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