The original entity of Zenith American Solutions has been in business since 1944. First American Financial Corporation 1 First American Way Santa Ana, California 92707. Chattanooga, TN 37422-7223. Toll Free: 718-834-1256. 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. Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: Medical Claims. Dental Claims. 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 The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. About Us; Contact; Helpful Links; Online Forms; Coordination of . Take control of your benefits. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. The new PAI provider portal is going live. Also, customers and vendors may be requested to provide electronic payment options for invoices. Once logged in,you will have the ability to: EBPA encourages providers to take advantage of the online resources we have made available. 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. 1.800.426.9786. Toll Free: 866.742.4900 Hours: 7:00 a.m. - 6:00 p.m CST. 152 0 obj <>stream Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com. 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. PAI will not require that you repay the refund until PAI has concluded its review. 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. Fax an updated W-9 to (803) 264-9089 Electronically Electronic/Payor ID: 50114. Phonee: 718-625-6300. Sarasota, FL 34230-1558, Report a Property, Liability, or Auto Claim, Agent & Broker Resources, Support & Online Tools. 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. There are two easy ways to submit claims to Sana. 2018 Zenith American Solutions, Inc. All Rights Reserved. Box 855 Arnold, MD 21012 Its not easy to accomplish but it has been my experience and I am very grateful.". Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. We are proud to offer our own unique Claims processing and Benefit administration solutions. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. PRAC Bulletin. endstream endobj startxref hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k o ID Cards include the TPA or insurer's telephone number and address(es), for eligibility, benefits, claim status and payment inquiry. Get tools and flyers to share with your clients Dental Network Together, we can build a solution that's right for your clients For more information, email CignaPayerSolutions@cigna.com or call 1 (888) 284-6851. Staff Photography by Jessica Marie Photography Inc. Need answers now? Please use the form below to contact AMA Insurance. o Each card also includes the paper and electronic claims submission addresses. Its almost here! %%EOF 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. 1-800-303-5242. 1 (800) 244-6224. Receiving illegal calls claiming to be from American Benefits Group? We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. Phone: 800-777-3575 Login to your account. AllCare Health Plan MRIPA N N/A Address - Some payers have multiple locations, but claims go to the same electronic location *Indicates claim is routed by paper. To be complete, a claim must include a claim form that has been signed and dated by the account holder, and the following five pieces of information: Claims must be accompanied with receipts for the services rendered - for HRA claims an Explanation of Benefits (EOB) is required to show that the expense was applied to the insurance deductible. PO Box 182223. Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. Copyright 2016 AMA Insurance, Inc. All rights reserved. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; 3333 Hesper Road hbbd```b`` `>"@``rXd."#;H)`'`y f\"y7A$g-Xd2#7mVXD]"MAD = G`$C PAI P.O. 7:00 a.m. 8:00 p.m. MST, Monday-Thursday d '7y[ f| m x06w a>g Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. Box 380844 endstream endobj 1230 0 obj <. 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 . Cigna shares the administration of the plan with a third party. Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. Fill out our Request for Proposal Form. M-F Need answers now? Billings MT 59102 Please note that ABG does not allow you to pay your provider directly in the WealthCare Portal. Zenith Insurance Company 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 forward your refund repayments to: 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? *Out-of-network form submission deadlines may vary by plan. 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. 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. Submitthe request via email to PAI Provider Maintenance at paiprovmtn@paisc.com. Return the completed form and your itemized paid receipts to: First American Administrators, Inc. Attn: OON Claims P.O. %PDF-1.6 % Client/Employer Support:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: PAI All rights reserved. endstream endobj startxref We offer a state-of-the art member portal to help you make the most of your health benefits. You will receive a response within 2 business days. 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. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. AMA Insurance Agency, Inc. Corporate Headquarters. Access the link below for easy-to-use claim filing. To all our customers and vendors, please note that American Benefit Administrators will continue to provide you with continued support and continue our operations. The team uses PMI standards and project management tools along with IT industry best practices. Claim Number Email Date of Service Phone Your Message Additional Contact Information Phone 1-888-627-5880 Business Hours 8 am - 5 pm CT, Monday - Friday Email AMA Insurance claims@amainsure.com Claims Mailing Address AMA Insurance Agency, Inc. PO Box 804238 Chicago, IL 60680-4104 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. 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 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. 0 For questions concerning your online portal, including login information, please email:helpdesk@zenith-american.com. megamenu1. Try taking a look at our Frequently Asked Questions page. Home; About; Advantages; Solutions/Services; Resources; Contact us 6:00 a.m. 8:00 p.m. MST, Corporate Office Please let us know if you experience any trouble or if you need help using the AMA Insurance Verification of Benefits Portal. If you are a participating CompNet provider seeking to manage addresses and . I was very impressed with American Benefits Group after separation from my employer. Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. *As part of our effort in achieving a 100% paperless office we encourage you to receive your reimbursements directly into your bank account. Hours: 7:00 a.m. 6:00 p.m CST. 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. 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. You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. New User?Please click here to register. For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. For group-specific prior authorization information, please log in to the MyPAI Provider Portal above and review the members health benefit plan document. 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. 83 0 obj <> endobj Its almost here! 0 %PDF-1.6 % Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . All Rights Reserved. ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK 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. This team is diligent and kind. You would need to reimburse yourself and then pay your provider directly. 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. American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. You will need an Employer ID when you register. 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 They are web-based or Internet-accessible solutions that facilitate seamless front office and back office operations. If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. Box 9055 As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. Cigna. Participant Inquiries: cobra@americanbenefitadministrators.com Benefits administration is a difficult, increasingly complex business. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network, CompNet. (888) 505-7724 updates@sbmamec.com P.O. P.O. 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 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. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. If you use the EDGE portal, additional login information can be found on theEDGE Hub. Birmingham, AL 35238, 2023 American Benefit Administrators. The cost of healthcare continues to grow at an unsustainable pace. AMERICAN INSURANCE ADMINISTRATORS. 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. This is nothing new; however, this is a good time to remind everyone of the feature. Zenith Insurance Company For general assistance, please call your Client Services representative or your Customer Care team. Notice of Privacy. Prior authorization varies from group to group. HCP Login. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit LOS ANGELES, CA 90017-1906. Attention: Refund Analyst As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. 2023 Planned Administrators Inc. All rights reserved. CareFirst contracts with Third Party Administrators to the Network claims product. Box 1558 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 ABA is committed and confident it will provide the same level of service. SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. MAILING ADDRESS: American Insurance Administrators P O BOX 17908 LOS ANGELES, CA 90017-0908. PAI will not require that you repay the refund until PAI has concluded its review. Claims paid under PSIP Program are subject to county audit. These tools focus on quality and ensuring the best possible end result for each and every user. PO Box 804238 Several payers that DO receive claims electronically have been placed on this list for having poor services available. We will quickly get back to you with the information you need. For further information, please contact the precertification number located on the members identification card. Please submit claims electronically using EDI Payer Codes: Professional - 580, Facility - 190. Changes made will not be reflected on all impacted systems for up to 2 business days. Columbia, SC 29260. For general inquiries or to file a claim, visit our Submitting a Claim page. American Plan Administrators - Contact us. 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. By Mail Sana Benefits Claims P.O. View Map, Employee BenefitManagement Services Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. 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:
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