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