CLAIMS & ERA PAYER LIST September 9 2022
Sep 9 2022 Payer 75185 to HealthSmart Benefit Solutions (EDI. Payer ID #37283). Claims submitted under payer ID. AARP - UnitedHealthcare Insurance ...
EPS Payer Id Payer Name Type 13162 1199 NATIONAL BENEFIT
EPS Payer Id. Payer Name. Type. 13162 1199 NATIONAL BENEFIT FUND 82018 HCS - HEALTH CLAIMS SERVICE (BOISE ID) ... 95279 Keenan Associates (CA).
Institutional (Hospital) and Professional (Medical) Payer Listing
Payer ID. Payer Name. Services. Hospital. (837I). Medical. (837P). 00046 Hill Physicians Medical Group 95279 Keenan Associates (CA).
Change Healthcare Dental Payer List 8/16/2016 1 State Payer ID
Aug 16 2016 ID. Type. Model. Grou p #. Enrol l. Payer Enrollment Turnaround ... Use this Payer ID for submitting ... 95279. Par. COMMERCIAL.
Payer Identification Information Claims Information Remittance
ID. Payer Name. Additional Info. Status. Enrollment. Required To submit to Payors not on this list use Payor ID "06126" ... 95279 Keenan Associates.
Change Healthcare Dental Payer List 8/16/2016 1 State Payer ID
Aug 16 2016 ID. Type. Model. Grou p #. Enrol l. Payer Enrollment Turnaround ... Use this Payer ID for submitting ... 95279. Par. COMMERCIAL.
Payer Claims List
Payer ID. Payer Name. Req. Enroll. 22384. Administrative Concepts (Wayne PA) 95279. Keenan Associates (Torrance
TPL Carrier File
ID. 83707. 8007867930. 10079. ABS. PO BOX 30570. PHOENIX. AZ 85046. 6238897200 95279. UNITED HEALTHCARE. P.O. BOX 30551. SALT LAKE CITY. UT 84130.
Payer list PDF dump
Aug 7 2015 Each claim must be associated with a payer ID. If sending directly from your ... 95279. Commercial. CA. Keenan and Associates. Institutional.
eAttachments Payer Identification Information Claims Processing
To submit to Payors not on this list use Payor ID "06126" 95279. Keenan Associates. Non Par. Batch. 73100. Kempton Company (OK).
Payer ID provider number reference — Professional
Payer ID provider number reference — Professional Rev January 2022 Use this guide as a reference tool when submitting professional claims The information was current at the time of publication We will announce changes on the Provider News Center and the Provider Engagement Analytics & Reporting (PEAR) portal
HRSA COVID-19 Coverage Assistance Fund Claim Submission Guide
submitting an EDI file using Payer ID UHNDC you must successfully complete specific EDI testing Contact your clearinghouse to begin the testing process Refer to NDC Claim Submission or call UnitedHealthcare EDI Support at 800-842-1109 for more information Other
Institutional Claim Payers List (05/08/2023) - Optum
complete enrollment form under payer ID 95044) 23037 Y AMERIHEALTH HMO TRUE G AmeriHealth NorthEast (Dates of Service on or before Dec 31 2020 may continue to use the following until Dec 31 2021 For dates of service 01/01/21 or after use payer ID 22248) ** 77001 Y AMERIHEALTH NE FALSE G Amerihealth PPO New Jersey** 12X28 N
Clearance EDI Eligibility Payer List - Change Healthcare
Payer-assigned Payer ID:Payer ID assigned by the payer Connectivity Type Available: Indicates X12 Portal or Both Authorization Required: X12 or Portal: Payer requires authorization for providers to submit through Change Healthcare for the Connectivity Type indicated No: No authorization required for the Connectivity Type indicated
Searches related to payer id 95279 filetype:pdf
This Payer Sheet applies to BIN 610279 Only CLAIM BILLING/CLAIM REBILL TRANSACTION For BIN 610297 we will select one of the following COB options: Scenario 1 - Other Payer Amount Paid Repetitions Only Scenario 2 – Other Payer -Patient Responsibility Amount Repetitions CLAIM BILLING/CLAIM REBILL PAID (OR DUPLICATE OF PAID) RESPONSE
What is payer ID 99999-0aqs?
- Payer ID 99999-0AQS has been established for the HRSA COVID-19 Coverage Assistance Fund, and claim submission to the Fund should be accomplished via providers’ regular electronic claim submission methods.
What is payer ID 45276?
- Payer ID 45276 West Virginia Family Health Plan will remain active only for claims for service dates prior to 7/1/2019. Providers should check member cards to ensure they send claims to the correct WV MCO plan for service dates 7/1/2019 and forward.
When to use payer ID 20976 or 90440?
- Use Payer ID 20976 for claims with DOS 4/1/09 and after. For claims with DOS prior to 4/1/09 use former payer ID 90440. Premier HealthCare Exchange GEC91953I 88056 GEC91953P Premier Managed Care Inc. (Ohio BWC) Presbyterian (NM) GEC91100P 05003 GEC91100I Prestige Health Choice GEC92596P 77003 Payer effective 5/1/2014.
What is payer ID 87726?
- The health care ID card for members who have transitioned indicates payer ID 87726. Link: UHCprovider.com/claimslink Online: UHCprovider.com/claims(policies, instructions and tips)
Tesia Clearinghouse
www.Tesia.com1540 W Edgewood Drive
Indianapolis, IN 46217
Tel: (800) 724-7240
Clearinghouse Payer List
eAttachmentsPayer IDPayer NameAdditional InfoStatus
Enrollment
RequiredType
270sAvailable
Enrollment
RequiredType
Level of
ResponseEligibility Notes
835sAvailable
Enrollment
Required
Paper EOBs
Shutoff
whenEnrolledERA Notes
Accepts Tesia
eAttachments CX044A & I Benefit Plan AdministratorsNon ParBatch39640A&D Charitable Foundation Inc (dba GreatLakes PACE)a Mediture PayerNon ParBatch
AARP1AARP Dental Insurance PlanParBatchTRUERTDetailedTRUESTRUETRUE
43178Acceptius (Benefit Management Inc of MO)Non ParBatch
TLZ17Access Administrators (CA ONLY)ParBatchTRUE
CX097Access DentalNon ParBatch
64071AcclaimsNon ParBatch
TLX81ACEC Health Plans (Salt Lake City, UT)ParBatchTRUESTRUEMust Enroll in EFT FirstTRUE72468ACS Benefit Consulting Services, Inc.Non ParBatch
61474ACS Benefit SolutionsNon ParBatch
TLU02Administration Systems Research CorporationNon ParBatch CX076Administrative Services Only (ASO)ParRTTRUERTGeneralTRUETLX97ADN Administrators (MI)ParBatchTRUE
CCPSAAdvantage by Superior Non ParBatch93524Advantage Dental Plan, Inc. PlatinumRTTRUERTGeneralTRUEOIn-State, Credentialed
Providers OnlyTRUE
83077Advantek Benefit Administrators (Fresno, CA)Non ParBatch
43168Advantica (fka Essex Dental Benefits)ParRTTRUE
95340Adventist Health System West - Roseville, CANon ParBatch
60054Aetna ParBatchTRUERTDetailedTRUEWTRUETRUE
57604Aetna Affordable Health Choices (SM) - SRCParBatchTRUERTDetailedTRUEWTRUETRUE
128WVAetna Better Health of West VirginiaNon ParBatch
68246Aetna DMOParBatchTRUERTDetailedTRUEWTRUETRUE
18014Aetna MedicareNon ParBatch
TLW02Affordable Benefit Administrators, Inc.Non ParBatch58066AFLAC of GeorgiaNon ParBatch
52080AFLAC of New YorkNon ParBatch
91136AGC International Union of Operating Engineers Local 701 (F07)Non ParBatch
91136AK United Food and Commercial Workers (AK UFCW) (F45)Non ParBatch
CX083Alameda Alliance (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
91136Alaska Carpenters (F40)Non ParBatch
AKEF1Alaska Electrical Health & Welfare FundNon ParBatch91136Alaska Hotel Employees, Restaurant & Camp Employees (AK HERE) (F41)Non ParBatch
91136Alaska Laborers Construction Industry Health & Security Trust (F23)Non ParBatch
91136Alaska Machinists Health and Welfare Trust (F21)Non ParBatch
91136Alaska Pipe Trades U A Local 375 (F24)Non ParBatch
91136Alaska Public Employees Association (APEA/JESS Health & Welfare Trust) (F60)Non ParBatch
44423Alexian Brothers Community Services of TNa Mediture PayerNon ParBatch
ALH01Aliera HealthcareNon ParBatch
CXALCAllCare CCO DentalA Performance Health Technology PayerNon ParBatch TLU11Allegiance Benefit Plan ManagementNon ParBatch93658Alliance CoalNon ParBatch
70106Alliant Services (aka Voluntary Benefits Plan and US Life Ins Co)Non ParBatch
TLX56Allied Benefit SystemsNon ParBatch
91136Allied Metal Crafts Security Plan Trust Fund (F18)Non ParBatch
50503Altus Dental ParBatch
STR01Always Care BenefitsNon ParBatch
13343Amalgamated Life / AliCareParBatch
TLU15Amalgamated Life / AliCareParBatch
TLY53Amalgamated Life / AliCareParBatch
TLU23Ameriben Solutions (formerly IEC Insurance)ParBatch75240American Administrative Group, Inc. (AAG)Non ParBatch
42112American Administrators (IA)Non ParBatch
CX084American Benefits Corp (Huntington, WV)ParBatch CX001American Medical SecurityParBatchTRUESTRUEMust Enroll in EFT FirstTRUE16120America's TPANon ParBatch
47009Ameritas Life Insurance CompanyParBatchTRUETRUE
38255Amway Corporation / DentalNon ParBatch
53085Anchor Benefit Consulting IncNon ParBatch
CX083Anthem Health Plans - HMOD & HMOG (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans Previously
Submitted Under TPC12ParBatchTRUE
CX083Anthem Health Plans of Kentucky - OSB High & Low (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
CX083Anthem Health Plans of Kentucky - PPOB & PPOD (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
CX083Anthem Health Plans of Virginia - OSB High & Low (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
CX083Anthem Health Plans of Virginia - PPOB & PPOD (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
CX083Anthem HMO Colorado - HMO-B (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
Payer Identification InformationClaims ProcessingEligibility and Benefits InformationRemittance InformationTo submit to Payors not on this list, use Payor ID "06126"
and be sure to submit all required fields, including Payor Name and Complete Address.(C) 2014 Tesia Clearinghouse
Tesia Dental Payer Listing - Website (v 11.27.19).xlsx1 of 16
Tesia Clearinghouse
www.Tesia.com1540 W Edgewood Drive
Indianapolis, IN 46217
Tel: (800) 724-7240
Clearinghouse Payer List
eAttachmentsPayer IDPayer NameAdditional InfoStatus
Enrollment
RequiredType
270sAvailable
Enrollment
RequiredType
Level of
ResponseEligibility Notes
835sAvailable
Enrollment
Required
Paper EOBs
Shutoff
whenEnrolledERA Notes
Accepts Tesia
eAttachmentsPayer Identification InformationClaims ProcessingEligibility and Benefits InformationRemittance Information
CX083Anthem Insurance - OSB High & Low (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
CX083Anthem Insurance - PPOB & PPOD (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
34196Apex Benefit ServicesNon ParBatchTRUEWTRUE
TLW68APIPA (Arizona Physicians IPA) - Claims ONLYParBatchTRUESTRUEMust Enroll in EFT FirstTRUETLX06APIPA (Arizona Physicians IPA) - Pre Determinations ONLYParBatchTRUESTRUEMust Enroll in EFT FirstTRUE
44444APWU Health PlanNon ParBatch
ARCMSAR Medicare AdvantageParBatchTRUEDetailedTRUESTRUECXARCARC AdministratorsNon ParBatch
ARGUSArgus Dental Plan (Encounters)Non ParBatch
81883Arkansas Municipal Health Benefit FundNon ParBatch
63240ARM LTDNon ParBatch
90475Arrow Benefits GroupNon ParBatch
TLX61ASEA / AFSCME Local 52ParBatchTRUERTGeneralTRUETLU02ASR CorporationNon ParBatch
TLU02ASR Health BenefitsNon ParBatch
ASHC1Assurant Health Supplemental DentalNon ParBatchTLX83Assured Benefit AdministratorsNon ParBatch
93221AsurisNon ParBatchTRUE
ADN01Atlantic Dental (ADI)Non ParBatch
ATPA1ATPA - Associated Third Party Administrators (CA offices)Non ParBatchAULTCAultCare Dental (OH)Non ParBatch
37242Aultra Administrative GroupNon ParBatch
38259Automated Benefit ServicesNon ParBatch
37280Automated Group Administration (AGA)Non ParBatch
86098Avesis ParBatchTRUE
A2051BAC Local 15 Welfare Fund (Kansas)Non ParBatchTLY50Banner Health and Dental PlanNon ParBatch
77078Banner Plan AdministrationNon ParBatch
CHSBABay Area Automotive Group
Administered by Health Services Benefit
AdministratorsNon ParBatch
CHSBDBay Area Delivery Drivers
Administered by Health Services Benefit
AdministratorsNon ParBatch
47198BC - California (Wellpoint)Non ParBatchTRUEOTRUE
CBAL1BCBS - AlabamaNon ParBatchTRUERTGeneralTRUEWTRUE47570BCBS - AlaskaParBatchTRUERTGeneral
TBX01BCBS - Arizona
Includes BCBS Arizona FEP Claims Previously
Submitted Under Payer ID TLZ14Non ParBatchTRUEWTRUE83470BCBS - ArkansasParBatch TRUE RTDetailedTRUESTRUE
TFQ45BCBS - Arkansas FEP Claims ONLYNon ParOBatchTRUEW84099BCBS - Colorado Non ParBatchTRUEOTRUE
65358BCBS - Connecticut Non ParBatchTRUEOTRUE
00700BCBS - Connecticut (Family Plan)Non ParBatchTRUEOTRUE
53287BCBS - Delaware Non ParBatch
TFL02BCBS - Florida - FEDERAL CLAIMSNon ParBatch
SB601BCBS - GeorgiaNon ParBatchTRUEOTRUE
CB621BCBS - Illinois
Includes BCBS Illinois FEP Claims Previously
Submitted Under Payer ID TLW12Non ParBatch
TLU89BCBS - Indiana (FEP)Non ParBatchTRUEOTRUE
84105BCBS - Indiana (Anthem)Non ParBatchTRUEOTRUE
CBIA2BCBS - Iowa (aka Wellmark Blue Dental)Non ParWBatch CBIA1BCBS - Iowa (FEP and Farm Bureau ONLY)Non ParWBatchTLU90BCBS - Kentucky (FEP)Non ParBatchTRUEOTRUE
84105BCBS - Kentucky (Anthem) Non ParBatchTRUEOTRUE
23739BCBS - Louisiana
Includes BCBS - Louisiana FEP Claims Previously
Submitted Under Payer ID TLU05Non ParSBatchTRUERTGeneralTRUEWBME01 BCBS - Maine (Anthem)Non ParBatchTRUEOTRUE
TLX88BCBS - Maryland / CareFirst
Includes Claims for BCBS MD CareFirst Previously
Submitted under Payer IDs TLX85, TLX86, TLX87,
TLZ09, and TLU18Non ParBatch
TRUERTDetailed
TRUESTRUETRUE
CBMA1BCBS - MassachusettsNon ParBatch
BCBSMBCBS - MichiganNon ParBatch
CBMI1BCBS - Michigan (FEP Claims Only)Non ParBatchBXMN1BCBS - MinnesotaNon ParBatch
TLU22BCBS - Minnesota - Federal Employee Program (FEP)Non ParBatchTBS01BCBS - Mississippi
Includes BCBS Mississippi FEP Claims Previously
Submitted Under Payer ID TBS02Non ParSBatchTRUES
TBS03BCBS - Mississippi (CHIP Claims ONLY)ParBatchTRUESTRUEMust Enroll in EFT FirstTRUE TBS04BCBS - Mississippi (SPECIAL)Non ParBatchTRUESTLX52BCBS - Missouri Non ParBatchTRUEOTRUE
TLU06BCBS - MontanaNon ParBatch
TLU88BCBS - NebraskaNon ParBatch
To submit to Payors not on this list, use Payor ID "06126"and be sure to submit all required fields, including Payor Name and Complete Address.(C) 2014 Tesia Clearinghouse
Tesia Dental Payer Listing - Website (v 11.27.19).xlsx2 of 16
Tesia Clearinghouse
www.Tesia.com1540 W Edgewood Drive
Indianapolis, IN 46217
Tel: (800) 724-7240
Clearinghouse Payer List
eAttachmentsPayer IDPayer NameAdditional InfoStatus
Enrollment
RequiredType
270sAvailable
Enrollment
RequiredType
Level of
ResponseEligibility Notes
835sAvailable
Enrollment
Required
Paper EOBs
Shutoff
whenEnrolledERA Notes
Accepts Tesia
eAttachmentsPayer Identification InformationClaims ProcessingEligibility and Benefits InformationRemittance Information
84101BCBS - NevadaNon ParBatchTRUEOTRUE
BNH01BCBS - New Hampshire (Anthem)Non ParBatchTRUEOTRUE84100BCBS - New Mexico Non ParBatch
61473BCBS - North CarolinaNon ParBatch
61472BCBS - North Carolina (FEP Program & Health Choice for Children)Non ParBatch
52133BCBS - North Carolina (Salt Lake City, UT ONLY)ParBatchTRUERTGeneralTRUESTRUEMust Enroll in EFT FirstTRUE
84105BCBS - Ohio (Anthem)Non ParBatchTRUEOTRUE
TLU91BCBS - Ohio (FEP)Non ParBatchTRUEOTRUE
TBOK1BCBS - OklahomaNon ParBatch
CB870BCBS - Rhode Island
FEP claims should NOT be submitter under this
Payer ID - Please use Payer ID RIFEPParBatchTRUERTDetailedTRUES TRUERIFEPBCBS - Rhode Island FEP
Only FEP claims should be submitted under this
Payer IDNon ParBatchTRUERTDetailedTRUEWOnly in-state providers may enroll for ERA.38520BCBS - South Carolina
Includes BCBS - South Carolina FEP Claims
Previously Submitter Under Payer ID TLW74Non ParBatchTLY09BCBS - South DakotaNon ParWBatch
CBTN1BCBS - Tennessee (Claims ONLY - no PTE)Non ParWBatchTRUERTGeneralTRUEWL84980BCBS - Texas Non ParBatch
84103BCBS - Virginia (Trigon)Non ParBatchTRUEOTRUE
47570BCBS - WashingtonParBatchTRUERTGeneral
TLY47BCBS - Washington DCNon ParBatchTRUERTDetailedTRUESTRUETRUE00301BCBS - Western New YorkParBatchTRUEW
39141BCBS - Wisconsin
Includes BCBS WI Claims Previously Submitted
Under Payer ID CB950 & Claim Management
Services Claims Previously Submitted Under Payer
ID CMS01Non ParBatchTRUEOTRUE
TLX12BCBS - WyomingParBatchTRUESTRUE
BBMDQBCBS MI / BCBS MI Medicare AdvantageNon ParBatch49153BCI Administrators, Inc.ParBatch
BEAM1Beam DentalParBatch
60054Bell AtlanticParBatchTRUERTDetailedTRUEWTRUETRUE
23210BeneCare Dental Plan ParBatchTRUE
41205Benefit Administration ServicesNon ParBatch
TFQ64Benefit Administrative Systems (BAS) (Homewood, IL)Non ParBatch25145Benefit Coordinators Corporation (Pittsburgh, PA)Non ParBatch
R7003Benefit Inc. (MN)Non ParBatchTRUERTDetailedTRUESTRUE43471Benefit Management / IneticoParBatch
36459Benefit Management Group (NV)Non ParBatch
48611Benefit Management of KansasNon ParBatch
TLU45Benefit Management Services (NC)Non ParBatch
37212Benefit Management Systems (MS)Non ParBatch
19753Benefit Plan Administrators IncNon ParBatch
39081Benefit Plan Administrators, Inc. (Eau Claire, WI)
Includes Custom Benefit Administrators Claims
Previously Submitter Under Payer ID 39170 and 3P
Administrator Claims Previously Submitted Under
Payer ID 20413ParBatchTRUE
07000Benefits Inc (Construction Suppliers Group only)Non ParBatchTRUERTDetailedTRUESTRUE
BMX01BeneMaxNon ParBatch
95604Best Life & Health Insurance CompanyNon ParBatch
TLY26Blue Advantage (BCBS of AR)ParBatch TRUE RTDetailedTRUESTRUE47163Blue Cross Blue Shield of KansasNon ParBatchTRUEW
47171Blue Cross Blue Shield of Kansas CityNon ParBatchTRUEW
CX083Blue Cross Blue Shield of Wisconsin - PPOD (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
BCD01Blue Cross Dental (MD) / Dominion / Capital Blue CrossParBatchTRUERTGeneralTRUE CX083Blue Cross of California - OSB High & Low (Admin by LIBERTY Dental) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
CX083Blue Cross of California - Plan SS10 & SS20 (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
CX083Blue Cross of California - PPOA (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
CBID1Blue Cross of IdahoNon ParWBatchTRUEW
52133Blue Shield of California ParBatchTRUERTGeneralTRUESTRUEMust Enroll in EFT FirstTRUE
BSCA2Blue Shield of California (FEP Only)Non ParBatch CB865Blue Shield of Pennsylvania (Camp Hill)PlatinumRTTRUERTDetailedTRUESTRUE CBPA2Blue Shield of Pennsylvania - Dental Plus (UCCI)PlatinumRTTRUERTDetailedTRUESTRUE36609Boilermakers National Health & Welfare Fund (Int'l Brotherhood of Boilermakers)Non ParBatch
TLX71Bollinger InsuranceParBatch
74237Boon-Chapman Benefit Administrators IncNon ParBatch
04210Boston University Dental Health PlanNon ParBatch
CX028Bridgeport LLC of Missouri (St. Charles, MO)ParRTTRUEBRIDGBridgespan HealthNon ParBatchTRUE
51037Brokerage ConceptsNon ParBatch
To submit to Payors not on this list, use Payor ID "06126"and be sure to submit all required fields, including Payor Name and Complete Address.(C) 2014 Tesia Clearinghouse
Tesia Dental Payer Listing - Website (v 11.27.19).xlsx3 of 16
Tesia Clearinghouse
www.Tesia.com1540 W Edgewood Drive
Indianapolis, IN 46217
Tel: (800) 724-7240
Clearinghouse Payer List
eAttachmentsPayer IDPayer NameAdditional InfoStatus
Enrollment
RequiredType
270sAvailable
Enrollment
RequiredType
Level of
ResponseEligibility Notes
835sAvailable
Enrollment
Required
Paper EOBs
Shutoff
whenEnrolledERA Notes
Accepts Tesia
eAttachmentsPayer Identification InformationClaims ProcessingEligibility and Benefits InformationRemittance Information
CX032Brokers National ParBatchTRUETRUE
00800BS Northeastern New YorkParBatchTRUEW
61301Businessmen's Assurance (NE)ParBatchTRUETRUE
42150Butler Dental (IA)Non ParBatch
CAS89C.A.S. Benefit PlansParBatch
CX083Cal Optimal - OneCare (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
71057Cannon Cochran Management Services, Inc. (LA Plan ONLY)Non ParBatch
CBC01Capital Blue Cross (CBC) / Blue Cross Dental (MD)ParBatchTRUERTGeneralTRUE68011Capitol AdministratorsNon ParBatch
CX095Capitol Dental Plan (OR)Non ParBatch
CAPHPCaprock Health PlansNon ParBatch
CX083Care 1st Health Plan Medicare Advantage (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
CX083Care 1st PHP LA & San Bernadino County (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
TLY44Careington CorporationParBatchTRUE
93975CareOregonNon ParBatch
GACS1Caresource - GAParBatch
KYCS1Caresource - KYParBatchTRUE
WVCS1Caresource - WVParBatch
CKOH2Caresource (OH)ParBatch
INCS1CareSource of IN (Just4Me)ParBatch
TLU48Carolina Summit Healthcare IncNon ParBatch
TFQ25Carpenters Combined Funds (PA)PlatinumRTTRUERTDetailedTRUESTRUE TLW16Carpenter's Health & Welfare Fund (Philadelphia, PA)ParBatchTRUE TLW06Carpenters Health and Welfare Trust Funds (St. Louis, MO)ParRTTRUERTDetailedTRUECHA01Cascade Comprehensive Care IncNon ParBatch
37060Caterpillar IncParBatchTRUESTRUEMust Enroll in EFT FirstTRUE
03036CBA Blue Dental / Emp Benefit Plan AdminNon ParBatch
TLZ03CCPOA Benefit Trust FundNon PariBatch
88022CDS Group Health (NV)Non ParBatch
91136Cement Masons & Plasterers Health & Welfare Trust (F16)Non ParBatch
TLU51Central PA Teamsters Health & Welfare FundParBatchTRUESTRUETRUE TLW76Central Reserve Life Insurance CompanyNon ParBatch36215Central States Health & Welfare Fund (IL)ParBatchTRUE
84147CHAMPVA - HAC
CHAMPVA-HAC is not associated with and does not
process claims for TRICARE (fka CHAMPUS)Non ParBatchTLU92Chesterfield Resources, Inc.Non ParBatch
TLY40Chicago Regional Council of CarpentersParBatchTRUE84147Children of Women Vietnam Veterans - VA HACNon ParBatch
60054Choice Plus (TRW)ParBatchTRUERTDetailedTRUEWTRUETRUE
38308Christian Brothers Services (CBS Health Benefits)Non ParBatch
62308CIGNA
Includes Cigna Flex Care (NM) Claims Previously
Submitted Under Payer ID TLX70ParBatchTRUES
Paper remittances turned off if
enrolled in EFT.10050CIGNA (DHMO)ParBatchTRUES
Paper remittances turned off if
enrolled in EFT. TLU52Citizens Security Life Insurance CoNon ParBatch38219ClaimChoice AdministratorsNon ParBatch
89461Claims Bridge NorthNon ParBatch
44219Claims Bridge NWNon ParBatch
55731Claims Bridge SouthNon ParBatch
TLU53Combined Insurance ServiceNon ParImages
27905Community Health Alliance of TNNon ParBatch
75261Community Health Electronic Claims (CHEC/Webta)Non ParBatch
CX083Community Insurance - HMOA & PPOB (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
CX083Community Insurance - PPOD & PPOF (Admin by LIBERTY Dental Plan) Includes Claims for Liberty Dental Plans PreviouslySubmitted Under TPC12ParBatchTRUE
48005Companion LifeNon ParBatch
77828Companion LifeNon ParBatch
CX021CompBenefits (Chicago, IL)Non ParBatch
PBGSMComprehensive Benefit AdministratorsNon ParBatch TLW14Comprehensive Benefits & Claims AdministratorsNon ParBatch00720Comprehensive Care ServicesNon ParBatch
WT011Comprehensive Healthcare OptionsNon ParBatch
10166Comprehensive Medical and Dental Program CMDPNon ParBatch
37307Connecticut Carpenters Health FundParBatchTRUERTDetailedTRUESTRUETRUE
62308Connecticut General (CIGNA)ParBatchTRUES
Paper remittances turned off if
enrolled in EFT.37135Consociate GroupNon ParBatch
61305Consolidated Group DentalNon ParBatch
45321Consumers Choice Health Plan - State of SCNon ParBatch
To submit to Payors not on this list, use Payor ID "06126"and be sure to submit all required fields, including Payor Name and Complete Address.(C) 2014 Tesia Clearinghouse
Tesia Dental Payer Listing - Website (v 11.27.19).xlsx4 of 16
Tesia Clearinghouse
www.Tesia.com1540 W Edgewood Drive
Indianapolis, IN 46217
Tel: (800) 724-7240
Clearinghouse Payer List
eAttachmentsPayer IDPayer NameAdditional InfoStatus
Enrollment
RequiredType
270sAvailable
Enrollment
RequiredType
Level of
ResponseEligibility Notes
835sAvailable
Enrollment
Required
Paper EOBs
Shutoff
whenEnrolledERA Notes
Accepts Tesia
eAttachmentsPayer Identification InformationClaims ProcessingEligibility and Benefits InformationRemittance Information
52132Cooperative Benefit AdministratorsNon ParBatch
TLX80CORE Administrative ServicesNon ParBatch
TFQ74CoreFiveParBatchTRUE
75136CoreSource ARNon ParBatch
41045CoreSource AZ MNNon ParBatch
48117CoreSource KC (fka FMH Benefit Services Inc)Non ParBatch
35182CoreSource MD PA ILNon ParBatch
35180CoreSource NC INNon ParBatch
35183CoreSource OH (Clinton, IA)
Includes Coresource IA Claims Previously SubmittedUnder Payer ID TFQ37Non ParBatch
58102Covenant AdministratorsNon ParBatch
25148Coventry Health Care of GeorgiaNon ParBatch
87043Coventry Healthcare National NetworkNon ParBatch
37320Creative Plan Administrators (MD)Non ParBatch
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