Payer id life1

The Provider Tax ID and zip code for each location. ... Payer ID: (Electronic Submission): GI813 Mailing Address: Managed DentalGuard PO Box 981587 El Paso, TX 79998-1587 Fax Number: (916) 679-7197 Note: Only claims that do NOT require x-rays can be faxed. Where can I look up the status of a claim?

Payer id life1. 1199 NATIONAL BENEFIT FUND Payer ID: 13162. Transaction Type Portal Batch Real Time (SOAP) REST (API) Enrollment Required; Eligibility and Benefits Inquiry (270)--Contact Sales: Contact Sales-Professional Claims (837P) Get Essentials Plus: Get EDI Plan---Professional Encounters (837P)-Get EDI Plan---

Electronic Payer ID: CX083 LIBERTY Dental Plan Attn: Claims Department P.O. Box 26110 Santa Ana, CA 92799 Provider Portal: www.libertydentalplan.com Phone: 1-888-352-7294 Prescriptions/ Specialty Pharmacy Express Scripts Express Scripts ATTN: Commercial Claims P.O. Box. 14711 Lexington, KY 40512-4711 Legal Statement

Member ID: Group Number: Member: State ID: PCP Name: NE WASHINGTON HEALTH PROGRAMS. PCP Phone: (509)258-4234. 0501. Payer ID: Rx Bin: 610494. Rx GRP: ACUWA. Rx ...Claim.MD can get you started fast. Check our payer list to identify payers unaffected by the Change Healthcare issue. Learn more about Claim.MD's excellent pricing. Attend a Webinar to learn more and ask questions from our sales team. See how Claim.MD makes Payer Enrollments faster and easier than ever.Our payer ID lookup tool helps providers find payer identifiers for claims management and eligibility. Ask us how to automate this for you!LIFE1-Optum Medical Network (previously Lifeprint) OSCAR-Oscar Health 06111-Oxford Health Plans OXDLF-Oxford Life Insurance Company 87020-Pan American Life ...What is the new payer ID? As of Jan. 1, 2023, the new payer ID for all products is 87726. Supervisory billing will also still be allowed. What is the Payer ID I need to use for my 835-remittance advice? • ERA payer ID CSP Facets is 04567 • ERA payer ID COSMOS is 87726 . You’ll need to re-register with their clearinghouses.Submitting a claim. For electronic submissions, use payer ID: LIFE1. For paper submissions, use: Optum Care Claims P.O. Box 30539 Salt Lake City, UT 84130. …

Washington. Login. Top. If you're an Optum Care provider, you can access the information you need securely. Select a login based on your location.68068 ALL. Y CENPATICO INDIANA Y. FALSE G. Cenpatico Massachusetts 68068 MA Y CENPATICO MASSACH Y FALSE G Cenpatico Ohio 68068 OH Y CENPATICO OHIO Y FALSE G Centene Advantage Plans (claims for former payer ID 95567 with DOS on or …Select the appropriate Payer ID below to view Medica claim submission and product guidelines for each plan. Payer ID: 94265 +. Address for Claims and Claim Appeals. Medica. PO Box 30990. Salt Lake City, UT 84130-0990. Attachment/Appeal Fax#. 1-801-994-1076. Claim Adjustment or Appeal Request Form (DOC) Get help with Change Healthcare products, find resources such as enrollment forms and payer lists, and quicklly resolve common issues. Enrollment Services Find forms for medical claims, patient eligibility, ERA, and EFT payment information. By phone: 877-370-2845. Member ID cards. Members in the affected plans will get new member ID cards that show the Payer ID LIFE1 and will have other applicable delegation-specific descriptors such as delegate name and delegate website listed as the care provider contact.They may have a proprietary ID for you to use prior to submitting claims to PGBA, LLC (HNFS' partner for claims processing). TRICARE West Region Payer ID: 99726. Note: If your clearinghouse is Change Healthcare, the West Region payer ID is SCWI0 for professional claims and 12C01 for institutional claims. Please call your Change Healthcare ...As part of our transition to a next-generation platform, we created new payer ID grids that will become effective January 1, 2024. Changes include the addition of our new AmeriHealth Medicare PPO product with a new prefix . The professional and facility payer ID grids contain valuable information to assist you in claims submission, including ...Payer IDs route EDI transactions to the appropriate payer. Anthem Payer ID: 00265: Anthem Blue Cross and Blue Shield Healthcare Solutions: Note: If you use a clearinghouse, billing service or vendor, please work with them directly to determine payer ID. Electronic remittance advice (835)

EDI Payer ID #39026 UnitedHealthcare Shared Services P.O. Box 30783 Salt Lake City, UT 84130-0783 UHC Provider Services Phone: (877) 343-1887 If the patient has Medicare primary coverage, mail to GEHA: GEHA FEHB Medical P.O. Box 21542 Eagan, MN 55121. UnitedHealthcare Choice Plus (all 50 states) EDI Payer ID #39026 UnitedHealthcare Shared ServicesPayer ID. Payer Name. Enrollment. 10001. AARP. 13187. Access Medicare. 10916. ACS Benefit Services, Inc. 10923. Administrative Services, Inc. 10927. Advantage ...For electronic submissions, use payer ID: LIFE1 For paper submissions, use Attention: OptumCare Claims P.O. Box 30539 Salt Lake City, UT 84130 Electronic funds transfer (EFT) OptumCare works exclusively with InstaMed as our free payer payments solution for providers. To continue receiving your OptumCare payments electronically,For electronic submissions, use payer ID: LIFE1 For paper submissions, use Attention: OptumCare Claims P.O. Box 30539 Salt Lake City, UT 84130 Electronic funds transfer (EFT) OptumCare works exclusively with InstaMed as our free payer payments solution for providers. To continue receiving your OptumCare payments electronically,Whether you drive or not, at some point, you’ll likely need to provide some form of valid identification. A state-issued ID card is one of the best forms of identification that you... Payer ID 3. Network name 4. Plan name 5. Provider services toll-free number 6. Medical claims address 7. UHC Medicare assigned H contract number Health Plan (80840): For Members911-87726-04 Member ID: RxBIN: RxPCN: RxGrp: H0609-025-000 Group Number: HCFAC9 Payer ID: LIFE1 Member: SAMPLE A MEMBER PCP Name: SAMPLE, M.D., PROVIDER Copay: PCP $0 ...

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Claim.MD can get you started fast. Check our payer list to identify payers unaffected by the Change Healthcare issue. Learn more about Claim.MD's excellent pricing. Attend a Webinar to learn more and ask questions from our sales team. See how Claim.MD makes Payer Enrollments faster and easier than ever. Access the Claim.MD Knowledge Base. Payer ID: LIFE1 Dental Providers: uhcdental.com 1-877-816-3596 Med Claims: P.O. Box 30539, Salt Lake City, UT 84130-0539 Rx Claims: OptumRx P.O. Box 650287, Dallas, TX 75265-0287 For Pharmacists: 1-877-889-6510 Nurseline: 1-877-512-9339 front front back backMember ID 123456789-00 Sample Plan Name with Dental RxBIN 99999 RxPCN 9999 RxGRP XXX front Card #: 99999 9999 9999 9999Security Code: 9999 SAMPLE For Members: memberurl.com 1-999-999-9999, TTY 711 Providers: providerurl.com 1-999-999-9999 Payer ID: XXXXX Dental Providers: dentalurl.com 1-999-999-9999 Med Claims: P.O. Box 99999, CITY NAME, STATE ...Creating a new Google email ID is an easy and straightforward process. With just a few simple steps, you can have your own personalized email address that you can use to communicat...

payer name payer id; u s concrete incorporated - wc: j3132: u.a. local 350 plumbers & pipefitters - era onl: ec350: u.s. networks and administrative services: usn01: ubh: 87726: ubh rios: 87726: ubh united healthcare 87726: 87726: uc care (university of ca) 68241: uc health plan administrators: 89789: uc irvine: uci01: ucare of minnesota: 55413 ... TRICARE East region Claims, CHCBP Claims, PO Box 7981, Madison, WI 53707-7981. Claims for NOAA Members. All Locations. U.S. Department of Commerce. Office of the General Counsel. Office of the Assistant General Counsel for Finance and Litigation General. Litigation Division. 1401 Contitution Ave. NW, Room 5890.Provider Portal. info. LHI is now Optum Serve. Different name, unwavering commitment to those we serve. Thank you for your patience as we transition our materials over the coming months. Click here for more information.We would like to show you a description here but the site won’t allow us.You are responsible for verifying any information before relying on it. Eclaims.com provides a searchable payer id code list, spanning all states for BCBS, MDCR and MDCD. Search by carrier or state in one easy step to locate the correct payer id code, neccessary to route EDI transactions to the correct payer.Payer ID: Per the payer list www.esolutionsinc.com 2020-09-18 . InstaMed . Electronic Remittance Advice . ERA 835 . ERA Enrollment Instructions: ... LIFE1 OptumCare – Lifeprint, Northwest Physicians Network 61325 Passport Health …Each business owner or manager must educate themselves on the proper use of federal tax IDs. This information is crucial for compliance with tax laws as well as for employment-rela...For electronic submissions, use payer ID: LIFE1 via Optum 360 clearinghouse or clearing house of your choice. You can view the status of claims on the Optum Care Provider Center, our online provider portal. OneHealthPort users will have access to the Optum Care Provider Center within OneHealthPort via https://onehealthport.com.Payer ID: LIFE1 Dental Providers: uhcdental.com 1-877-816-3596 Med Claims: P.O. Box 30788, Salt Lake City, UT 84130-0788 Rx Claims: OptumRx P.O. Box 650287, Dallas, TX 75265-0287 For Pharmacists: 1-877-889-6510 front front back back Sample member ID cards for illustration only; actual information varies depending on payer, plan and other ...

For electronic submissions, use payer ID: LIFE1 and Clearinghouse: Optum 360. For paper submissions, use: Optum Care Network Claims PO Box 30781 Salt Lake City, UT 84130 …

Forms and resources for health care professionals. (131) Advance beneficiary notice of noncoverage (ABN) Please complete and return the form to the requesting department. Advance beneficiary notice of noncoverage (ABN) Please complete and return the form to the requesting department.EDI Payer ID #39026 UnitedHealthcare Shared Services P.O. Box 30783 Salt Lake City, UT 84130-0783 UHC Provider Services Phone: (877) 343-1887 If the patient has Medicare primary coverage, mail to GEHA: GEHA FEHB Medical P.O. Box 21542 Eagan, MN 55121. UnitedHealthcare Choice Plus (all 50 states) EDI Payer ID #39026 UnitedHealthcare … To select the correct payer ID, first upload the client’s insurance ID for reference. To do this: Navigate to the client’s Overview page. Click Edit > Billing and Insurance. Scroll down to their Insurance info. Click + Insurance info. Under Insurance card, click browse to upload the front of the insurance card. following electronic Payer ID or mailing address: Payer ID: LIFE1 Mailing address: Optum Care Network Claims P.O. Box 30539 Salt Lake City, UT 84130-0539 Submit claim reconsiderations: Online: Optum Pro portal By phone: 855-822-4325 By mail: Optum Care Provider Dispute Resolution P.O. Box 30539 Salt Lake City, UT 84130-0539 Check the status of yourCreating a new Google email ID is an easy and straightforward process. With just a few simple steps, you can have your own personalized email address that you can use to communicat...Claims. Submit claims using the following electronic Payer ID or mailing address: Payer ID: LIFE1. Mailing address: Optum Care Network – Idaho. P.O. Box 30539 Salt Lake City, …Each business owner or manager must educate themselves on the proper use of federal tax IDs. This information is crucial for compliance with tax laws as well as for employment-rela...

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If your 1099-R form is the standard IRS version and not a "Substitute" version, it should be on the left side just below the Payer's name and address. It may say "Payer's TIN". It should be just to the left of your TIN (the recipient's TIN.) June 5, 2019 4:54 PM. Is " Payer's Federal identification number ".What is changing? New Payer ID: LIFE1. New Claims Address: Optum Medical Network Claims. PO Box 46770. Las Vegas, NV 89114-6770. New Sample Card for AARP MedicareComplete Essential …2 days ago · 1. If you want claims to be submitted directly to Bankers after Medicare has paid, the following needs to be completed on your electronic submission to Medicare. 2330B loop (Other Payer Information) needs to be completed. 2. Enter on NM101: PR (payer) 3. Enter on NM102: 2 (non Person entity) 4. Enter on NM103: Bankers Life & Casualty or Bankers ... Payer ID Claim Office Number; State Reports; Entered As Secondary** Enrollment Payer Type; American Insurance Company of TX 81949 NOCD ALL N AMER INS OF TEXAS N FALSE G American LIFECARE (Group Number required. Valid only for claims with a billing address of 1100 Poydras ST. #2600, New Orleans, LA 70163) 72099 NOCD;In the “Eligibility, Claims Status & Referrals” tab, enter “Coventry” in the “Payer Name” field. For medical plans, use 25133. For MHNet, use 74289. Use the payer IDs listed in the claims column. Visit www. aetnabetterhealth. com. Select the appropriate state’s plan to learn how to get this information. Visit www.Referrals must be submitted by the member’s PCP or a PCP within the same group and tax ID number (TIN) Specialists must confirm a referral is on file before seeing the member. You can submit referrals electronically and check status using the Referrals tool on the portal. Some services don’t require a referral. PCA-1-22-02816-E&I-QRG_08182022.Jan 5, 2024 · Payer ID (also known as payor ID OR EDI) is a unique ID assigned to each insurance company e.g. Cigna, BCBS, United Healthcare to receive claims electronically. It allows healthcare providers and insurance systems to interchange data with each another for eligibility and benefits verification, claims submission, and to check status of claims. Box 5: Facility tax ID. Box 6: Statement covers period (DOS) Box 7: Administrative necessary days. Member validation Box 8a-b: Patient name. Box 9a-d: Patient address. Box 10: Patient DOB. Box 11: Patient gender. Admission information. Box 12: Admission date. Box 13: Admission hour. Box 14: Admit type (reason for admission) Box 15: Source of ... ….

To select the correct payer ID, first upload the client’s insurance ID for reference. To do this: Navigate to the client’s Overview page. Click Edit > Billing and Insurance. Scroll down to their Insurance info. Click + Insurance info. Under Insurance card, click browse to upload the front of the insurance card.Formerly payer ID 75278. New payer ID effective for claims submitted December 15, 2017 and after FALSE G Arkansas Managed Care Organization, Inc. (AMCO) ** 36335 Y HFNIN FALSE G Arkansas Total Care ** 68069 Y AK TOTAL CARE FALSE G Arnett Health Plans ** Former PayerID 95440 87726 Y ARNETT HEALTH PLA FALSE C To select the correct payer ID, first upload the client’s insurance ID for reference. To do this: Navigate to the client’s Overview page. Click Edit > Billing and Insurance. Scroll down to their Insurance info. Click + Insurance info. Under Insurance card, click browse to upload the front of the insurance card. Member ID: RxBIN: RxPCN: RxGrp: H0609-025-000 Group Number: HCFAC9 Payer ID: LIFE1 Member: SAMPLE A MEMBER PCP Name: SAMPLE, M.D., PROVIDER Copay: PCP $0 Spec $30 610097 9999 SHCO ER $90 PLAN CODE: YRU UHC Dental Benefits PCP Phone: (719) 582-1489 X43136512900001 Customer Service Hours: 8 am - 8 pm 7 …Payer ID (also known as payor ID OR EDI) is a unique ID assigned to each insurance company e.g. Cigna, BCBS, United Healthcare to receive claims electronically. It allows healthcare providers and insurance systems to interchange data with each another for eligibility and benefits verification, claims submission, and to check status of claims.Creating a new Google email ID is an easy and straightforward process. With just a few simple steps, you can have your own personalized email address that you can use to communicat...Non-Participating Payor. Professional. 68037. OMNI/Medicore HP. Non ... HCS HEALTH CLAIMS SERVICE (BOISE ID. Non ... LIFE1. Lifeprint. Non-Participating Payor.Hiding a computer's ID, commonly referred to as an IP address, is primarily done to conceal your identify and location. While some methods rely on completely hiding all or part of ... Payer id life1, Electronic Data Interchange (EDI): Payer ID for medical claims is 12115. Payer ID for dental claims is 12116. If electronic capability is not available, providers can submit claims by mail. MEDICAL & DENTAL. Mailing Address: VHA Office of Finance P.O. Box 30780, Tampa FL 33630-3780. Local Contract, The EDI 837 Health Care Claim transaction is the electronic transaction for claims submissions. UnitedHealthcare accepts the following claim types from both participating and non-participating care providers: 837P: Professional (physician) and vision claims. 837I: Institutional (hospital or facility) claims. 837D: Dental claims., Check our payer list to identify payers unaffected by the Change Healthcare issue. ... Payer ID: LIFE1; Electronic Services Available (EDI) Professional/1500 Claims: YES:, Carson Tahoe Regional Medical Center (Hospital) Insurance. Please feel free to contact Patient Financial Services with any questions at (775) 445-7550. Access to Healthcare. AETNA Medicare. AETNA PPO - (uses Nevada Preferred Healthcare Providers network) Ambetter. Anthem BlueCross BlueShield of NV (Excluding Payor ID LIFE1), Payer Name Payer ID AARP by United HealthCare 36273 Aetna Healthcare 00002 AllSavers Life Insurance Company 81400 Altius Health Plans 00364 ... PAYER LIST . Office Ally | P.O. Box 872020 | Vancouver, WA 98687 www.officeally.com Phone: 360-975-7000 Fax: 360-896-2151 ., Payer ID: LIFE1 Dental Providers: uhcdental.com 1-877-816-3596 Med Claims: P.O. Box 30788, Salt Lake City, UT 84130-0788 Rx Claims: OptumRx P.O. Box 650287, Dallas, TX 75265-0287 For Pharmacists: 1-877-889-6510 front front back back Sample member ID cards for illustration only; actual information varies depending on payer, plan and other ..., Payer ID LIFE1 Claims Mailing Address PO Box 30788, Salt Lake City, UT 84130-0788 Claims Issue Escalation [email protected] (Please first contact the Service Center) Health Care Coordination Pre-authorization https://onehealthport.com 8 a.m.‒5 p.m., Monday‒Friday Phone: 877-836-6806 Fax: 855-402-1684 Health Care Coordination, need to be sent under this payer ID) ## 22248 Y AMERIHEALTH MERCY FALSE G Amerihealth NJ/DE - HMO ** (Must 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 , Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem) uses Availity as its exclusive partner for managing all electronic data interchange (EDI) transactions. EDI, including electronic remittance advices (ERAs) and electronic funds transfers (EFTs), allows for a faster, more efficient and cost-effective way for providers and employers ..., Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem) uses Availity as its exclusive partner for managing all electronic data interchange (EDI) transactions. EDI, including electronic remittance advices (ERAs) and electronic funds transfers (EFTs), allows for a faster, more efficient and cost-effective way for providers and employers ..., Aug 26, 2014 · Payer ID: LIFE1. Benefits of EDI: 1. Reduces costs: No more handling, sorting, distributing or searching paper documents and it Keeps healthcare affordable to the end customer 2. Reduces errors: Improves accuracy of information exchanged between healthcare participant and the quality of healthcare delivery and its processes. 3. , 86066 Y. HEALTH MGMT ASSOC FALSE N. HMC Healthworks aka Health Management Co ## 75318 N HMC HEALTHWORKS FALSE G HMO Louisiana Blue Advantage ## (Use payer ID 72107 for claims with a DOS on or after 01/01/21) 72107 N LA BLUE ADVAN FALSE G., Formerly payer ID 75278. New payer ID effective for claims submitted December 15, 2017 and after FALSE G Arkansas Managed Care Organization, Inc. (AMCO) ** 36335 Y HFNIN FALSE G Arkansas Total Care ** 68069 Y AK TOTAL CARE FALSE G Arnett Health Plans ** Former PayerID 95440 87726 Y ARNETT HEALTH PLA FALSE C, G: AlohaCare (837I & 837P) ALL ALOHA Y G AMA Insurance Agency (837I & 837P) ALL TH071 Y G Amalgamated (837I & 837P) ALL 13550 Y G Ambetter ALL 68069 Y G , Claim.MD can get you started fast. Check our payer list to identify payers unaffected by the Change Healthcare issue. Learn more about Claim.MD's excellent pricing. Attend a Webinar to learn more and ask questions from our sales team. See how Claim.MD makes Payer Enrollments faster and easier than ever. Access the Claim.MD Knowledge Base., (LOB) Brand Name / Plan Name or Region Payer ID Payer ID COB Edits Comments ... LIFE1 N N. Medicare, Retirement OptumCare ... Relay Health Pay or Ids. Document ..., Claim.MD can get you started fast. Check our payer list to identify payers unaffected by the Change Healthcare issue. Learn more about Claim.MD's excellent pricing. Attend a Webinar to learn more and ask questions from our sales team. See how Claim.MD makes Payer Enrollments faster and easier than ever. Access the Claim.MD Knowledge Base., Jan 16, 2020 ... payer ID 38224 for claims with a date of service ... LIFE1. R. LIFEPRINT. FALSE. C. BOTH. #. OptumHealth ... ID. Reports. Enter As Name. Additional., Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem) uses Availity as its exclusive partner for managing all electronic data interchange (EDI) transactions. EDI, including electronic remittance advices (ERAs) and electronic funds transfers (EFTs), allows for a faster, more efficient and cost-effective way for providers and employers ..., Creating an effective ID badge template is a great way to ensure that all of your employees have a consistent and professional look. ID badges are also a great way to make sure tha..., Hiding a computer's ID, commonly referred to as an IP address, is primarily done to conceal your identify and location. While some methods rely on completely hiding all or part of ..., Claim.MD can get you started fast. Check our payer list to identify payers unaffected by the Change Healthcare issue. Learn more about Claim.MD's excellent pricing. Attend a Webinar to learn more and ask questions from our sales team. See how Claim.MD makes Payer Enrollments faster and easier than ever. Access the Claim.MD Knowledge Base., 86066 Y. HEALTH MGMT ASSOC FALSE N. HMC Healthworks aka Health Management Co ## 75318 N HMC HEALTHWORKS FALSE G HMO Louisiana Blue Advantage ## (Use payer ID 72107 for claims with a DOS on or after 01/01/21) 72107 N LA BLUE ADVAN FALSE G. , Member ID 123456789-00 Sample Plan Name with Dental RxBIN 99999 RxPCN 9999 RxGRP XXX front Card #: 99999 9999 9999 9999Security Code: 9999 SAMPLE For Members: memberurl.com 1-999-999-9999, TTY 711 Providers: providerurl.com 1-999-999-9999 Payer ID: XXXXX Dental Providers: dentalurl.com 1-999-999-9999 Med Claims: P.O. Box 99999, CITY NAME, STATE ... , Are you looking to create ID cards without breaking the bank? Look no further. In this step-by-step tutorial, we will guide you through the process of creating professional-looking..., For electronic submissions, use payer ID: LIFE1 For paper submissions, use Attention: OptumCare Claims P.O. Box 30539 Salt Lake City, UT 84130 Electronic funds transfer (EFT) OptumCare works exclusively with InstaMed as our free payer payments solution for providers. To continue receiving your OptumCare payments electronically,, By phone: 877-370-2845. Member ID cards. Members in the affected plans will get new member ID cards that show the Payer ID LIFE1 and will have other applicable …, Payer ID Tech ID OI Code Coverage Type Payer Phone Street City State Payer Name 00029005 359274 05 AS (999) 999-9999 600 LAFAYETTE,PO BOX 2500 DETROIT MI BCBSM 00029010 359274 89 AS (999) 999-9999 PO BOX 2500,600 LAFAYETTE DETROIT MI BCBSM 00029015 359274 87 RX (999) 999-9999 PO BOX 2500, 600 …, The payer ID for claims is 61101, and the payer ID for encounters is 61102. Some clearinghouses might charge a service fee. Please contact your clearinghouse for more information. To access your patient’s plan summary: Paper claims filing Humana’s MA HMO plans Please submit your claims electronically whenever possible., As part of our transition to a next-generation platform, we created new payer ID grids that will become effective January 1, 2024. Changes include the addition of our new AmeriHealth Medicare PPO product with a new prefix . The professional and facility payer ID grids contain valuable information to assist you in claims submission, including ..., For up-to-date payer information, please access the payer list from the OptumInsight website at: http://www.ingenix/connectivity or contact OptumInsight Customer Service …, 1. If you want claims to be submitted directly to Bankers after Medicare has paid, the following needs to be completed on your electronic submission to Medicare. 2330B loop (Other Payer Information) needs to be completed. 2. Enter on NM101: PR (payer) 3. Enter on NM102: 2 (non Person entity) 4. Enter on NM103: Colonial Penn 5., In the “Eligibility, Claims Status & Referrals” tab, enter “Coventry” in the “Payer Name” field. For medical plans, use 25133. For MHNet, use 74289. Use the payer IDs listed in the claims column. Visit www. aetnabetterhealth. com. Select the appropriate state’s plan to learn how to get this information. Visit www.