About Us; Contact; Helpful Links; Online Forms; Coordination of . endstream endobj startxref 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. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. Hours: 7:00 a.m. 6:00 p.m CST. 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. We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. 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. This field is for validation purposes and should be left unchanged. For assistance with portal registration or portal password assistance, please call 877-777-0031. We also provide access to many other Preferred Provider Networks, both national and regional, and sometimes in combination. . PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. Benefits administration is a difficult, increasingly complex business. Once logged in,you will have the ability to: EBPA encourages providers to take advantage of the online resources we have made available. Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. %PDF-1.6 % 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. Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. Chattanooga, TN 37422-7223. 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: Need answers now? Login to your account. Dental Claims. 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. Toll Free: 866.742.4900 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. 0 Authorized to administer business in all 50 states, hundreds of employers across the country and their covered employees rely on PAI. 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. P.O. To request reimbursement, please complete and sign the itemized claim form. 1.800.426.9786. 1 (800) 244-6224. Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. PAI will not require that you repay the refund until PAI has concluded its review. Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 1-800-303-5242. P.O. PO Box 21367 Billings, MT 59104 Local Phone: 406-245-3575 Phone: 800-777-3575 Fax: 406-652-5380 Contact Us Several payers that DO receive claims electronically have been placed on this list for having poor services available. 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. The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. Our online tools will give you all the information access you need to utilize patients health benefits to support their care. 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 Submitthe request via email to PAI Provider Maintenance at paiprovmtn@paisc.com. These tools focus on quality and ensuring the best possible end result for each and every user. Please Be Advised. 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. Client/Employer Support:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more. hbbd```b`` `>"@``rXd."#;H)`'`y f\"y7A$g-Xd2#7mVXD]"MAD = G`$C Ple ase send all c orrespondence and non-claim inquiries to the TPA addresses below. Preferred Network Arrangements. 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 Also, customers and vendors may be requested to provide electronic payment options for invoices. o ID Cards include the TPA or insurer's telephone number and address(es), for eligibility, benefits, claim status and payment inquiry. 2018 Zenith American Solutions, Inc. All Rights Reserved. (888) 505-7724 updates@sbmamec.com 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? Van Nuys, CA 91409-9055, Other States: Medical Claims. Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. PRAC Bulletin. 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. The team uses PMI standards and project management tools along with IT industry best practices. Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. Attention: Refund Analyst 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. For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. New User?Please click here to register. (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. Driving Directions. Staff Photography by Jessica Marie Photography Inc. Cigna shares the administration of the plan with a third party. American Plan Administrators - Contact us. 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 . Receiving illegal calls claiming to be from American Benefits Group? endstream endobj startxref Sarasota, FL 34230-1558, Report a Property, Liability, or Auto Claim, Agent & Broker Resources, Support & Online Tools. We appreciate hearing from you. Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. 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 View Map, Employee BenefitManagement Services support@americanbenefitadministrators.com, clientservices@americanbenefitadministrators.com. 0 Provider Address Change Fax an updated W-9 to (803) 264-9089 2022 Employee Benefit Management Services, LLC. PSIP Reimbursement Rates for 2020/ . Need answers now? Register at launch to take advantage of the enhanced functionality launch date will be announced soon. Its a stark contrast from the individuals I spoke to at carriers when following up on enrollments. Zenith Insurance Company 18 Heyward St. Brooklyn, NY 11249. This team was incredibly patient, kind, and helpful. Title Claims Contact. Take control of your benefits. 3333 Hesper Road Or you can request a meeting on a specific topic, CLICK HERE to schedule. 2009-2023 Zenith Insurance Company. 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 Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. All rights reserved. As may vary by group, please call the phone number listed on the member ID card. Please let us know if you experience any trouble or if you need help using the AMA Insurance Verification of Benefits Portal. 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. First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday Box 855 Arnold, MD 21012 Cigna. 6:00 a.m. 8:00 p.m. MST, Corporate Office 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. megamenu1. 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. hb```f``Z`qA2l,1`c(.`Wb4kE/'fLBmlm>x2faTn`9w]B@/.Se~i Ip2) iF r,`qRf`@ 1 Employees. Toll Free: 1.800.854.3643 Local: 1.714.250.3000. 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. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. As the largest Taft-Hartley third-party administrator in the United States, weve used our industry know-how and resources to develop leading-edge technologies for our own use, as well as for self-administered trust funds. 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 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. PAI Please use the form below to contact AMA Insurance. 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 Electronically Electronic/Payor ID: 50114. 24 hours a day, 365 days a year. 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. You will receive a response within 2 business days. For further information, please contact the precertification number located on the members identification card. endstream endobj 1230 0 obj <. Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM Birmingham, AL 35238, 2023 American Benefit Administrators. PAI 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. There you will find answers to common questions, details about your plan, and much more. Prior authorization varies from group to group. If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. 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. Changes made will not be reflected on all impacted systems for up to 2 business days. Its not easy to accomplish but it has been my experience and I am very grateful.". PAI will not require that you repay the refund until PAI has concluded its review. 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 December 2020. Copyright 2016 AMA Insurance, Inc. All rights reserved. Fax: 406-652-5380. Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. 83 0 obj <> endobj 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. Access the link below for easy-to-use claim filing. Box 380844 HCP Login. Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com.
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