mVXD]"MAD = G`$C 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 If youre interested in improving your benefit plan and improving lives, drop us a line. PAI 2023 Planned Administrators Inc. All rights reserved. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. P.O. Need answers now? American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. 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. Return the completed form and your itemized paid receipts to: First American Administrators, Inc. Attn: OON Claims P.O. As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. 2018 Zenith American Solutions, Inc. All Rights Reserved. Fax: 406-652-5380. The cost of healthcare continues to grow at an unsustainable pace. PO Box 21367 Billings, MT 59104 Local Phone: 406-245-3575 Phone: 800-777-3575 Fax: 406-652-5380 Contact Us These tools focus on quality and ensuring the best possible end result for each and every user. Please use the form below to contact AMA Insurance. Its a stark contrast from the individuals I spoke to at carriers when following up on enrollments. 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. Please refer to the members identification card to determine the applicable network. You will receive a response within 2 business days. Attention: Refund Analyst Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. 1 (800) 244-6224. Notice of Privacy. American Plan Administrators. This is nothing new; however, this is a good time to remind everyone of the feature. hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k New User?Please click here to register. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network, CompNet. 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. o Each card also includes the paper and electronic claims submission addresses. Toll Free: 866.742.4900 Hours: 7:00 a.m. - 6:00 p.m CST. 1268 0 obj <>stream This field is for validation purposes and should be left unchanged. By Mail Sana Benefits Claims 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 Ple ase send all c orrespondence and non-claim inquiries to the TPA addresses below. (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. Take control of your benefits. Participant Inquiries: cobra@americanbenefitadministrators.com 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. Claims paid under PSIP Program are subject to county audit. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. Toll Free: 866.742.4900 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 Medical Claims. *Out-of-network form submission deadlines may vary by plan. Home; About; Advantages; Solutions/Services; Resources; Contact us Receiving illegal calls claiming to be from American Benefits Group? About Us; Contact; Helpful Links; Online Forms; Coordination of . Box 855 Arnold, MD 21012 Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. Driving Directions. Sarasota, FL 34230-1558, Report a Property, Liability, or Auto Claim, Agent & Broker Resources, Support & Online Tools. (888) 505-7724 updates@sbmamec.com Toll Free: 1.800.854.3643 Local: 1.714.250.3000. 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 P.O. 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. Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. 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. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit 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. SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. Login to your account. %PDF-1.6 % For general inquiries or to file a claim, visit our Submitting a Claim page. Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more. You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. Several payers that DO receive claims electronically have been placed on this list for having poor services available. 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. Cigna. 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. 24 hours a day, 365 days a year. Columbia, SC 29260. For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. If you currentlyparticipate with the Preferred Blue Network, then you are already set up with PAI as a participating provider. Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. Box 9055 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 7:00 a.m. 8:00 p.m. MST, Monday-Thursday 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. Chicago, IL 60680-4104. Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. Box 1558 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 6:00 a.m. 8:00 p.m. MST, Corporate Office They are web-based or Internet-accessible solutions that facilitate seamless front office and back office operations. Please Be Advised. As may vary by group, please call the phone number listed on the member ID card. 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. I was very impressed with American Benefits Group after separation from my employer. Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. For general assistance, please call your Client Services representative or your Customer Care team. Log in to your account to confirm your specific . %PDF-1.6 % First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday This team was incredibly patient, kind, and helpful. 2023 Planned Administrators Inc. All rights reserved. megamenu1. 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 View Map, Employee BenefitManagement Services 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. Together with the TPA, our goal is to educate members so they can make better, more informed health care decisions. View the drug lists thatapply to members with PAIs pharmacy benefit coverage with OptumRx. Hours: 7:00 a.m. 6:00 p.m CST. Electronically Electronic/Payor ID: 50114. 3333 Hesper Road The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. Email: sales@americanbenefitadministrators.com, American Benefit Administrators 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. To request reimbursement, please complete and sign the itemized claim form. 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. P.O. Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . 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 This team is diligent and kind. If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. 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. Copyright 2016 AMA Insurance, Inc. All rights reserved. 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) Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) Zenith Insurance Company 2009-2023 Zenith Insurance Company. Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. 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. As a health care provider, you are an integral part of our team. PO Box 182223. Employees. PAI P.O. For group-specific prior authorization information, please log in to the MyPAI Provider Portal above and review the members health benefit plan document. PAI will not require that you repay the refund until PAI has concluded its review. American Plan Administrators - Contact us. Van Nuys, CA 91409-9055, Other States: Access the link below for easy-to-use claim filing. Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: 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. December 2020. 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 HCP Login. Client/Employer Support:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: