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FOXFIRE SYSTEMS GROUP PAYER LIST
For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 13162 13162 J1585 J1585 41556 41556 93044 93044 11983 41556 36273 36273 41556 48185 48185 E3510 3443 WT009 3443 AHP01 68055 68055 J1477 AHS01 TLZ17 COACC A1680 Name State 1199 NATIONAL BENEFIT FUND 1199 NATIONAL BENEFIT FUND - INST 1ST AUTO AND CASUALTY 1ST AUTO AND CASUALTY (AUTO ONLY) 21ST CENTURY INSURANCE 22125 ROSCOE CORP A I BENEFIT PLAN ADMINISTRATORS A I BENEFIT PLAN ADMINISTRATORS - INST AAA MINNESOTAIOWA (AUTO) AAA NORTHERN CALIFORNIA, NEVADA AND UTAH INSURANCE EXCHANGE AARP MEDICARE SUPPLEMENTAL - UNITED HEALTHCARE AARP MEDICARE SUPPLEMENTAL - UNITED HEALTHCARE INST ABC CONST COMPANY ABC HEALTH PLAN ABC HEALTH PLAN OF NEW YORK ABMA MEDICAL CORPORATION ABRAZO ADVANTAGE HEALTH PLAN NY CA AZ ABRAZO ADVANTAGE HEALTH PLAN DENTAL ABRAZO ADVANTAGE HEALTH PLAN INST AZ ABRI HEALTH PLAN ABSOLUTE TOTAL CARE - SC ABSOLUTE TOTAL CARE - SC INST SC SC ACADIA INSURANCE COMPANY ACCESS ADMINISTRATORS ACCESS ADMINISTRATORS (CA ONLY) ACCESS HEALTH BENEFIT SOLUTIONS (AHBS) ACCESS HEALTH PLAN (MI) CO MI Payer Type CI CI WC AM WC WC CI CI AM WC CI CI WC CI CI CI CI CI CI CI CI CI WC CI CI CI CI Real Time Real Time N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N Y N N N N N N Format Claim Status Eligibility Prof Inst Prof Prof Prof Prof Prof Inst Prof Prof Prof Inst Prof Inst Prof Prof Prof Dental Inst Dental Prof Inst Prof Prof Dental Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N Y Y N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name AMM06 ACCESS MEDICAL GROUP AMG01 ACCESS MEDICAL GROUP (CA) 19305 ACCESS MEDICARE - CUATRO 64071 ACCLAIM 64071 ACCLAIM INST 21356 ACCLAIM REPRICING - INST IAC01 ACCOUNTABLE HEALTH PLAN IAC01 ACCOUNTABLE HEALTH PLAN AHIPA ACCOUNTABLE IPA J1024 ACCURIDE CORPORATION 41556 ACE PROPERTY AND CASUALTY INS CO TLX81 ACEC HEALTH PLANS (SALT LAKE CITY, UT) J1578 ACIG INSURANCE COMPANY J1578 ACIG INSURANCE COMPANY (AUTO ONLY) 87066 ACMG FKA FORMAX INC IACD ACS (IOWA MEDICAID) 72467 ACS BENEFIT SERVICES INC 38254 ACTIVA BENEFIT SERVICES, LLC 38254 ACTIVA BENEFITS 38254 ACTIVA BENEFITS J1240 ACUITY, A MUTUAL INSURANCE COMPANY J1667 AD-COMP J1667 AD-COMP (AUTO ONLY) J1690 ADELANTO SCHOOL DISTRICT (CA) J1690 ADELANTO SCHOOL DISTRICT (CA) (AUTO ONLY) FAMR1 ADM MEDICAL SERVICES 95285 ADMAR CORPORATION MED NETWORK State CA CA IA SD Payer Type CI CI CI CI CI CI CI CI CI WC WC CI WC AM CI CI CI CI CI CI WC WC AM WC AM CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Inst Inst Inst Prof Prof Prof Prof Dental Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1241 22384 FAMR1 59141 CX076 37278 37278 J1242 J1608 J1608 58202 68056 68056 68056 68056 ACIPA 93524 35209 35219 35219 59374 25141 95340 13373 45423 45423 36320 Name State ADMINISTAFF ADMINISTRATIVE CONCEPTS ADMINISTRATIVE MED SD ADMINISTRATIVE SERVICES INC (ASI) ADMIN SERVICES ONLY (ASO) SELF INSURED DENTAL SERVICES (NY) ADMINONE ADMINONE ADP TOTAL SOURCE INC ADVANCE SERVICES, INC ADVANCE SERVICES, INC (AUTO ONLY) ADVANCED DATA SOLUTIONS ADVANTAGE BY BRIDGEWAY HEALTH SOLUTIONS ADVANTAGE BY BUCKEYE COMMUNITY HEALTH ADVANTAGE BY MANAGED HEALTH SERVICES ADVANTAGE BY SUPERIOR HEALTH PLAN ADVANTAGE CARE IPA ADVANTAGE DENTAL PLAN ADVANTAGE HEALTH SOLUTIONS ADVANTAGE HEALTH SOLUTIONS (DUNMORE, PA) ADVANTAGE HEALTH SOLUTIONS (DUNMORE, PA) -INST ADVANTICA EYE CARE ADVANTRA GHP ADVENTIST HEALTH SYSTEM ADVICA NEW YORK HOSPITAL COMMUNITY HEALTH PLAN ADVICARE ADVICARE INST ADVOCATE HEALTH CENTERS AZ OH IN TX Payer Type WC CI CI CI CI CI CI WC WC AM CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N Y Y Y Y N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Inst Prof Dental Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Dental Prof Prof Inst Prof Prof Prof Prof Prof Inst Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y N N N N N N Y N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 36320 65093 65093 AEGIS 60054 60054 60054 57604 57604 26337 34734 23228 23228 50023 60054 68246 60054 60054 60054 38692 38692 B0054 ADOCS 23334 13334 13333 95426 Name ADVOCATE HEALTH CENTERS State IL ADVOCATE HEALTH PARTNERS ADVOCATE HEALTH PARTNERS IL AEGIS SECURITY - AMERICAN SENTINEL AETNA AETNA AETNA AETNA AFFORDABLE HEALTH CHOICES - SRC AETNA AFFORDABLE HEALTH CHOICES - SRC - INST AETNA BETTER HEALTH - ILLINOIS MEDICAID AETNA BETTER HEALTH - NEW YORK MEDICAID AETNA BETTER HEALTH - PENN MEDICAID AETNA BETTER HEALTH - PENN MEDICAID INST IL NY PA PA AETNA BETTER HEALTH PLAN OHIO AETNA DENTAL AETNA DMO AETNA HMO AETNA INST AETNA PDO (PREFERRED DENTAL ORGANIZATION) AETNA TEXAS MEDICAID CHIP AETNA TEXAS MEDICAID CHIP INST TX TX AETNA WITH AETNA ID REQ AFFILIATED DOCTORS ORANGE COUNTY AFFINITY ESSENTIALS AFFINITY HEALTH PLAN - MEDICAID AFFINITY HEALTH PLAN - MEDICARE AFFORDABLE BENEFIT ADMINISTRATORS INC CA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI MC CI CI CI CI CI CI CI Real Time Real Time N N N N Y Y Y N N N N N N N N N Y Y N N N N N N N N N N N N N N Y N N N N N N N Y N N N N N N N N N N Y Y N Format Claim Status Eligibility Prof Inst Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Inst Prof Dental Dental Prof Inst Dental Prof Inst Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y N N N N N N N Y Y N N N Y N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 34444 34444 13346 13346 41556 37280 95241 41556 31138 BS230 19402 J1516 J1243 J1243 6311 IP108 91136 91136 91136 92600 92600 91136 91136 J1577 J1577 91136 91136 Name State AFL CIO FOOD BEV TRUST HOS AFLCIO FOOD BEVERAGE DEALERS TRUST FUND OH AFTRA HEALTH FUND AFTRA HEALTH FUND NY AG FACILITIES OPERATIONS, LLC AGA AGIA INC AGRI BEEF CO AHPO AHS STATE NETWORK - MISSISSIPPI STATE TEACHSERS MS AIG AIR LIQUIDE USA LLC ALA CARTE ALA CARTE (AUTO ONLY) ALABAMA MEDICAL SURGICAL ASSOCIATES ALAMEDA ALLIANCE ALASKA CARPENTERS TRUST ALASKA CHILDRENS SERVICES ALASKA CHILDRENS SERVICES, INC ALASKA ELECTRICAL HEALTH WELFARE FUND ALASKA ELECTRICAL HEALTH WELFARE FUND ALASKA LABORERS CONSTRUCTION INDUSTRY TRUST ALASKA LABORERS CONSTRUCTION INDUSTRY TRUST GRP F23 ALASKA NATIONAL INSURANCE ALASKA NATIONAL INSURANCE (AUTO ONLY) ALASKA PIPE TRADES LOCAL 375 ALASKA PIPE TRADES LOCAL GRP F24 AK AK Payer Type CI CI CI CI WC CI CI WC CI CI WC WC WC AM CI CI CI CI CI CI CI CI CI WC AM CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N Y N N N N N N Format Claim Status Eligibility Inst Prof Inst Prof Prof Inst Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Inst Prof Inst Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 91136 91136 J1244 13550 13550 58213 39160 81400 81400 AC101 J1245 81040 81040 81040 ADSL1 23071 23071 96218 23251 23251 13079 52149 87726 81400 AMS01 J1619 J1619 Name State ALASKA UNITED FOOD COMMERCIAL WORKERS ALASKA UNITED FOOD COMMERCIAL WORKERS HEALTH WELFARE TRUST GRP F45 ALCOA FASTENERS SYSTEMS ALICARE ALICARE ALIGNIS ALL SAINTS COVENANT ALL SAVERS INSURANCE (UNITEDHEALTHONE) ALL SAVERS INSURANCE (UNITEDHEALTHONE) - INST ALLCARE IPA ALLEGHENY TECHNOLOGIES ALLEGIANCE BENEFIT PLAN MANAGEMENT MT ALLEGIANCE BENEFIT PLAN MANAGEMENT ALLEGIANCE BENEFIT PLAN MANAGEMENT ALLIANCE - ALPHA CARE GOLD ALLIANCE BEHAVIORAL HEALTH ALLIANCE BEHAVIORAL HEALTH - INST ALLIANCE HEALTH NETWORK ALLIANCE HEALTH PLAN PENNSYLVANIA ALLIANCE HEALTH PLAN (PA) ALLIANCE HEALTHCARE SRRIPA ALLIANCE PPO ALLIANCE PPO, LLC ALLIANCE SELECT ALLIANCE SELECT ALLIANT ENERGY ALLIANT ENERGY (AUTO ONLY) PA Payer Type CI CI WC CI CI CI CI CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC AM Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Inst Prof Prof Inst Prof Inst Prof Prof Prof Inst Prof Prof Prof Inst Inst Prof Inst Prof Prof Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N Y Y N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 58234 58234 J1452 94177 37308 37308 J1733 J1118 J1550 J1550 J1589 J1589 C1037 77066 77083 ALOHA ALOHA ALQST ADSYS 75261 87043 87043 41556 E3510 IP080 J1246 J1247 Name State ALLIANT HEALTH PLANS OF GEORGIA ALLIANT HEALTH PLANS OF GEORGIA GA ALLIANZ ALLIED ADMINISTRATORS OF SAN FRANCISCO ALLIED BENEFIT SYSTEMS ALLIED BENEFIT SYSTEMS ALLIED CLAIMS ADMINISTRATION, INC ALLIED CONSTRUCTION ALLIED INSURANCE COMPANIES ALLIED PROPERTY AND CASUALTY INS CO ALLMERICA FINANCIAL BENEFITS INSURANCE COMPANY ALLMERICA FINANCIAL BENEFITS INSURANCE COMPANY (AUTO ONLY) ALLSTATE - EXCEPT NEW JERSEY (AUTO ONLY) ALLSTATE INSURANCE COMPANY ALLSTATE WORKPLACE - AMERICAN HERITAGE LIFE ALOHACARE - INST ALOHACARE MEDICARE ADVANTAGE ALOHACARE QUEST HI HI HI ALPHA DATA SYSTEMS ALPHA DATA SYSTEMS - WEB TPA ALTA HEALTH STRATEGIES - COVENTRY ALTA HEALTH STRATEGIES - COVENTRY ALTA HEALTHCARE ALTA SENIOR CARE ALTAMED ALTEC ALTEC INDUSTRIES CA CA Payer Type CI CI WC CI CI CI WC WC WC WC WC AM AM CI CI CI CI MC CI CI CI CI WC CI CI WC WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Dental Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 25133 50503 J1025 J1248 AMAIA 13550 13550 68069 68069 76061 76061 76061 J1550 AMS01 38219 75137 75137 J1427 26378 26378 26378 75240 75240 63103 63106 95170 ACN01 Name ALTIUS HEALTH PLANS (COVENTRY) State UT ALTUS DENTAL ALVEY SYSTEMS (AON RISK) ALVEY SYSTEMS (AON RISK) (AUTO ONLY) AMA INSURANCE AGENCY AMALGAMATED AMALGAMATED LIFE AMBETTER HEALTH PLAN FROM MHS AMBETTER OF ARKANSAS AR AMCARE OF LOUISIANA AMCARE OF OKLAHOMA AMCARE OF TEXAS AMCO INS CO AMER HEALTHCARE PLAN NET WI AMERAPLAN AMERIBEN SOLUTIONS AMERIBEN SOLUTIONS AMERICA FIRST AMERICAID AMERIGROUP (MARYLAND) AMERICAID AMERIGROUP (NEW JERSEY) AMERICAID AMERIGROUP (NEW MEXICO) AMERICAN ADMINISTRATIVE GROUP AMERICAN ADMINISTRATIVE GROUP - AAG - UICI AMERICAN BEHAVIORAL AMERICAN BEHAVIORAL FED-ITS AMERICAN BENEFIT PLAN ADMINISTRATORS AMERICAN CHIROPRACTIC NETWORK MD NJ NM Payer Type CI CI WC AM CI CI CI CI CI CI CI CI WC CI CI CI CI WC CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Dental Prof Prof Prof Prof Inst Prof Prof Inst Inst Inst Prof Prof Prof Inst Prof Prof Inst Inst Inst Inst Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N Y Y Y N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41161 41160 J1236 J1236 J1026 37128 37128 37128 GEN02 J1027 TAD01 TAD02 IP080 TH095 56071 41556 62030 62030 1066 1066 66065 J1250 J1250 36369 81949 41556 23212 Name State AMERICAN CHIROPRACTIC NETWORK (PAN) AMERICAN CHIROPRACTIC NETWORK IPA OF NY AMERICAN CLAIMS MANAGEMENT (ACM) AMERICAN CLAIMS MANAGEMENT (ACM) (AUTO ONLY) AMERICAN COIN MERCHANDISING, INC AMERICAN COMMERCIAL BARGE LINES AMERICAN COMMERCIAL BARGE LINES AMERICAN COMMERCIAL LINES AMERICAN CONTINENTAL AKA GENWORTH FINANCIAL AMERICAN CYANAMID AMERICAN DENTAL PROFESSIONAL SERVICES AMERICAN DENTAL PROFESSIONAL SERVICES (REPRICED CLAIMS) AMERICAN FAMILY HEALTH PROVIDERS CA AMERICAN FAMILY INSURANCE GROUP AMERICAN FAMILY PPO POLICIES AMERICAN FURNITURE WAREHOUSE AMERICAN GENERAL AMERICAN GENERAL AMERICAN HEALTH ALLIANCE AMERICAN HEALTH ALLIANCE INST AMERICAN HEALTH MEDICARE (AHM) AMERICAN HOME CRAFT AMERICAN HOME CRAFT (AUTO ONLY) AMERICAN IMAGING MANAGEMENT, INC AMERICAN INSURANCE COMPANY OF TEXAS AMERICAN LIBERTY INSURANCE COMPANY AMERICAN MEDICAL AND LIFE INSURANCE PR Payer Type CI CI WC AM WC CI CI CI CI WC CI CI CI CI CI WC CI CI CI CI MB WC AM CI CI WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Dental Dental Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Inst Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 81400 81400 J1524 74048 74048 APBPN 44444 44444 42011 42011 17965 TLX55 J1028 ASH01 J1029 37322 20553 20553 26078 26078 20029 ARAZ 16120 86047 86001 86048 86002 Name AMERICAN MEDICAL SECURITY AMERICAN MEDICAL SECURITY - INST AMERICAN MINING INSURANCE GROUP, LLC AMERICAN NATIONAL INS CO (ANICO) AMERICAN NATIONAL INS CO (ANICO) - INST AMERICAN PIONEER BREVARD PHYSICIANS NETWORK AMERICAN POSTAL WORKERS UNION AMERICAN POSTAL WORKERS UNION HEALTH PLAN AMERICAN REPUBLIC INSURANCE CO AMERICAN REPUBLIC INSURANCE CO - INST AMERICAN SENTINEL INSURANCE AMERICAN SENTINEL INSURANCE INC AMERICAN SPECIALTY COMPANIES AMERICAN SPECIALTY HEALTH AMERICAN SPECIALTY INS MIB AMERICAN WORKER HEALTH PLUS AMERICAS 1ST CHOICE - SOUTH CAROLINA GEORGIA AMERICAS 1ST CHOICE - SOUTH CAROLINA GEORGIA AMERICAS 1ST CHOICE HEALTH AMERICAS 1ST CHOICE HEALTH - INST AMERICAS CHOICE HEALTHPLANSNMS AMERICAS PPO AMERICAS PPO AMERICHOICE - NEW JERSEY MEDICAID CHIP DENTAL AMERICHOICE - NEW JERSEY MEDICARE AMERICHOICE - NEW YORK MEDICAID CHP FHP AMERICHOICE - NEW YORK MEDICARE State Payer Type CI CI WC CI CI CI CI CI CI CI CI CI WC CI WC CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y N Y N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Inst Prof Prof Inst Prof Prof Inst Prof Inst Prof Dental Prof Prof Prof Prof Inst Prof Prof Inst Prof Inst Prof Dental Dental Dental Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N Y Y N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 86049 86003 86001 86001 86048 86048 86048 86002 86002 WT004 WT005 WT006 86049 86003 86003 26375 26378 27514 26375 28809 28808 28804 28804 28804 26375 26375 26375 Name State AMERICHOICE - PENNSYLVANIA MEDICAID CHIP AMERICHOICE - PENNSYLVANIA MEDICARE AMERICHOICE NEW JERSEY PERSONAL CARE PLUS AMERICHOICE NEW JERSEY PERSONAL CARE PLUS AMERICHOICE NEW YORK CHILD HEALTH PLUS THRU 8-31-2013 AMERICHOICE NEW YORK MEDICAID INST THRU DOS 8-31-2013 AMERICHOICE NEW YORK MEDICAID THRU DOS 8-31-2013 AMERICHOICE NEW YORK PERSONAL CARE PLUS THRU 8-31-2013 AMERICHOICE NEW YORK PERSONAL CARE PLUS THRU 8-31-2013 NJ NJ NY NY NY NY NY AMERICHOICE OF RHODE ISLAND AMERICHOICE OF TENNESSEE AMERICHOICE OF TEXAS AMERICHOICE PENNSYLVANIA MEDICAID INST AMERICHOICE PENNSYLVANIA PERSONAL CARE AMERICHOICE PENNSYLVANIA PERSONAL CARE PLUS TX PA PA PA AMERIGROUP AMERIGROUP AMERIGROUP AMERIGROUP AMERIGROUP FLORIDA AMERIGROUP ILLINOIS FL IL AMERIGROUP MARYLAND VIRGINIA DC AMERIGROUP NEW JERSEY AMERIGROUP OHIO AMERIGROUP (AUSTIN DFW) AMERIGROUP (AUSTIN DFW) AMERIGROUP (FT WORTH) NJ OH TX TX TX Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y Y Y Y Y Y N Y N Format Claim Status Eligibility Dental Dental Inst Prof Prof Inst Prof Inst Prof Dental Dental Dental Inst Inst Prof Prof Inst Inst Prof Prof Prof Prof Prof Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N Y Y Y N N N Y Y Y Y Y N Y Y N Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 26374 28804 26375 26375 CX014 26378 26378 26378 26378 28804 26378 26375 26375 26378 26375 54763 54763 54763 27357 22248 22248 93688 77002 95044 23037 95044 CX014 Name AMERIGROUP (HOUSTON CORPUS SA) State TX AMERIGROUP - MULTI STATES AMERIGROUP COMMUNITY CARE AMERIGROUP COMMUNITY CARE NEVADA NV AMERIGROUP DENTAL AMERIGROUP FLORIDA AMERIGROUP FLORIDA AMERIGROUP GEORGIA AMERIGROUP GEORGIA AMERIGROUP HOUSTON CORPUS SAN ANTONIO AMERIGROUP ILLINOIS AMERIGROUP LOUISIANA BAYOU HEALTH AMERIGROUP NEW JERSEY AMERIGROUP OHIO AMERIGROUP TEXAS FL FL GA GA TX IL LA NJ OH TX AMERIHEALTH ADMINISTRATORS AMERIHEALTH ADMINISTRATORS AMERIHEALTH ADMINISTRATORS AMERIHEALTH CARITAS LOUISIANA FKA LACARE LA AMERIHEALTH CARITAS PENN FKA MERCY - INST AMERIHEALTH CARITAS PENN FKA MERCY HEALTH PLAN AMERIHEALTH DELAWARE PPO AMERIHEALTH DISTRICT OF COLUMBIA AMERIHEALTH HMO AMERIHEALTH HMO NEW JERSEY AND DELAWARE AMERIHEALTH HMO NEW JERSEY DELAWARE AMERIHEALTH MERCY HEALTH PLAN DE Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI MC CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N Y N Y Y Y N Y N Y Y N N Y N Y N N N N N N Format Claim Status Eligibility Inst Prof Prof Inst Dental Inst Prof Inst Prof Prof Prof Prof Prof Inst Prof Prof Dental Inst Prof Inst Prof Prof Prof Prof Prof Prof Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N Y N N N N N Y N Y Y Y N Y Y N N N Y Y Y Y Y N Y Y Y Y Y N N N N N Y N Y Y Y N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 95044 60061 60061 77001 22355 77007 77006 26374 26375 12504 J1206 J1205 1757 J1453 12287 24818 24818 76052 AMILR FAMR1 IP080 41556 41556 53085 53085 86062 86062 Name State AMERIHEALTH NEW JERSEY HMO POS - INST AMERIHEALTH NEW JERSEY PPO NJ AMERIHEALTH NEW JERSEY PPO - INST AMERIHEALTH NORTHEAST AMERIHEALTH VIP CARE (2014) AMERIHEALTH VIP CARE DC (2014) AMERIHEALTH VIP CARE LA (2014) AMERIKIDS - HOUSTON AMERIKIDS- FORT WORTH DC LA TX TX AMERIPRISE AUTO AND HOME INSURANCE (AUTO ONLY) AMERISURE INSURANCE AMERISURE MUTUAL INSURANCE AMFIRST INS MORGAN WHITE ADMIN AMGUARD INSURANCE COMPANY - GUARD DBA AMICA MUTUAL INSURANCE COMPANY (AUTO ONLY) AMIDA CARE AMIDA CARE - INST AMIL ARIA AMILARIA VIA MEDIVIEW AMSI AMVI ANACO ANAIC CIBUS ANCHOR BENEFIT CONSULTING ANCHOR BENEFIT CONSULTING, INC ANCILLARY BENEFITS - ARIZONA FOUNDATION FOR MEDICAL CARE ANCILLARY BENEFITS - ARIZONA FOUNDATION FOR MEDICAL CARE TX SD CA Payer Type CI CI CI CI CI CI CI CI CI AM WC WC CI WC AM CI CI CI CI CI CI WC WC CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Inst Prof Inst Prof Prof Prof Prof Inst Inst Prof Claim Enrollment Required ERA Enrollment Required Y Y Y N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1620 J1620 43101 34192 41556 16140 16140 34196 34196 APCRS 54160 54160 44444 J1502 ARAZ 52312 J1251 77045 77045 J1735 J1735 J1252 19801 39185 39185 41556 AZFMC Name State ANHEUSER BUSCH ANHEUSER BUSCH (AUTO ONLY) ANPAC (AUTO ONLY) ANTARES MANAGEMENT SOLUTIONS OH ANTELOPE VALLEY RET APA PARTNERS INC APA PARTNERS, INC APEX BENEFIT SERVICES APEX BENEFIT SERVICES INST APIPA-CRS MEDICAID APS HEALTHCARE INC APS HEALTHCARE INC APWUAFFORDABLE NETWORK ARAMARK ARAZ ARBOR HEALTH PLAN NE ARCADIA INSURANCE COMPANY ARCADIAN MANAGEMENT SERVICES THRU DOS 12-31-2012 ARCADIAN MANAGEMENT SERVICES THRU DOS 12-31-2012 ARCHER DANIELS MIDLAND COMPANY ARCHER DANIELS MIDLAND COMPANY (AUTO ONLY) ARGENBRIGHT HOLDINGS LIMITED ARGONAUT INSURANCE COMPANY(ARGO) ARISE HEALTH PLAN FKA PREVEA (TPA ONLY) ARISE HEALTH PLAN FKA PREVEA (TPA ONLY) - INST ARIZONA AND 21ST CORP DBA BERKLEY EAST CONV HOSPITAL ARIZONA FOUNDATION FOR MEDICAL CARE - AFMC AZ Payer Type WC AM AM CI WC CI CI CI CI CI CI CI CI WC CI CI WC CI CI WC AM WC WC CI CI WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N Y N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Inst Prof Inst Dental Inst Prof Prof Prof Inst Prof Prof Inst Prof Prof Prof Prof Prof Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 53172 27154 27154 75278 75278 62176 62176 87726 87726 IP002 TPC16 56192 38265 38265 ASRM1 ASRM1 35326 FAABC FAABC ATPA1 36326 36326 37294 C1034 70408 39065 ASNTH Name State ARIZONA HEALTH CONCEPTS ARIZONA PRIORITY CARE PLUS (AZPCP) ARIZONA PRIORITY CARE PLUS (AZPCP) - INST AZ AZ ARKANSAS BEST CORPORATION ARKANSAS BEST CORPORATION - CHOICE BENEFITS ARKANSAS MANAGED CARE ORG - AMCO ARKANSAS MANAGED CARE ORG - AMCO AR AR ARNETT HEALTH PLANS - INST ARNETT HEALTH PLANS FKA 95440 ARROWHEAD PHYSICIAN ALLIANCE CA ASBESTOS WORKERS L-201 ASCENDIA HEALTHCARE MGMT HOS ASR CORPORATION ASR CORPORATION - INST ASRM CORP NJ ASRM CORP NJ - INST ASSOC FOR HEALTH CARE AHC ASSOCIATED BENEFITS CORPORATION (ABC) ASSOCIATED BENEFITS CORPORATION (ABC) ASSOCIATED THIRD PARTY ADMINISTRATION ASSOCIATES FOR HEALTH CARE - INST ASSOCIATES FOR HEALTHCARE ASSOCIATION SERVICES OF WASHINGTON ASSURANCE COMPANY OF AMERICA (AUTO ONLY) ASSURANT EMPLOYEE BENEFIT - EMPLOYEE DENTAL ASSURANT HEALTH ASSURANT HEALTH (REPRICING FOR HEALTHSPAN NETWORK ONLY) NJ NJ Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI AM CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Format Claim Status Eligibility Prof Prof Inst Prof Inst Inst Prof Inst Prof Prof Dental Inst Prof Inst Prof Inst Inst Prof Inst Prof Inst Prof Prof Prof Dental Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 58730 58730 39065 75068 88035 88035 74240 76044 93221 65064 TPC18 TPC19 95691 95691 ADN01 22285 19895 22304 22304 ATLAD ATLAD ATPA1 ATRIO ATRIO AULTC 37242 37242 Name State ASSURANT HEALTH ASA (LUBBOCK) ASSURANT HEALTH ASA (LUBBOCK) INST ASSURANT HEALTH INST ASSURANT HEALTH SELF FUNDED (ALLIED BENEFIT) ASSURECARE INC ASSURECARE INC ASSURED BENEFITS ADMINISTRATORS ASSURED BENEFITS ADMINISTRATORS ASURIS NORTHWEST HEALTH ATA - FL ATE ASEA CWA 1181 (ACTIVES) ATE ASEA CWA 1181 (RETIREES) ATHENS AREA HEALTH PLAN SELECT ATHENS AREA HEALTH PLAN SELECT ATLANTIC DENTAL (ADI) ATLANTIC MEDICAL INSURANCE ATLANTIC MUTUAL INSURANCE ATLANTICARE ADMINISTRATORS ATLANTICARE ALSO KNOWN AS HORIZON HEALTHCARE ATLAS ADMINISTRATORS ATLAS ADMINISTRATORS ATPA ATRIO HEALTH PLAN ATRIO HEALTH PLAN AULTCARE AULTRA ADMINISTRATIVE GROUP AULTRA ADMINISTRATIVE GROUP OH Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Format Claim Status Eligibility Prof Inst Inst Prof Inst Prof Prof Inst Prof Prof Dental Dental Inst Prof Dental Prof Prof Prof Inst Prof Prof Prof Inst Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID PHD01 J1682 J1682 CMSEB 11983 11983 J1580 J1580 J1583 J1583 J1699 J1699 J1688 J1688 J1556 J1556 J1596 J1596 38259 38259 37280 37280 37280 91136 91136 46045 46045 Name State AURORA ASSOCIATED PHYSICIANS INC AUSTIN MUTUAL INS AUSTIN MUTUAL INS (AUTO ONLY) AUSTIN REGIONAL CLINIC EMPLOYEE BENEFIT PLAN AUTO CLUB INSURANCE (ACIA) AUTO CLUB PROPERTY-CASUALTY INSURANCE COMPANY AUTO-OWNERS HOME-OWNERS INSURANCE COMPANY AUTO-OWNERS HOME-OWNERS INSURANCE COMPANY (AUTO ONLY) AUTO-OWNERS OWNERS INSURANCE COMPANY AUTO-OWNERS OWNERS INSURANCE COMPANY (AUTO ONLY) AUTO-OWNERS PROPERTY-OWNERS INSURANCE CO AUTO-OWNERS PROPERTY-OWNERS INSURANCE CO (AUTO ONLY) AUTO-OWNERS SOUTHERN-OWNERS COMPANY AUTO-OWNERS SOUTHERN-OWNERS COMPANY (AUTO ONLY) AUTO-OWNERS INSURANCE COMPANY AUTO-OWNERS INSURANCE COMPANY (AUTO ONLY) AUTO-OWNERS LIFE INSURANCE COMPANY AUTO-OWNERS LIFE INSURANCE COMPANY (AUTO ONLY) AUTOMATED BENEFIT SERVICES AUTOMATED BENEFIT SERVICES INST AUTOMATED GROUP ADMINISTRATION AUTOMATED GROUP ADMINISTRATION, INC AUTOMATED GROUP ADMINISTRATION, INC AUTOMOTIVE MACHINISTS LOCAL 289 HEALTH AUTOMOTIVE MACHINISTS LOCAL 289 HEALTH WELFARE TRUST GRP F32 AVERA HEALTH PLANS AVERA HEALTH PLANS MI MI IN Payer Type CI WC AM CI AM AM WC AM WC AM WC AM WC AM WC AM WC AM CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Inst Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 87098 41556 95266 59274 59274 J1018 FAMR1 A2051 41556 BKRFM TPC20 J1729 J1729 74227 SX145 12X42 77078 74275 J1533 J1503 J1686 J1686 41556 37248 16112 BLUPP 83470 Name State AVESIS VISION CLAIMS AVIR INC AVMA GROUP HEALTH AVMED HEALTH PLAN AVMED HEALTH PLAN - INST AYERS TRUCKING BAAI BAC LOCAL 15 WELFARE FUND (KANSAS) BAKER TANKS, INC BAKERSFIELD FAMILY MEDICAL CENTER BAKERY DRIVERS LOCAL 194 BANK OF AMERICA BANK OF AMERICA (AUTO ONLY) BANKERS UNITED LIFE (STUDENT DIVISION) BANNER HEALTH PLAN BANNER HEALTH PLAN INST BANNER MEDISUN BAPTIST HEALTHCARE NETWORK BARI MANAGEMENT (MURPHY AND BEANE) BARNES BARRETT BUSINESS SERVICES INC (BBSI) BARRETT BUSINESS SERVICES INC (BBSI) (AUTO ONLY) BASIC RESOURCES, INC BASS ADMINISTRATORS INC BATAVIA CITY SCHOOLS TRI-COUNTY MEDICAL PLAN BCBS ALL PAPER HCFA BCBS ARKANSAS FL FL Payer Type CI WC CI CI CI WC CI CI WC CI CI WC AM CI CI CI CI CI WC WC WC AM WC CI CI BL BL Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N Y N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Inst Prof Inst Dental Prof Prof Dental Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID TFQ45 76031 HMSA1 HMSA2 CB621 84105 BSIA2 47163 23739 23738 CBMA1 CBMA1 FEPMI FEPMI TBS03 TBS02 TBS04 TPC06 EXC02 EXC01 EXC01 EXC02 EXC01 52133 BSNDV CX014 84980 Name State BCBS ARKANSAS FEP CLAIMS ONLY BCBS FLORIDA (FLORIDA COMBINED LIFE) DENTAL BCBS HAWAII (HMSA) - COMMERCIAL DENTAL BCBS HAWAII (HMSA) - FEDERAL DENTAL BCBS ILLINOIS DENTAL BCBS INDIANA DENTAL BCBS IOWA MEDICARE COB BCBS KANSAS IL IN IA KS BCBS LOUISIANA BCBS LOUISIANA POS - HMO LOUISIANA BCBS MASSACHUSETTS DENTAL BCBS MASSACHUSETTS DENTAL BLUE BCBS MICHIGAN FEP FEDERAL EMP INST BCBS MICHIGAN FEP FEDERAL EMPLOYEES LA MA MA MI MI BCBS MISSISSIPPI (CHIP CLAIMS ONLY) BCBS MISSISSIPPI (CHIP FEP CLAIMS ONLY) BCBS MISSISSIPPI (CHIP PRE-D'S ONLY) BCBS MISSISSIPPI - STATE CLAIMS BCBS NEW YORK (CENTRAL NEW YORK) BCBS NEW YORK (FINGER LAKES REGION) BCBS NEW YORK (ROCHESTER) BCBS NEW YORK (SYRACUSE) BCBS NEW YORK (UTICAWATERTOWN) BCBS NORTH CAROLINA DENTAL BCBS NORTH DAKOTA VISION NC ND BCBS OF KANSAS CITY BCBS TEXAS DENTAL TX Payer Type BL BL CI CI BL BL BL BL CI BL BL BL CI CI BL BL BL BL BL BL BL BL BL BL BL BL BL Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y Y N N N N N N N N N N N N N Format Claim Status Eligibility Dental Dental Dental Dental Dental Dental Prof Dental Dental Prof Dental Dental Inst Prof Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Prof Dental Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N Y N N Y N Y Y N N N N N N N N N N Y N N N N N N N N N N N Y N N Y Y N N N N N N N N N N Y N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 301 SC400 SC400 SC402 SC402 SC481 SC403 49153 43324 43324 J1234 J1030 J1690 J1690 45967 95377 95377 41556 63100 60054 60054 68241 PR002 J1257 J1257 37125 41205 Name State BCBS WESTERN NEW YORK (WNY) BCBSSC STATE EMPLOYEES HEALTH PLAN BCBSSC STATE EMPLOYEES HEALTH PLAN INST BCBSSC FEDERAL EMPLOYEES PLAN FEP BCBSSC FEDERAL EMPLOYEES PLAN FEP INST BCBSSC PREFERRED BLUE BCBSSC PREFERRED HEALTH SYSTEMS-HMO BLUE BCI ADMINISTRATORS INC BEACON HEALTH STRATEGIES BEACON HEALTH STRATEGIES INST BEACON MUTUAL BEALL'S INC MIDWEST EMPLOYERS BEAR VALLEY UNIFIED SCHOOL DISTRICT (CA) BEAR VALLEY UNIFIED SCHOOL DISTRICT (CA) (AUTO ONLY) BEAVER MEDICAL GROUP BEECH STREET CORPORATION BEECH STREET CORPORATION BEEVILLE ISD BEHAVIORAL HEALTH SYSTEMS BELL ATLANTIC BELL ATLANTIC BELL ATLANTIC BELL ATLANTIC BENCHMARK INSURANCE BENCHMARK INSURANCE (AUTO ONLY) BENEFIRST BENEFIT ADMINISTRATION SERVICES SC SC SC SC SC SC Payer Type BL BL BL BL BL BL BL CI CI CI WC WC WC AM CI CI CI WC CI CI CI CI CI WC AM CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N Y Y N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Dental Prof Inst Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Inst Prof Prof Dental Prof Inst Prof Prof Prof Inst Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y Y N N N N N N N N N N N N N Y N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 36149 36149 41205 99320 25145 25145 BMATP BMG01 48611 48611 56139 TLU04 TLU05 999 999 37212 37212 13310 37286 39081 37118 37118 88027 39081 39081 37222 37222 State Name BENEFIT ADMINISTRATIVE SYSTEMS BENEFIT ADMINISTRATIVE SYSTEMS BENEFIT ADMISTRATIVE SERVICES(BAS) BENEFIT AND RISK MANAGEMENT SERVICES PA BENEFIT COORDINATORS CORP BENEFIT COORDINATORS CORPORATION (PITTSBURGH, BENEFIT MANAGEMENT ADMIN (SAN ANTONIO) BENEFIT MANAGEMENT GROUP INC (BMG) KS KS BENEFIT MANAGEMENT INC OF KANSAS BENEFIT MANAGEMENT INC OF KANSAS INST BENEFIT MANAGEMENT SERVICES BENEFIT MANAGEMENT SERVICES (LA) BENEFIT MANAGEMENT SERVICES -- FEP CLAIMS (LA) BENEFIT MANAGEMENT SERVICES OF LOUISIANA BENEFIT MANAGEMENT SERVICES OF LOUISIANA INST LA LA BENEFIT MANAGEMENT SYSTEMS INC - MISSISSIPPI BENEFIT MANAGEMENT SYSTEMS INC - MISSISSIPPI MO BENEFIT PLAN ADMIN ST LOUIS BENEFIT PLAN ADMINISTRATORS BENEFIT PLAN ADMINISTRATORS CO (EAU CLAIRE, WI) VA VA BENEFIT PLAN ADMINISTRATORS INC BENEFIT PLAN ADMINISTRATORS INC BENEFIT PLAN ADMINISTRATORS INC BENEFIT PLAN ADMINISTRATORS, CO (EAU CLAIRE, WI) BENEFIT PLAN ADMINISTRATORS, INC (EAU CLAIRE, WI) BENEFIT PLAN MANAGEMENT BENEFIT PLAN MANAGEMENT Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI BL CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Prof Prof Inst Prof Prof Prof Inst Prof Dental Dental Prof Inst Prof Inst Prof Prof Inst Inst Prof Prof Prof Dental Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 74223 74223 2053 34178 TLZ27 38257 36342 36342 75135 75135 42148 BMX01 87265 87265 37248 37248 37248 BNMK1 J1477 J1477 J1523 J1477 J1526 TP019 41556 20044 23243 Name State BENEFIT PLANNERS, INC BENEFIT PLANNERS, INC BENEFIT RESOURCES BENEFIT SERVICES (AKRON OH) IN OH BENEFIT SERVICES OF HAWAII BENEFIT SOURCE, INC BENEFIT SYSTEMS SERVICES BENEFIT SYSTEMS SERVICES, INC (BSSI) BENEFITS MANAGEMENT BENEFITS MANAGEMENT HOS BENEFITS, INC BENEMAX BENESIGHT BENESIGHT BENESYS BENESYS BENESYS, INC (LAFAYETTE, LA) BENMARK BERKLEY AGRIBUSINESS RISK SPECIALISTS BERKLEY NATIONAL INSURANCE COMPANY BERKLEY NET UNDERWRITERS, LLC BERKLEY REGIONAL INSURANCE COMPANY BERKLEY RISK ADMINISTRATORS COMPANY, LLC BERKLEY SPECIALTY UNDERWRITERS BERKLEY VALLEY CONV HOSPITAL BERKSHIRE HATHAWAY HOMESTATE COMPANIES (BHHC) BERKSHIRE HEALTH PARTNERS PPO (BHP) MS Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC WC WC WC WC WC WC WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Inst Prof Prof Dental Inst Prof Inst Inst Inst Inst Dental Inst Prof Inst Prof Dental Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 95606 41556 J1031 95604 95604 TPC21 20488 32006 25175 25175 41556 44219 BSHS1 J1738 J1738 CX025 41556 J1691 J1691 J1579 J1579 BV001 BV001 BV001 BVTX1 BVTX1 BVTX1 Name State BERKSHIRE LEHIGH PARTNERS BERNARDO H CO CLUB BERWIND CORPORATION BEST LIFE HEALTH INSURANCE CO BEST LIFE HEALTH INSURANCE CO BETHPAGE CONGRESS OF TEACHERS BETTER HEALTH OF FLORIDA BETTER HEALTH PLAN OF SOUTH CAROLINA FL SC BETTER HEALTH PLANS (UNISON) BETTER HEALTH PLANS (UNISON) INST BEVERLY HILLS CARMEL BHP-UNITY BIENVIVIR SENIOR BIG 5 CORP BIG 5 CORP (AUTO ONLY) BIG LOTS ASSOCIATES BENEFIT PLAN BIGHORN CONSTRUCTION BITUMINOUS FIRE AND MARINE BITUMINOUS FIRE AND MARINE (AUTO ONLY) BITUMINOUS INSURANCE COMPANY BITUMINOUS INSURANCE COMPANY (AUTO ONLY) BLOCK VISION INC BLOCK VISION INC BLOCK VISION INC BLOCK VISION OF TEXAS BLOCK VISION TEXAS BLOCK VISION TEXAS TX TX TX Payer Type CI WC WC CI CI CI CI CI CI CI WC CI CI WC AM CI WC WC AM WC AM CI CI CI CI CI CI Real Time Real Time N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N Y N N N Y N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Inst Prof Dental Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1347 870 TLY26 37308 3036 3036 37244 BCNMI 53589 BS020 50 60 BC590 BC101 130 47163 160 53120 200 BC210 220 BS230 790 621 621 241 332 Name State BLOOMINGDALE'S BLUE SHIELD RHODE ISLAND RI BLUE ADVANTAGE (BCBS OF AR) BLUE BELL BENEFITS TRUST BLUE BENEFIT ADMINISTRATORS OF MA BLUE BENEFIT ADMINISTRATORS OF MA - INST MA MA BLUE BONNET ADMINISTRATORS BLUE CARE NETWORK MICHIGAN BLUE CROSS BLUE SHIELD ARIZONA INST BLUE CROSS BLUE SHIELD ARKANSAS INST BLUE CROSS BLUE SHIELD COLORADO INST BLUE CROSS BLUE SHIELD CONNECTICUT INST BLUE CROSS BLUE SHIELD FLORIDA INST BLUE CROSS BLUE SHIELD GEORGIA INST BLUE CROSS BLUE SHIELD INDIANA INST BLUE CROSS BLUE SHIELD KANSAS INST BLUE CROSS BLUE SHIELD KENTUCKY INST BLUE CROSS BLUE SHIELD LOUISIANA INST BLUE CROSS BLUE SHIELD MASSACHUSETTS INST BLUE CROSS BLUE SHIELD MICHIGAN INST BLUE CROSS BLUE SHIELD MINNESOTA INST BLUE CROSS BLUE SHIELD MISSISSIPPI BLUE CROSS BLUE SHIELD NEW MEXICO INST BLUE CROSS BLUE SHIELD OF ILLINOIS (HCSC) BLUE CROSS BLUE SHIELD OF ILLINOIS (HCSC) INST BLUE CROSS BLUE SHIELD OF MISSOURI INST BLUE CROSS BLUE SHIELD OHIO INST MI AZ AR CO CT FL GA IN KS KY LA MA MI MN MS NM IL IL MO OH Payer Type WC BL BL CI CI CI CI CI BL BL BL BL BL BL BL BL BL BL BL CI BL CI BL BL BL BL BL Real Time Real Time N N N N N N N N N N Y N N N N N N N N N N N Y Y Y N N N Y N N Y N N Y N Y N N N Y N N N N N Y N Y N N N N N Format Claim Status Eligibility Prof Prof Dental Prof Prof Inst Inst Prof Inst Inst Inst Inst Inst Inst Inst Inst Inst Inst Inst Inst Inst Prof Inst Prof Inst Inst Inst Claim Enrollment Required ERA Enrollment Required N Y N N N N N Y N N N N N N N Y N N Y Y N Y N N N N N N Y N N N N N Y Y N Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name BSOK1 BLUE CROSS BLUE SHIELD OKLAHOMA INST SC481 BLUE CROSS BLUE SHIELD SOUTH CAROLINA INST BC390 BLUE CROSS BLUE SHIELD TENNESSEE INST BC980 BLUE CROSS BLUE SHIELD TEXAS INST BCVA1 BLUE CROSS BLUE SHIELD VIRGINIA INST 450 BLUE CROSS BLUE SHIELD WISCONSIN INST 932 BLUE CROSS BLUESHIELD WA REGENCE INST BC305 BLUE CROSS CENTRAL NEW YORK - INST BCCMI BLUE CROSS COMPLETE MICHIGAN BCD01 BLUE CROSS DENTAL (MD) DOMINION CAPITAL BLUE CROSS 60147 BLUE CROSS NORTHEASTERN PENNSYLVANIA 47198 BLUE CROSS OF CALIFORNIA (WELLPOINT) 47198 BLUE CROSS OF CALIFORNIA INST 610 BLUE CROSS OF IDAHO IP061 BLUE LAKE RANCHERIA 56152 BLUE MEDICARE ADVANTAGE NORTH CAROLINA 56152 BLUE MEDICARE ADVANTAGE NORTH CAROLINA INST NMPPO BLUE MEDICARE PPO NEW MEXICO 510 BLUE SHIELD ALABAMA 510 BLUE SHIELD ALABAMA DENTAL 53589 BLUE SHIELD ARIZONA BS520 BLUE SHIELD ARKANSAS 570 BLUE SHIELD DELAWARE HIGHMARK BS590 BLUE SHIELD FLORIDA 621 BLUE SHIELD ILLINOIS BSIA1 BLUE SHIELD IOWA 47163 BLUE SHIELD KANSAS State OK SC TN TX VA WI WA NY MI PA CA CA ID CA NC NC NM AL AL AZ AR DE FL IL IA KS Payer Type BL BL BL BL BL BL CI BL CI BL BL CI BL CI CI CI CI CI BL BL BL BL BL BL BL BL BL Real Time Real Time Y N N Y N N N N N N N Y N N N N N N N N N N N Y Y N N N N Y N N N N N Y N Y Y N Y N Y N N Y N Y Y N Y Y Y Y Format Claim Status Eligibility Inst Inst Inst Inst Inst Inst Inst Inst Prof Dental Prof Prof Inst Prof Prof Prof Inst Prof Prof Dental Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N Y N N N N Y N N N N N Y N N N N Y Y N Y Y N N Y Y Y Y Y Y Y Y Y Y N N Y Y Y N N Y Y N Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 53120 680 200 BS710 720 241 BSMT0 760 BS804 BS801 BS806 BSND1 BSOK1 54771 SC401 BSSD1 BS390 BSVT1 BSVA1 950 BSWY1 84980 BS805 50 60 601 BS115 Name BLUE SHIELD LOUISIANA BLUE SHIELD MAINE ANTHEM BLUE SHIELD MASSACHUSETTS BLUE SHIELD MICHIGAN BLUE SHIELD MINNESOTA BLUE SHIELD MISSOURI BLUE SHIELD MONTANA BLUE SHIELD NEBRASKA BLUE SHIELD NEW YORK ROCHESTER BLUE SHIELD NEW YORK WESTERN - BUFFALO BLUE SHIELD NEW YORK UTICA WATERTOWN BLUE SHIELD NORTH DAKOTA BLUE SHIELD OKLAHOMA BLUE SHIELD PENN HIGHMARK BCBS BLUE SHIELD SOUTH CAROLINA BLUE SHIELD SOUTH DAKOTA BLUE SHIELD TENNESSEE BLUE SHIELD VERMONT BLUE SHIELD VIRGINIA (ANTHEM) BLUE SHIELD WISCONSIN BLUE SHIELD WYOMING BLUE SHIELD BCBS TEXAS BLUE SHIELD CENTRAL NEW YORK BLUE SHIELD COLORADO BLUE SHIELD CONNECTICUT (ANTHEM) BLUE SHIELD GEORGIA BLUE SHIELD HAWAII (HMSA) State Payer Type LA ME MA MI MN MO MT NE NY NY NY ND OK PA SC SD TN VT VA WI WY TX NY CO CT GA HI BL BL BL CI BL BL BL BL BL BL BL BL BL BL BL BL BL BL BL BL BL BL BL BL BL BL BL Real Time Real Time N N N N Y Y N N N N N N Y N N N N N Y Y N Y N Y Y Y N Y N Y Y Y Y Y Y Y N Y Y Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N Y Y N N Y Y Y Y Y Y N Y N Y Y N N N Y N Y N N N Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 47171 770 790 BSNC1 BSNC2 BS800 94036 52133 94036 611 630 BS660 265 800 834 CB865 CBPA2 932 BSWA2 851 54828 BCFP7 SC922 403 61124 61124 CX014 Name BLUE SHIELD KANSAS CITY REGION BLUE SHIELD NEW HAMPSHIRE ANTHEM BLUE SHIELD NEW MEXICO BLUE SHIELD NORTH CAROLINA BLUE SHIELD NORTH CAROLINA INST BLUE SHIELD NORTHEASTERN NEW YORK BLUE SHIELD OF CALIFORNIA State MO NH NM NC NC NY CA BLUE SHIELD OF CALIFORNIA DENTAL BLUE SHIELD OF CALIFORNIA INST BLUE SHIELD OF IDAHO (REGENCE) BLUE SHIELD OF INDIANA BLUE SHIELD OF KENTUCKY BLUE SHIELD OF NEVADA CA ID IN KY NV BLUE SHIELD OF NORTHEASTERN NEW YORK (NENY) BLUE SHIELD OF OHIO OH BLUE SHIELD OF PENNSYLVANIA BLUE SHIELD OF PENNSYLVANIA - DENTAL PLUS (UCCI) BLUE SHIELD OF WASHINGTON (REGENCE) BLUE SHIELD OF WASHINGTON REGENCE (PIN) BLUE SHIELD OREGON (REGENCE) BLUE SHIELD WEST VIRGINIA BLUECARE FAMILY PLAN CONNECTICUT BLUECHOICE HEALTH PLAN (BCBSSC) BLUECHOICE SOUTH CAROLINA MEDICAID (WELLPOINT) WA WA OR WV CT SC SC BLUEGRASS FAMILY HEALTH BLUEGRASS FAMILY HEALTH INST BMC COMMONWEALTH MASS - DENTAQUEST MA Payer Type BL BL BL BL BL BL BL BL BL CI BL BL BL BL BL BL BL BL BL BL BL MC CI MC CI CI CI Real Time Real Time N N Y N N N N N N N Y Y Y N Y N N N N N N Y N N N N N Y N Y Y N N Y N N Y Y Y Y N Y N N Y Y Y Y Y Y Y Y N N Format Claim Status Eligibility Prof Prof Prof Prof Inst Prof Prof Dental Inst Prof Prof Prof Prof Dental Prof Dental Dental Prof Prof Prof Prof Prof Prof Prof Prof Inst Dental Claim Enrollment Required ERA Enrollment Required Y N N Y N Y N N N N N N N N N N N N N N Y N N N N N N Y Y Y Y Y Y Y N Y Y Y Y Y N Y N N Y Y Y Y N Y N Y Y N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 43178 43178 J1258 J1259 41556 36609 36609 BOLL1 BOLL1 TLX71 BOONG BOONG 74238 74238 74238 13337 13337 38324 38324 7689 41556 37273 37273 37273 37273 37286 48964 Name State BMI - JOPLIN CLAIMS BMI - JOPLIN CLAIMS BMW MANUFACTURING CORP BMW NORTH AMERICA BOBRICK WASHROOM BOILERMAKERS NATIONAL HEALTH WELFARE FUND BOILERMAKERS NATIONAL HEALTH WELFARE FUND BOLLINGER INC BOLLINGER INC BOLLINGER INSURANCE BOON GROUP BOON GROUP BOON-CHAPMAN BENEFIT ADMINISTRATORS BOON-CHAPMAN BENEFIT ADMINISTRATORS, INC BOONCHAPMAN BENEFIT ADMIN BOSTON MEDICAL CENTER (BMC) HEALTHNET BOSTON MEDICAL CENTER HEALTH - INST BOTSFORD HEALTH PLAN BOTSFORD HEALTH PLAN (FARMINGTON HILLS, MI) BOULDER ADMINISTRATION SERVICES BOULDER COMMUNITY HOSPITAL BOYD BROS TRANSPORTATION INC BOYD BROS TRANSPORTATION, INC BOYDCARE BOYDCARE BPABENEFIT PLAN ADMINISTRATORS (NORTH DAKOTA) BPS, INC MA MA MI Payer Type CI CI WC WC WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Prof Prof Inst Prof Inst Prof Dental Inst Prof Prof Inst Inst Prof Inst Prof Inst Prof Prof Prof Inst Inst Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 52192 52192 65005 41556 TPC22 TPC23 TPC24 77025 38365 BRIDG 68054 68054 TP021 51037 51037 J1445 J1445 94316 94316 BTSS1 41556 11150 J1032 J1261 932 32004 32004 Name State BRAVO HEALTH ELDER HEALTH BRAVO HEALTH - INST BREATHCOCSL PULMONARY BREMCO CONSTRUCTION BRICKLAYERS - PLAN A BRICKLAYERS - PLAN B BRICKLAYERS - RETIREES BRICKSTREET MUTUAL INSURANCE BRIDGE BENEFITS BRIDGESPAN HEALTH BRIDGEWAY HEALTH SOLUTIONS ARIZ INST BRIDGEWAY HEALTH SOLUTIONS ARIZONA OH UT AZ AZ BROADSPIRE, A CRAWFORD COMPANY BROCKERAGE CONCEPTS, INC BROKERAGE CONCEPTS BROTHERHOOD MUTUAL INSURANCE BROTHERHOOD MUTUAL INSURANCE (AUTO ONLY) BROWN AND TOLAND MEDICAL GROUP BROWN AND TOLAND MEDICAL GROUP BROWN AND TOLAND SUTTER SELECT CA CA CA BROWNSVILLE INDEPENDENT SCHOOL DISTRICT BROWNYARD GROUP INC (ARCH INSURANCE) BRUNSWICK CORPORATION BRUNSWICK CORPORATION (AUTO ONLY) BS WASHINGTON (REGENCE) BUCKEYE COMMUNITY HEALTH PLAN OHIO BUCKEYE COMMUNITY HEALTH PLAN OHIO INST WA OH OH Payer Type CI CI CI WC CI CI CI CI CI CI CI CI WC CI CI WC AM CI CI CI WC WC WC AM BL CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N Y N Format Claim Status Eligibility Prof Inst Prof Prof Dental Dental Dental Prof Prof Prof Inst Prof Prof Inst Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID CX014 50240 J1501 TPC25 J1435 J1033 41556 42150 42150 J1533 41556 23708 16126 62413 59129 41556 J1535 68069 IP020 41556 CWS99 41556 59334 41556 37105 37105 71057 Name State BUCKEYE HEALTH PLAN BUENAVENTURA MEDICAL GROUP BUFFETS INC (OLD COUNTRY BUFFETT, RYAN'S, HOMETOWN BUFFET) BUILDING SERVICE 32BJ HEALTH FUND BUNCH AND ASSOCIATES BURLINGTON COAT FACTORY WAREHO BURTON WAY CARMEL BUTLER BENEFITS IA BUTLER DENTAL (LA) BV GENERAL (MURPHY AND BEANE) BYCOR GEN CONTRACT C O EMPLOYEES HOSPITAL ASSOCIATION C NY MANAGED CARE CAC CAC RAMSEY CADET UNIFORM SUPPLY CALIFORNIA FAIR SERVICES AUTHORITY CALIFORNIA HEALTH AND WELLNESS CALIFORNIA PRIMARY CARE MEDICAL GROUP CA CA CALIFORNIA WATER SERVICE COMPANY CALIFORNIA WATER SERVICES CALLAHAN, MCCUNE CAMBRIDGE ISG CAMPBELL UNION SCHOOL DISTRICT CANNON COCHRAN MANAGEMENT SERV CANNON COCHRAN MANAGEMENT SERVICES INC CANNON COCHRAN MANAGEMENT SERVICES, INC CA Payer Type CI CI WC CI WC WC WC CI CI WC WC CI CI CI CI WC WC CI CI WC CI WC CI WC CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N Format Claim Status Eligibility Dental Prof Prof Dental Prof Prof Prof Prof Dental Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 37105 CAPMN 38245 38245 J1637 J1637 CBC01 CAPBC CAPBC CDPHP 95112 95112 68011 68011 J1262 J1262 CAPHP CAPHP CAPHP 41556 86044 86044 GCVCP 57116 57116 65063 77082 Name State CANNON COCHRAN MANAGEMENT SVC-ILLINOIS CAP MANAGEMENT SYSTEMS CAPE HEALTH PLAN CAPE HEALTH PLAN CAPISTRANO UNIFIED SCHOOL DISTRICT (CA) CAPISTRANO UNIFIED SCHOOL DISTRICT (CA) (AUTO ONLY) CAPITAL BLUE CROSS (CBC) CAPITAL BLUE CROSS - CAPITAL ADVANTAGE CAPITAL BLUE CROSS INST CAPITAL DISTRICT PHP CAPITAL HEALTH PLAN CAPITAL HEALTH PLAN INST PA PA NY FL FL CAPITOL ADMINISTRATORS CAPITOL ADMINISTRATORS CAPITOL INDEMNITY CAPITOL INDEMNITY (AUTO ONLY) CAPROCK HEALTH PLANS CAPROCK HEALTH PLANS - DENTAL CAPROCK HEALTH PLANS - INST CAPS-SIG CAPSTONE HEALTH PLAN CAPSTONE HEALTH PLAN AZ AZ CARDIOVASCULAR CARE PROVIDERS INC (CVCP) CARE 1ST HEALTH PLAN OF ARIZONA CARE 1ST HEALTH PLAN OF ARIZONA - INST CARE ACCESS PSN CARE IMPROVEMENT PLUS AZ AZ FL Payer Type CI CI CI CI WC AM CI BL BL CI CI CI CI CI WC AM CI CI CI WC CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y Y N N N N N Y N N N N N N N N N N Format Claim Status Eligibility Dental Prof Inst Prof Prof Prof Dental Prof Inst Prof Prof Inst Inst Prof Prof Prof Prof Dental Inst Prof Inst Prof Prof Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 77082 340 11331 43172 43172 11345 14182 14179 14180 14188 75190 SB580 SB690 SB580 SB690 SB691 25140 CLUHS 91136 CARMO 25142 93975 93975 22248 95092 77023 KYCS1 Name State CARE IMPROVEMENT PLUS INST CARE MANAGEMENT RESOURCES CARE MGMT GROUP GREATER NY CARE PARTNERS CARE PARTNERS CARECENTRIX CARECORE NATIONAL CARECORE NATIONAL - AETNA RADIOLOGY CLAIMS CARECORE NATIONAL - OXFORD RADIOLOGY CARECORE WELLCARE NY RADIOLOGY NY CAREFIRST ADMINISTRATORS NCAS CAREFIRST BCBS DCNCA CAREFIRST BCBS MARYLAND CAREFIRST BCBS DCNCA INST CAREFIRST BCBS MARYLAND INST CAREFIRST DELMARVA HEALTH PLAN DC MD DC MD MD CARELINK MEDICAID INST CARELINK UNIVERSITY HEALTH SYSTEM CAREMARK CAREMORE IPA CA CARENET CAREOREGON CAREOREGON CAREPARTNERS OR OR MO CAREPLUS HEALTH PLAN CAREPOINT HEALTH PLANS CARESOURCE KENTUCKY KY Payer Type CI CI CI CI CI CI CI CI CI CI CI BL BL BL BL CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N Y Format Claim Status Eligibility Inst Prof Inst Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Inst Prof Inst Prof Inst Prof Inst Inst Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y N N N N N Y N N N N N Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 38325 38325 31114 31114 MRCHP MRCHP DAKC DAKC 35167 77015 FAMR1 62073 62073 62072 62072 37245 SC498 29076 29076 56195 56195 25125 25125 CAS01 93040 93040 J1630 Name CARESOURCE MICHIGAN CARESOURCE MICHIGAN INST CARESOURCE OHIO CARESOURCE OHIO INST CARESOURCE OREGON CARESOURCE OREGON INST CAREWEST State MI MI OH OH OR OR SD CAREWEST CAREWISE CARILION CLINIC MEDICARE HEALTH PLAN CARING PROGRAM CARITEN HEALTH PLAN CARITEN HEALTHCARE - INST CARITEN SENIOR HEALTH CARITEN SENIOR HEALTH - INST CAROLINA BENEFIT ADMINISTRATOR CAROLINA BENEFIT ADMINISTRATORS - BCBSSC SC CAROLINA CARE PLAN (FORMERLY 57105) CAROLINA CARE PLAN (FORMERLY 57105) CAROLINA SUMMIT HEALTHCARE INC CAROLINA SUMMIT HEALTHCARE INC CARPENTERS HEALTH WELFARE ST LOUIS CARPENTERS HEALTH AND WELFARE TRUST FUND OF CASCADE EAST HEALTH PLAN CASCADE EAST HEALTH PLANS CASCADE EAST HEALTH PLANS CASITAS MUNICIPAL WATER DISTRICT (CA) OR Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N Y N N N N N N N N N Format Claim Status Eligibility Prof Inst Prof Inst Prof Inst Inst Inst Prof Prof Inst Prof Inst Prof Inst Inst Prof Prof Inst Inst Prof Prof Inst Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N Y N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1630 37060 37060 41556 41556 41556 3036 55438 55438 31158 65391 J1533 88019 J1010 10050 88022 OBAEW 95166 41556 95167 95167 CELTC 68063 CX014 68060 68060 37250 Name State CASITAS MUNICIPAL WATER DISTRICT (CA) (AUTO ONLY) CATERPILLAR CATERPILLAR INC CATHOLIC DIOCESE OF SAN DIEGO CATHOLIC MUTUAL - PREFERRED PROFESSIONAL INSURANCE COMPANY CATHOLIC MUTUAL - VIRGINIA SURETY COMPANY, INC CBA BLUE (COMPREHENSIVE BENEFITS ADMINISTRATOR, INC) CBCA ADMINISTRATORS CBCA ADMINISTRATORS - INST CBIZ BENEFITS INSURANCE SERVICES CBNHP HEALTH CHOICES CBS STUDIOS (MURPHY AND BEANE) CCEA WELFARE BENEFIT TRUST (TEACHERS HEALTH TRUST) CCMSI CDH (CIGNA DENTAL CARE) CDS GROUP HEALTH CEDAR RAPIDS ELECTRICAL WORKERS (IBEW405) CEDARS SINAI MEDICAL NETWORK CLAIMS CA CEDARS-SINAI HEALTH SYSTEM CEDARS-SINAI MEDICAL NETWORK SERVICES CEDARSSINAI MEDICAL NETWORK ENCOUNTERS CA CELTIC INSURANCE CELTIC INSURANCE CELTICARE - DENTAQUEST CELTICARE HEALTH PLAN CELTICARE HEALTH PLAN INST CEMARA ADMINISTRATORS MA MA MA Payer Type AM CI CI WC WC WC CI CI CI CI CI WC CI WC CI CI CI CI WC CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N Y N N Format Claim Status Eligibility Prof Prof Inst Prof Prof Prof Dental Prof Inst Prof Prof Prof Prof Prof Dental Prof Prof Prof Prof Prof Prof Prof Prof Dental Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 37250 91136 91136 J1034 68068 68048 68058 68050 68065 68065 68052 68068 68047 68068 68068 68068 68048 68051 68059 68053 68068 68056 68056 19895 TPC14 13357 13360 Name State CEMARA ADMINISTRATORS INC CEMENT MASONS PLASTERERS HEALTH WELFARE CEMENT MASONS PLASTERERS HLTH WELFARE TRUST GRP F16 CENDANT CORPORATION CENPATICO BEHAVIORAL HEALTH CENPATICO BEHAVIORAL HEALTH ARIZONA CENPATICO BEHAVIORAL HEALTH FLORIDA CENPATICO BEHAVIORAL HEALTH GEORGIA CENPATICO BEHAVIORAL HEALTH ILLINOIS CENPATICO BEHAVIORAL HEALTH ILLINOIS INST CENPATICO BEHAVIORAL HEALTH INDIANA AZ FL GA IL IL IN CENPATICO BEHAVIORAL HEALTH INST CENPATICO BEHAVIORAL HEALTH KANSAS CENPATICO BEHAVIORAL HEALTH KENTUCKY CENPATICO BEHAVIORAL HEALTH MASSACHUSETTS CENPATICO BEHAVIORAL HEALTH NEW HAMPSHIRE CENPATICO BEHAVIORAL HEALTH OF ARIZONA INST CENPATICO BEHAVIORAL HEALTH OHIO CENPATICO BEHAVIORAL HEALTH SOUTH CAROLINA CENPATICO BEHAVIORAL HEALTH TEXAS CENPATICO BEHAVIORAL HEALTH WISCONSIN CENTENE ADVANTAGE PLANS CENTENE ADVANTAGE PLANS CENTENNIAL INSURANCE COMPANY CENTER CARE CENTERCARE CENTERLIGHT HEALTHCARE KS KY MA NH AZ OH SC TX WI Payer Type CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y N Y N Y N Y Y N Y Y Y Y N Y N N N Y Format Claim Status Eligibility Inst Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Inst Prof Prof Dental Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y Y Y N Y Y Y Y Y Y Y Y Y N Y N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID IP080 75243 75196 31118 31118 31118 31118 31118 31118 CCA01 WH001 IP037 J1605 J1605 J1035 2041 2041 IP010 34097 34097 36215 36215 37214 IP131 48120 20356 20356 Name CENTINELA IPA State CA CENTRA CENTRA BENEFITS TX CENTRAL BENEFITS LIFE CENTRAL BENEFITS LIFE CENTRAL BENEFITS MUTUAL CENTRAL BENEFITS MUTUAL CENTRAL BENEFITS NATIONAL CENTRAL BENEFITS NATIONAL CENTRAL CALIFORNIA ALLIANCE FOR HEALTH CENTRAL CALIFORNIA WOMENS HEALTH CENTRAL COAST IPA CA CA CA CENTRAL CONTRA COSTA TRANSIT AUTHORITY CENTRAL CONTRA COSTA TRANSIT AUTHORITY (AUTO ONLY) CENTRAL HOCKEY LEAGUE CENTRAL MASS HEALTH CARE CENTRAL MASS HEATH CARE CENTRAL PENNSYLVANIA PHYSICIANS PA CENTRAL RESERVE LIFE CENTRAL RESERVE LIFE CENTRAL STATES HEALTH WELFARE FUNDS CENTRAL STATES HEALTH WELFARE FUNDS CENTRAL STATES JOINT BOARD HEALTH WELFARE TRUST FUND CENTRAL VALLEY MEDICAL GROUP CENTURY HEALTH SOLUTIONS CERNER HEALTHPLAN SERVICES (THE HEALTH EXCHANGE) CERNER HEALTHPLAN SERVICES - INST IL CA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI WC AM WC CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N Y N N N N N N N Format Claim Status Eligibility Prof Prof Prof Inst Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Inst Prof Prof Prof Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID TPC26 23171 J1646 J1646 84146 84146 41556 41556 J1036 16600 16600 25131 25131 75261 59223 34154 34154 J1479 J1479 COACC 41556 41556 DCHCH UHSCH TTPCH UPGCH ACN01 Name State CEWF - LOCAL 3 CHA HEALTH CHAFFEY JOINT UNION H S DISTRICT (CA) CHAFFEY JOINT UNION H S DISTRICT (CA) (AUTO ONLY) CHAMP VA HAC CHAMP VA HAC - INST CHANDLER'S P VERDES CHAPMAN CONVALESCENT CHARMING SHOPPES, INC CHAUTAUQUA COUNTY HC MAYVILLE CHAUTAUQUA COUNTY HEALTHCARE PLAN CHC DIAMOND MEDICAID INST CHC DIAMOND MEDICAID MARYLAND MD CHEC - WEB TPA CHESAPEAKE LIFE INSURANCE COMPANY CHESTERFIELD RESOURCES CHESTERFIELD RESOURCES INST CHESTERFIELD SERVICES, INC CHESTERFIELD SERVICES, INC (AUTO ONLY) CHILD HEALTH PLAN (COACC CHP) CO CHILDREN'S HOSPITAL COLORADO CHILDREN'S HOSPITAL OF ORANGE COUNTY - FIRST AID CHIP DRISCOLL CHILDRENS HEALTH PLAN CHIP - CHOICEONE UTMB CHIP-TEENS TO TOTS TX UNIVERSITY HEALTH CHIP-TX UNIVERSITY HEALTH PLAN UPG CHIROCARE TX TX TX TX Payer Type CI CI WC AM CI CI WC WC WC CI CI CI CI CI CI CI CI WC AM CI WC WC CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N Y N Y N N N N Y N N N N N N N Format Claim Status Eligibility Dental Inst Prof Prof Prof Inst Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID ACN01 ACN01 CMG01 76049 76049 PR002 60054 60054 68241 UHSCH 90441 90441 38308 38308 SPOHN 37288 J1554 J1554 J1561 J1561 41556 J1265 J1725 J1264 J1532 J1532 62308 Name CHIROPRATIC CARE OF MINNESOTA CHIROPRATIC CARE OF WISCONSIN State MN WI CHOICE MEDICAL GROUP CHOICE ONE UTMB CHIP HEALTH PLAN TX CHOICE ONEUTMB CHIP HEALTH PLAN CHOICE PLUS CHOICE PLUS (TRW) CHOICE PLUS (TRW) CHOICE PLUS (TRW) CHOICEONE- UTMB CHIP CHP DIRECT SUPERMED CHP DIRECT SUPERMED CHRISTIAN BROTHERS SERVICES CHRISTIAN BROTHERS SERVICES - INST CHRISTUS SPOHN HEALTH PLAN CHS CLAIMS CHUBB AND SON CHUBB AND SON (AUTO ONLY) CHUBB SERVICES CHUBB SERVICES (AUTO ONLY) CHULA VISTA ELEMENTARY SCHOOL DISTRICT CHURCH MUTUAL INSURANCE COMPANY (WC ONLY) CHURCH MUTUAL INSURANCE COMPANY (WC ONLY) CHURCH MUTUAL INSURANCE COMPANY - AUTO ONLY CIGA CIGA (AUTO ONLY) CIGNA TX Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC AM WC AM WC WC WC AM WC AM CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N Y N N N N N N N N N N N N N Y Format Claim Status Eligibility Prof Prof Prof Prof Inst Prof Dental Prof Inst Prof Inst Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 62308 10050 2331 2331 62308 TLX70 62308 52192 62308 86033 86033 62308 62308 TLW66 C1028 CIMHP J1562 J1562 J1582 J1582 TLU52 10207 J1613 J1613 J1267 COA01 J1118 Name State CIGNA PPO CIGNA (DHMO) CIGNA BEHAVIORAL HEALTH CIGNA BEHAVIORAL HEALTH - INST CIGNA DENTAL CIGNA FLEX CARE (NEW MEXICO ONLY) CIGNA HEALTH PLAN CIGNA HEALTHSPRING CIGNA INSTITUTIONAL CIGNA MEDICARE ADVANTAGE CIGNA MEDICARE ADVANTAGE - INST CIGNA PREMIER PLUS CIGNA PROVIDER PIN CIGNA VOLUNTARY (FORMERLY STAR HRG STAR ADMINISTRATIVE SERVICES) CIM INSURANCE CORPORATION (AUTO ONLY) CIMARRON HEALTH PLAN (COMMERCIAL) NM CINCINNATI INSURANCE CINCINNATI INSURANCE (AUTO ONLY) CITIZENS INSURANCE COMPANY OF AMERICA CITIZENS INSURANCE COMPANY OF AMERICA (AUTO ONLY) CITIZENS SECURITY LIFE INSURANCE CO CITRUS HEALTH CITRUS VALLEY HEALTH PARTNERS CITRUS VALLEY HEALTH PARTNERS (AUTO ONLY) CITY OF AMARILLO (AUSTIN) CITY OF AMARILLO HEALTH PLAN CITY OF AMES TX Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI AM CI WC AM WC AM CI CI WC AM WC CI WC Real Time Real Time Y N N N N N Y N Y Y Y Y Y N N N N N N N N N N N N N N Y N N N N N N N Y Y Y Y N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Dental Prof Inst Dental Dental Prof Prof Inst Prof Inst Prof Prof Dental Prof Prof Prof Prof Prof Prof Dental Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N Y N Y N N Y Y N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID A0033 41556 J1516 41556 41556 41556 41556 41556 41556 41556 41556 41556 J1441 41556 J1118 41556 A0046 41556 41556 J1680 J1680 J1632 J1632 J1634 J1634 41556 41556 Name CITY OF ARLINGTON CITY OF ASHLAND CITY OF ATLANTA CITY OF BEAVERTON CITY OF BELMONT (SELF INSURED) CITY OF CAMPBELL CITY OF CARLSBAD CITY OF CARMEL BY THE SEA CITY OF CARSON CITY OF CHULA VISTA CITY OF COLTON CITY OF CORONADO CITY OF DALLAS CITY OF DEL MAR CITY OF DES MOINES CITY OF EDINBURG, TEXAS CITY OF EL PASO CITY OF ENCINITAS CITY OF ESCONDIDO CITY OF FORT WORTH (TX) CITY OF FORT WORTH (TX) (AUTO ONLY) CITY OF FOUNTAIN VALLEY (CA) CITY OF FOUNTAIN VALLEY (CA) (AUTO ONLY) CITY OF GARDENA (CA) CITY OF GARDENA (CA) (AUTO ONLY) CITY OF GRAND JUNCTION CITY OF HILLSBORO State Payer Type WC WC WC WC WC WC WC WC WC WC WC WC WC WC WC WC WC WC WC WC AM WC AM WC AM WC WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1444 41556 41556 J1504 J1711 J1711 J1653 J1653 41556 J1268 41556 J1536 41556 J1269 J1714 J1714 J1640 J1640 41556 41556 75600 J1721 J1721 41556 J1657 J1657 J1617 Name CITY OF HOUSTON CITY OF IMPERIAL BEACH (VOUCHER) CITY OF IRVING CITY OF JACKSONVILLE CITY OF LA MESA 11 (CA) CITY OF LA MESA 11 (CA) (AUTO ONLY) CITY OF LAGUNA HILLS (CA) CITY OF LAGUNA HILLS (CA) (AUTO ONLY) CITY OF LEMON GROVE CITY OF LEWISVILLE CITY OF LOS ALTOS CITY OF LOS ANGELES CITY OF MERCED CITY OF MINNEAPOLIS CITY OF MONROVIA (CA) CITY OF MONROVIA (CA) (AUTO ONLY) CITY OF MONTEBELLO (CA) CITY OF MONTEBELLO (CA) (AUTO ONLY) CITY OF NATIONAL CITY CITY OF OCEANSIDE CITY OF ODESSA CITY OF OMAHA (NE) CITY OF OMAHA (NE) (AUTO ONLY) CITY OF ONTARIO CITY OF PASADENA (CA) CITY OF PASADENA (CA) (AUTO ONLY) CITY OF REDDING (CA) State Payer Type WC WC WC WC WC AM WC AM WC WC WC WC WC WC WC AM WC AM WC WC CI WC AM WC WC AM WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1617 41556 J1497 J1727 J1727 41556 J1749 J1598 J1598 41556 41556 J1602 J1602 J1636 J1636 J1664 J1664 J1607 J1607 J1645 J1645 41556 41556 J1649 J1649 J1118 J1700 Name CITY OF REDDING (CA) (AUTO ONLY) CITY OF RICHARDSON CITY OF SAN DIEGO CITY OF SAN MATEO (CA) CITY OF SAN MATEO (CA) (AUTO ONLY) CITY OF SANTEE CITY OF SIMI VALLEY CITY OF SNYDER (TX) CITY OF SNYDER (TX) (AUTO ONLY) CITY OF SOLANA BEACH CITY OF SOUTH SAN FRANCISCO CITY OF ST PAUL (MN) CITY OF ST PAUL (MN) (AUTO ONLY) CITY OF STANTON (CA) CITY OF STANTON (CA) (AUTO ONLY) CITY OF STOCKTON (CA) CITY OF STOCKTON (CA) (AUTO ONLY) CITY OF TOPEKA (KS) CITY OF TOPEKA (KS) (AUTO ONLY) CITY OF UPLAND (CA) CITY OF UPLAND (CA) (AUTO ONLY) CITY OF VISTA CITY OF WACO CITY OF WEST COVINA (CA) CITY OF WEST COVINA (CA) (AUTO ONLY) CITY OF WEST DES MOINES CITY OF WESTMINSTER (CA) State Payer Type AM WC WC WC AM WC WC WC AM WC WC WC AM WC AM WC AM WC AM WC AM WC WC WC AM WC WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1700 J1708 J1708 41556 TPC27 41556 TPC28 TPC30 CLFR2 TLZ18 CMS01 39141 62413 J1271 39141 39141 11752 57080 SHP11 J1037 CCS99 77201 34172 J1739 J1739 2041 20443 Name State CITY OF WESTMINSTER (CA) (AUTO ONLY) CITY OF YORBA LINDA (CA) CITY OF YORBA LINDA (CA) (AUTO ONLY) CITY OF YUMA CITYWIDE ASSOC OF LAW ASSISTANTS WF CIVIL CONSTRUCTORS CIVIL SERVICE BAR ASSOC CIVIL SERVICE EMPLOYEES LOCAL 806 CL FRATES CL FRATES (OK) DENTAL CLAIM MANAGEMENT SERVICES (WI) CLAIM MANAGEMENT SERVICES INC CLAIMS ADMINISTRATION CORP CLAIMS ADMINISTRATIVE SERVICES (CAS) CLAIMS MANAGEMENT SERVICES CLAIMS MANAGEMENT SERVICES CLAIMSBRIDGE HPN CLAIMSWARE CLARENDON KIDS CHIP PROGRAM TX CLASSIC RESIDENCE BY HYATT CLAYTON COUNTY HEALTH BENEFIT PLAN CLEAR CHOICE HEALTH PLANS CLEVELAND HEALTH NETWORK CLOUGHERTY PACKING, LLC CLOUGHERTY PACKING, LLC (AUTO ONLY) CMHC CNA INSURANCE OR Payer Type AM WC AM WC CI WC CI CI CI CI CI CI CI WC CI CI CI CI MC WC CI CI CI WC AM CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Dental Prof Dental Dental Prof Dental Dental Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name C1035 CNA INSURANCE (AUTO ONLY) CHCNT CNIC - CHOICENET - INTERCARE CHCNT CNIC - CHOICENET - INTERCARE 16126 CNY MANAGE CARE 16126 CNY MANAGED CARE 41556 CO GRANDE CASINO J1272 COACH USA 41556 COAST CONVERTERS 77052 COASTAL ADMINISTRATIVE SERVICES CCPN1 COASTAL COMMUNITIES PHYSICIAN NETWORK J1038 COCA-COLA ENTERPRISES INC 38335 COFINITY (PPOM) 38335 COFINITY (PPOM) 38335 COFINITY FKA SLOANS LAKE 41556 COLLIN COUNTY 37123 COLONIAL HEALTHCARE COACC COLORADO ACCESS COACC COLORADO ACCESS - INST PHD02 COLORADO ASSOCIATED PRIMARY CARE COHMO COLORADO BLUE ADVANTAGE J1428 COLORADO CASUALTY 41556 COLORADO CONTRACTORS PROGRAM 49718 COLORADO HEALTH INSURANCE COOPERATIVE 41556 COLORADO HEALTHCARE ASSOC - SAFETY NATIONAL CASUALTY CORP 41556 COLORADO PRIME CORP 25351 COLUMBIA CORNELL CARE 25351 COLUMBIA CORNELL CARE State CO CO CO CO CO CO Payer Type AM CI CI CI CI WC WC WC CI CI WC CI CI CI WC CI CI CI CI CI WC WC CI WC WC CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N Format Claim Status Eligibility Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1039 91162 41556 37271 37271 62308 73143 34181 34181 77170 37237 37237 CATPA 14315 14315 23171 23282 23282 73143 39126 39126 26231 26231 26231 J1655 J1655 CAPMN Name State COLUMBIA SUSSEX CORPORATION COLUMBIA UNITED PROVIDERS COLUMBINE HEALTH SYSTEMS COMBINED BENEFITS, INC COMBINED BENEFITS, INC COMED CIGNA COMM CARE MANAGED HLTH OK COMMERCE BENEFITS GROUP COMMERCE BENEFITS GROUP COMMON GROUND HEALTH COOPERATIVE COMMONWEALTH ADMINISTRATIVE GROUP COMMONWEALTH ADMINISTRATIVE GROUP COMMONWEALTH ADMINISTRATORS VA COMMONWEALTH CARE ALLIANCE COMMONWEALTH CARE ALLIANCE - INST COMMONWEALTH HEALTH ALLIANCE CHA COMMUNITY CARE BEHAVIORAL HEALTH ORGANIZATION COMMUNITY CARE BEHAVORIAL HEALTH ORGANIZATION COMMUNITY CARE MANAGED HEALTH CARE PLANS OF OK OK COMMUNITY CARE ORGANIZATION COMMUNITY CARE ORGANIZATION COMMUNITY CLAIMS ADMINISTRATION COMMUNITY CLAIMS ADMINISTRATION COMMUNITY CLAIMS ADMINISTRATION COMMUNITY DEVELOPMENT COMMISSION (CA) COMMUNITY DEVELOPMENT COMMISSION (CA) (AUTO ONLY) COMMUNITY FAMILY CARE MEDICAL GROUP CA Payer Type WC CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC AM CI Real Time Real Time N N N N N Y N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N Y N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Inst Prof Inst Dental Prof Prof Inst Prof Prof Prof Inst Prof Prof Inst Prof Inst Prof Dental Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name COMMF COMMUNITY FIRST COMMF COMMUNITY FIRST STAR HEALTH PLAN 39162 COMMUNITY HEALTH 35193 COMMUNITY HEALTH ALLIANCE 48145 COMMUNITY HEALTH CHOICE 48145 COMMUNITY HEALTH CHOICE - MEDICAID 75261 COMMUNITY HEALTH ELEC CLAIMS 75261 COMMUNITY HEALTH ELECTRONIC 60495 COMMUNITY HEALTH PLAN CHPWA COMMUNITY HEALTH PLAN OF WASHINGTON 90010 COMMUNITY HEALTH PLAN ST JOSEPH 90010 COMMUNITY HEALTH PLAN ST JOSEPH - INST 39162 COMMUNITY HEALTH PLAN-MILWAUKEE, WI CLA11 COMMUNITY HEALTH SOLUTIONS OF LOUISIANA (CHSLA) CMGWVCOMMUNITY MEDICAL GROUP OF THE WEST VALLEY 13374 COMMUNITY PREMIER PLUS 32481 COMMUNITY PREMIER PLUS 32481 COMMUNITY PREMIER PLUS FOR NEIGHBORHOOD 34177 COMP - OHIO (AUSTINTOWN, OH) 34177 COMP - OHIO (AUSTINTOWN, OH) J1040 COMPASS GROUP USA, INC J1533 COMPASS HEALTH (MURPHY AND BEANE) CX021 COMPBENEFITS (CHICAGO) - DENTAL 34177 COMPENSATION PROGRAMS OF OHIO 59314 COMPREHENSIVE BEHAVIORAL CARE 59314 COMPREHENSIVE BEHAVIORAL CARE 3036 COMPREHENSIVE BENEFITS ADMIN State TX WA MO WI LA CA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI MC CI CI CI CI CI CI WC WC CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N Y N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Inst Prof Inst Prof Prof Inst Prof Prof Prof Inst Prof Prof Prof Inst Prof Inst Prof Inst Prof Prof Dental Dental Inst Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 3036 COMPREHENSIVE BENEFITS ADMINISTRATOR CCMC1 COMPREHENSIVE CARE MANAGEMENT GROUP J1652 COMPTON UNIFIED SCHOOL DISTRICT (CA) J1652 COMPTON UNIFIED SCHOOL DISTRICT (CA) (AUTO ONLY) COMPU COMPUSYS OF COLORADO 37363 COMPYSCH 80667 CONFED ADMIN SERVICES, INC 62308 CONN GEN 6105 CONNECTICARE 6105 CONNECTICARE INST 78375 CONNECTICARE MEDICARE VIP 78375 CONNECTICARE MEDICARE VIP INST 37307 CONNECTICUT CARPENTERS HEALTH FUND 37307 CONNECTICUT CARPENTERS HEALTH FUND 37307 CONNECTICUT CARPENTERS HEALTH FUND 62308 CONNECTICUT GENERAL 62308 CONNECTICUT GENERAL 62308 CONNECTICUT GENERAL (CIGNA) DENTAL 37135 CONSOCIATE GROUP 37135 CONSOCIATE GROUP 75284 CONSOLIDATED ASSOCIATES RAILROAD 75284 CONSOLIDATED ASSOCIATES RAILROAD TPC31 CONSOLIDATED EDISON CO OF NY INC 61305 CONSOLIDATED GROUP DENTAL 4274 CONSOLIDATED GROUP HPS 87843 CONSOLIDATED HEALTH PLANS 87843 CONSOLIDATED HEALTH PLANS INST State CO Payer Type CI CI WC AM CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N Y Y Y N N N N N Y Y N N N N N N N N N N N N N N N N N Y Y N N N N N N N Y N N N Y N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Inst Dental Inst Prof Inst Prof Dental Inst Prof Prof Inst Dental Dental Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N N N N N Y Y N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 66077 CNTNM 37295 37295 58112 45321 J1041 J1042 71404 71404 35315 35315 J1274 13397 J1715 47046 47046 J1043 41556 CCHP1 CCHP1 CCHP9 CCHP9 35149 35149 52132 52132 Name CONSTELLATION HEALTH CONSULTEC - NEW MEXICO MEDICAID State PR NM CONSUMER HEALTH SOLUTIONS CONSUMER HEALTH SOLUTIONS - INST CONSUMER MUTUAL OF MICHIGAN MI CONSUMERS CHOICE HEALTH SC CONTECH CONSTRUCTION PRODUCTS CONTINENTAL AIRLINES CONTINENTAL GENERAL INSURANCE COMPANY CONTINENTAL GENERAL INSURANCE COMPANY INST CONTINENTAL KEY FAMILY CONTINENTAL KEY FAMILY INST CONTINENTAL WESTERN INSURANCE CO (CWG) CONTINUUM ABC MSO CONTRA COASTAL COUNTY SCHOOLS INSURANCE GROUP (CCCSIG) CONTRACTORS LABORERS TEAMSTERS ENGINEERS CONTRACTORS LABORERS TEAMSTERS ENGINEERS CONVERGYS CORPORATION COOK AND SOLIS CONST COOK CHILDRENS HEALTH PLAN COOK CHILDRENS HEALTH PLAN INST COOK CHILDRENS STAR HEALTH PLAN COOK CHILDRENS STAR HEALTH PLAN INST COOK GROUP HEALTH PLAN COOK GROUP HEALTH PLAN COOPERATIVE BENEFIT ADMINISTRATORS COOPERATIVE BENEFIT ADMINISTRATORS (CBA) TX TX TX TX Payer Type CI MC CI CI CI CI WC WC CI CI CI CI WC CI WC CI CI WC WC CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N Y N Y N N N Y N Format Claim Status Eligibility Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Inst Prof Prof Prof Prof Inst Prof Inst Inst Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 52132 COOPERATIVE BENEFIT ADMINISTRATORS (CBA) - INST 52132 COOPERATIVE BENEFIT ADMINISTRATORS - DENTAL 35199 COOPERATIVE MANAGED CARE SERVICES HPAMN COOPORTUNITY HEALTH 14829 COORDINATED BENEFIT PLANS 14829 COORDINATED BENEFIT PLANS INST 68069 COORDINATED CARE WASHINGTON 68069 COORDINATED CARE WASHINGTON INST 58204 COORDINATED MEDICAL SPECIALISTS 58231 CORE MANAGEMENT RESOURCES GROUP FAMR1 CORESOURCE 35182 CORESOURCE AZ MN FAMR1 CORESOURCE EMC 75136 CORESOURCE LITTLE ROCK 35182 CORESOURCE MD PA IL 35182 CORESOURCE NC IN 35180 CORESOURCE NC-IN DENTAL 35182 CORESOURCE OF AZ - MN 75136 CORESOURCE OF LITTLE ROCK 35182 CORESOURCE OF MD-PA-IL 35182 CORESOURCE OF NC-IN 35183 CORESOURCE OF OHIO 35183 CORESOURCE OH 35187 CORESOURCE-INTERNAL 35187 CORESOURCE-INTERNAL 43160 CORIZON FKA CORRECTIONAL MEDICAL SERVICES CORIZ CORIZON HEALTH INC State WA WA SD SD AR Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N Y Y Y N Y N N N N N Format Claim Status Eligibility Inst Dental Prof Prof Prof Inst Prof Inst Prof Prof Inst Inst Inst Inst Inst Inst Dental Prof Prof Prof Prof Prof Inst Inst Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y N N N N Y N Y Y Y N Y Y Y Y Y Y N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 35202 56116 56116 37246 37246 TPC32 TPC33 J1044 J1045 48146 37288 37288 J1683 J1683 J1684 J1684 J1712 J1712 J1572 J1572 J1591 J1591 J1709 J1709 62553 62553 J1702 Name CORNERSTONE BENEFIT ADMINISTRATORS INDIANA CORPORATE BENEFITS SERVICE, INC (NC) CORPORATE BENEFITS SERVICE, INC (NC) CORPORATE SYSTEMS ADMINISTR CORPORATE SYSTEMS ADMINISTRATION CORRECTION CAPTAINS ACTIVE CORRECTION CAPTAINS RETIREES CORRECTIONAL MANAGEMENT SERVICE CORRECTIONS CORP OF AMERICA CORSOLUTIONS COTTAGE HEALTH SYSTEM COTTAGE HOSPITAL COTTINGHAM AND BUTLER CLAIM SERVICES, INC COTTINGHAM AND BUTLER CLAIM SERVICES, INC (AUTO ONLY) COUNTRY CASUALTY INSURANCE COMPANY COUNTRY CASUALTY INSURANCE COMPANY (AUTO ONLY) COUNTRY INSURANCE MODERN SERVICE CASUALTY INSUR CO COUNTRY INSURANCE MODERN SERVICE CASUALTY INSUR CO (AUTO ONLY) COUNTRY INSURANCE MOUNTAIN STATES INSURANCE COUNTRY INSURANCE MOUNTAIN STATES INSURANCE (AUTO ONLY) COUNTRY INSURANCE MSI PREFERRED INSURANCE COMPANY COUNTRY INSURANCE MSI PREFERRED INSURANCE COMPANY (AUTO ONLY) COUNTRY INSURANCE MUTUAL SERVICE CASUALTY INSUR CO COUNTRY INSURANCE MUTUAL SERVICE CASUALTY INSUR CO (AUTO ONLY) COUNTRY LIFE INSURANCE COMPANY COUNTRY LIFE INSURANCE COMPANY COUNTRY MUTUAL INSURANCE COMPANY State IN Payer Type CI CI CI CI CI CI CI WC WC CI CI CI WC AM WC AM WC AM WC AM WC AM WC AM CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N Y N Format Claim Status Eligibility Prof Prof Inst Inst Prof Dental Dental Prof Prof Prof Inst Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1702 J1705 J1705 41556 41556 41556 J1603 J1603 J1625 J1723 J1625 J1722 41556 J1513 J1631 J1631 J1631 J1631 J1631 J1631 J1616 J1616 J1662 J1662 J1666 J1666 60827 Name State COUNTRY MUTUAL INSURANCE COMPANY (AUTO ONLY) COUNTRY PREFERRED INSURANCE COMPANY COUNTRY PREFERRED INSURANCE COMPANY (AUTO ONLY) COUNTRY VILLA HEALTH SERVICES - SNCC COUNTRY VILLA OX HLTH COUNTY OF ALAMEDAAIG COUNTY OF HUMBOLDT (CA) COUNTY OF HUMBOLDT (CA) (AUTO ONLY) COUNTY OF LOS ANGELES COUNTY OF LOS ANGELES (AIMS SANTA CLARITA) COUNTY OF LOS ANGELES (AUTO ONLY) COUNTY OF LOS ANGELES (TRISTAR SANTA ANA) COUNTY OF MARIN COUNTY OF SAN DIEGO COUNTY OF SANTA BARBARA (CA) COUNTY OF SANTA BARBARA (CA) (AUTO ONLY) COUNTY OF SANTA BARBARA-CSAC (CA) COUNTY OF SANTA BARBARA-CSAC (CA) (AUTO ONLY) COUNTY OF SANTA BARBARA-NON-CSAC (CA) COUNTY OF SANTA BARBARA-NON-CSAC (CA) (AUTO ONLY) COUNTY OF SHASTA (CA) COUNTY OF SHASTA (CA) (AUTO ONLY) COUNTY OF SONOMA (CA) COUNTY OF SONOMA (CA) (AUTO ONLY) COUNTY OF TULARE (CA) COUNTY OF TULARE (CA) (AUTO ONLY) COUNTYCARE IL Payer Type AM WC AM WC WC WC WC AM WC WC AM WC WC WC WC AM WC AM WC AM WC AM WC AM WC AM CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 58102 58102 58102 CMSEB 25133 25152 25152 25152 25152 25139 25140 25142 CX014 25133 25133 25133 25133 87043 25149 25130 25130 25133 25127 25127 25146 25132 Name State COURTYARD HEALTH C COVENANT ADMIN ATLANTA, GA COVENANT ADMINISTRATORS COVENANT ADMINISTRATORS, INC (ATLANTA, GA) COVENANT MGMT SYSTEMS EMPLOYEE BENEFIT PLAN COVENTRY - KANSAS CITY MEDICARE (ADVANTRA) COVENTRY ADVANTRA FREEDOM COVENTRY ADVANTRA FREEDOM COVENTRY ADVANTRA FREEDOM COVENTRY ADVANTRA FREEDOM (TX NM AZ ONLY) COVENTRY CARELINK ADVANTRA COVENTRY CARELINK MEDICAID COVENTRY CARENET COVENTRY DIAMOND PLAN COVENTRY HEALTH AND LIFE OKLAHOMA COVENTRY HEALTH AND LIFE TENNESSEE OK TN COVENTRY HEALTH CARE COVENTRY HEALTH CARE COVENTRY HEALTH CARE MISSOURI COVENTRY HEALTH CARE NEVADA COVENTRY HEALTH CARE OF DELAWARE NV DE COVENTRY HEALTH CARE OF DELAWARE, INC COVENTRY HEALTH CARE OF FLORIDA FL COVENTRY HEALTH CARE OF GEORGIA COVENTRY HEALTH CARE OF GEORGIA COVENTRY HEALTH CARE OF ILLINOIS FKA PERSONALCARE COVENTRY HEALTH CARE OF IOWA GA IL IA Payer Type WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y N Y Y N N Y Y Y N Y N Y Y Y Format Claim Status Eligibility Prof Inst Dental Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Dental Prof Prof Inst Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y Y Y Y N Y N Y Y Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 25132 25133 25133 25133 25135 25135 25141 25136 25136 25129 25128 25133 25147 25131 25129 25143 87043 87043 25133 25150 25133 25133 25133 37227 J1046 41556 19 Name State COVENTRY HEALTH CARE OF IOWA, INC COVENTRY HEALTH CARE OF KANSAS, INC - KANSAS KS COVENTRY HEALTH CARE OF KANSAS, INC - KANSAS COVENTRY HEALTH CARE OF KANSAS-WICHITA KS COVENTRY HEALTH CARE OF LOUISIANA COVENTRY HEALTH CARE OF LOUISIANA COVENTRY HEALTH CARE OF MISSOURI FKA GHP (GROUP HEALTH PLAN) COVENTRY HEALTH CARE OF NEBRASKA COVENTRY HEALTH CARE OF NEBRASKA, INC LA MO NE NE COVENTRY HEALTH CARE OF THE CAROLINAS COVENTRY HEALTH CARE OF VIRGINIA FKA SOUTHERN HEALTH SERVICES COVENTRY HEALTH CARE OF WV VA WV COVENTRY HEALTH CARE SOUTH COVENTRY HEALTHCARE OF INDIANA IN COVENTRY HEALTHCARE OF THE CAROLINAS COVENTRY HEALTHCARE USA COVENTRY NATIONAL NETWORK COVENTRY NATIONAL NETWORK COVENTRYCARES OF KENTUCKY COVENTRYCARES OF MICHIGAN FKA OMNICARE COVENTRYCARES OF NEBRASKA FKA COVENTRY MEDICAID COVENTRYCARES OF PENNSYLVANIA KY MI NE PA COVENTRYONE COVERCOLORADO COWORX STAFFING, LLC COX CONSTRUCTION CO COX HEALTH PLAN CO Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y Y Y N Y Y Y N N N Y N Y Y Y Y N Y N N N N Format Claim Status Eligibility Inst Prof Inst Prof Inst Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y Y Y Y Y Y Y N Y Y Y Y Y Y N Y N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 119 41556 CPSA1 J1516 64068 64068 37320 J1455 56213 J1550 37266 TPC34 TPC35 62308 J1690 J1690 59140 J1282 CUN99 39170 82056 82056 68241 PR002 60054 J1457 88056 Name State COX HEALTH PLAN INST CPS SECURITY SOLUTIONS CPSA ARIZONA REG BEHAVIORAL HEALTH AUTHORITY CR AND R CREATIVE MEDICAL SYSTEMS CREATIVE MEDICAL SYSTEMS CREATIVE PLAN ADMINISTRATORS CREATIVE RISK SOLUTIONS CRESCENT HEALTH SOLUTIONS CRESTBROOK INSURANCE COMPANY CROY-HALL MGMT INC CSA ACTIVE WELFARE FUND CSA RETIREE WELFARE FUND CT GENERAL CUCAMONGA SCHOOL DISTRICT (CA) CUCAMONGA SCHOOL DISTRICT (CA) (AUTO ONLY) CULINARY HEALTH FUND CUMIS INSURANCE SOCIETY CUNA MUTUAL CUSTOM BENEFIT ADMINISTRATORS (LACROSSE, WI) CUSTOM DESIGN BENEFITS CUSTOM DESIGN BENEFITS CUSTOMCARE CUSTOMCARE CUSTOMCARE (PRUDENTIAL) CVSCAREMARKMINUTE CLINIC CYPRESS BENEFIT ADMINISTRATORS AZ Payer Type CI WC MC WC CI CI CI WC CI WC CI CI CI CI WC AM CI WC CI CI CI CI CI CI CI WC CI Real Time Real Time N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Dental Dental Inst Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N Y N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 47083 20044 DEW99 DEW01 J1118 41556 21415 C1029 DAK01 DAK01 65099 41556 J1494 J1051 41556 41556 TPC36 J1058 39113 39113 87726 87726 J1681 J1681 25137 63081 63081 Name State CYPRESS BENEFIT ADMINISTRATORS- GMS INC CYPRESS INSURANCE COMPANY (MEMBER OF BHHC) D EDWARD WRIGHT D EDWARD WRIGHT TPA DAHL'S FOODS DAIMLERCHRYSLER CORPORATION DAKOTA FIRE DAKOTA FIRE DAKOTACARE DAKOTACARE - INST SD SD DALE ELECTRONICS DALLAS COUNTY COMMUNITY COLLEGE DISTRICT DALLAS INDEPENDENT SCHOOL DISTRICT TX DANAHER CORPORATION DAVIS MECH SYSTEMS DAYLIGHT TRANSPORT DCC-CSA WELFARE FUND DE BARTOLOS, INC DEAN HEALTH PLAN WI DEAN HEALTH PLAN - INST DEFINITY HEALTH PLAN DEFINITY HEALTH PLAN INST DEL TACO, LLC DEL TACO, LLC (AUTO ONLY) DELAWARE CARE (CHC OF DELAWARE MEDICAID) INST DELAWARE HEALTH PLAN CONSORTIUM DELAWARE HLTH PLAN CONSORTIUM DE Payer Type CI WC CI CI WC WC WC AM CI CI CI WC WC WC WC WC CI WC CI CI CI CI WC AM CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Dental Prof Prof Prof Prof Prof Inst Inst Prof Prof Prof Prof Prof Dental Prof Prof Inst Prof Inst Prof Prof Inst Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N Y Y N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 27009 25137 94276 94276 94276 DELAR 77777 CDCA1 84056 22189 51022 94276 94276 82029 47598 DELTI CDKS1 CDKY1 94276 23166 4614 DELTA CDMN1 94276 43090 TFQ69 94276 Name State DELAWARE PHYSICIANS CARE DELAWARECARE DELTA DENTAL INSURANCE COMPANY DDIC DELTA DENTAL OF ALABAMA DELTA DENTAL OF ALASKA DELTA DENTAL OF ARKANSAS DELTA DENTAL OF CALIFORNIA DELTA DENTAL OF CALIFORNIATRICARE RETIREE DENTAL (TRICARE ONLY - NOT DD OF CA) DELTA DENTAL OF COLORADO DELTA DENTAL OF CONNECTICUT DELTA DENTAL OF DELAWARE DELTA DENTAL OF FLORIDA DELTA DENTAL OF GEORGIA DELTA DENTAL OF IDAHO DELTA DENTAL OF ILLINOIS DELTA DENTAL OF INDIANA DELTA DENTAL OF KANSAS DELTA DENTAL OF KENTUCKY DELTA DENTAL OF LOUISIANA DELTA DENTAL OF MARYLAND DELTA DENTAL OF MASSACHUSETTS MA DELTA DENTAL OF MICHIGAN DELTA DENTAL OF MINNESOTA DELTA DENTAL OF MISSISSIPPI DELTA DENTAL OF MISSOURI (CLAIMS ONLY) DELTA DENTAL OF MISSOURI (PRE-DETERMINATIONS ONLY) DELTA DENTAL OF MONTANA MN Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N Y N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 94276 22189 DELTM 11198 56101 DELTO DELOK 23166 5029 43091 54097 DELTN 94276 94276 CDVA1 91062 52147 31096 39069 7025 94235 94235 DHS01 CDCA2 52133 52133 DCP01 Name State DELTA DENTAL OF NEVADA DELTA DENTAL OF NEW JERSEY DELTA DENTAL OF NEW MEXICO DELTA DENTAL OF NEW YORK DELTA DENTAL OF NORTH CAROLINA NC DELTA DENTAL OF OHIO DELTA DENTAL OF OKLAHOMA DELTA DENTAL OF PENNSYLVANIA DELTA DENTAL OF RHODE ISLAND DELTA DENTAL OF SOUTH CAROLINA SC DELTA DENTAL OF SOUTH DAKOTA DELTA DENTAL OF TENNESSEE DELTA DENTAL OF TEXAS TX DELTA DENTAL OF UTAH DELTA DENTAL OF VIRGINA VA DELTA DENTAL OF WASHINGTON DELTA DENTAL OF WASHINGTON DC DELTA DENTAL OF WEST VIRGINIA DELTA DENTAL OF WISCONSIN DELTA DENTAL OF WYOMING DELTA HEALTH SYSTEMS DELTA HEALTH SYSTEMS - INST DELTA HEALTH SYSTEMS CALIFORNIA DELTACARE USA PRIVATE MEDICAL CARE (PMI) - CLAIMS ONLY DENTAL BENEFIT PROVIDERS (CA) DENTAL BENEFIT PROVIDERS (CT) -- PTE'S UTILIZATION DENTAL CARE PLUS (DCP) CA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Prof Inst Prof Dental Dental Dental Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID TFQ14 DSL01 4356 AMS01 AMS01 84135 84135 41556 J1449 J1438 J1448 J1514 J1550 41556 IP114 41556 MDL99 25172 41556 J1480 23706 23706 J1059 J1611 J1611 J1060 J1118 Name State DENTAL CLAIM PAYORS (NY) DENTAL SELECT, INC DENTAQUEST COMMERCIAL DENTEMAX DENTEMAXDPI MI MI DENVER HEALTH MEDICAL PLAN DENVER HEALTH MEDICAL PLAN DENVER PUBLIC SCHOOLS DEPARTMENT OF ENERGY DEPARTMENT OF LABOR DEPARTMENT OF LABOR BLACK LUNG DEPARTMENT OF WATER AND POWER OF THE CITY OF LOS ANGELES (LADWP) DEPOSITORS INS CO DESERT HOSPITAL DISTRICT DESERT MEDICAL GROUP OASIS DESERT PRINCESS DETROIT LABORERS DH EVANS AND ASSOCIATES DIAMOND FARMING COMPANY DILLARD'S STORE SERVICES DIRECTORS GUILD OF AMERICA DIRECTORS GUILD OF AMERICA INST DIRECTORY DISTRIBUTING ASSOC DISCOUNT TIRE DISCOUNT TIRE (AUTO ONLY) DISCOVER RE (BURGER KING) DISCOVERY HY-VEE MI Payer Type CI CI CI CI CI CI CI WC WC WC WC WC WC WC CI WC CI CI WC WC CI CI WC WC AM WC WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N Y N N N N N N Format Claim Status Eligibility Dental Dental Dental Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 6102 6102 SX105 16003 17003 18003 19003 TPC38 TPC39 TPC40 IP110 DOM01 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 Name State DIVERSIFIED ADMINISTRATION CORPORATION DIVERSIFIED ADMINISTRATION CORPORATION DMBA - DESERET MUTUAL BENEFITS ASSOCIATION DMERC REGION A DMERC REGION B DMERC REGION C DMERC REGION D DOCTORS COUNCIL BENEFIT PLAN DOCTORS COUNCIL RETIREE WF DOCTORS COUNCIL WELFARE DOCTORS MEDICAL GROUP DOMINION DENTAL USA (DHMO AND COMMERCIAL) DORAL DENTAL OF ARIZONA NON GLOBAL BUDGET DORAL DENTAL OF CONNECTICUT DORAL DENTAL OF ILLINOIS DORAL DENTAL OF KANSAS DORAL DENTAL OF KENTUCKY DORAL DENTAL OF MARYLAND HELIX DORAL DENTAL OF MARYLAND PHYSICIANS CARE DORAL DENTAL OF MARYLAND PRIORITY PARTNERS DORAL DENTAL OF MINNESOTA (M) DORAL DENTAL OF MINNESOTA MEDICARE DORAL DENTAL OF MISSOURI ST LOUIS DORAL DENTAL OF MISSOURI- KANSAS CITY DORAL DENTAL OF NEBRASKA DORAL DENTAL OF NEW JERSEY AMERIGROUP DORAL DENTAL OF NEW JERSEY HEALTHNET UT Payer Type CI CI CI MB MB MB MB CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Prof Prof Prof Prof Dental Dental Dental Prof Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Claim Enrollment Required ERA Enrollment Required N N Y Y Y Y Y N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 41556 74284 74284 74284 TPC41 35186 Name State DORAL DENTAL OF NEW MEXICO DORAL DENTAL OF NEW YORK DORAL DENTAL OF NEW YORK NON GLOBAL BUDGET DORAL DENTAL OF OHIO (M) DORAL DENTAL OF OKLAHOMA COMMUNITY CARE DORAL DENTAL OF OKLAHOMA HEARTLAND DORAL DENTAL OF OKLAHOMA NON GLOBAL BUDGET DORAL DENTAL OF OKLAHOMA UNICARE DORAL DENTAL OF OKLAHOMA UNICARE NON GLOBAL DORAL DENTAL OF PENNSYLVANIA HEALTHMATE DORAL DENTAL OF PENNSYLVANIA PITTSBURGH DORAL DENTAL OF PENNSYLVANIA -- AMERIHEALTH DORAL DENTAL OF PENNSYLVANIA -- KEYSTONE DORAL DENTAL OF PENNSYLVANIA -- PHILADELPHIA DORAL DENTAL OF ARIZONA - CIGNA DORAL DENTAL OF VIRGINIA COMMERCIAL DORAL DENTAL OF VIRGINIA PREMIER DORAL DENTAL OF VIRGINIA SENTARA DORAL DENTAL OF VIRGINIA UNICARE DORAL DENTAL OF VIRGINIA (M) DORAL DENTAL PLAN OF WISCONSIN DOUGLAS COUNTY DRISCOLL CHILDRENS HEALTH PLAN DRISCOLL CHILDRENS HEALTH PLAN DRISCOLL CHILDRENS HEALTH PLAN CHIP DRYWALL TAPERS INSURANCE FUNDS DUNN AND ASSOCIATES TX TX TX Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Dental Prof Inst Prof Prof Dental Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1061 41556 J1118 J1062 34159 34159 75232 41556 36434 J1690 J1690 J1639 J1639 J1453 13853 24770 62308 81039 EBS01 41556 J1289 41556 22521 22521 J1204 98006 EPF37 Name State DUNN-EDWARDS CORPORATION DURANGO COFFEE CO DUSTROL DYNAMEX, INC E-V BENEFITS MANAGEMENT, INC E-V BENEFITS MANAGEMENT, INC E3 HEALTH INC EAGLE PASS ISD EARLY INTERVENTION CENTRAL BILLING EAST SAN GABRIEL VALLEY ROP (CA) EAST SAN GABRIEL VALLEY ROP (CA) (AUTO ONLY) EASTERN MUNICIPAL WATER DISTRICT (CA) EASTERN MUNICIPAL WATER DISTRICT (CA) (AUTO ONLY) EASTGUARD INSURANCE COMPANY - GUARD DBA EASY CHOICE HEALTH PLAN NY - ATLANTIS COMM NY EASY CHOICE HEALTH PLAN NY - MEDICARE EATON BENEFITS OH EBMS - EMPLOYEE BENEFIT MANAGEMENT SERVICES, INC EBS BENEFIT SOLUTIONS ECHO PACIFIC DEVELOP EDIC EDINBURG CONSOLIDATED INDEPENDENT SCHOOL DISTRICT EDS ADMIN SERVICES OK EDS ADMIN SERVICES HARRINGTON BENEFIT - INST EDWARDS CLAIM ADMINISTRATION EHS GROUP HEALTH PLAN EL PASO - HEALTHCARE OPTIONS TX Payer Type WC WC WC WC CI CI CI WC CI WC AM WC AM WC CI CI CI CI CI WC WC WC CI CI WC CI CI Real Time Real Time N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Inst Dental Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Dental Prof Prof Prof Prof Inst Prof Inst Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N Y N N N N N N N N N Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID EPF37 A0106 EPF03 EPF03 EPF02 EPF02 EPF10 EPF10 J1017 J1737 J1737 41556 31625 EWF99 EWF01 FAMR1 41556 ECISF 37253 37253 C1029 21415 C1029 21407 34167 34167 J1679 Name EL PASO - HEALTHCARE OPTIONS State TX EL PASO COMMUNITY COLLEGE (TX JUR) EL PASO FIRST - CHIP EL PASO FIRST - CHIP EL PASO FIRST - STAR - PREMIER EL PASO FIRST - STAR - PREMIER EL PASO FIRST- PREFERRED ADMINISTRATORS EL PASO FIRST- PREFERRED ADMINISTRATORS EL PASO WATER UTIL TX JUR EL POLLO LOCO EL POLLO LOCO (AUTO ONLY) ELC ELECTRIC INC ELDERPLAN, INC ELECTRICAL WORKERS BENEFIT FUND ELECTRICAL WORKERS BENEFIT FUND DENTAL ELECTRONIC ESI ELITE COMP ELLIS CONSULTANTS, INC ELMCO ELMCO EMC PROPERTY AND CASUALTY - AUTO ONLY EMC PROPERTY AND CASUALTY - WC ONLY EMCASCO INSURANCE CO - AUTO ONLY EMCASCO INSURANCE CO - WC ONLY EMERALD HEALTH NETWORK EMERALD HEALTH NETWORK, INC (ALL PPO EMERITUS CORPORATION TX TX TX TX TX TX Payer Type CI WC CI CI CI CI CI CI WC WC AM WC CI CI CI CI WC CI CI CI AM WC AM WC CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Inst Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Dental Inst Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required Y N Y Y Y Y Y Y N N N N N N N N N N N N N N N N N N N Y N Y Y Y Y Y Y N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1679 SX110 PR002 60054 73288 BC303 BS803 IP115 IP079 87726 CX025 95288 38241 38241 38241 37257 31074 81039 12X44 3036 3036 3036 37216 37216 EBSSA 41198 37257 Name State EMERITUS CORPORATION (AUTO ONLY) EMIA EDUCATORS MUTUAL INSURANCE ASSN UT EMORYCARE EMORYCARE (PRUDENTIAL) EMPHESYS EMPIRE BLUE CROSS BLUE SHIELD NEW YORK INST EMPIRE BLUE SHIELD NEW YORK NY NY EMPIRE MEDICAL GROUP EMPIRE PHYSICIANS MEDICAL GROUP EPMG CA EMPIRE PLAN UNITED HEALTHCARE EMPLOYEE BENEFIT MANAGEMENT CORP (EBMC) - DENTAL EMPLOYEE BENEFIT ADMINISTRATORS MGMT EMPLOYEE BENEFIT CONCEPTS EMPLOYEE BENEFIT CONCEPTS (FARMINGTON HILLS, EMPLOYEE BENEFIT CONCEPTS DENTAL EMPLOYEE BENEFIT CONSULTANTS, INC EMPLOYEE BENEFIT MANAGEMENT CORP (EBMC) EMPLOYEE BENEFIT MANAGEMENT SVCS EMPLOYEE BENEFIT MANAGEMENT SYSTEM (EBMS) EMPLOYEE BENEFIT PLAN ADMIN EMPLOYEE BENEFIT PLAN ADMINISTRATION EMPLOYEE BENEFIT PLAN ADMINISTRATION, INC (EBPA) EMPLOYEE BENEFIT SERVICES EMPLOYEE BENEFIT SERVICES EMPLOYEE BENEFIT SERVICES (EBS) OF SAN ANTONIO EMPLOYEE BENEFIT SERVICES OF LOUISIANA (A DIVISION OF HARRINGTON BENEFIT SVCS) EMPLOYEE BENEFITS CONSULTANTS DENTAL Payer Type AM CI CI CI CI BL BL CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N Y Y N N Y N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Dental Prof Prof Inst Dental Prof Prof Prof Inst Inst Prof Dental Prof Inst Prof Prof Dental Claim Enrollment Required ERA Enrollment Required N Y N N N Y N N N N N N N N N N N N N N N N N N N N N N Y N Y N Y Y N N Y N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 75184 75299 35112 35112 35112 54098 54098 J1232 74212 74212 J1559 J1232 MSI01 36335 MIDSC J1232 75232 75236 75235 75233 75223 J1696 J1696 MSI01 MIDSC 73288 20508 Name EMPLOYEE CLAIM ADJUDICATION SERVICES EMPLOYEE HEALTH SYSTEM MEDICAL GROUP EMPLOYEE PLANS, LLC EMPLOYEE PLANS, LLC EMPLOYEE PLANS, LLC EMPLOYEE SECURITY INC EMPLOYEE SECURITY, INC EMPLOYER INSURANCE GROUP (EIG) EMPLOYER PLAN SERVICES EMPLOYER PLAN SERVICES - INST EMPLOYER'S CLAIM SERVICE, INC - CITY OF NAPERVILLE EMPLOYERS ASSURANCE COMPANY EMPLOYERS COALITION ON HEALTH EMPLOYERS COALITION ON HEALTH (ECOH) EMPLOYERS COALITION ON HEALTH (ECOH) EMPLOYERS COMPENSATION INSURANCE COMPANY EMPLOYERS DIRECT HEALTH EMPLOYERS DIRECT HEALTH (EMPLOYEE PLAN) EMPLOYERS DIRECT HEALTH (FULLY INSURED) EMPLOYERS DIRECT HEALTH (SELF FUNDED PLAN) EMPLOYERS DIRECT HEALTH - SF EMPLOYERS GENERAL INSURANCE GROUP EMPLOYERS GENERAL INSURANCE GROUP (AUTO ONLY) EMPLOYERS HEALTH COOPERATIVE EMPLOYERS HEALTH COOPERATIVE (EHC) EMPLOYERS HEALTH INSURANCE EMPLOYERS HEALTH NETWORK State TX Payer Type CI CI CI CI CI CI CI WC CI CI WC WC CI CI CI WC CI CI CI CI CI WC AM CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Dental Prof Inst Inst Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 20508 39206 37249 37249 37249 C1029 21415 59298 59298 J1232 37110 37110 35206 36364 36364 91136 91136 J1294 36878 36878 J1063 41556 41556 EPNSH 28777 62308 62308 Name State EMPLOYERS HEALTH NETWORK EMPLOYERS INS OF WAUSAU HOSP EMPLOYERS LIFE INSURANCE CORP EMPLOYERS LIFE INSURANCE CORP EMPLOYERS LIFE INSURANCE CORP ELIC EMPLOYERS MUTUAL CASUALTY - AUTO ONLY EMPLOYERS MUTUAL CASUALTY - WC ONLY EMPLOYERS MUTUAL INC FL EMPLOYERS MUTUAL, INC (FL) EMPLOYERS PREFERRED INSURANCE COMPANY ENCOMPASS ENCOMPASS ENCORE HEALTH NETWORK ENH MEDICAL GROUP IPA ENH MEDICAL GROUP IPA ENSTAR NATURAL GAS ENSTAR NATURAL GAS ENTERPRISE RENT A CAR ENTRUST ENTRUST ENVIROSOURCE ENVISION RADIOLOGY, LLC EPLICA, INC EPN - SETON HEALTH EXCLUSIVE PROVIDER NETWORK EPOCH GROUP EQUICOR EQUICOR PPO TX Payer Type CI CI CI CI CI AM WC CI CI WC CI CI CI CI CI CI CI WC CI CI WC WC WC CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N N N N N Y N Format Claim Status Eligibility Prof Inst Inst Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Inst Prof Inst Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 62308 62308 75196 73126 73126 73126 41556 J1734 J1734 74234 J1022 34108 TP043 J1064 J1451 J1454 57082 43168 25712 87726 35605 35605 58233 58233 J1065 59313 59313 Name State EQUICOR PPO EQUICOREQUITABLE EQUIFAX HEALTHCARE ADMIN SVC EQUITABLE PLAN SERVICES OK EQUITABLE PLAN SERVICES EQUITABLE PLAN SERVICES (OKLAHOMA CITY, OK) ERICKSON-HALL CONSTR ERIE INSURANCE ERIE INSURANCE (AUTO ONLY) ERISA ERMC ES BEVERIDGE AND ASSOCIATES ESIS ESIS - FIRST AMERICAN INSURANCE CO ESIS - KELLY SERVICES ESIS - LOCKHEED MARTIN CORPORATION ESSENCE HEALTHCARE ESSEX DENTAL BENEFITS ESURANCE INSURANCE COMPANY (AUTO ONLY) EVERCARE VIA UNITED HEALTHCARE EVERENCE EVERENCE INST EVERGREEN HEALTH PLAN EVERGREEN HEALTH PLAN EVOLUTION INSURANCE COMPANY EVOLUTIONS HEALTHCARE SYSTEMS EVOLUTIONS HEALTHCARE SYSTEMS OH Payer Type CI CI CI CI CI CI WC WC AM CI WC CI WC WC WC WC CI CI AM CI CI CI CI CI WC CI CI Real Time Real Time Y Y N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N Y N N Y Y N N N N N N Format Claim Status Eligibility Prof Prof Prof Inst Prof Dental Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Dental Prof Prof Prof Inst Inst Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N Y N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID IP080 71412 71412 TEMU1 J1606 J1606 BVES1 BVES1 BVES1 41556 37289 95432 37300 37300 J1019 J1624 J1624 J1697 J1697 J1618 J1618 22254 IP017 60995 FCD01 PHR01 FCM01 Name EXCEPTIONAL CARE MEDICAL State CA EXCLUSICARE EXCLUSICARE EXCLUSICARE (MUST HAVE UCCI ON BACK OF MEMBER CARD) EXXONMOBIL CORPORATION EXXONMOBIL CORPORATION (AUTO ONLY) EYE SPECIALISTS EYE SPECIALISTS EYE SPECIALISTS F AND G GUARANTY INS COMAIN STREET PROGRAM COLORADO FA RICHARD ASSOCIATES, INC FACEY MEDICAL FOUNDATION FACS GROUP FACS GROUP FACTORY 2 U FAIRCHILD FASTENERS FAIRCHILD FASTENERS (AUTO ONLY) FAIRMONT SPECIALTY INSURANCE COMPANY - TX FAIRMONT SPECIALTY INSURANCE COMPANY - TX (AUTO ONLY) FAIRVIEW HEALTH SERVICES FAIRVIEW HEALTH SERVICES (AUTO ONLY) FALLON COMMUNITY HEALTH FAMILY SENIORS MEDICAL GROUP FAMILY CARE FAMILY CARE MEDICAID FAMILY CARE MEDICARE (FCR01) FAMILY CARE MENTAL HEALTH CA Payer Type CI CI CI CI WC AM CI CI CI WC CI CI CI CI WC WC AM WC AM WC AM CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N Y Format Claim Status Eligibility Prof Inst Prof Dental Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID IP080 41556 51909 AMS01 31472 31472 43173 43173 96865 39518 36396 FPA11 FPA11 37289 37289 37289 37289 14140 J1687 J1687 J1703 J1703 J1706 J1706 J1710 J1710 J1701 Name FAMILY CHOICE MEDICAL State CA FAMILY HEALTH AND HOUSING FAMILY HEALTH NETWORK FAMILY HEALTH NETWORK - WISCONSIN (AMS01) FAMILY HEALTH PARTNERS - HEALTHWAVE FAMILY HEALTH PARTNERS - HEALTHWAVE - INST FAMILY HEALTH PARTNERS MISSOURI FAMILY HEALTH PARTNERS MISSOURI FAMILY HEALTH PLAN CONTACT PAM CAMPBELL WI KS KS MO MO OH FAMILY HEALTH SYSTEMS FAMILY MEDICAL NETWORK FAMILY PRACTICE ASSOCIATES FAMILY PRACTICE ASSOCIATES CONTACT FARA FARA BENEFIT SERVICES FARA BENEFIT SERVICES, INC FARA FA RICHARD ASSOCIATES FARM FAMILY FARMERS CIVIC PROPERTY AND CASUALTY COMPANY FARMERS CIVIC PROPERTY AND CASUALTY COMPANY (AUTO ONLY) FARMERS EXACT PROPERTY AND CASUALTY COMPANY FARMERS EXACT PROPERTY AND CASUALTY COMPANY (AUTO ONLY) FARMERS FIRE INSURANCE EXCHANGE FARMERS FIRE INSURANCE EXCHANGE (AUTO ONLY) FARMERS MID-CENTURY INSURANCE COMPANY FARMERS MID-CENTURY INSURANCE COMPANY (AUTO ONLY) FARMERS NEIGHBORHOOD SPIRIT PROPERTY AND CASUALTY COMPANY NY Payer Type CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC AM WC AM WC AM WC AM WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Inst Inst Prof Prof Inst Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1701 J1713 J1713 C1025 C1034 C1034 J1563 TPC42 J1551 59069 33033 71056 37300 37300 J1297 J1297 37300 37300 41556 41041 41041 13935 11118 28304 AMS01 59321 11315 Name State FARMERS NEIGHBORHOOD SPIRIT PROPERTY AND CASUALTY COMPANY (AUTO ONLY) FARMERS TRUCK INSURANCE EXCHANGE FARMERS TRUCK INSURANCE EXCHANGE (AUTO ONLY) FARMERS INSURANCE (AUTO ONLY) FARMERS INSURANCE COMMERCIAL (AUTO ONLY) FARMERS INSURANCE EXCHANGE (AUTO ONLY) FARMERS INSURANCE EXCHANGE (WC ONLY) FARMINGDALE FEDERATION OF TEACHERS FARMLAND MUTUAL INS CO FBMC FCE BENEFIT ADMINISTRATORS FED EX FREIGHT EAST, INC FEDERATED BENEFITS FEDERATED BENEFITS FEDERATED CLAIMS SERVICE CORP FEDERATED DEPARTMENT STORES, INC FEDERATED HR SERVICES FEDERATED HR SERVICES FACS GROUP FEDERATED LINEN AND UNIFORM FEDERATED MUTUAL HEALTH INSURANCE COMPANY MN FEDERATED MUTUAL INSURANCE FEDERATED MUTUAL INSURANCE COMPANY FEDERATED RURAL ELECTRIC (TX) FEDERATED SERVICES INSURANCE COMPANY FHC SUPER SELECT FHHS - FLORIDA HOSPITAL HEALTHCARE SYSTEMS FIDELIS CARE NEW YORK FL FL NY Payer Type AM WC AM AM AM AM WC CI WC CI CI CI CI CI WC WC CI CI WC CI CI WC WC WC CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N Y N N N N N N Y Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Dental Prof Prof Prof Dental Inst Prof Prof Prof Inst Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID CX014 11315 77054 77054 FBI99 21873 C1019 J1274 FAMR1 TLU67 FAMR1 FSTAG FSTAG FAMR1 FAMR1 56196 56196 14162 14163 91131 91131 75138 75138 TLU63 73159 73159 73159 Name State FIDELIS CARE NEW YORK DENTAL FIDELIS CARE NEW YORK INST NY FIDELIS SECURECARE FIDELIS SECURECARE - INST FIDELITY BENEFIT ADMINISTRATORS FIREMAN'S FUND INSURANCE COMPANY FIREMAN'S FUND INSURANCE COMPANY (AUTO ONLY) FIREMEN'S INSURANCE COMPANY FIRST ADMINISTRATORS SD FIRST ADMINISTRATORS FIRST ADMINISTRATORS SD FIRST AGENCY FIRST AGENCY INST FIRST AMERICAN FIRST AMERICAN ADMIN FIRST CAROLINA CARE FIRST CAROLINA CARE NC FIRST CHOICE (CT) FIRST CHOICE (CT) FIRST CHOICE HEALTH NETWORK FIRST CHOICE HEALTH NETWORK FIRST CHOICE OF MIDWEST (PPO) FIRST CHOICE OF MIDWEST (PPO) FIRST DENTAL HEALTH (FDH) FIRST HEALTH NETWORK - COVENTRY FIRST HEALTH NETWORK - COVENTRY - INST FIRST HEALTH NETWORK FKA PPO OKLAHOMA OK Payer Type CI CI CI CI CI WC AM WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Dental Inst Prof Inst Prof Prof Prof Prof Inst Dental Prof Prof Inst Inst Inst Inst Prof Inst Prof Inst Prof Inst Prof Dental Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 22324 FP660 23241 59276 63080 94999 94999 94998 94998 J1011 CX014 90060 90061 11244 11244 J1047 60054 60054 59276 59276 59322 12611 AMS01 AMS01 59321 48116 48116 Name State FIRST OPTION HEALTH PLAN FIRST PLUS PR FIRST PRIORITY HEALTH - FPLIC FIRST SERVICE ADMINISTRATORS INC FIRST STATE HEALTH PLAN FIRSTCARE FIRSTCARE INST FIRSTCARE STAR MEDICAID FIRSTCARE STAR MEDICAID INST TX TX FIRSTCOMP FIRSTGUARD HEALTH PLAN FIRSTGUARD HEALTH PLAN KANSAS FIRSTGUARD HEALTH PLAN MISSOURI KS MO FITZHARRIS COMPANY (FARMINGTON, NY) FITZHARRIS COMPANY, INC (FARMINGDALE, NY) FKI INDUSTRIES, INC FLEXCARE FLEXCARE FLORIDA 1ST FL FLORIDA 1ST FLORIDA HEALTH CARE PLANS (FHCP) FLORIDA HEALTH CARE PLUS (FHP) FLORIDA HEALTH CHOICE FLORIDA HEALTH CHOICESELECT FLORIDA HOSPITAL HEALTHCARE SERVICES FL FL FL FL FL FLORIDA HOSPITAL WATERMAN FLORIDA HOSPITAL WATERMAN EMPLOYEE BENEFIT PLAN FL Payer Type CI CI CI CI CI CI CI CI CI WC CI CI CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N Y N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Dental Prof Prof Dental Prof Prof Dental Prof Prof Inst Prof Prof Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y N Y N N N N N N N N N N N N Y N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 68241 60054 26492 26492 48117 48117 37305 11185 J1529 39065 39065 70408 70408 39065 39065 TKFMC FH001 FH002 FH002 FH002 59257 59257 59257 64069 FVMCH FVMC1 64069 Name State FLORIDA POWER FLORIDA POWER LIGHT PRUDENTIAL FLORIDA TRUE HEALTH FLORIDA TRUE HEALTH - INST FL FL FL FMH BENEFIT SERVICES (CORESOURCE) FMH BENEFIT SERVICES (CORESOURCE) - INST FORD METER BOX COMPANY FOREMOST (AUTO ONLY) FORGE INDUSTRIAL STAFFING FORTIS FORTIS BENEFITS FORTIS BENEFITS INSURANCE COMPANY FORTIS BENEFITS INSURANCE COMPANY FORTIS INSURANCE COMPANY (FORMERLY TIME INSURANCE) FORTIS WESTERN FOUNDATION FOR MEDICAL CARE OF TULARE AND KINGS COUNTY FOUNDATION HEALTH FOUNDATION HEALTH HMO FOUNDATION HEALTH AMERIMED HMO FOUNDATION HEALTH AMERIMED SENIOR HMO FOUNDATION HEALTH PLAN FOUNDATION HEALTH PLAN (SUNRISE FL) FOUNDATION HEALTH PLAN (SUNRISE, FL) FOX EVERETT INGALLS SHIP BUILDING FOX VALLEY MEDICINE SITE 199 FOX VALLEY MEDICINE SITE 451 FOX-EVERETT INC CA CA CA CA CA Payer Type CI CI CI CI CI CI CI AM WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Dental Inst Dental Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y Y N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 64069 64067 41556 J1440 71768 71768 31313 31313 41212 41212 62324 23130 41556 41556 59204 J1533 34171 J1633 J1633 TP117 TP057 30005 30005 J1519 41556 GARET J1302 Name State FOX-EVERETT, INC FOXEVERETT INGALLS SHIP BLDG FRANCO CONSTRUCTION FRANKENMUTH MUTUAL FREEDOM BLUE MEDICARE ADV WEST VIRGINIA FREEDOM BLUE MEDICARE ADV WEST VIRGINIA INST FREEDOM FIRST WV WV FL FREEDOM FIRST - INST FREEDOM HEALTH PLAN FL FREEDOM HEALTH PLAN - INST FREEDOM LIFE INSURANCE CO FRESENIUS MEDICAL CARE FRESNO COUNTY OFFICE OF EDUCATION FRESNO COUNTY SELF INSURANCE GROUP FRINGE BENEFIT COORDINATORS FRONT PORCH (MURPHY AND BEANE) FRONTPATH FULLERTON UNION HIGH SCHOOL DISTRICT (CA) FULLERTON UNION HIGH SCHOOL DISTRICT (CA) (AUTO ONLY) GAB ROBBINS, INC GALLAGHER BASSETT GALVESTON COUNTY INDIGENT HEALTH GALVESTON COUNTY INDIGENT HEALTH CARE GARDEN GROVE UNIFIED SCHOOL DISTRICT GARDEN REGIONAL HOSPITAL AND MED CENTER, INC GARRETSON RESOLUTION GROUP GATEGOURMET 836 FL Payer Type CI CI WC WC CI CI CI CI CI CI CI CI WC WC CI WC CI WC AM WC WC CI CI WC WC CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N Y N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Inst Prof Prof Prof Inst Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N Y N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1302 J1066 41556 41556 25169 25169 60550 60550 43175 4317M 41556 J1557 J1557 67815 67815 44054 57254 44054 44054 GEHA9 GEHA9 J1747 75273 75273 MCS03 TPC43 J1678 Name State GATEGOURMET 836 (AUTO ONLY) GATES CORP DBA GATES RUBBER CO GATES ODOHERTY GATES ODOHERTY G AND G GATEWAY HEALTH PLAN - MEDICAID PENN GATEWAY HEALTH PLAN - MEDICAID PENN INST PA PA GATEWAY HEALTH PLAN - MEDICARE ASSURED GATEWAY HEALTH PLAN - MEDICARE ASSURED INST GATEWAY TO BETTER HEALTH PLAN - ENCOUNTERS GATEWAY TO BETTER HEALTH PLAN - FFS MO MO GATEWAY TRANS INC GE AUTO GE AUTO (AUTO ONLY) GE GROUP LIFE ASSURANCE COMPANY GE GROUP LIFE ASSURANCE COMPANY GEHA GEHA - GOVERNMENT EMPLOYEES HOSP ASSN GEHA - GOVERNMENT EMPLOYEES HOSP ASSN INST GEHA DENTAL GEHA HEALTH GROUP NEVADA GEHA HEALTH GROUP NEVADA INST GEICO GEISINGER HEALTH PLAN GEISINGER HEALTH PLAN INST GEMCARE HEALTH PLAN - KERN COUNTY EPO GENERAL BUILDING LABORERS GENERAL PARTS INTERNATIONAL CA Payer Type AM WC WC WC CI CI CI CI CI CI WC WC AM CI CI CI CI CI CI CI CI AM CI CI CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N N N N N N N N Y N N N N N N Y N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Dental Prof Inst Prof Prof Inst Prof Dental Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N Y N Y N N N N Y Y N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name J1678 GENERAL PARTS INTERNATIONAL (AUTO ONLY) GHEDI GENERATIONS HEALTHCARE HMO 16112 GENESEE COUNTY MEDICAL PLAN 41556 GENESIS CONSTRUCTION IP087 GENESIS HEALTHCARE GEN01 GENWORTH - CONTINENTAL LIFE INSURANCE J1461 GEO 52098 GEORGE WASHINGTON HP HSP 1124 GEORGIA POWER CO 23212 GETTYSBURG HEALTH 91051 GHC - COMMERCIAL 91051 GHC MEDICARE CHOICE CX014 GHI - DORAL DENTAL 13551 GHI GROUP HEALTH INC 13551 GHI GROUP HEALTH NEW YORK 25531 GHI HMO GROUP HEALTH 25141 GHP (GROUP HEALTH PLAN) 58204 GI INNOVATIVE MANAGEMENT 7205 GILSBAR 7205 GILSBAR INC 7205 GILSBAR INC 91136 GLASSWORKERS HEALTH WELFARE FUND 91136 GLASSWORKERS HLTH WELFARE FUND 41556 GLENDALE ELEMENTARY SCHOOL DISTRICT NO 40 7689 GLOBAL CARE 7689 GLOBAL CARE INST MPM05 GLOBAL CARE IPA State CA NY NY NY Payer Type AM CI CI WC CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Inst Inst Prof Inst Inst Dental Inst Prof Prof Inst Prof Prof Inst Prof Inst Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N Y N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID GHOKC C1028 C1028 77160 77160 J1067 J1430 37602 37602 J1306 J1306 GTPA1 J1647 J1647 IP086 76923 J1462 J1621 J1621 44054 44054 58204 95453 10322 14060 68069 37234 Name GLOBALHEALTH State OK GMAC INSURANCE COMPANY ONLINE, INC GMAC INSURANCE MANAGEMENT CORPORATION GOLD COAST HEALTH PLAN GOLD COAST HEALTH PLAN GOLDEN CORRAL CORPORATION GOLDEN EAGLE GOLDEN RULE INSURANCE COMPANY GOLDEN RULE INSURANCE COMPANY - INST GOLDEN STATE SUPPLY GOLDEN STATE SUPPLY (AUTO ONLY) GOLDEN TRIANGLE PHYSICAIN ALLIANCE GOOD SAMARITAN HOSPITAL GOOD SAMARITAN HOSPITAL (AUTO ONLY) GOOD SAMARITAN MEDICAL PRACTICE ASSOCIATION CA GOOD SHEPHERD HOSPICE GOODRICH GOODWILL INDUSTRIES GOODWILL INDUSTRIES (AUTO ONLY) GOVERNMENT EMPLOYEES HOSP ASSN (GEHA) GOVERNMENT EMPLOYEES HOSPITAL ASSOCIATION GRADY HEALTHCARE GRAND VALLEY HEALTH PLAN MI GRANGE MUTUAL CASUALTY COMPANY GRANGE WC GRANITE STATE HEALTH PLAN - NEW HAMPSHIRE GRANT PHYSICIANS PRACTICE ASSOCIATION NH Payer Type CI AM AM CI CI WC WC CI CI WC AM CI WC AM CI CI WC WC AM CI CI CI CI AM WC CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N Y N Format Claim Status Eligibility Prof Prof Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N Y Y N N N N Y N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 37234 GRANT PHYSICIANS PRACTICE ASSOCIATION 25984 GRAPHIC ARTS MUTUAL GCU99 GRAPHIC COMMUNICATIONS UNION LOCAL 8M 96B HEALTH WELFARE FUND TPC44 GRAPHICS COMMUNICATIONS L-612M 26832 GREAT AMERICAN ALLIANCE INS CO 26344 GREAT AMERICAN ASSURANCE CO 16691 GREAT AMERICAN INS CO 22136 GREAT AMERICAN INS CO OF NY J1308 GREAT CENTRAL J1308 GREAT CENTRAL (AUTO ONLY) 25224 GREAT DIVIDE INSURANCE 95467 GREAT LAKES HEALTH PLAN (UHC) 95467 GREAT LAKES HEALTH PLAN (UHC) INST 80705 GREAT WEST HEALTHCARE 80705 GREAT WEST HEALTHCARE 80705 GREAT WEST HEALTHCARE 80705 GREAT WEST LIFE GCMG1 GREATER COVINA MEDICAL GROUP GNOCH GREATER NEW ORLEANS COMMUNITY HEALTH CONNECTION (GNOCHC) NMM01 GREATER ORANGE COUNTY MEDICAL GROUP PDT01 GREATER TRI CITY IPA 95379 GREATWEST HEALTHCARE CA 66893 GREATWEST HEALTHCARE FKA NEW ENGLAND FINANCIAL 95569 GREATWEST HEALTHCARE GA J1642 GREEN DIAMOND WA J1642 GREEN DIAMOND WA (AUTO ONLY) TPC45 GREENBURGH TEACHERS FEDERATION WF State CA LA CA CA GA Payer Type CI WC CI CI WC WC WC WC WC AM WC CI CI CI CI CI CI CI MC CI CI CI CI CI WC AM CI Real Time Real Time N N N N N N N N N N N N N Y Y Y Y N N N N N N N N N N N N N N N N N N N N N Y N Y N Y N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Dental Prof Prof Prof Prof Prof Prof Prof Prof Inst Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N Y N Y Y Y Y N Y N N Y Y Y N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 78521 41556 41556 41556 41556 J1571 J1571 J1541 J1541 48143 GASA1 36338 36338 48143 48143 72153 72153 72153 38223 72087 GE001 39167 39168 39168 39167 91051 Name State GREENE RAD MALONEY GREENTREE ADMINISTRATORS GREER CONSTRUCTON CO GREIF BROTHERS CORPORATION GREVE CLIFFORD WENGEL AND PARAS GRIMMWAY ENTERPRISES INC GRINNELL REINSURANCE COMPANY GRINNELL REINSURANCE COMPANY (AUTO ONLY) GRINNELL SELECT GRINNELL SELECT (AUTO ONLY) GROUP PENSION ADMINISTRATORS, INC GROUP ADMIN SELFFUNDED ALTERNATIVE GROUP ADMINISTRATORS LTD GROUP ADMINISTRATORS LTD GROUP AND PENSION ADMINISTRAT GROUP AND PENSION ADMINISTRATORS GROUP BENEFIT ADMINISTRATORS (HENDERSONVILLE, GROUP BENEFIT ADMINISTRATORS (HENDERSONVILLE, TN) GROUP BENEFIT ADMINISTRATORS (HENDERSONVILLE, TN) GROUP BENEFIT SVCS MI HOS GROUP BENEFITS LOUISIANA GROUP HEALTH GROUP HEALTH COOP - SO CENTRAL WISCONSIN GROUP HEALTH COOP - SO CENTRAL WISCONSIN (ENCOUNTERS) GROUP HEALTH COOP - SO CENTRAL WISCONSIN (ENCOUNTERS) GROUP HEALTH COOP - SO CENTRAL WISCONSIN - INST GROUP HEALTH COOPERATIVE LA MO WI Payer Type WC CI WC WC WC WC WC AM WC AM CI CI CI CI CI CI CI CI CI CI BL CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N Y Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Inst Dental Prof Inst Prof Prof Prof Prof Inst Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 91121 91051 95192 95192 91051 13551 13551 91121 37276 CX015 41556 41556 J1068 J1453 77010 77010 64246 64246 64246 J1590 J1590 J1574 J1574 RENBL CB624 RENGQ CB624 Name State GROUP HEALTH COOPERATIVE - EAST GROUP HEALTH COOPERATIVE - WEST GROUP HEALTH COOPERATIVE OF EAU CLAIRE GROUP HEALTH COOPERATIVE OF EAU CLAIRE GROUP HEALTH COOPERATIVE PUGET SOUND GROUP HEALTH INC GHI WA NY GROUP HEALTH INSURANCE - GHI DENTAL GROUP HEALTH NORTHWEST GROUP INSURANCE SERVICE CENTER GROUPLINK - INDIANA GRUNDFOS MANUFACTURING CORPORATION GS METALS GSE LINING TECHNOLOGY, INC GUARD GUARDIAN HEALTHCARE INC GUARDIAN HEALTHCARE INC GUARDIAN LIFE INSURANCE COMPANY GUARDIAN LIFE INSURANCE COMPANY DENTAL GUARDIAN LIFE INSURANCE COMPANY OF AMERICA GUIDEONE ELITE INSURANCE GUIDEONE ELITE INSURANCE (AUTO ONLY) GUIDEONE MUTUAL INSURANCE GUIDEONE MUTUAL INSURANCE (AUTO ONLY) GULF QUEST IPA - HMO BLUE GULF STREAM GENERAL DYNAMICS GULFQUEST RENAISSANCE - HOUSTON GULFSTREAM (CORESOURCE) TX Payer Type CI CI CI CI CI CI CI CI CI CI WC WC WC WC CI CI CI CI CI WC AM WC AM CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Inst Dental Prof Prof Prof Dental Prof Prof Dental Prof Prof Prof Prof Inst Prof Prof Dental Inst Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 39180 39180 J1672 J1672 65101 65101 C1029 21415 J1463 J1693 J1693 J1588 J1588 J1595 J1595 36406 36406 36405 36405 75126 75196 J1493 75201 75202 C1046 C1041 41556 Name State GUNDERSEN LUTHERAN HEALTH PLAN GUNDERSEN LUTHERAN HEALTH PLAN - INST H AND R BLOCK H AND R BLOCK (AUTO ONLY) HAA PREFERRED PARTNERS HAA PREFERRED PARTNERS HAMILTON MUTUAL - AUTO HAMILTON MUTUAL - WC HANNAFORD HANOVER INSURANCE COMPANY HANOVER INSURANCE COMPANY (AUTO ONLY) HANOVER LLOYD'S INSURANCE COMPANY HANOVER LLOYD'S INSURANCE COMPANY (AUTO ONLY) HARLEYSVILLE INSURANCE COMPANY HARLEYSVILLE INSURANCE COMPANY (AUTO ONLY) HARMONY HEALTH PLAN OF ILLINOIS HARMONY HEALTH PLAN OF ILLINOIS HARMONY HEALTH PLAN OF INDIANA HARMONY HEALTH PLAN OF INDIANA HOOSIER HEALTHWISE HARPETH IPA - AMERIVANTAGE (SRRIPA) HARRINGTON BENEFIT SERVICES, INC HARRIS COUNTY HARRIS METHODIST HEALTH PLAN HARRIS METHODIST HEALTH PLAN HARTFORD ACCIDENT AND INDEMNITY COMPANY (AUTO ONLY) HARTFORD CASUALTY INSURANCE COMPANY (AUTO ONLY) HARTFORD DEALERSHIP ADVANTAGE PROGRAM - WC IL IL IN IN Payer Type CI CI WC AM CI CI AM WC WC WC AM WC AM WC AM CI CI CI CI CI CI WC CI CI AM AM WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N N N N N N N N Format Claim Status Eligibility Prof Inst Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Inst Prof Inst Inst Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID C1040 C1040 C1040 C1043 C1044 C1047 C1045 C1042 4245 4245 4271 4271 TLW11 TPC46 41556 TPC47 TFQ61 TPC08 J1426 86068 41556 J1450 HCCMI 37329 37329 37111 37111 Name State HARTFORD FIRE INSURANCE COMPANY (AUTO ONLY) HARTFORD INS CO OF ILLINOIS (AUTO ONLY) HARTFORD INS CO OF THE SOUTHEAST HARTFORD INSURANCE COMPANY OF THE MIDWEST (AUTO ONLY) HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (AUTO ONLY) HARTFORD LIFE AND ANNUITY INSURANCE COMPANY (AUTO ONLY) HARTFORD LIFE INSURANCE COMPANY (AUTO ONLY) HARTFORD UNDERWRITERS INSURANCE COMPANY (AUTO ONLY) HARVARD COMMUNITY HEALTH PLAN HARVARD COMMUNITY HEALTH PLAN HARVARD PILGRIM HEALTH CARE HARVARD PILGRIM HEALTH CARE - INST HARVARD PILGRIM HEALTHCARE DENTAL MA HASTINGS AUXILIARY PERSONNEL HASTINGS COLLEGE OF THE LAW HASTINGS TEACHERS ASSOCIATION HAWAII MEDICAL ASSURANCE ASSOCIATION (HMAA) HAWAII-WESTERN MANAGEMENT GROUP (HWMG) HAWKEYE HAWKI HAYHOE CONSTRUCTION HCA-HOSPTIAL CORPORATION OF AMERICA HCC LIFE INSURANCE CO HCH ADMINISTRATION ALBQ SELF FUNDED HCH ADMINISTRATION ALBQ-SELF FUNDED HCH ADMINISTRATION (ILLINOIS) HCH ADMINISTRATION (ILLINOIS) IA Payer Type AM AM AM AM AM AM AM AM CI CI CI CI CI CI WC CI CI CI WC CI WC WC CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Dental Dental Prof Dental Dental Dental Prof Prof Prof Prof Prof Prof Inst Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 82018 HCS HEALTH CLAIMS SERVICE (BOISE, ID) 82018 HCS HEALTH CLAIMS SERVICES HDMCO HDM BENEFIT SOLUTIONS HDMCO HDM BENEFIT SOLUTIONS 77950 HEALTH ALLIANCE MEDICAL PLAN 77950 HEALTH ALLIANCE MEDICAL PLAN - INST 38224 HEALTH ALLIANCE PLAN OF MICHIGAN (HAP) 38224 HEALTH ALLIANCE PLAN OF MICHIGAN INST 25126 HEALTH AMERICA BOONG HEALTH AND WELFARE BENEFIT SYSTEMS (HWBS) 25126 HEALTH ASSURANCE HEALTH AMERICA 25126 HEALTH ASSURANCE HEALTH AMERICA ADVANTRA TLX24 HEALTH BENEFIT CLAIMS DEPT 68241 HEALTH CARE ALLIAN 60054 HEALTH CARE ALLIANCE SEARS HCDPB HEALTH CARE DISTRICT PALM BEACH COUNTY 42102 HEALTH CARE NETWORK OF WISCONSIN (HCN) 34193 HEALTH CARE PAYERS HCPC HOS 34193 HEALTH CARE PAYERS COALITION 88028 HEALTH CARE RESOURCES INC 56142 HEALTH CARE SAVINGS 56142 HEALTH CARE SAVINGS, INC 62180 HEALTH CHOICE GENERATIONS 46221 HEALTH CHOICE INSURANCE CO 62179 HEALTH CHOICE OF ARIZONA 62179 HEALTH CHOICE OF ARIZONA INST 45399 HEALTH CHOICE OF UTAH State MI MI OH AZ AZ UT Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI MC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N Y N N N N N N N N N N N N Y Y N N Format Claim Status Eligibility Inst Prof Inst Prof Prof Inst Prof Inst Prof Prof Prof Inst Dental Inst Prof Prof Inst Inst Prof Prof Prof Inst Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N Y Y Y N Y Y N N Y N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 22521 22521 34158 34158 75196 16112 16112 95019 95019 34185 30946 30946 59087 95568 95570 38309 38309 95567 95567 43132 6108 6108 SX185 AMS01 20199 65062 PHD05 Name HEALTH CHOICE OKLAHOMA (EGID) HEALTH CHOICE OKLAHOMA (EGID) - INST HEALTH DESIGN PLUS State OK OK OH HEALTH DESIGN PLUS (HUDSON, OH) HEALTH ECONOMICS CORPORATION HEALTH ECONOMICS GROUP, INC HEALTH ECONOMICS GROUP, INC HEALTH FIRST HEALTH PLAN HEALTH FIRST HEALTH PLAN - INST HEALTH FIRST TPS - HOUSTON TX HEALTH FUTURE HEALTH FUTURE HEALTH HELP NETWORK INC HEALTH NET CA ENCOUNTERS HOSP HEALTH NET CALIFORNIA (ENCOUNTERS) HEALTH NET OF ARIZONA HEALTH NET OF ARIZONA - INST CA AZ AZ HEALTH NET OF CALIFORNIA AND OREGON HEALTH NET OF CALIFORNIA AND OREGON - INST HEALTH NET OF KANS HEALTH NET OF THE NORTHEAST HEALTH NET OF THE NORTHEAST, INC HEALTH NET PEARL HEALTH NET PLUS TN HEALTH NETWORK AMERICA HEALTH NETWORK ONE (HN1) HEALTH NETWORKS OF COLORADO SPRINGS CO Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N Y N N N Y N Y N N Y N N N N N N Format Claim Status Eligibility Prof Inst Prof Inst Prof Dental Prof Prof Inst Prof Inst Prof Prof Inst Prof Prof Inst Prof Inst Inst Prof Inst Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y N Y Y N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 4286 58216 62157 62157 31478 80142 80142 CX014 20270 63719 76342 83253 83253 68035 HPSM1 HPSM1 94254 HPUOV HPUOV 59256 44273 44273 11324 23342 20896 20896 37290 Name State HEALTH NEW ENGLAND HEALTH ONE ALLIANCE PPO HOS HEALTH PARTNERS TN HEALTH PARTNERS - JACKSON, TN HEALTH PARTNERS OF KANSAS (HPK) HEALTH PARTNERS OF PHILADELPHIA KS PA HEALTH PARTNERS, PA HEALTH PARTNERS, PHILADELPHIA HEALTH PAYMENT SYSTEMS INC HEALTH PLAN MANAGEMENT SERVICES HEALTH PLAN NEVADA HEALTH PLAN OF MICHIGAN (HPM) HEALTH PLAN OF MICHIGAN (HPM) - INST HEALTH PLAN OF SAN JOAQUIN HEALTH PLAN OF SAN MATEO HEALTH PLAN OF SAN MATEO (HPSM) HEALTH PLAN OF THE REDWOODS CA HEALTH PLAN OF UPPER OHIO VALLEY HEALTH PLAN OF UPPER OHIO VALLEY - INST HEALTH PLAN SE TALLAHASSEE FL HEALTH PLANS HEALTH PLANS INC HEALTH PLUS PHSP HEALTH REPUBLIC - NEW JERSEY COOP (QUALCARE NETWORK) HEALTH SERVICES CONSULTING GROUP - HSCG HEALTH SERVICES CONSULTING GROUP - HSCG HEALTH SERVICES FOR CHILDREN (HSCSN) NJ Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N Y N N N N N N N Y N Y N Y N N N N N N N N N Format Claim Status Eligibility Prof Inst Prof Inst Prof Prof Inst Dental Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Inst Inst Prof Inst Prof Prof Inst Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 37290 HEALTH SERVICES FOR CHILDREN (HSCSN) HSM01 HEALTH SERVICES MANAGEMENT (HSM) 16105 HEALTH SERVICES MEDICAL GROUP 34167 HEALTH SERVICES PREFERRED (HSP) BY EMERALD OBAVG HEALTH SERVICES PURCHASING COALITION 56240 HEALTH SOURCE PLAN OF MICHIGAN 36332 HEALTH STAR HTHTX HEALTH TEXAS 41154 HEALTH TRADITION HEALTH PLAN (MMSI) 61101 HEALTH VALUE MANAGEMENT MPM06 HEALTHCARE LA IPA HCP02 HEALTHCARE PARTNERS AZ HCP02 HCP01 HEALTHCARE PARTNERS CALIFORNIA (HCP01) 11328 HEALTHCARE PARTNERS IPA 11328 HEALTHCARE PARTNERS IPA NY 90001 HEALTHCARE PLAN PPO AMS01 HEALTHCARE PREFERRED 82468 HEALTHCARE RESOURCE GROUP 82468 HEALTHCARE RESOURCES GROUP (HRG) 73147 HEALTHCARE SOLUTIONS GROUP 25143 HEALTHCARE USA TPC15 HEALTHCARE USA CX014 HEALTHCARE, USA - ST LOUIS 36335 HEALTHCARES FINEST NETWORK HCOMP HEALTHCOMP 85729 HEALTHCOMP (CA) DENTAL HCOMP HEALTHCOMP - INST State MI TX WI AZ CA NY NY IA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N Format Claim Status Eligibility Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Inst Prof Inst Dental Dental Prof Prof Dental Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N Y N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 85729 14163 14163 41178 41178 CX014 80141 80141 80141 75289 75289 75234 75234 23274 23226 23226 59087 96475 96475 90001 90001 43132 CX014 43132 52133 55204 55204 Name State HEALTHCOMP INC HEALTHEASE - WELLCARE FL HEALTHEASE - WELLCARE - INST HEALTHEZ HEALTHEZ HEALTHFIRST HEALTHFIRST INC INST HEALTHFIRST NEW JERSEY HEALTHFIRST NEW YORK HEALTHFIRST TPA - AUSTIN HEALTHFIRST TPA - AUSTIN HEALTHFIRST TPA - TYLER HEALTHFIRST TPA - TYLER TX NY NJ NY TX TX TX TX HEALTHGROUP LIMITED HEALTHGUARD HEALTHGUARD OF LANCASTER HEALTHHELP NETWORK, INC (HHNI) HEALTHLINK HMO HEALTHLINK HMO - INST HEALTHLINK PPO HEALTHLINK PPO - INST HEALTHNET KANSAS CITY MO HEALTHNET - DORAL DENTAL HEALTHNET OF KANSA HEALTHNET OF OREGON HEALTHNOW NEW YORK HEALTHNOW NY NY NY Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N Y Y N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Inst Prof Inst Dental Inst Prof Prof Inst Prof Inst Prof Prof Inst Prof Inst Prof Inst Prof Inst Prof Dental Inst Dental Prof Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N Y Y N N N N N N N N N N N N N N N N N N N N N N Y N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name State 44547 HEALTHPARTNERS HPAMN HEALTHPARTNERS MN MN HPAMN HEALTHPARTNERS MN INST MN 59140 HEALTHPLAN SERVICES 59140 HEALTHPLAN SERVICES INST 59256 HEALTHPLAN SOUTHEAST HPSE FL 11271 HEALTHPLEX, INC TLZ11 HEALTHPLEX, INC - CHILD HEALTH PLUS (CHP) FAMILY HEALTH PLUS (PHP) CLAIMS ONLY 38216 HEALTHPLUS MICHIGAN MI 95009 HEALTHPLUS OF LOUISIANA LA 68195 HEALTHPOINT CORP 31106 HEALTHPOWER HMO 6142 HEALTHRIGHT INC 71063 HEALTHSCOPE BENEFITS 71063 HEALTHSCOPE BENEFITS - INST J1481 HEALTHSMART 75237 HEALTHSMART ACCEL 37283 HEALTHSMART BENEFIT SOLUTIONS (HSBS) 37283 HEALTHSMART BENEFIT SOLUTIONS (HSBS) 87815 HEALTHSMART BENEFIT SOLUTIONS FKA WELLS FARGO TPA 87815 HEALTHSMART BENEFIT SOLUTIONS FKA WELLS FARGO TPA - INST HSPC1 HEALTHSMART PREFERRED CARE 75250 HEALTHSMART PREFERRED CARE INC HSPC1 HEALTHSMART PREFERRED CARE INC 62308 HEALTHSOURCE AR AR 62308 HEALTHSOURCE IN IN 62308 HEALTHSOURCE KY KY Payer Type WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N Y N N N N N N Y N N N N Y N N N N N N N N N N Y Y Y Format Claim Status Eligibility Prof Prof Inst Prof Inst Prof Dental Dental Prof Prof Prof Prof Inst Prof Inst Prof Prof Inst Prof Prof Inst Prof Prof Inst Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N Y Y N N N N N Y N N N N N N N N N N N N N N N N N N N Y Y N N N N N Y N N N N Y Y N N N N N N N N N Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 62308 62308 62308 62308 62308 62308 62308 62308 2041 62308 62308 62308 2041 62308 16126 62308 62308 62308 68195 62308 68195 62308 62308 71074 71075 71075 58210 Name HEALTHSOURCE MA HEALTHSOURCE ME HEALTHSOURCE N TX HEALTHSOURCE NC HEALTHSOURCE NH HEALTHSOURCE OH HEALTHSOURCE SC HEALTHSOURCE TENNESSEE State MA ME TX NC NH OH SC TN HEALTHSOURCE CMHC HEALTHSOURCE GA HEALTHSOURCE IN HEALTHSOURCE KY HEALTHSOURCE MASSACHUSETTS, INC HEALTHSOURCE ME HEALTHSOURCE NEW YORK HEALTHSOURCE NH HEALTHSOURCE OH HEALTHSOURCE PROVI HEALTHSOURCE PROVIDENT HEALTHSOURCE PROVIDENT ADMINISTRATORS HEALTHSOURCE PROVIDENT ADMINISTRATORS (CIGNA) HEALTHSOURCE PROVIDENT INS CO HEALTHSOURCE SOUTH HEALTHSOURCE, AR HEALTHSOURCE, AR (MED) (CIGNA) HEALTHSOURCE, AR (MED) (CIGNA) - INST HEALTHSOURCE, GA (CIGNA) AR AR Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time Y Y Y Y Y Y Y Y N Y Y Y N Y N Y Y Y N Y N Y Y N N N N Y N Y Y Y Y Y N N N N N N N N N N N N Y N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Inst Inst Inst Inst Inst Inst Inst Inst Inst Inst Inst Prof Dental Prof Inst Inst Prof Inst Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y Y Y Y N Y Y Y N Y N Y Y Y N Y N Y Y N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 35167 61127 1041 75255 56147 2038 31141 6119 62129 HSPAN 52192 63092 63092 HT001 36332 36332 HESUN TLZ34 91051 95827 77180 41556 J1677 J1677 HGL01 HGLWF HGL99 Name State Payer Type TN CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC WC AM CI CI CI HEALTHSOURCE, IN HEALTHSOURCE, KY HEALTHSOURCE, ME HEALTHSOURCE, N TX (CIGNA) HEALTHSOURCE, NC (CIGNA) HEALTHSOURCE, NH HEALTHSOURCE, OH HEALTHSOURCE, SC HEALTHSOURCE, TN (CIGNA) HEALTHSPAN NETWORK REPRICING HEALTHSPRING ELDER HEALTH DENTAL HEALTHSPRING HMO MEDICARE CHOICE HEALTHSPRING HMO MEDICARE CHOICE - INST HEALTHSPRING TN HEALTHSTAR HEALTHSTAR, INC HEALTHSUN HEALTH PLAN HEALTHY FAMILIES (CA) HEALTHY OPTIONS (DSHS) HEALTHY PALM BEACHES HEALTHYCT CO-OP HEARTLAND EMPLOYMENT SERVICES, LLC HEARTLAND EXPRESS HEARTLAND EXPRESS (AUTO ONLY) HEAVY GENERAL LABORERS HEAVY GENERAL LABORERS WELFARE HEAVY GENERAL LABORERS WELFARE FUND CT Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N N N N N N N N N N N N N Format Claim Status Eligibility Inst Inst Inst Inst Inst Inst Inst Inst Inst Prof Dental Prof Inst Prof Prof Inst Prof Dental Inst Prof Prof Prof Prof Prof Dental Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 33600 J1654 J1654 37114 37114 37114 59230 J1069 HPN11 36335 36335 IP125 41556 91164 91164 5477C 5477W 35145 35145 HIL01 59347 59347 37105 55247 55247 37323 HMA01 Name State HELMSMAN MANAGEMENT SERVICES HEMET UNIFIED SCHOOL DISTRICT (CA) HEMET UNIFIED SCHOOL DISTRICT (CA) (AUTO ONLY) HEREIU WELFARE PENSION FUNDS HEREIU WELFARE PENSION PLAN FUN HEREIU WELFARE PENSION PLAN FUNDS HERITAGE CONSULTANTS HERITAGE GROUP HERITAGE PHYSICAN NETWORK HFN HFN, INC HIGH DESERT MEDICAL GROUP CA HIGHLAND GOLF HIGHLINE MEDICAL SERVICE ORGANIZATION HIGHLINE MEDICAL SERVICE ORGANIZATION HIGHMARK BCBS PENN CENTRAL INST HIGHMARK BCBS PENN WESTERN INST PA PA HIGHMARK KEY FAMILY HIGHMARK KEY FAMILY HILL PHYSICIANS MEDICAL GROUP CA HILLCREST BENEFIT ADMINISTRATORS HILLCREST BENEFIT ADMINISTRATORS HINSDALE PHYSICIANS HEALTHCARE (SAGE) HIP HEALTH INS PLAN OF GREATER NEW YORK HIP HEALTH INS PLAN OF GREATER NEW YORK - INST HM LIFE INSURANCE COMPANY HMA HEALTHCARE MANAGEMENT ADMINISTRATORS NY NY SC Payer Type WC WC AM CI CI CI CI WC CI CI CI CI WC CI CI BL BL CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N Y N N N Format Claim Status Eligibility Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Prof Prof Inst Prof Inst Inst Inst Prof Prof Inst Prof Prof Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N Y Y N N Y N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N Y Y N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name HMA01 HMA HEALTHCARE MANAGEMENT ADMINISTRATORS - INST 39044 HMA ADMINISTRATORS LLC 86066 HMA INC - HAWAII MAINLAND ADMINISTRATORS 48330 HMAA (HAWAII MEDICAL ASSURANCE ASSOCIATION) HM033 HMO BLUE MEDICAID 84980 HMO BLUE SHIELD 53172 HMO BLUE STAR PLUS HOUSTON ONLY CONTACT MARK MESSER 84980 HMO BLUE TEXAS HMOBR HMO BLUE TEXASARIA COHMO HMO OF COLORADO BS115 HMSA AKAMAI ADVANTAGE (MEDICARE) FE115 HMSA FEDERAL EMPLOYEE PLAN (FEP) MC115 HMSA QUEST (MEDICAID) J1612 HMSHOST J1612 HMSHOST (AUTO ONLY) 41556 HOGAN MOTOR LEASING 41556 HOGAN PERSONELL J1070 HOLLY FARMS CORP 68069 HOME STATE HEALTH PLAN MISSOURI 41556 HOME SWEET HOME AMS01 HOMESTEAD CHPS 88023 HOMETOWN HEALTH PLAN NEVADA CX015 HOOSIER DENTAL BENEFIT TRUST CX015 HOOSIER DENTAL PLANS 220SP HORIZON BCBS NEW JERSEY - SPECIALIST 22099 HORIZON BLUE CROSS BLUE SHIELD NEW JERSEY 22099 HORIZON BLUE CROSS BLUE SHIELD NEW JERSEY INST State HI HI TX TX TX CO HI HI HI MO WI NJ NJ NJ Payer Type CI CI CI CI CI CI CI BL CI CI BL CI MC WC AM WC WC WC CI WC CI CI CI CI BL BL BL Real Time Real Time N N N N N Y N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y Y Y N N N N N Y N N Y N N Y Y N Format Claim Status Eligibility Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Dental Dental Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N Y Y Y N N N N N N N N N N N Y Y Y N N N N N Y N Y N N Y Y Y N N N N N Y N N N N N Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 22304 22326 22326 22326 13978 91136 91136 J1071 A0107 J1020 22521 94254 58227 58277 58227 36410 HSM01 13335 J1072 61101 73288 61101 61101 61101 61101 95348 61101 Name State HORIZON HEALTHCARE ADMIN (HHA) HORIZON MERCY NEW JERSEY HORIZON MERCY NEW JERSEY HORIZON NJ HEALTH NJ NJ NJ HORTICA FLORIST MUTUAL INSURANCE HOTEL EMPLOYEES RESTAURANT EMPLOYEES HOTEL EMPLOYEES RESTAURANT EMPLOYEES HLTH TRUST HOUSEHOLD MERCH NNI HOUSING AUTHORITY EL PASO (TX) HOUSTON HUNTERS PATROL, INC HP ADMINISTRATIVE SERVICES LLC OK HPR HPS PARADIGM HPS PARADIGM INC HOSPITAL HPS PARADIGM, INC HRH OF ILLINOIS HSM HUDSON HEALTH PLAN NY HUGHES TOOL COMPANY HUMANA CARE PLAN HUMANA DENTAL HUMANA EMPHESYS HUMANA EMPLOYERS HEALTH INST HUMANA EMPLOYERS HEALTH INSURANCE HUMANA GOLD PLUS HUMANA HEALTH PLANS OF OHIO HUMANA INC OH Payer Type CI CI CI CI WC CI CI WC WC WC CI CI CI CI CI CI CI CI WC CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N Y N Y Y Y Y N Y N N N Y N N N N N N N N N N N N N N N Y N N N N N N N Format Claim Status Eligibility Inst Inst Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Inst Inst Prof Prof Prof Prof Dental Prof Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y Y Y Y N Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 61101 61101 61125 61125 PR000 61120 61102 IP059 37260 37260 J1626 J1626 J1118 37279 IAT99 TPC48 A1117 A1464 A1317 IBE98 A1461 A4681 IBE97 TLZ16 TPC49 68241 68241 Name State HUMANA INST HUMANA INSURANCE CHOICE CARE NETWORK HUMANA MILITARY - TRICARE SOUTH - PGBA HUMANA MILITARY - TRICARE REGIONS 3 AND 4 HUMANA PUERTO RICO (INMEDIATA) PR HUMANA VETERANS HEALTHCARE - ARCH PROJECT HUMANA, INC (ENCOUNTERS) HUMBOLDT (CALIF CARE) HUNT INSURANCE GROUP HUNT INSURANCE GROUP HUTCHINSON TECHNOLOGY HUTCHINSON TECHNOLOGY (AUTO ONLY) HY-VEE IAA IATSE ATLANTA HEALTH WELFARE FUND IATSE NATIONAL HEALTH AND WELFARE IBEW LOCAL 117 IBEW LOCAL 364 IBEW LOCAL 38 IBEW LOCAL 38 IBEW LOCAL 461 IBEW LOCAL 481 IBEW LOCAL 481 IBEW LOCAL UNION 270 IBEW-LOCAL 1968 IBM MEDICAL PLANS IBM MEDICAL PLANS CA Payer Type CI CI CI CI CI CI CI CI CI CI WC AM WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time Y Y N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Inst Prof Dental Dental Dental Dental Prof Dental Dental Prof Dental Dental Prof Inst Claim Enrollment Required ERA Enrollment Required N N Y N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 60054 11695 11695 37296 75185 75185 27847 12504 22175 22175 68066 68066 J1575 J1575 36600 21415 C1029 86069 CX014 72091 72091 41600 41600 IMGIN IMGIN 41556 IMSMS Name State IBM MEDICAL PLANS ICARE (INDEPENDENT CARE HEALTH PLAN) ICARE (INDEPENDENT CARE HEALTH PLAN) WI WI ICM ICON BENEFIT ADMINISTRATORS ICON BENEFITS ADMINISTRATORS ICW (INSURANCE CO OF THE WEST) IDS PROPERTY CASUALTY INSURANCE COMPANY (AUTO ONLY) IE SHAFFER (WEST TRENTON, NJ) IE SHAFFER (WEST TRENTON, NJ) ILLINICARE GROUP HEALTH ILLINICARE GROUP HEALTH IL IL ILLINOIS CASUALTY ILLINOIS CASUALTY (AUTO ONLY) ILLINOIS CENTRAL HOSPITAL ASSOC ILLINOIS EMCASCO ILLINOIS EMCASCO ILLINOIS HEALTH SOLUTIONS IL ILLINOIS MEDICAL ASSISTANCE PROGRAM IMA LOUISIANA IMA LOUISIANA LA LA IMCARE IMCARE IMG INTERNATIONAL MEDICAL GROUP IMG INTERNATIONAL MEDICAL GROUP IMPERIAL IRRIGATION DISTRICT IMS MANAGEMENT SERVICES TX Payer Type CI CI CI CI CI CI WC AM CI CI CI CI WC AM CI WC AM CI CI CI CI CI CI CI CI WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Inst Prof Prof Inst Prof Prof Prof Dental Prof Inst Prof Prof Prof Prof Prof Prof Prof Dental Inst Prof Inst Prof Inst Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N Y Y N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 86070 IMX EZ 41556 INCONEN CORPORATION 40585 INDECS OF EBASCO TA720 INDEPENDENCE ADMINISTRATORS 54704 INDEPENDENCE BC PERSONAL CHOICE (IBC) - INST 89070 INDEPENDENCE BLUE CROSS (IBC) DENTAL PLAN BLUEEXTRASM 54704 INDEPENDENCE BLUE CROSS PERSONAL CHOICE (IBC) MHM01 INDEPENDENCE MEDICAL GROUP IMG01 INDEPENDENCE MEDICAL GROUP - KERN COUNTY IMG02 INDEPENDENCE MEDICAL GROUP - TULARE COUNTY 95308 INDEPENDENT HEALTH NEW YORK DELOK INDIAN HEALTH SERVICES ICW01 INDIANA CARPENTERS WELFARE PENSION FUND ICW99 INDIANA CARPENTERS WELFARE FUND ICHIA INDIANA COMPREHENSIVE HEALTH INS (PAPER) ESP01 INDIANA IHCP ESP (ANTHEM) J1425 INDIANA INSURANCE 35161 INDIANA PRO HEALTH NETWORK 35161 INDIANA PROHEALTH 35107 INDIANA TEAMSTERS HEALTH BENEFIT FUNDS TPC50 INDUSTRY LOCAL 338 P W FU 43471 INETICO INC 43471 INETICO INC - INST 52196 INFORMED 52196 INFORMED LLC INST 50946 INFORMED UHC COMPASS ROSE 50946 INFORMED UHC COMPASS ROSE INST State NV PA PA CA CA NY IN IN IN IN Payer Type CI WC CI CI CI CI BL CI CI CI CI CI CI CI CI BL WC CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Inst Dental Prof Prof Prof Prof Prof Dental Dental Prof Prof Prof Prof Prof Prof Dental Dental Prof Inst Prof Inst Prof Inst Claim Enrollment Required ERA Enrollment Required N N N Y Y N Y N N N Y N N N N N N N N N N N N N N N N N N N Y Y N Y N N N Y N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 36348 IEHP1 IEHP1 41556 31172 J1599 J1599 J1601 J1601 4320 4320 VAICE J1073 68241 37279 37279 63082 63082 13315 13315 IMSMS IMSMS ISL11 39182 39182 IAC01 IAC01 Name State INGALLS PROVIDER GROUP INLAND EMPIRE HEALTH PLAN (IEHP) INLAND EMPIRE HEALTH PLAN (IEHP) - INST CA CA INLAND VALLEY HOSPICE INNOVANTE BENEFIT ADMINISTRATOR INNOVATIVE CLAIM SOLUTIONS (ICS) - RANCHO CORDOVA INNOVATIVE CLAIM SOLUTIONS (ICS) - RANCHO CORDOVA (AUTO ONLY) INNOVATIVE CLAIM SOLUTIONS (ICS) - SAN RAMON INNOVATIVE CLAIM SOLUTIONS (ICS) - SAN RAMON (AUTO ONLY) INNOVATIVE HEALTHWARE SOLUTIONS INNOVATIVE HEALTHWARE SOLUTIONS - INST INS HEALTH SERVICES (IMMIGRATION HEALTH SERVICES) INSILCO CORP INSTITUTES OF QUAL INSURANCE ADMINISTRATOR OF AMERICA INSURANCE ADMINISTRATORS OF AMERICA, INC INSURANCE CLAIMS SERVICES (BIRMINGHAM, AL) INSURANCE CLAIMS SERVICES, INC (BIRMINGHAM, INSURANCE DESIGN ADMINISTRATORS INSURANCE DESIGN ADMINISTRATORS INSURANCE MANAGEMENT SERVICES OF TEXAS INSURANCE MANAGEMENT SERVICES OF TEXAS INSURANCE SERVICE OF LUBBOCK INSURANCE TPACOM INSURANCE TPACOM - INST INSURER'S ADMINISTRATIVE CORP INSURERS ADMINISTRATIVE CORPORATION TX Payer Type CI CI CI WC CI WC AM WC AM CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Prof Inst Prof Inst Inst Prof Inst Prof Prof Prof Inst Dental Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID IAC01 C1028 C1028 C1028 C1028 C1028 51020 51020 51020 31127 31127 31129 23229 23229 37124 34167 20050 68053 68053 58200 10322 14303 23252 J1542 J1542 60280 60280 Name State INSURERS ADMINISTRATIVE CORPORATION INTEGON CASUALTY INSURANCE CO INTEGON GENERAL INSURANCE CORP INTEGON INDEMNITY CORP INTEGON NATIONAL INSURANCE CO INTEGON PREFERRED INSURANCE CO INTEGRA ADMINISTRATIVE GROUP INTEGRA ADMINISTRATIVE GROUP - DENTAL INTEGRA ADMINISTRATIVE GROUP - INST INTEGRA GROUP INTEGRA GROUP INTEGRA GROUP - CHA INTEGRAL QUALITY CARE INTEGRAL QUALITY CARE - INST INTEGRATED BENEFIT SERVICES IL INTEGRATED CARE NETWORK (ICN) BY EMERALD INTEGRATED MEDICAL SOLUTIONS LLC INTEGRATED MENTAL HEALTH SERVICES (IMHS) INTEGRATED MENTAL HEALTH SERVICES (IMHS) INTEGRITY BENEFITS NETWORK INTEGRITY MUTUAL INSURANCE COMPANY INTEGRITY WC INTER COUNTY HEALTH PLAN - ICHP (AHA) INTERCARE INTERCARE (AUTO ONLY) INTERFACE EAP INTERFACE EAP (IEAP) PA Payer Type CI AM AM AM AM AM CI CI CI CI CI CI CI CI CI CI CI CI CI CI AM WC CI WC AM CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Dental Inst Inst Prof Prof Prof Inst Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 23287 23287 IAT99 36609 48603 48603 66053 37241 37269 37269 IHP01 IHP02 IHS01 CX014 AMS01 86068 OBALB J1074 TPC51 TPC52 J1075 ISL11 42600 A0138 37272 37272 JAI01 Name State INTERGROUP SERVICES CORPORATION INTERGROUP SERVICES PPO INTERNATIONAL ASSOCIATION OF THEATRICAL STAGE EMPLOYEES GA INTERNATIONAL BROTHERHOOD OF BOILERMAKERS INTERNATIONAL BROTHERHOOD OF BOILERMAKERS (IBBEHC) INTERNATIONAL BROTHERHOOD OF BOILERMAKERS (IBBEHC) - INST INTERNATIONAL MEDICAL CARD (IMC) PR PR INTERNATIONAL UNION OF OPERATING ENGINEERS INTERNATIONAL UNION OF OPERATING ENGINEERS INTERNATIONAL UNION OF OPERATING ENGINEERS, LOCAL 15 INTOTAL HEALTH FKA AMERIGROUP VIRGINIA INTOTAL HEALTH FKA AMERIGROUP VIRGINIA INST VA VA INTRAHEALTH SOLUTIONS (FORMERLY DEDWARD WRIGHT, INC) ION HEALTH, INC IOWA ENVOY PLATINUM IOWA HEALTH SOLUTIONS IOWA IRON WORKERS HEALTH PLAN IREX CORPORATION IRONWORKERS L40, L361, L417 IRONWORKERS LOCAL 455 IRONWORKING CONTRACT IP ISOL ITASCA MEDICAL CARE J B HUNT TRANSPORT INC J SMITH LANIER CO ADMINISTRATORS J SMITH LANIER COF JAI MEDICAL IA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI WC CI CI WC CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Inst Prof Inst Prof Prof Inst Prof Prof Inst Dental Dental Prof Prof Prof Prof Dental Dental Prof Prof Dental Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 41556 JPF01 JEN01 JEN99 41556 J1006 JISSP 59171 41099 41099 41099 65099 65099 38310 38310 41556 JMH01 68031 37215 37215 52189 52123 52123 J1118 J1076 34136 Name State JD MECHANICAL JEFFERSON COUNTY TEXAS JEFFERSON PILOT GUARANTEE LIFE INSURANCE COMPANY (GLIC) JENKINS ASSOCIATES JENKINS ASSOCIATES GA JH MCCORMACK CONST JI SPECIALTY SERVICES JI SPECIALTY SERVICES, INC COMMERCIAL JMH MEDICARE ADVANTAGE JOHN ALDEN LIFE JOHN ALDEN LIFE INSURANCE CO JOHN ALDEN LIFE INSURANCE CO JOHN HANCOCK JOHN HANCOCK GIC INDEMNITY JOHN MORRELL CO - AVERA AHPBA JOHN MORRELL CO - AVERA AHPBA JOHN MUIR HEALTH JOHN MUIR PHYSICIANS NETWORK JOHN MUIR TRAMA JOHN P PEARL ASSOC JOHN P PEARL ASSOCIATES JOHNS HOPKINS EHP - PRIORITY PARTNERS JOHNS HOPKINS HEALTH CARE USHFP JOHNS HOPKINS HEALTH CARE USHFP JOHNSTON SCHOOLS JONES TRUCK LINES,INC JP FARLEY CORPORATION CA CA Payer Type WC WC CI CI CI WC WC CI CI CI CI CI CI CI CI CI WC CI CI CI CI CI CI CI WC WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N Y N N N N N Format Claim Status Eligibility Prof Prof Dental Dental Prof Prof Prof Prof Prof Prof Dental Inst Inst Prof Inst Prof Prof Prof Prof Inst Prof Prof Inst Prof Prof Prof Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 34136 34136 37272 37272 41556 J1077 94320 94320 91617 COKSR COKSR 21313 21313 94135 94134 94134 KS007 KS007 KS008 KS005 KPIC1 KS003 KS001 57038 57038 57038 57038 Name State JP FARLEY CORPORATION JP FARLEY CORPORATION JSL ADMINF JSL ADMINISTRATORS JUDSON ISD JUVENILE JAIL FACILITY MANAGEM KAISER CSI-CALIFORNIA SELECT FOR INDIVIDUALS KAISER CSI-CALIFORNIA SELECT FOR INDIVIDUALS - INST KAISER FOUNDATION COLORADO KAISER FOUNDATION COLORADO - INST KAISER FOUNDATION HEALTH PLAN COLORADO KAISER FOUNDATION HEALTH PLAN OF GEORGIA KAISER FOUNDATION HEALTH PLAN OF GEORGIA INST KAISER FOUNDATION HEALTH PLAN OF NORTHERN CA REGION KAISER FOUNDATION HEALTH PLAN OF SOUTHERN CA INST KAISER FOUNDATION HEALTH PLAN OF SOUTHERN CA REGION CO CO CO GA GA CA CA CA KAISER FOUNDATION HOSP NW REGION KAISER FOUNDATION HOSP NW REGION - INST KAISER HEALTH PLAN - MID ATLANTIC STATES KAISER OHIO REGION AKA HEALTHSPAN INTEGRATED CARE OH KAISER PERMANENTE - PHCS PPO KAISER PERMANENTE NORTHERN CA KAISER PERMANENTE SOUTHERN CA KANAWHA HEALTHCARE SOLUTIONS KANAWHA HEALTHCARE SOLUTIONS, INC KANAWHA INSURANCE CO KANAWHA INSURANCE COMPANY CA CA Payer Type CI CI CI CI WC WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N Y N Y Y N N Y N N N N N N N Format Claim Status Eligibility Inst Prof Inst Prof Prof Prof Prof Inst Prof Inst Prof Prof Inst Prof Inst Prof Prof Inst Prof Prof Prof Prof Prof Prof Inst Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 47171 A2032 44030 KMG11 41556 37313 J1078 J1498 KELSE C1030 J1576 J1576 J1587 J1587 73100 73100 73100 73100 J1079 77894 63077 63077 68067 68067 68067 37124 37124 Name KANSAS CITY BLUE SHIELD State KS KANSAS CITY LABORERS WELFARE FUND KANSAS CITY LIFE INSURANCE CO KATY MEDICAL GROUP KAUTZ VINYARDS KBA ASSURANT HEALTH KCI HOLDINGS USA KEENAN AND ASSOCIATES (EXCLUDING CITY OF PASADENA) KELSEY-SEYBOLD KEMPER PREFERRED KEMPERUNITRIN AUTO AND HOME KEMPERUNITRIN AUTO AND HOME (AUTO ONLY) KEMPERUNITRIN SAFEGUARD INS COMPANY KEMPERUNITRIN SAFEGUARD INS COMPANY (AUTO ONLY) KEMPTON COMPANY KEMPTON COMPANY KEMPTON GROUP ADMINISTRATORS KEMPTON GROUP ADMINISTRATORS KEN DAVIS INDUSTRIES INC KENTUCKY HEALTH COOPERATIVE KY KENTUCKY HEALTH SELECT KENTUCKY HEALTH SELECT KENTUCKY SPIRIT - DOS THRU 7-05-2013 KENTUCKY SPIRIT HEALTH PLAN - DOS THRU 7-05-2013 KENTUCKY SPIRIT HEALTH PLAN INST - DOS THRU 7-05-2013 KEPPLE CO KEPPLE AND CO KY KY KY KY IL Payer Type BL CI CI CI WC CI WC WC CI AM WC AM WC AM CI CI CI CI WC CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Dental Dental Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Inst Prof Prof Prof Inst Prof Inst Claim Enrollment Required ERA Enrollment Required Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID KERN1 37217 37217 IP082 J1521 37321 J1118 23045 95056 95056 23284 23284 CX014 23284 84223 SKLA0 41556 41556 J1614 J1614 KPS01 34145 34145 KAMG1 41556 41556 HM039 Name KERN FAMILY HEALTH CA State CA KEY BENEFIT ADMINISTRATORS KEY BENEFIT ADMINISTRATORS, INC KEY MEDICAL GROUP CA KEY RISK MANAGEMENT SERVICES LLC KEY SELECT KEYSTONE KEYSTONE HEALTH PLAN CENTRAL KEYSTONE HEALTH PLAN EAST PA PA KEYSTONE HEALTH PLAN EAST - INST KEYSTONE MERCY HEALTH PLAN PA KEYSTONE MERCY HEALTH PLAN KEYSTONE MERCY HEALTH PLAN - DENTAL KEYSTONE MERCY HEALTH PLAN - INST PA KEYSTONE VIP CHOICE KIDMED LA LA KING PAK POTATO COMPANY LLC KING RANCH KIRKLAND'S, INC KIRKLAND'S, INC (AUTO ONLY) KITSAP PHYSICIANS SERVICE KLAIS COMPANY KLAIS COMPANY KOREAN AMERICAN MEDICAL GROUP CA KTA CONSTRUCTION (COSD2) L ARROWHEAD C CLUB LA CARE ENCOUNTER DATA ONLY CA Payer Type CI CI CI CI WC CI WC CI CI CI CI CI CI CI CI MC WC WC WC AM CI CI CI CI WC WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y N N N N Y N N N N Y N N N N N N Format Claim Status Eligibility Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Dental Inst Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N Y Y Y N N N N N Y N N N N N N N N N N N N N N N N N N Y Y Y N N N N N Y N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 66019 LA CRUZ AZUL (LCA) LSH99 LABORERS SOUTHEAST HEALTH WELFARE PLAN LSH01 LABORERS' SOUTHEAST HEALTH WELFARE PLAN 27357 LACARE HEALTH PLAN - INST 41556 LACLEDE CHAIN 41556 LACLEDE STEEL 41556 LAKE ELSINORE SCHOOL DISTRICT 37112 LAKE FOREST MANAGE CARE HOS 37112 LAKE FOREST MANAGED CARE ASSOCIATES LCHC1 LAKESIDE COMPREHENSIVE HEALTHCARE 95415 LAKESIDE HEALTH SERVICES LMG11 LAKESIDE MEDICAL GROUP 41556 LAMAR CONSOLIDATED ISD 41556 LAMESA ISD 16109 LANCASTER GENERAL HEALTH GROUP 41556 LANDMARK GOLF CO 41556 LANDMARK GRAD AND PAVING LNDMK LANDMARK HEALTHCARE J1080 LANDSTAR BCO WC PROGRAM 41556 LANE COUNTY 41556 LARIMER COUNTY - WC NMM02 LASALLE MEDICAL ASSOCIATES NMM02 LASALLE MEDICAL ASSOCIATES - INST MPM14 LASALLE MEDICAL GROUP 41556 LB AUTOPACIFIC PART 41556 LB AUTOPACIFIC SUPP 52193 LBA HEALTH PLANS State PR LA CA CA CA Payer Type CI CI CI MC WC WC WC CI CI CI CI CI WC WC CI WC WC CI WC WC WC CI CI CI WC WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Dental Inst Prof Prof Prof Inst Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1527 41556 37316 41556 TPC54 J1650 J1650 CX083 87071 33600 33600 33600 37281 37281 33600 37281 37281 LIIC2 LIIC3 LIICA 25181 41136 41136 94245 LFGRD 53172 76870 Name LEAGUE OF MINNESOTA CITIES INSURANCE TRUST LEKOS ELECTRIC LEON MEDICAL CENTER HEALTH PLAN LEVIN ENTERPRISES, INC LEVTTTOWN UNITED TEACHERS LFP CORPORATION LFP CORPORATION (AUTO ONLY) LIBERTY DENTAL PLAN LIBERTY HEALTH ADVANTAGE LIBERTY MUTUAL LIBERTY MUTUAL MIDDLE MARKETS LIBERTY NORTHWEST LIBERTY UNION LIBERTY UNION LIFE ASSURANCE CO LIBERTY WAUSAU LIFE ASSURANCE COMPANY LIFE ASSURANCE COMPANY LIFE INVESTORS INS CO OF AMERICA LIFE INVESTORS INS CO OF AMERICA LIFE INVESTORS INS CO OF AMERICA LIFE PITTSBURGH LIFE TRAC LIFE TRAC LIFEGUARD LIFEGUARD LIFEMARK CONTACT MARK MESSER LIFEPATH HOSPICE State MN Payer Type WC WC CI WC CI WC AM CI CI WC WC WC CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Dental Prof Prof Dental Prof Prof Prof Prof Inst Prof Prof Inst Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID LIFE1 LIFE1 61104 EBSRM 93093 91049 91049 CX061 73288 75283 75283 LIPA1 41556 41556 TPC55 TPC56 TPC57 35107 35107 PCM01 TPC58 TPC59 TPC60 TPC61 IBT99 TPC62 62308 Name State LIFEPRINT LIFEPRINT LIFESYNCH LIFETIME BENEFIT SOLUTIONS LIFEWISE HEALTH PLAN OF OREGON LIFEWISE HEALTH PLAN OF WASHINGTON LIFEWISE HEALTH PLAN OF WASHINGTON INST LINCOLN FINANCIAL GROUP (LINCOLN NATIONAL LIFE) LINCOLN NATIONAL LINN COUNTY LINN COUNTY LIPA AGATE RESOURCES - TRILLIUM ADVANTAGE LIVINGSTON ISD LK ARROWHEAD CO CLUB LOCAL 1 POINTERS CAULKERS LOCAL 1-0318 HEALTH WELFARE FUND LOCAL 1034 LOCAL 135 HEALTH BENEFITS FUND (INDIANAPOLIS, LOCAL 135 HEALTH BENEFITS FUND (INDIANAPOLIS, IN) LOCAL 148 HEALTH WELFARE FUND LOCAL 153 DISCOUNT DENTAL PLAN LOCAL 153 HEALTH FUND LOCAL 1730 ILA LOCAL 1969 CIVIL SERVICE EMPLOYEES LOCAL 295851 IBT EMPLOYER GROUP WELFARE FUND LOCAL 306 IATSE MUNICIPAL EMPLOYEES LOCAL 371 - CIGNA OR WA WA Payer Type CI CI CI CI CI BL BL CI CI CI CI CI WC WC CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y Format Claim Status Eligibility Inst Prof Prof Prof Prof Prof Inst Dental Prof Prof Inst Prof Prof Prof Dental Dental Dental Inst Prof Dental Dental Dental Dental Dental Prof Dental Prof Claim Enrollment Required ERA Enrollment Required N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N N Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID TPC63 TPC64 41556 37267 37267 37267 37267 37267 37267 37226 45289 J1515 J1464 PR002 LAF99 LAF01 28680 28680 68069 68069 MCDLA J1547 CX014 SX159 90328 90328 J1465 Name State LOCAL 802 WELFARE FUND LOCAL 807 LABOR-MGMNT HEALTH FUND LODI MEMORIAL HOSPITAL LOMA LINDA UNIVERSITY ADVENTIST LOMA LINDA UNIVERSITY ADVENTIST HEALTH LOMA LINDA UNIVERSITY BEHAVIORAL MEDICINE LOMA LINDA UNIVERSITY EMPLOYEE HEALTH PLAN LOMA LINDA UNIVERSITY HEALTH CARE EMPLOYEE LOMA LINDA UNIVERSITY STUDENT HEALTH PLAN LONDON HEALTH ADMINISTRATORS LONE STAR TPA LONG BEACH UNIFIED SCHOOL DISTRICT LONGS DRUGS LOS ALAMOS TOTAL CARE LOS ANGELES FIREMANS RELIEF FUND CA LOS ANGELES FIREMENS RELIEF ASSOCIATION (LAFRA) LOUISIANA HEALTH COOPERATIVE - INST DOS BEG 7-01-2014 LOUISIANA HEALTH COOPERATIVE DOS BEG 7-01-2014 LOUISIANA HEALTHCARE CONNECTIONS - BAYOU HEALTH LOUISIANA HEALTHCARE CONNECTIONS INST LOUISIANA MEDICAID LA LA LA LA LA LOUISIANA WORKERS' COMPENSATION CORPORATION (LWCC) LOVELACE COMMUNITY HEALTH PLAN LOVELACE SALUD MEDICAID THRU 7-31-2013 LOVELACE SANDIA HEALTH PLAN LOVELACE SANDIA HEALTH PLAN INST LOWE'S NM Payer Type CI CI WC CI CI CI CI CI CI CI CI WC WC CI CI CI CI CI MC MC MC WC CI CI CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N N N Y N N Format Claim Status Eligibility Dental Dental Prof Prof Inst Inst Inst Inst Inst Prof Prof Prof Prof Prof Prof Dental Inst Prof Prof Inst Prof Prof Dental Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1081 J1341 J1341 J1540 MP330 J1669 J1669 52133 36334 J1345 J1346 J1347 41556 22445 1260 1260 11303 11303 68062 68062 34103 62413 62413 45341 26372 J1082 22195 Name State LSG SKY CHEFS INTERNATIONAL LUBA CASUALTY INSURANCE COMPANY LUBA CASUALTY INSURANCE COMPANY (AUTO ONLY) LUMBERMEN'S UNDERWRITING ALLIANCE CA LUTHERAN PREFERRED LYNWOOD UNIFIED SCHOOL DISTRICT (CA) LYNWOOD UNIFIED SCHOOL DISTRICT (CA) (AUTO ONLY) M-PLAN DENTAL MACNEAL HEALTH PROVIDERS MACYS (DALY CITY) MACYS (NEWPORT BEACH) MACYS CORPORATE SERVICES INC MADERA COMMUNITY HOSPITAL MAG MUTUAL HEALTHCARE HOSPITAL MAGELLAN BEHAVIORAL HEALTH MAGELLAN BEHAVIORAL HEALTH INST MAGNACARE MAGNACARE INST MAGNOLIA HEALTH PLAN MAGNOLIA HEALTH PLAN INST MS MS MAHONING TRUMBULL BLDNG TRADES MAIL HANDLERS BENEFIT PLAN MAIL HANDLERS BENEFIT PLAN INST MAINE COMMUNITY HEALTH OPTIONS MAJESTA CARE MAJOR LEAGUE BASEBALL 8 MAKSIN MANAGEMENT CORP ME Payer Type WC WC AM WC CI WC AM CI CI WC WC WC WC CI CI CI CI CI CI CI CI CI CI CI CI WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N Y N N Y N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Dental Prof Prof Prof Prof Prof Inst Prof Inst Prof Inst Prof Inst Inst Prof Inst Prof Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N Y Y N Y Y N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 22195 87726 87726 65030 35162 35162 MCS01 39186 CX014 22771 CX014 39186 39187 39187 41159 93900 41556 98010 75258 46000 66040 52461 41556 41556 9908 CX014 IP097 Name State MAKSIN MANAGEMENT CORP MAMSI LIFE AND HEALTH INSURANCE CO (MLH) MAMSI LIFE HEALTH INS CO (MLH) MANAGED CARE OF NORTH AMERICA (MCNA) MANAGED CARE SERVICES MANAGED CARE SERVICES, LLC MANAGED CARE SYSTEMS MANAGED HEALTH CARE SERVICES INDIANA CA IN MANAGED HEALTH INC (MHI) MANAGED HEALTH NETWORK MANAGED HEALTH SERVICES - WI STATE EMPLOYEES MANAGED HEALTH SERVICES OF INDIANA MANAGED HEALTH SERVICES WISCONSIN MANAGED HEALTH SERVICES WISCONSIN INST IN WI WI MANAGED PHYSICAL NETWORK MANAGED PHYSICAL NETWORK MANUFACTURERS ALLIANCE INSURANCE COMPANY MANULIFE, W J SUTTON, CO (TORONTO, CANADA) MAPCO MAPFRE MAPFRE MEDICARE EXCEL PR PR MARCH VISION CARE MARCOTTE AND HEARNE MARICOPA COUNTY COMMUNITY COLLEGE DISTRICT MARICOPA HEALTH PLAN - UNIV OF ARIZONA AZ MARICOPA HEALTH SYSTEMS HEALTH PLANS MARIN IPA CA Payer Type CI CI CI CI CI CI CI MC CI CI CI MC CI CI CI CI WC CI CI CI CI CI WC WC CI CI CI Real Time Real Time N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N Y N N N Y Y N N N N N N Y Y N N N Y N N Format Claim Status Eligibility Prof Inst Prof Dental Prof Inst Prof Prof Dental Prof Dental Prof Prof Inst Prof Prof Prof Dental Prof Prof Prof Prof Prof Prof Prof Dental Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N Y N N N Y Y Y Y Y N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 41556 MARIPOSA COUNTY 247 MARLAND PHYSICIANS CARE 48055 MARQUETTE NATIONAL LIFE INSURANCE 20805 MARRICK MEDICAL FINANCE LLC 68241 MARRIOTT PR002 MARRIOTT MPHC1 MARTINS POINT HEALTH CARE ( MPHC) C1034 MARYLAND CASUALTY COMPANY (AUTO ONLY) 22322 MARYLAND HEALTH PARTNERS HOSP CX014 MARYLAND HELIX MCDMDMARYLAND MEDICAID INSTITUTIONAL 22348 MARYLAND PHYSICIANS CARE 22348 MARYLAND PHYSICIANS CARE INST CX014 MARYLAND PHYSICIANS CARE MCO DENTAL SX069 MARYLAND PMHS SX069 MARYLAND PUBLIC MENTAL HEALTH SYSTEM 37121 MASHANTUCKET PEQUOT TRIBAL NATION 37121 MASHANTUCKET PEQUOT TRIBAL NATION J1689 MASSACHUSETTS BAY INSURANCE COMPANY J1689 MASSACHUSETTS BAY INSURANCE COMPANY (AUTO ONLY) MMPHB MASTERS, MATES AND PILOTS PLAN 41556 MATAGORDA COUNTY J1736 MATHESON TRUCKING J1736 MATHESON TRUCKING (AUTO ONLY) TP075 MATRIX ABSENCE MANAGEMENT 2030 MATTHEW THORNTON HEALTH PLAN J1083 MAXIM CRANE WORKS State MD MD MD MD Payer Type WC CI CI CI CI CI CI AM CI CI MC CI CI CI CI CI CI CI WC AM CI WC WC AM WC CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Inst Prof Prof Inst Prof Prof Prof Inst Dental Inst Prof Inst Dental Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1347 41193 41154 41154 83028 83028 87065 56205 56205 J1084 25160 38264 38264 59331 59331 36328 36328 3833C 3833N 3833T 3833R 3833A 38338 38338 66039 87726 87726 Name State MAY DEPARTMENT STORES MAYO CLINICRECOVERY AND CLAIMS SERVICES MAYO MANAGEMENT SERVICES MAYO MANAGEMENT SERVICES - INST MBA BENEFITS ADMINISTRATORS MBA BENEFITS ADMINISTRATORS INST MBA OF WYOMING MBS - MEDCOST BENEFIT SERVICES MBS - MEDCOST BENEFIT SERVICES INST MC DONALD'S-MCOPCO MCA ADMINISTRATORS MCARE MCARE MCCREARY CORPORATION MCCREARY CORPORATION MCHENRY MEDICAL ASSOCIATES MCHENRY MEDICAL ASSOCIATES (IL) MCLAREN (MHP) MEDICAID MCLAREN ABW - NORTHERN HEALTH PLAN MCLAREN ABW - TENCON HEALTH PLAN MCLAREN ADVANTAGE HMO SNP MCLAREN HEALTH ADVANTAGE MCLAREN HEALTH PLAN (MHP) MCLAREN HEALTH PLAN - INST MCS CLASSIC CARE MD INDIVIDUAL PRACTICE ASSOC MD - INDIVIDUAL PRACTICE ASSOCIATION, INC (MD PR Payer Type WC WC CI CI CI CI CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N Y N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Inst Prof Inst Prof Prof Inst Prof Prof Prof Inst Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name MDAPN MD ANDERSON PHYSICIAN NETWORK 6118 MD HEALTH PLAN 11338 MDNY HEALTHCARE 11338 MDNY HEALTHCARE 41556 MDSI PHYS GROUP INC 20475 MDWISE HOOSIER ALLIANCE PLAN SX172 MDWISE MARKETPLACE R6139 MDWISE SELECT HEALTH INDIANA SX172 MDWISE TOTAL HEALTH FKA IU MEDICAL J1478 MEADOWBROOK INSURANCE GROUP J1478 MEADOWBROOK INSURANCE GROUP (AUTO ONLY) M3CA1 MED3000 CALIFORNIA AFFILIATED PHYSICIAN GROUP M3F10 MED3000 CMS EARLY STEPS M3F11 MED3000 CMS SAFETY NET M3F13 MED3000 CMS TITLE 19 NONREFORM M3F12 MED3000 CMS TITLE 19 REFORM M3F14 MED3000 CMS TITLE 21 M3I01 MED3000 HEALTHSELECT IPA BCBS M3F09 MED3000 HEALTHSPRINGS M3F03 MED3000 HEALTHY KIDS M3F08 MED3000 PEDICARE TITLE 19 M3F06 MED3000 PEDICARE TITLE 21 M3I02 MED3000 SOUTHWEST IPA BCBS 58202 MEDADMIN SOLUTIONS 58204 MEDADMIN SOLUTIONS 58204 MEDADMIN SOLUTIONS 74323 MEDBEN (NEWARK, OH) State NY NY IN IN IN IN CA FL FL FL FL FL IL FL FL FL FL IL Payer Type CI CI CI CI WC MC CI CI CI WC AM CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Inst Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Inst Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 59231 MEDCOM 59231 MEDCOM 68241 MEDCONNECTION 56162 MEDCOST 56162 MEDCOST INST 95321 MEDFOCUS MCDCA MEDI-CAL CALIFORNIA MCCA0 MEDI-CAL CALIFORNIA 04 (OP) INST 94265 MEDICA CHOICE (UHC) 94265 MEDICA HEALTH (UHC) INST 78857 MEDICA HEALTHCARE PLAN FLORIDA 12422 MEDICA2 75254 MEDICAID ALABAMA MCDAK MEDICAID ALASKA MCDAR MEDICAID ARKANSAS MCDAR MEDICAID ARKANSAS INST 77016 MEDICAID COLORADO 77027 MEDICAID FLORIDA 77034 MEDICAID GEORGIA 77034 MEDICAID GEORGIA INST MCDIN MEDICAID INDIANA 18049 MEDICAID IOWA MCDKS MEDICAID KANSAS MCDKY MEDICAID KENTUCKY MCDME MEDICAID MAINE MCDMDMEDICAID MARYLAND MCDMA MEDICAID MASSACHUSETTS State CA CA FL AL AK AR AR CO FL GA GA IN IA KS KY ME MD MA Payer Type CI CI CI CI CI CI MC MC CI CI CI CI MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC Real Time Real Time N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N N N Y N Y N Y Y Y N Y Y Y Y Y Y Y Format Claim Status Eligibility Inst Prof Inst Prof Inst Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Inst Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N Y Y N N N N N Y N N Y Y Y Y N Y N Y N Y Y N N N N N N Y Y Y Y N N Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name MCDMA MEDICAID MASSACHUSETTS INST MCDMI MEDICAID MICHIGAN MCDMNMEDICAID MINNESOTA 77032 MEDICAID MISSISSIPPI 77032 MEDICAID MISSISSIPPI INST 77039 MEDICAID MONTANA MCDNE MEDICAID NEBRASKA MCDNE MEDICAID NEBRASKA DENTAL MCDNV MEDICAID NEVADA MCDNJ MEDICAID NEW JERSEY MCDNY MEDICAID NEW YORK MCDNY MEDICAID NEW YORK INST DNC00 MEDICAID NORTH CAROLINA INST MCDOH MEDICAID OHIO MCDOH MEDICAID OHIO INST MCDOK MEDICAID OKLAHOMA MCDOR MEDICAID OREGON MCDPA MEDICAID PENNSYLVANIA MCDSC MEDICAID SOUTH CAROLINA MCDVA MEDICAID VIRGINIA MCDWAMEDICAID WASHINGTON MCDWAMEDICAID WASHINGTON INST MCDWVMEDICAID WEST VIRGINIA MCDWI MEDICAID WISCONSIN MC055 MEDICAID WISCONSIN HIRSP ONLY 77046 MEDICAID WYOMING 75254 MEDICAID ALABAMA DENTAL (EDS) State Payer Type MA MI MN MS MS MT NE NE NV NJ NY NY NC OH OH OK OR PA SC VA WA WA WV WI WI WY AL MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC CI MC MC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N Y N N Y Y Y N Y Y N Y Y Y Y Y Y N Y Y N Y N Format Claim Status Eligibility Inst Prof Prof Prof Inst Prof Prof Dental Prof Prof Prof Inst Inst Prof Inst Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Dental Claim Enrollment Required ERA Enrollment Required Y Y Y Y Y Y Y Y Y Y Y Y Y N N N Y N Y N Y Y N N N Y N Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name MCDAK MEDICAID ALASKA INST MCDPP MEDICAID ALL PAPER HCFA MCDAZ MEDICAID ARIZONA 77016 MEDICAID COLORADO INST MCDCT MEDICAID CONNECTICUT MCDCT MEDICAID CONNECTICUT INST MCDDC MEDICAID DC - DEPT OF HEALTHCARE FINANCE MCDDE MEDICAID DELAWARE 77060 MEDICAID HAWAII MCDID MEDICAID IDAHO MCDIL MEDICAID ILLINOIS MCDIL MEDICAID ILLINOIS INST MCDIN MEDICAID INDIANA INST MCDKS MEDICAID KANSAS INST MCDME MEDICAID MAINE INST MCDMOMEDICAID MISSOURI CKMO1 MEDICAID MISSOURI DENTAL MODMEMEDICAID MISSOURI DME MCDMOMEDICAID MISSOURI INST MCDNE MEDICAID NEBRASKA INST MCDNH MEDICAID NEW HAMPSHIRE MCDNMMEDICAID NEW MEXICO DNC00 MEDICAID NORTH CAROLINA MCDND MEDICAID NORTH DAKOTA CKCT1 MEDICAID OF CONNECTICUT CX014 MEDICAID OF ILLINOIS CKIN1 MEDICAID OF INDIANA State AK AZ CO CT CT DC DE HI ID IL IL IN KS ME MO MO MO MO NE NH NM NC ND CT IN Payer Type MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N Y Y Y Y Y N Y N N Y N N N N Y Y Y Y N N N Format Claim Status Eligibility Inst Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Inst Inst Inst Inst Prof Dental Prof Inst Inst Prof Prof Prof Prof Dental Dental Dental Claim Enrollment Required ERA Enrollment Required Y N N Y Y N Y Y Y N Y Y N N N N Y N N Y Y Y Y N Y N N Y N N Y Y N Y Y N Y Y Y Y Y Y Y N Y Y Y Y Y Y N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name CKKY1 MEDICAID OF KENTUCKY REGION 3 (DORAL DENTAL) CKMA1 MEDICAID OF MASSACHUSETTS DENTAL DNC00 MEDICAID OF NORTH CAROLINA DENTAL CX014 MEDICAID OF PENNSYLVANIA CKSC1 MEDICAID OF SOUTH CAROLINA DENTAL CX014 MEDICAID OF TENNESSEE TNC01 MEDICAID OF TENNESSEE (TENNCARE) WRAP1 MEDICAID OHIO - WRAP AROUND OKFOS MEDICAID OKLAHOMA FOSTER CARE FOR ATYPICAL USE ONLY MCDOK MEDICAID OKLAHOMA INST MCDPA MEDICAID PENNSYLVANIA INST MCDRI MEDICAID RHODE ISLAND MCDSD MEDICAID SOUTH DAKOTA EP916 MEDICAID TEXAS EPSDT - PIN 86916 MEDICAID TEXAS INST 86916 MEDICAID TEXAS TMHP 86916 MEDICAID TX MCDUT MEDICAID UTAH - FFS MCDVT MEDICAID VERMONT MCDWVMEDICAID WEST VIRGINIA - INST MEDAD MEDICAL ADMINISTRATORS PAPER WPROV ID 41556 MEDICAL BEN ADMIN 68041 MEDICAL BENEFITS ADMINISTRATION 37298 MEDICAL BENEFITS ADMINISTRATORS OF MD 74323 MEDICAL BENEFITS ADMINISTRATORS, INC (NEWARK, 74323 MEDICAL BENEFITS COMPANIES (NEWARK, OH) 74323 MEDICAL BENEFITS MUTUAL State MA NC SC OH OK OK PA RI SD TX TX TX TX UT VT WV Payer Type MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC MC CI MC CI WC CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N Y N Y N N N N N N N N N Format Claim Status Eligibility Dental Dental Dental Dental Dental Dental Dental Prof Prof Inst Inst Prof Prof Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Inst Inst Prof Claim Enrollment Required ERA Enrollment Required N N Y N N N N N N N N Y Y N N N N Y N N N N N N N N N N N Y N N N N Y Y Y Y Y Y Y Y Y Y Y N Y N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 74323 74323 4258 4258 52181 29076 29076 CSMED 80026 80026 33029 13375 13375 IP186 38224 MBAL2 MBAK2 MBAZ2 MBAR2 MBCA1 MACA1 MBCO2 MBCT2 MBDC2 MBDE2 MBFL2 MBGA2 Name State MEDICAL BENEFITS MUTUAL (NEWARK, OH) MEDICAL BENEFITS MUTUAL LIFE INSRANCE CO MEDICAL CLAIMS SERVICE MEDICAL CLAIMS SERVICE INC MEDICAL DEVELOPMENT INTERNATIONAL MEDICAL MUTUAL OF OHIO MEDICAL MUTUAL OF OHIO HOSPITAL MEDICAL NETWORK OF COLORADO SPRINGS OH OH CO MEDICAL PARTNERS OF AMERICA MEDICAL PARTNERS OF AMERICA MEDICAL PATHWAYS MEDICAL SELECT MANAGEMENT MEDICAL SELECT MANAGEMENT HSP MEDICAL SERVICES INITIATIVE MEDICAL VALUE PLAN MVPOH MEDICARE ALABAMA MEDICARE ALASKA MEDICARE ARIZONA MEDICARE ARKANSAS MEDICARE CALIFORNIA NORTHERN REGION MEDICARE CALIFORNIA PART A MEDICARE COLORADO MEDICARE CONNECTICUT MEDICARE DC METRO MEDICARE DELAWARE MEDICARE FLORIDA MEDICARE GEORGIA OH AL AK AZ AR CA CA CO CT DC DE FL GA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI MB MB MB MB MB MA MB MB MB MB MB MB Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N Y Y Y Y Y Y Y Y Y Y Y Y Format Claim Status Eligibility Inst Inst Prof Inst Prof Prof Inst Prof Inst Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N Y Y Y Y Y Y Y Y Y Y Y Y N N N N N Y Y N N N N N N N N Y Y Y Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name MAGA1 MEDICARE MBHI2 MEDICARE MBID2 MEDICARE MBIL2 MEDICARE MBIN2 MEDICARE MB849 MEDICARE MBKY2 MEDICARE MBLA2 MEDICARE MBME2 MEDICARE MBMA2 MEDICARE MBMI2 MEDICARE MBMN2 MEDICARE MBMS2 MEDICARE MBMT2 MEDICARE 655 MEDICARE MBNH2 MEDICARE MBNJ2 MEDICARE MBNY4 MEDICARE MBNY3 MEDICARE MBNC2 MEDICARE MBND2 MEDICARE MBOK2 MEDICARE MBPA2 MEDICARE MBRI2 MEDICARE MBSC2 MEDICARE MBSD2 MEDICARE MBTN2 MEDICARE GEORGIA PART A HAWAII IDAHO ILLINOIS INDIANA IOWA KENTUCKY LOUISIANA MAINE MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MONTANA NEBRASKA NEW HAMPSHIRE NEW JERSEY NEW YORK QUEENS COUNTY ONLY NEW YORK UPSTATE NORTH CAROLINA NORTH DAKOTA OKLAHOMA PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE State Payer Type GA HI ID IL IN IA KY LA ME MA MI MN MS MT NE NH NJ NY NY NC ND OK PA RI SC SD TN MA MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB MB Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y Y Y Y Y Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Y Y Y Format Claim Status Eligibility Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name MBUT2 MEDICARE UTAH MBVT2 MEDICARE VERMONT MBWA2 MEDICARE WASHINGTON MBWV2 MEDICARE WEST VIRGINIA MBWI2 MEDICARE WISCONSIN MBWY2 MEDICARE WYOMING RH450 MEDICARE A RURAL - FQHC - LEGACY - NGS RH301 MEDICARE A RURAL - FQHC - LEGACY CAHABA RH400 MEDICARE A RURAL - FQHC - NOVITAS 60 MEDICARE ADVANTAGE CONNECTICUT - BLUE MR710 MEDICARE ADVANTAGE MICHIGAN PLUS BLUE MR710 MEDICARE ADVANTAGE MICHIGAN INST MAAR1 MEDICARE ARKANSAS PART A MBCA2 MEDICARE CALIFORNIA SOUTHERN REG MACO1 MEDICARE COLORADO PART A MAFL1 MEDICARE FLORIDA PART A MAID1 MEDICARE IDAHO PART A MAIL1 MEDICARE ILLINOIS PART A MAIN1 MEDICARE INDIANA J8 PART A MAJ49 MEDICARE J4901 PART A 650 MEDICARE KANSAS MBKS2 MEDICARE KANSAS MAKS1 MEDICARE KANSAS J5 PART A MALA1 MEDICARE LOUISIANA PART A MBMD2 MEDICARE MARYLAND MAMA1 MEDICARE MASSACHUSETTS PART A MAMI1 MEDICARE MICHIGAN PART A State UT VT WA WV WI WY TX CT MI MI AR CA CO FL ID IL IN KS KS KS LA MD MA MI Payer Type MB MB MB MB MB MB MA MA MA BL MB MA MA MB MA MA MA MA MA MA MB MB MA MA MB MA MA Real Time Real Time N N N N N N N N N Y N N N N N N N N N N N N N N N N N Y Y Y Y Y Y Y Y N Y Y N Y Y Y N Y Y Y Y N Y N Y Y Y Y Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Inst Inst Inst Prof Prof Inst Inst Prof Inst Inst Inst Inst Inst Inst Prof Prof Inst Inst Prof Inst Inst Claim Enrollment Required ERA Enrollment Required Y Y Y Y Y Y Y Y Y Y Y N Y Y Y N N Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y N Y Y Y N N Y Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name MBMO2 MEDICARE MISSOURI EASTERN MAMO1MEDICARE MISSOURI J5 PART A 740 MEDICARE MISSOURI WEST - KANSAS CITY MBKC2 MEDICARE MISSOURI WEST - KANSAS CITY MBNE2 MEDICARE NEBRASKA MANE1 MEDICARE NEBRASKA J5 PART A MBNV2 MEDICARE NEVADA MANH1 MEDICARE NEW HAMPSHIRE PART A MBNM2 MEDICARE NEW MEXICO MBNY2 MEDICARE NEW YORK EMPIRE DOWNSTATE MANC1 MEDICARE NORTH CAROLINA PART A MBOH2 MEDICARE OHIO MAOH1 MEDICARE OHIO PART A MAOK1 MEDICARE OKLAHOMA PART A MBOR2 MEDICARE OREGON MCRPP MEDICARE PART B PAPER HCFA MAPA1 MEDICARE PENNSYLVANIA PART A MBPR2 MEDICARE PUERTO RICO 882 MEDICARE RAILROAD MATN1 MEDICARE TENNESSEE PART A MATX1 MEDICARE TEXAS PART A AND INDIAN HEALTH SERVICES MBTX2 MEDICARE TEXAS PART B MAVA1 MEDICARE VIRGINIA PART A MBVA2 MEDICARE VIRGINIA PART B MAWV1 MEDICARE WEST VIRGINIA PART A MAWI1 MEDICARE WISCONSIN PART A RH280 MEDICARE WPS J5 NATIONAL PART A 05901 State MO MO MO MO NE NE NV NH NM NY NC OH OH OK OR PA PR TN TX TX VA VA WV WI Payer Type MB MA MB MB MB MA MB MA MB MB MA MB MA MA MB MB MA MB MB MA MA MB MA MB MA MA MA Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N Y Y Y N Y Y Y Y Y Y Y Y Y Y Y Y Y Y N Y N Y Y Format Claim Status Eligibility Prof Inst Prof Prof Prof Inst Prof Inst Prof Prof Inst Prof Inst Inst Prof Prof Inst Prof Prof Inst Inst Prof Inst Prof Inst Inst Inst Claim Enrollment Required ERA Enrollment Required Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 66058 MEDICARE Y MUCHO MAS (MMM) HDM04 MEDICO INSURANCE COMPANY 95655 MEDIGOLD 94254 MEDIPRIME 20039 MEDITURE 37304 MEDIVERSAL CLAIMS ADMINISTRATION 412MP MEDPARTNERS (CHS) MPAS1 MEDPARTNERS ADMIN SERVICES 35205 MEDPARTNERS ADMIN SERVICES (IN) 62160 MEDSOLUTIONS 62160 MEDSOLUTIONS INST 82160 MEDSPAN 243 MEDSTAR FAMILY CHOICE 11983 MEEMIC (AUTO ONLY) 74227 MEGA LIFE HEALTH INS (STUDENT INSURANCE) 11983 MEMBER SELECT INSURANCE COMPANY (AUTO ONLY) 11030 MEMIC MCA11 MEMORIAL CLINICAL ASSOCIATES 41556 MEMORIAL HEALTH SERVICES MHHNP MEMORIAL HERMANN HEALTH INSURANCE MHHNP MEMORIAL HERMANN HEALTH NETWORK PLAN INST 59064 MEMORIAL INTEGRATED HEALTHCARE 59065 MEMORIAL INTEGRATED HEALTHCARE MEDICAID 36193 MEMPHIS MANAGED CARE 36196 MEMPHIS MANAGED CARETLC HOS 33650 MENDOTA INSURANCE COMPANY (AUTO ONLY) MNM01 MENNONITE MUTUAL AID State PR GA TX TX TX Payer Type MB CI CI CI CI CI CI CI CI CI CI CI CI AM CI AM WC CI WC CI CI CI CI CI CI AM CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N Format Claim Status Eligibility Prof Dental Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Inst Prof Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name MNM99 MENNONITE MUTUAL AID 86052 MERCY CARE PLAN ARIZONA MRC01 MERCY CARE PLAN ARIZONA 86052 MERCY CARE PLAN ARIZONA - INST 43166 MERCY COVENTRY HEALTH PLAN 33628 MERCY MARICOPA INTEGRATED CARE IP079 MERCY PHYSICIANS MEDICAL GROUP SAN DIEGO MPMG 41556 MERIDIAN CONSTRUCTION PROGRAM - WC 13189 MERIDIAN HEALTH PLAN 13189 MERIDIAN HEALTH PLAN - INST 14145 MERIDIAN HEALTH PLAN OF IOWA 14145 MERIDIAN HEALTH PLAN OF IOWA INST 52563 MERIDIAN HEALTH PLAN OF MICHIGAN 52563 MERIDIAN HEALTH PLAN OF MICHIGAN INST 41556 MERITAGE CORPORATION 41124 MERITAIN HEALTH - IBI 64158 MERITAIN HEALTH AGENCY SERVICES INST 41124 MERITAIN HEALTH - CBSA 41124 MERITAIN HEALTH - CBSA - CORP BENEFIT SERVICES OF AMERICA 41124 MERITAIN HEALTH - CORP BENEFIT SERVICES OF AMERICA 41124 MERITAIN HEALTH - IOWA BENEFITS INC 64157 MERITAIN HEALTH - NORTH AMERICAN 64157 MERITAIN HEALTH - NORTH AMERICAN - INST 38232 MERITAIN HEALTH - WEYCO 38232 MERITAIN HEALTH - WEYCO - INST 37299 MERITAIN HEALTH FKA NYHART COMPANY 37299 MERITAIN HEALTH FKA NYHART COMPANY State AZ AZ AZ CA IA IA MI MI Payer Type CI CI CI CI CI CI CI WC CI CI CI CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N Y N N N N N N Y N Format Claim Status Eligibility Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Prof Inst Prof Inst Prof Inst Inst Inst Prof Inst Inst Prof Inst Prof Inst Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 86062 41556 41556 85035 85035 65113 65113 AMS01 65978 87726 87726 87726 87726 87726 87726 87726 82135 CX014 13265 13265 J1355 MDL99 10850 52627 MHP 10850 AM726 Name MERITUS MUTUAL HEALTH PARTNERS PPO (AZ FOUNDATION) State AZ MESA COUNTY COLORADO MESA COUNTY VALLEY SCHOOL DISTRICT 51 MESA MENTAL HEALTH MESA MENTAL HEALTH NM NM METCARE HEALTH PLANS METCARE HEALTH PLANS METHODIST SW PRV ORG METLIFE METRA HEALTH INST METRAHEALTH NETWORK METRAHEALTH NETWORK METRAHEALTH NETWORK METRAHEALTH PLAN ADMINISTRATORS METRAHEALTH PLAN ADMINISTRATORS METRAHEALTH RAILROAD METRO ALLIANCE METRO PLUS METRO PLUS HEALTH PLAN METRO PLUS HEALTH PLAN INST METROPOLITAN COUNCIL METROPOLITAN DETROIT LABORERS MI METROPOLITAN HEALTH PLAN METROPOLITAN HEALTH PLAN (MEDICAID) METROPOLITAN HEALTH PLAN (MEDICAID) METROPOLITAN HEALTH PLAN (MHP) METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (AUTO ONLY) MN MN MN Payer Type CI WC WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI MC MC CI AM Real Time Real Time N N N N N N N N N N Y Y N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Format Claim Status Eligibility Prof Prof Prof Inst Prof Inst Prof Prof Dental Inst Inst Prof Prof Prof Prof Prof Prof Dental Prof Inst Prof Prof Inst Inst Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N Y Y Y Y Y Y Y N N N N N N N N N Y N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name J1238 METROPOLITAN TRANSIT AUTHORITY MWP01 METROWEST HEALTH PLANPREFERRED CARE MWS01 METROWEST STAR MEDICAID 41556 MEXICANA AIRLINES 74289 MHNET - MENTAL HEALTH NETWORK 74289 MHNET - MENTAL HEALTH NETWORK 3918A MHS WISCONSIN INST (ATYPICAL USE ONLY) 92579 MIAMI BEHAVIORAL HEALTH C1028 MIC GENERAL INSURANCE CORP C1028 MIC PROPERTY AND CASUALTY INS CORP 41556 MICHAEL HOGAN ASSOC 37127 MICHAEL REESE PHYSICIANS GROUP 37127 MICHAEL REESE PHYSICIANS GROUP A1432 MICHIGAN LABORERS HEALTH CARE FUND 38238 MICHIGAN REGIONAL COUNCIL OF CARPENTERS EMPLOYEE BENEFIT PLAN BCCMI MICHIGAN STATE BCCCP A1404 MICHIGAN STATE PAINTERS 43132 MID AMERICA HEALTH 25147 MID AMERICA HEALTH (LEASED PPO) 63079 MID ATLANTIC HEALTH PLAN 52149 MID ATLANTIC PSYCHIATRIC SERVICES (MAPSI) 87726 MID ATLANTIC PSYCHIATRIC SERVICES, INC (MAPSI) C1034 MID CENTURY INSURANCE COMPANY (AUTO ONLY) MRIPA MID ROGUE OREGON HEALTH PLAN MRIPA MID ROGUE OREGON HEALTH PLAN 37281 MID-AMERICA ASSOCIATES 37281 MID-AMERICA ASSOCIATES, INC State WI FL MI MO OR OR Payer Type WC CI CI WC CI CI CI CI AM AM WC CI CI CI CI MC CI CI CI CI CI CI AM CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Inst Dental Dental Prof Dental Inst Prof Prof Prof Inst Prof Inst Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N Y N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 22823 MID-AMERICAN BENEFITS 63079 MID-ATLANTIC HEALTH SYSTEM 74227 MID-WEST NATIONAL LIFE INSURANCE CO OF 59224 MID-WEST NATIONAL LIFE INSURANCE CO OF TENNESSEE 59224 MID-WEST NATIONAL LIFE OF TENN 37281 MIDAMERICA ASSOCIATES IP004 MIDCOAST CARE 47081 MIDLANDS BENEFITS ADMIN 47080 MIDLANDS CHOICE 47080 MIDLANDS CHOICE 47080 MIDLANDS CHOICE, INC 47080 MIDLANDS HEALTH PARTNERS 62168 MIDSOUTH ADMINISTRATIVE GROUP J1119 MIDWEST DRYWALL J1685 MIDWEST FAMILY MUTUAL INSURANCE CO J1685 MIDWEST FAMILY MUTUAL INSURANCE CO (AUTO ONLY) 61146 MIDWEST GROUP BENEFITS 61146 MIDWEST GROUP BENEFITS MHP77 MIDWEST HEALTH PLAN MSI01 MIDWEST SECURITY ADMINISTRATION 79480 MIDWEST SECURITY ADMINISTRATORS DENTAL MSI01 MIDWEST SECURITY INSURANCE COMPANY 74227 MIDWEST UNITED LIFE MSI01 MIDWESTER PREFERRED J1482 MILLARD REFRIGERATED A1402 MILLRIGHTS MPMG1 MILLS PENINSULA MEDICAL GROUP State TN CA CA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI WC WC AM CI CI CI CI CI CI CI CI WC CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Inst Inst Prof Inst Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Inst Prof Prof Prof Dental Prof Prof Prof Prof Dental Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 68241 PR002 J1351 J1436 41556 41556 IP014 64084 37233 37233 75203 64088 41556 37275 37275 43179 J1085 J1692 J1692 J1694 J1694 37265 37265 J1622 J1622 13350 13350 Name State MINNEAPOLIS PRUD MINNEAPOLIS PRUDENTIAL BUSINESS MINNESOTA COUNTIES INS TRUST (MCIT) MINNESOTA DEPARTMENT OF LABOR AND INDUSTRY CLAIMS SERVICES UNIT MISSION AVIATION FELLOWSHIP MISSION LODGE SANITARIUM MISSION VALLEY IPA MEDICAL GROUPLOMPOC CA MISSISSIPPI PHYSICIANS CARE NETWORK MISSISSIPPI PUBLIC EMPLOYEE BENEFIT TRUST MS MISSISSIPPI PUBLIC ENTITY EMPLOYEE BENEFIT TRUST MISSISSIPPI SELECT MISSISSIPPI SELECT HEALTH CARE MS MISSOULA CART CO, IN MISSOULA COUNTY MEDICAL BENEFITS PLAN MISSOULA COUNTY MEDICAL BENEFITS PLAN MISSOURI CARE DOS BEFORE 5-01-2013 MITCHELL ENERGY AND DEVELOPMENT MITSUI SUMITOMO INSURANCE GROUP MITSUI SUMITOMO INSURANCE GROUP (AUTO ONLY) MITSUI SUMITOMO INSURANCE USA INC MITSUI SUMITOMO INSURANCE USA INC (AUTO ONLY) MLINK MLINK MMIC MMIC (AUTO ONLY) MODA HEALTH PLAN - INST MODA HEALTH PLAN FKA ODS HEALTH MO Payer Type CI CI WC WC WC WC CI CI CI CI CI CI WC CI CI CI WC WC AM WC AM CI CI WC AM CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Prof Prof Prof Prof Prof Prof Inst Inst Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 26193 38333 38333 51062 51062 20934 20934 38334 71079 71079 20676 NM505 CX014 20149 46299 46299 20554 20554 SX109 38336 38336 38336 ABRI1 ABRI1 72135 IP095 Name State MODESTO IRRIGATION DISTRICT MOLINA HEALTHCARE OF ARIZONA MOLINA HEALTHCARE OF CALIFORNIA MOLINA HEALTHCARE OF CALIFORNIA INST MOLINA HEALTHCARE OF FLORIDA MOLINA HEALTHCARE OF FLORIDA INST MOLINA HEALTHCARE OF ILLINOIS MOLINA HEALTHCARE OF ILLINOIS INST MOLINA HEALTHCARE OF MICHIGAN MOLINA HEALTHCARE OF MISSOURI - COMMUNITY CARE PLUS MOLINA HEALTHCARE OF MISSOURI - INST MOLINA HEALTHCARE OF NEVADA MOLINA HEALTHCARE OF NEW MEXICO AZ CA CA FL FL IL IL MI MO MO NV NM MOLINA HEALTHCARE OF NEW MEXICO (FORMERLY CIMARRON) MOLINA HEALTHCARE OF OHIO MOLINA HEALTHCARE OF SOUTH CAROLINA MOLINA HEALTHCARE OF SOUTH CAROLINA INST MOLINA HEALTHCARE OF TEXAS MOLINA HEALTHCARE OF TEXAS INST MOLINA HEALTHCARE OF UTAH MOLINA HEALTHCARE OF WA MOLINA HEALTHCARE OF WASHINGTON MOLINA HEALTHCARE OF WASHINGTON INST MOLINA HEALTHCARE OF WISCONSIN MOLINA HEALTHCARE OF WISCONSIN - INST OH SC SC TX TX UT WA WA WA WI WI MOMENTUM HEALTH SERVICES MONARCH HEALTHCARE IPA CA Payer Type WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N Y N Y Y N N Y N Y N N Y N Y N Y N N N N N Format Claim Status Eligibility Prof Prof Prof Inst Prof Inst Prof Inst Prof Prof Inst Prof Prof Dental Prof Prof Inst Prof Inst Prof Prof Prof Inst Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y N N Y Y Y N Y N Y Y Y Y Y Y Y Y Y Y Y N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 50749 50749 MONEX 1759 13174 13174 J1424 A0179 J1530 J1530 MMLI3 MMLI2 MMLIC J1644 J1644 52133 J1651 J1651 J1086 J1087 IP083 41556 MPI01 J1203 J1203 36111 36111 Name State MONDIAL ASSISTANCE MONDIAL ASSISTANCE MONEX HEALTH CARE IL MONITOR LIFE INS MORGAN WHITE ADMIN MONTEFIORE CMO MONTEFIORE CONTRACT MANAGEMENT ORGANIZATION MONTGOMERY MONTGOMERY COUNTY TEXAS MONUMENT ADMINISTRATORS - CORNERSTONE COMP MONUMENT ADMINISTRATORS - ELITE COUNTRY CLUB MONUMENTAL LIFE INS CO (HURST, TX) MONUMENTAL LIFE INS CO (KY) MONUMENTAL LIFE INS CO (LITTLE ROCK, AR) MORENO VALLEY UNIFIED SCHOOL DISTRICT (CA) MORENO VALLEY UNIFIED SCHOOL DISTRICT (CA) (AUTO ONLY) MORGAN WHITE MORONGO BASIN TRANSIT AUTHORITY (CA) MORONGO BASIN TRANSIT AUTHORITY (CA) (AUTO ONLY) MORRIS MATERIAL HANDLING MORRISON HEALTH CARE, INC MOSAIC IPA MEDICAL GROUP MOTION PICTURE AND TELEVISION FUND MOTION PICTURE INDUSTRY HEALTH PLAN MOTORIST MUTUAL INSURANCE MOTORIST MUTUAL INSURANCE (AUTO ONLY) MOTOROLA MOTOROLA CA Payer Type CI CI CI CI CI CI WC WC WC WC CI CI CI WC AM CI WC AM WC WC CI WC CI WC AM CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Dental Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name C1028 MOTORS INSURANCE CORPORATION 95655 MOUNT CARMEL SERVICES TPC65 MOUNT VERNON WELFARE FUND COMMAMOUNTAIN MEDICAL 86040 MOUNTAIN STATES ADMINISTRATIVE SERVICES 86040 MOUNTAIN STATES ADMINISTRATIVE SERVICES 80900 MPA - CUSTOM PROVIDER NETWORK 80900 MPA - CUSTOM PROVIDER NETWORK - INST 37233 MPE EMPLOYEE BENEFIT SERVICES 37233 MPE SERVICES INC 37233 MPEEBT 37233 MPEEBT 95444 MPLAN, INCHEALTHCARE GROUP, LLC 95444 MPLAN, INCHEALTHCARE GROUP, LLC J1641 MTS J1641 MTS (AUTO ONLY) J1533 MTV (MURPHY AND BEANE) 45235 MULTIPLAN - GEHA 45235 MULTIPLAN - GEHA - INST 41204 MULTIPLAN BASIC PLUS 41204 MULTIPLAN BASIC PLUS 34080 MULTIPLAN WISCONSIN PREFERRED PROVIDER NETWORK 34080 MULTIPLAN WISCONSIN PREFERRED PROVIDER NETWORK J1088 MUNFORD, INC 81883 MUNICIPAL HEALTH BENEFIT FUND 81883 MUNICIPAL HEALTH BENEFIT FUND J1118 MUSCO State CO MS MS Payer Type AM CI CI CI CI CI CI CI CI CI CI CI CI CI WC AM WC CI CI CI CI CI CI WC CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Format Claim Status Eligibility Prof Prof Dental Prof Prof Inst Prof Inst Prof Inst Prof Inst Inst Prof Prof Prof Prof Prof Inst Inst Prof Inst Prof Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID A1681 37256 37256 70491 CX087 TEMU1 71412 71412 SDMC 71412 71412 TEMU1 14165 14165 65085 65085 65085 34159 53011 53011 NANPR J1120 DMG01 NHCA1 58182 J1695 J1695 Name MUSKEGON CARE - ACCESS HEALTH PLAN MUTUAL ASSURANCE State MI OK MUTUAL ASSURANCE ADMINISTRATORS MUTUAL GROUP (THE) (US) MUTUAL OF OMAHA MUTUAL OF OMAHA (MUST HAVE UCCI LISTED ON BACK OF ID CARD) MUTUAL OF OMAHA INSURANCE COMPANY MUTUAL OF OMAHA INSURANCE COMPANY MUTUAL OF OMAHA MEDICARE SD MUTUALLY PREFERRED MUTUALLY PREFERRED MUTUALLY PREFERRED (MUST HAVE UCCI LISTED ON BACK OF ID CARD) MVP HEALTH PLAN OF NY MVP HEALTH PLAN OF NY INST NY NY NAA NAA (NORTH AMERICA ADMIN, LP) NAA (NORTH AMERICAN ADMINISTRATORS, LP) NABN NALC HEALTH BENEFITS THRU DOS 12312007 NALCAFFORDABLE NAMM PARTNERS INC NAP TOOLS NAPERVILLE - ILLINOIS HEALTH PARTNERS (DOS BEG JAN 2012) NAPERVILLE HEALTH CARE ASSOC (DOS PRIOR JAN 2012) NAPHCARE NATIONAL AMERICAN INSURANCE CO (NAICO) NATIONAL AMERICAN INSURANCE CO (NAICO) (AUTO ONLY) IL Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI CI WC AM Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N Y N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Inst Inst Dental Dental Inst Prof Inst Inst Prof Dental Prof Inst Prof Prof Inst Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N Y Y N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID AMS01 53011 53011 53011 56176 56175 56175 56176 J1551 J1484 90956 98205 C1028 88057 88050 75275 37232 NIA11 32620 41556 20044 J1021 52132 71412 71412 TEMU1 NTA11 Name State CI CI NATIONAL ASSOCIATION OF LETTER CARRIERS THRU 12312007 CI NATIONAL ASSOCIATION OF LETTER CARRIERSNALC CI NATIONAL BENEFIT ADMINIS NC CI NATIONAL BENEFIT ADMINIS NJ CI NATIONAL BENEFIT ADMINISTRATORS OF NEW JERSEY CI NATIONAL BENEFIT ADMINISTRATORS OF NORTH CAROLINA CI NATIONAL CASUALTY COMPANY WC NATIONAL FARMERS UNION PROPERTY AND CASUALTY COMPANY - QBE DBA WC NATIONAL FINANCIAL INSURANCE CO CI NATIONAL FOUNDATION LIFE INSURANCE CO CI NATIONAL GENERAL INSURANCE ONLINE, INC FORMERLY GMAC INS AM NATIONAL HEALTH BENEFITS CORP (NHBC) CI NATIONAL HEALTH BENEFITS CORP - NHBC02 CI NATIONAL HEALTH INSURANCE COMPANY CI NATIONAL HEALTHCARE EXCHANGE SERVICES CI NATIONAL IMAGING ASSOCIATES CI NATIONAL INTERSTATE WC NATIONAL JEWISH HEALTH WC NATIONAL LIABILITY AND FIRE INSURANCE COMPANY WC NATIONAL LOSS PREVENTION, INC WC NATIONAL RURAL ELECTRIC COOPERATIVE ASSOC CI NATIONAL RURAL LETTER CARRIER ASSOC (NALC) CI NATIONAL RURAL LETTER CARRIER ASSOCIATION CI NATIONAL RURAL LETTER CARRIER ASSOCIATION (MUST HAVE UCCI LISTED ON BACK OF ID CARD) CI NATIONAL TEACHERS ASSOCIATION CI NATIONAL ASSOC PREFERRED PRV TX NATIONAL ASSOCIATION OF LETTER CARRIERS NALC TX Payer Type Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Dental Prof Inst Inst Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Dental Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 52103 52103 37120 37120 J1552 J1551 J1551 31417 31417 J1552 J1552 J1552 J1552 J1552 19191 J1359 J1660 J1660 75191 75190 75190 71412 95123 96107 4293 4293 11325 Name State NATIONAL TELECOMM COOP ASSOC (NTCA) NATIONAL TELECOMM COOP ASSOC (NTCA) INST NATIONAL TRAVELERS LIFE NATIONAL TRAVELERS LIFE COMPANY NATIONWIDE AFFINITY INS CO OF AMERICA (NAICOA) NATIONWIDE AGRIBUSINESS COMPANIES NATIONWIDE AGRIBUSINESS INS CO NATIONWIDE HEALTH PLANS NATIONWIDE HEALTH PLANS NATIONWIDE INS CO OF AMERICA (NICOA) NATIONWIDE INSURANCE COMPANIES NATIONWIDE MUTUAL FIRE CO NATIONWIDE MUTUAL INSURANCE COMPANY NATIONWIDE PROPERTY AND CASUALTY INS CO NATIVE CARE HEALTH LLC NBC UNIVERSAL NC DEPARTMENT OF PUBLIC INSTRUCTION NC DEPARTMENT OF PUBLIC INSTRUCTION (AUTO ONLY) NCAS CHARLOTTE NCAS FAIRFAX VA NCAS FAIRFAX VA NC VA VA NCCI NEIGHBORHOOD HEALTH PARTNERSHIP NEIGHBORHOOD HEALTH PARTNERSHIP OF FLORIDA NEIGHBORHOOD HEALTH PLAN NEIGHBORHOOD HEALTH PLAN - INST NEIGHBORHOOD HEALTH PROVIDERS FL Payer Type CI CI CI CI WC WC WC CI CI WC WC WC WC WC CI WC WC AM CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N Y N N N N N N N N N N N N N N N Y N N Format Claim Status Eligibility Prof Inst Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Inst Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 11325 39164 39164 37255 37255 66055 66055 77076 4332 CX014 4332 39144 39111 AMS01 NDB01 90091 86067 86067 86067 95998 95998 NCHCA NCHCA NCHON NCHON 66893 43351 Name State NEIGHBORHOOD HEALTH PROVIDERS INST NEIGHBORLY CARE PLAN NEIGHBORLY CARE PLAN NESIKA HEALTH GROUP NESIKA HEALTH GROUP INST NETCARE LIFE AND HEALTH INSURANCE NETCARE LIFE AND HEALTH INSURANCE (HAGATNA, NETWORK PLATINUM PLUS NETWORK HEALTH MASS NETWORK HEALTH MASS - DENTAQUEST NETWORK HEALTH MASS INST NETWORK HEALTH PLAN OF WI MA MA MA WI NETWORK HEALTH PLAN OF WISCONSIN NETWORK HEALTH PPO (AMS01) WI NEVADA DENTAL BENEFITS NEVADA HEALTH CO-OP NEVADA HEALTH SOLUTIONS NEVADACARE NEVADACARE KIDS NV NV NV NV NEW AVENUES INC NEW AVENUES INC NEW CENTURY HEALTH - CAREPLUS CARDIOLOGY NEW CENTURY HEALTH - VISTA CARDIOLOGY - SUMMIT NEW CENTURY INFUSION - CAREPLUS ONCOLOGY NEW CENTURY INFUSION - VISTA ONCOLOGY NEW ENGLAND NEW ENGLAND DENTAL ADMINISTRATORS FL FL FL FL Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Inst Prof Inst Prof Inst Prof Prof Dental Inst Prof Inst Prof Dental Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 76031 76031 75281 75281 22603 12122 45129 45129 TPC66 TPC67 C1028 84141 84141 38332 38332 66915 11334 48186 48186 24819 24819 NYT01 38225 38225 38225 62124 CX014 Name State NEW ERA EMPLOYEE WELFARE BENEFIT PLAN TRUST NEW ERA EMPLOYEE WELFARE BENEFIT PLAN TRUST NEW ERA LIFE NEW ERA LIFE NEW JERSEY CARPENTERS HEALTH FUND NEW JERSEY MANUFACTURING NEW MEXICO HEALTH CONNECTIONS NEW MEXICO HEALTH CONNECTIONS INST NM NM NEW ROCHELLE EMPLOYEES L663 NEW ROCHELLE FUSE WELFARE FUND NEW SOUTH INSURANCE CO NEW WEST HEALTH PLAN NEW WEST HEALTH PLAN HOS NEW WORLD CLAIMS SERVICE NEW WORLD CLAIMS SERVICES NEW YORK LIFE INSURANCE CO NEW YORK NETWORK MANAGEMENT NY NEW YORK PRESBYTERIAN COMMUNITY HEALTH PLAN NEW YORK PRESBYTERIAN COMMUNITY HEALTH PLAN NEW YORK PRESBYTERIAN SYSTEM SELECT HEALTH NEW YORK PRESBYTERIAN SYSTEM SELECT HEALTH NY NY NY NEW YORK STATE TEAMSTERS UNION NGS AMERICAN NGS AMERICAN INST NGS CORESOURCE NHC HEALTH BENEFIT PLAN NHP COMMONWEALTH CARE - DENTAQUEST MA Payer Type CI CI CI CI CI WC CI CI CI CI AM CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Inst Prof Prof Prof Prof Inst Dental Dental Prof Prof Inst Prof Inst Inst Prof Inst Prof Inst Prof Dental Prof Inst Prof Inst Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 5047 J1533 81264 81264 81264 TPC68 35197 IP080 J1360 J1453 64157 34159 34159 34159 E3510 IP079 93100 64157 37314 NCLME 41556 41556 320 17516 46227 36392 36392 Name NHPRI (NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND) State RI NICKELODIAN (MURPHY AND BEANE) NIPPON LIFE INSURA NIPPON LIFE INSURANCE CO NIPPON LIFE INSURANCE DENTAL NJDCEA WELFARE FUND NNPN CONSECO HOS NOBLE COMMUNITY CA NORDSTROM, INC NORGUARD INSURANCE COMPANY - GUARD DBA NORTH AMERICAN ADMINISTRATORS NORTH AMERICAN BENEFITS NETWORK NORTH AMERICAN BENEFITS NETWORK NORTH AMERICAN BENEFITS NETWORK NORTH AMERICAN MEDICAL MANAGEMENT NORTHERN CALIFORNIA NORTH AMERICAN MEDICAL MANAGEMENT SO CALIFORNIA NORTH AMERICAN MEDICAL MANAGEMENT TEXAS CA CA TX NORTH AMERICAN PREFERRED NORTH BROWARD HOSPITAL DISTRICT NORTH CAROLINA LME REFERRALS - MEDICAID NC NORTH CLACKAMAS SCHOOL DISTRICT NO 12 NORTH COUNTY TRANSIT DISTRICT NORTH DAKOTA WORKFORCE SAFETY AND INS NORTH SHORE - LIJ (HEALTHFIRST) NORTH SHORE - LIJ CARECONNECT INSURANCE CO NORTH SUBURBAN ASSOCIATED PHYS NORTH SUBURBAN ASSOCIATED PHYS ND Payer Type CI WC CI CI CI CI CI CI WC WC CI CI CI CI CI CI CI CI CI MC WC WC CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Inst Prof Dental Dental Inst Prof Prof Prof Prof Dental Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N Y N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID NTX11 PROSP 2027 13376 38238 41556 36347 88027 C1031 48026 48026 52627 91060 36234 36234 J1361 J1361 NPN11 NPN11 36346 36346 J1089 16114 16114 41556 41556 16644 Name NORTH TEXAS HEALTHCARE NETWORK NORTH WEST ORANGE COUNTY MEDICAL GROUP State TX CA NORTHEAST DELTA DENTAL (ME-NH-VT) NORTHEAST GEORGIA HEALTH SYSTEM NORTHERN CALIFORNIA SHEET METAL WORKERS HEALTH CARE PLAN CA NORTHERN COLORADO SCHOOL DISTRICTS WORKERS' COMPENSATION POOL NORTHERN ILLINOIS HEALTH PLAN IL NORTHERN NEVADA TRUST FUND NORTHLAND AUTO NORTHSHORE PHYSICIANS ASSOCIATES NORTHSHORE PHYSICIANS ASSOCIATES INST NORTHSTAR ADVANTAGE HMO (MHP) NORTHWEST ADMINISTRATORS NORTHWEST COMMUNITY HEALTH PARTNERS NORTHWEST COMMUNITY HEALTH PARTNERS NORTHWEST INSURANCE NORTHWEST INSURANCE (AUTO ONLY) NORTHWEST PHYSICIANS NETWORK NORTHWEST PHYSICIANS NETWORK NORTHWEST SUBURBAN IPA (ILLINOIS) NORTHWEST SUBURBAN IPA (ILLINOIS) NORWOOD NOVA CASUALTY CO NOVA CASUALTY CO NOVA DEALERSHIP ADVANTAGE PROGRAM - WC NOVA ELITE COMP PROGRAM NOVA HEALTHCARE ADMINISTRATORS AZEROS MN Payer Type CI CI CI CI CI WC CI CI AM CI CI CI CI CI CI WC AM CI CI CI CI WC CI CI WC WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Dental Inst Prof Prof Prof Inst Prof Prof Inst Prof Dental Inst Prof Prof Prof Inst Prof Prof Inst Prof Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 16644 16644 41556 J1056 6226 71080 71080 NTX11 41556 91136 91136 91136 91136 91136 91136 TPC69 TPC70 CX014 14142 14142 TPC71 TPC72 TPC73 TPC74 TPC75 45052 J1670 Name State NOVA HEALTHCARE ADMINISTRATORS - DENTAL NOVA HEALTHCARE ADMINISTRATORS - INST NOVA METALS ADVANTAGE PLUS PROGRAM - WC NOVA PRO RISK SOLUTIONS NOVANET NOVASYS NOVASYS HEALTH NETWORK NTHN AR AR TX NUEVO ENGINEERING NW IRONWORKERS HEALTH SECURITY TRUST FUND INST NW IRONWORKERS HLTH SECURITY TRUST FUND NW ROOFERS EMPLOYERS HEALTH SECURITY INST NW ROOFERS EMPLOYERS HLTH SECURITY TRUST FUND NW TEXTILE PROCESSORS NW TEXTILE PROCESSORS GRP F14 NY OIL HEAT ASSOCIATION NY STATE NURSES - WESTCHESTER NY-PRESBYTERIAN COMMUNITY HEALTH PLAN NYC DEPARTMENT OF HEALTH (ADAP) NYC DEPARTMENT OF HEALTH (ADAP) - INST NYC MUNICIPAL PLUMBERPIPEFITTERS NYC RETIREES WELFARE FUND NYC STEAMFITTERS NYC STEAMFITTERS RETIREES NYDCC WELFARE FUND NYSIF O'REILLY AUTO PARTS NY Payer Type CI CI WC WC CI CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Dental Inst Prof Prof Prof Prof Inst Prof Prof Inst Prof Inst Prof Inst Prof Dental Dental Dental Prof Inst Dental Dental Dental Dental Dental Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1670 20044 NAOAK NAOAK IP016 72127 OCH01 61101 72127 L0140 72087 13310 14163 14163 OAC01 OAC99 24074 AMS01 34189 34189 74431 74431 24147 OLRMC 91150 65074 68037 Name State O'REILLY AUTO PARTS (AUTO ONLY) OAK RIVER INSURANCE COMPANY (MEMBER OF BHHC) OAK WEST PRIMARY PHYSICIANS ASSOCIATION OAK WEST PRIMARY PHYSICIANS ASSOCIATION OAKVIEW MEDICAL GROUP CA OCHSNER HEALTH PLAN OCHSNER HEALTH PLAN OCHSNER HEALTH PLAN INST OCHSNER HEALTH PLANS LA OCULAR BENEFITS OFFICE OF GROUP BENEFITS LOUISIANA OFFICE OF THE ADMINISTRATOR OHANA HEALTH PLAN OHANA HEALTH PLAN LA DC HI HI OHIO AFSCME CARE PLAN OHIO AFSCME CARE PLAN OH OHIO CASUALTY GROUP OHIO HEALTH CHOICE PLAN OHIO HEALTH CHOICE PPO OH OH OHIO HEALTH CHOICE, PPO OHIO PPO CONNECT OHIO PPO CONNECT - INST OH OH OLD REPUBLIC INSURANCE CO OLOLRMC UNINSURED PATIENT SERVICES PROGRAM OLYMPIC HLTH MANAGEMENT SYSTEMS OLYMPUS MANAGED HEALTH CARE OMNI MEDICORE HP LA Payer Type AM WC CI CI CI CI CI CI CI CI BL CI CI CI CI CI WC CI CI CI CI CI WC CI CI CI CI Real Time Real Time N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N Y N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Inst Prof Prof Inst Prof Inst Prof Prof Prof Prof Inst Prof Dental Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name MDCOR OMNI IPA MEDCARE HP IP088 OMNICARE MEDICAL GROUP (CA) ISL11 ON INSURANCE SERVICE OF LUBBOCK 20621 ONE BEACON C1026 ONE BEACON INSURANCE - AUTO 22321 ONE CALL MEDICAL 22321 ONE CALL MEDICAL INST 95379 ONE HEALTH PLAN OF CA HOSPITAL 95412 ONE HEALTH PLAN OF CO HOSPITAL 95412 ONE HEALTH PLAN OF COLORADO 95388 ONE HEALTH PLAN OF IL HOSPITAL 95388 ONE HEALTH PLAN OF ILLINOIS 95415 ONE HEALTH PLAN OF TEXAS 51459 ONE HEALTH PLAN OF TX HOSPITAL 96559 ONE HEALTH PLANOF GA HOSPITAL 52149 ONENET PPO 52149 ONENET PPO INST TPC76 OPEIU -DC 91136 OPERATING ENGINEERS LOCALS 302 612 HEALTH 91136 OPERATING ENGINEERS LOCALS 302 612 HLTH SECURITY FUND 56190 OPTICARE EYE HEALTH NETWORK 54154 OPTIMA HEALTH PLAN 54154 OPTIMA HEALTH PLAN 87726 OPTIMUM CHOICE INC 51248 OPTIMUM CHOICE INC HOSPITAL 52151 OPTIMUM CHOICE OF PENNSYLVANIA 52152 OPTIMUM CHOICE OF THE CAROLINAS State CA CO IL TX PA Payer Type CI CI CI WC AM CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Inst Inst Inst Prof Inst Prof Prof Inst Inst Prof Inst Dental Inst Prof Prof Inst Prof Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 87726 87726 GP133 20133 20133 37125 41194 21455 TPC77 J1090 13383 25681 13381 58204 58204 OSFMC 62171 CLF01 CLFR2 36365 36365 41556 41556 6111 OXHTH 6111 41556 Name State OPTIMUM CHOICE OF THE CAROLINAS, INC (OCCI) OPTIMUM CHOICE, INC (OCI) OPTIMUM HEALTH GOVERNMENT PROGRAMS OPTIMUM HEALTHCARE INC OPTIMUM HEALTHCARE INC OPTION SERVICES GROUP OPTUMHEALTH CARE SOLUTIONS OREGONS HEALTH CO-OP ORGANIZATION OF STAFF ANALYSTS ORICA, INC ORTHONET - AETNA ORTHONET - HEALTHNET ORTHONET CORPORATION ORTHOPEDIX NETWORK INC - HUMANA - OHU ORTHOPEDIX NETWORK INC - VISTA - OVI OSF CARE ADVANTAGE OSF HEALTHPLANS IL OSMA HEALTH (FORMERLY PLICO OKLAHOMA) OSMA HEALTH - C L FRATES AND COMPANY OUR LADY OF THE RESURRECTION OUR LADY OF THE RESURRECTION PHYSICIAN ASSOCIATION OUTRIGGER LODGING OVERHILL FARMS, INC OXFORD HEALTH OXFORD HEALTH OXFORD HEALTH - INST PACIFIC HYDROTECH CO IL Payer Type CI CI CI CI CI CI CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI WC WC CI CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N Format Claim Status Eligibility Inst Inst Dental Inst Prof Inst Prof Prof Dental Prof Prof Prof Prof Prof Prof Prof Prof Dental Prof Inst Prof Prof Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N Y Y Y N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID C1040 PCFCI IP101 41556 J1364 J1364 41556 33053 HM012 COFHP 95964 95964 95999 95959 95959 95999 COPHS 95962 95999 95959 95959 95999 95959 95959 95999 95959 95959 Name State PACIFIC INSURANCE COMPANY LTD PACIFIC IPA PACIFIC LUMBER COMPANY PALCO CA PACIFIC LUMBER COMPANY (MARATHON) PACIFIC MOTOR COMPANY PACIFIC MOTOR COMPANY (AUTO ONLY) PACIFIC SPECIALTY INSURANCE PACIFICARE BEHAVIORAL HEALTH PACIFICARE ENCOUNTERS PACIFICARE FHP COLORADO PACIFICARE OF ARIZONA HMO PACIFICARE OF ARIZONA HMO CLAIMS PACIFICARE OF ARIZONA PPO PACIFICARE OF CALIFORNIA HMO CLAIMS PACIFICARE OF CALIFORNIA HMO PACIFICARE OF CALIFORNIA PPO PACIFICARE OF COLORADO HMO PACIFICARE OF COLORADO HMO PACIFICARE OF COLORADO PPO PACIFICARE OF OKLAHOMA HMO CLAIMS PACIFICARE OF OKLAHOMA HMO PACIFICARE OF OKLAHOMA PPO PACIFICARE OF OREGON HMO CLAIMS PACIFICARE OF OREGON HMO PACIFICARE OF OREGON PPO PACIFICARE OF TEXAS HMO PACIFICARE OF TEXAS HMO CLAIMS CO AZ AZ AZ CA CA CA CO CO CO OK OK OK OR OR OR TX TX Payer Type AM CI CI WC WC AM WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N Y N Y Y Y N Y Y N Y N Y Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Inst Prof Inst Prof Prof Prof Inst Prof Prof Inst Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 95999 95959 95959 95999 95999 50014 50014 93029 93029 93029 20377 20377 37287 TPC78 TPC79 41556 J1475 37268 41556 4218 J1091 PAPER J1001 58174 58174 PARHC J1533 Name PACIFICARE OF TEXAS PPO PACIFICARE OF WASHINGTON HMO PACIFICARE OF WASHINGTON HMO CLAIMS PACIFICARE OF WASHINGTON PPO State TX WA WA WA PACIFICARE PPO - ALL STATES PACIFICSOURCE COMMUNITY - MEDICAID PACIFICSOURCE COMMUNITY - MEDICAID - INST PACIFICSOURCE HEALTH PLAN OR OR OR PACIFICSOURCE HEALTH PLAN - DENTAL PACIFICSOURCE HEALTH PLAN - INST PACIFICSOURCE MEDICARE PACIFICSOURCE MEDICARE - INST PAI PAINTERS LOCAL 155 WELFARE FUND PAINTING INDUSTRY INSURANCE PAJARO VLY COMNTY HEALTH TRUST PALADIN MANAGED CARE SERVICES, INC PALLADIAN EAP FKA PRISM PALO ALTO MEDICAL FOUNDATION PAN AMERICAN LIFE INSURANCE GROUP PAPA JOHN'S INTERNATIONAL INC PAPER CLAIMS PROFESSIONAL PARADIGM PARAGON BENEFITS INC PARAGON BENEFITS INC PARAMOUNT HEALTH CARE PARAMOUNT PICTURES (MURPHY AND BEANE) OR OR OR Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC WC CI WC CI WC CI WC CI CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y Y N N N Y N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Inst Prof Prof Inst Prof Inst Prof Dental Inst Prof Inst Inst Dental Dental Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y N N N N N N N N N N N N N N N N N N N N Y N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 58204 J1365 66917 66917 AMS01 56152 PHP02 41556 J1643 J1643 CX014 61129 CX014 61129 22248 PPN11 PAN01 10525 PPN11 41556 PRW99 27048 37210 95885 61101 65000 65007 Name State PARITY SOLUTIONS PARK DISTRICT RISK MANAGEMENT ASSOCIATION (PDRMA) PARKLAND COMMUNITY HEALTH PLAN - AETNA PARKLAND COMMUNITY HEALTH PLAN - AETNA - INST PARTNERS IN PRACTICE PARTNERS NATIONAL HEALTH PLANS OF NORTH CAROLINA PARTNERSHIP HEALTH PLAN TX NC CA PAS COFFEE ROASTERS PASADENA UNIFIED SCHOOL DISTRICT (CA) PASADENA UNIFIED SCHOOL DISTRICT (CA) (AUTO ONLY) PASSPORT FFS - KY - DENTAL PASSPORT HEALTH PLAN PASSPORT HEALTH PLAN - DENTAL PASSPORT HEALTH PLAN - INST PASSPORT KENTUCKY KY PATIENT PHYSICIAN NETWORK PATIENT ACCESS NETWORK FOUNDATION PATIENT ADVOCATES LLC PATIENT-PHYSICIAN NETWORK (PPN) PATTERSON BRO LIGHT PAVERS ROAD BUILDERS WELFARE FUND PAYER FUSION PAYNET, INC PCA HEALTH PLANS OF TEXAS PCA STAR MEDICAID PCMCICSL ALLERGY PCMCICSL CHIROPRACTIC TX Payer Type CI WC CI CI CI CI CI WC WC AM CI CI CI CI CI CI CI CI CI WC CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N Y N N N Y N N N N Y N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Dental Prof Dental Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 65001 65003 65002 68049 68049 20472 J1423 J1092 J1054 J1093 37086 37086 J1573 J1573 41556 41556 J1439 J1466 PBLIC 52133 72126 72126 J1623 J1623 TLX74 95397 25146 Name State PCMCICSL DERMATOLOGY PCMCICSL GASTROENTEROLOGY PCMCICSL PODIATRY PEACH STATE HEALTH PLAN PEACH STATE HEALTH PLAN - INST PEDIATRIC ASSOCIATES PEERLESS PEG DISCOVER RE PEG DISCOVER RE( FOOOD MERCHANT) PEGI-FAMILY DINING PEKIN INSURANCE PEKIN INSURANCE PENN MILLERS INSURANCE CO PENN MILLERS INSURANCE CO (AUTO ONLY) PENNSYLVANIA MANUFACTURERS INDEMNITY COMPANY PENNSYLVANIA MANUFACTURERS' ASSOCIATION INSURANCE COMPANY PENNSYLVANIA MANUFACTURING ASSOCIATES PEOPLE 20 PEOPLES BENEFIT LIFE INSURANCE PEOPLES BENEFIT LIFE INSURANCE COMPANY PEOPLES HEALTH NETWORK PEOPLES HEALTH NETWORK INST PERMA PERMA (AUTO ONLY) PERSONAL CHOICE (PA) PERSONAL INSURANCE ADMINISTRATORS PERSONAL PHYSICIAN CARE GA GA Payer Type CI CI CI MC MC CI WC WC WC WC CI CI WC AM WC WC WC WC CI CI CI CI WC AM CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N Y Format Claim Status Eligibility Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Dental Prof Inst Prof Prof Dental Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 41556 63088 J1570 J1570 45275 72099 72099 13306 13306 J1094 PHIF4 67814 67814 3440 74647 PHP01 67814 67814 67814 67814 37330 12399 12399 PA513 58204 PHPMD Name State PETALUMA VALLEY HOSPITAL PFLUGERVILLE ISD PHA ADMIN SERV, PRIME HEALTH OF ALABAMA PHARMACIST MUTUAL INSURANCE CO PHARMACIST MUTUAL INSURANCE CO (AUTO ONLY) PHCS - GEHA PHCS CLAIMS FKA AMERICAN LIFECARE PHCS CLAIMS FKA AMERICAN LIFECARE PHCS SAVILITY PHCS SAVILITY INST PHH FLEETAMERICA PHIFER WIRE PRODUCTS, INC PHOENIX AMERICAN PHOENIX AMERICAN LIFE PHOENIX HEALTH PLAN AZ PHOENIX HEALTH PLAN PHOENIX HEALTH PLAN (PHP) CLAIMS ONLY PHOENIX HOME LIFE PHOENIX HOME LIFE PHOENIX MUTUAL PHOENIX MUTUAL LIFE PHP MID MICHIGAN PHP OF NORTHERN INDIANA PHP OF NORTHERN INDIANA INST PHYSICIAN ASSOCIATES OF GREATER SAN GABRIEL VALLEY MI IN IN CA PHYSICIAN ASSOCIATES OF LOUSIANA PHYSICIAN HEALTH PARTNERS MEDICARE CO Payer Type WC WC CI WC AM CI CI CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Inst Prof Prof Prof Inst Prof Prof Inst Prof Prof Inst Prof Prof Prof Dental Inst Prof Inst Prof Prof Prof Inst Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 28943 PHYSICIANS ACCOUNTABLE CARE ORG - STONES RIVER IPA 57098 PHYSICIANS CARE NETWORK 36345 PHYSICIANS CARE NETWORK (ROCKFORD, IL) PCN12 PHYSICIANS CARE NETWORKPOLYCLINIC 36345 PHYSICIANS CARE ROCKFORD,IL 37136 PHYSICIANS HEALTH ASSOC OF IL 37136 PHYSICIANS HEALTH ASSOCIATION OF ILLINOIS 59221 PHYSICIANS HEALTH CARE SERVICES PHCS1 PHYSICIANS HEALTH CHOICE PHCS1 PHYSICIANS HEALTH CHOICE 20398 PHYSICIANS HEALTH COLLABORATIVE 20398 PHYSICIANS HEALTH COLLABORATIVE MHCM2 PHYSICIANS HEALTH NETWORK (PHN) TLX05 PHYSICIANS HEALTH PARTNERS CDOC (CO) 87726 PHYSICIANS HEALTH PLAN 12399 PHYSICIANS HEALTH PLAN OF NORTHERN INDIANA 65031 PHYSICIANS HEALTHCARE PLANS PHIPA PHYSICIANS HEALTHWAYS IPA 47027 PHYSICIANS MUTUAL INSURANCE COMPANY 47027 PHYSICIANS MUTUAL INSURANCE COMPANY PHD03 PHYSICIANS NETWORK OF COLORADO SPRINGS 91171 PHYSICIANS OF SOUTHWEST WASHINGTON CX014 PHYSICIANS PLUS INSURANCE CO, PRIMECARE, WISCONSIN STATE EMPLOYEES 39156 PHYSICIANS PLUS INSURANCE CORP 39156 PHYSICIANS PLUS INSURANCE CORPORATION 10775 PHYSICIANS UNITED PLAN 56151 PIEDMONT ADMINISTRATORS State MO IN Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N Y N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Inst Inst Prof Prof Inst Prof Inst Prof Prof Dental Prof Prof Prof Prof Inst Prof Prof Prof Dental Prof Inst Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 56151 251PD J1369 41556 TPC80 24735 24735 84109 CCIA1 IP104 PIP01 PIP99 PIP98 PIP02 59700 73074 73074 37224 37224 37224 AMS01 AMS01 AMS01 41556 PLAN SC886 37287 Name State PIEDMONT ADMINISTRATORS EMPLOYERS PIEDMONT WELLSTAR HEALTH PLAN PIER 1 INC USA PIMA COUNTY PINE BUSH TEACHERS PINNACLE CLAIMS MANAGEMENT PINNACLE CLAIMS MANAGEMENT, INC PINNACOL ASSURANCE PINNACOL ASSURANCE CO CO PIONEER MEDICAL GROUP PIPE TRADES INDUSTRY HEALTH WELFARE FUND PIPE TRADES INDUSTRY HEALTH WELFARE FUND PIPEFITTERS 597 IL PIPEFITTERS 597 (CHICAGO, IL) PIPEFITTERS LOCAL 597 PIPELINE INDUSTRY BENEFIT PIPELINE INDUSTRY BENEFIT FUND (TULSA, OK) PITTMAN ASSOC PITTMAN AND ASSOC PITTMAN AND ASSOCIATES PLAINES ADVISOR (AMS01) PLAINES IOWA (AMS01) IA PLAINES NETWORKS ENVOY PLAINVIEW ISD PLAN VISTA PLANNED ADMINISTRATORS INC - PAI - BCBSSC PLANNED ADMINISTRATORS, INC SC Payer Type CI CI WC WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Dental Prof Inst Inst Prof Prof Dental Prof Prof Dental Prof Prof Inst Inst Inst Prof Prof Prof Prof Prof Inst Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 37287 PCM99 TPC81 41556 333 PMGSJ 58204 POD1S 59324 59324 59069 J1370 32680 32680 41556 16111 16111 41556 TPC82 J1627 J1627 TPC83 6161 PPN11 PPN11 72148 72148 Name State PLANNED ADMINISTRATORS, INC PLASTERERS CEMENT MASONS HEALTH WELFARE FUND PLASTERERS' AND CEMENT MASONS L262 PLOTT HEALTH CARE PLUMBERS AND PIPEFITTERS LOCAL 33 PMG OF SAN JOSE IA CA PODI CARE MANAGED CARE PODIATRY FIRST PODIATRY NETWORK FLORIDA PODIATRY NETWORK FLORIDA FL FL POE BROWN POLY AMERICA LP POLY AMERICA MEDICAL DENTAL BENEFITS PLAN POLY AMERICA MEDICAL BENEFITS PLAN POLY-AMERICA POMCO POMCO INST PONDEROSA LANDSCAPE PORT CHESTER TEACHERS ASSOC WF PORT OF OAKLAND (CA) PORT OF OAKLAND (CA) (AUTO ONLY) PORT WASHINGTON TEACHERS ASSOC PPHN PENNSYLVANIA PREFERRED HEALTH NETWORK PPN PPN PPO PLUS PPO PLUS PA Payer Type CI CI CI WC CI CI CI CI CI CI CI WC CI CI WC CI CI WC CI WC AM CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N Y N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Dental Prof Prof Prof Prof Prof Inst Prof Prof Prof Inst Prof Prof Prof Inst Prof Dental Prof Prof Dental Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID PPOM1 72148 4334 J1118 36373 16105 53476 53476 61665 16112 SX089 PCNY0 65088 73145 73145 AMS01 60054 J1095 J1096 J1496 33898 61106 61106 31478 31478 60110 4320 Name State PPOM MI PPOPLUS LLC PRACTICARE, INC PRAIRIE MEADOWS PRAIRIE STATES ENTERPRISES, INC PRE-PAID HEALTHPLAN PREFERRED BENEFIT ADMINISTRATORS PREFERRED BENEFIT ADMINISTRATORS PREFERRED BENEFITS ADMINISTRATOR (PBA) PREFERRED CARE PREFERRED CARE PREFERRED CARE NEW YORK NY NY PREFERRED CARE PARTNERS PREFERRED COMMUNITY PREFERRED COMMUNITY CHOICE PREFERRED COMMUNITY CHOICE PREFERRED DENTAL ORGANIZATION PREFERRED EMPLOYERS PREFERRED EMPLOYERS GROUP PREFERRED EMPLOYERS INSURANCE COMPANY (PEI) PREFERRED HEALTH CARE PPO PREFERRED HEALTH PLAN KY PREFERRED HEALTH PLAN (LOUISVILLE, KY) PREFERRED HEALTH PROFESSIONALS - DENTAL PREFERRED HEALTH PROFESSIONALS KANSAS KS PREFERRED HEALTH SYSTEMS INSURANCE CO (PHSIC) PREFERRED HEALTHCARE SYSTEMS PPO PA Payer Type CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI WC WC WC CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Inst Prof Prof Prof Prof Inst Prof Prof Dental Prof Prof Prof Inst Prof Prof Dental Prof Prof Prof Prof Prof Inst Dental Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 4320 PFIPA 66059 36401 14163 14162 41147 41147 60110 41147 41147 BSAK1 430 430 CX078 61101 65054 251PR 251PR 90440 PREHP PREHP CX014 PRESA 45056 77003 45056 Name PREFERRED HEALTHCARE SYSTEMS PPO - INST State PA PREFERRED IPA PREFERRED MEDICARE CHOICE (PMC) PR PREFERRED NETWORK ACCESS, INC (DARIEN, IL) PREFERRED ONE (CT) WELLCARE CT PREFERRED ONE (CT), A DIVISION OF FIRST CHOICE PREFERRED ONE ADMINISTRATIVE SERVICES PREFERRED ONE COMMUNITY HEALTH PLAN PREFERRED PLUS OF KANSAS PREFERREDONE PREFERREDONE MN PREMERA BLUE CROSS BLUE SHIELD ALASKA KS MN MN AK PREMERA BLUE CROSS WASH ALASKA - INST PREMERA BLUE CROSS WASHINGTON WA PREMIER ACCESS INSURANCE PREMIER BENEFITS SYSTEM PREMIER EYE CARE PREMIER HEALTH PLAN (OHIO) PREMIER HEALTH PLAN (OHIO) INST PREMIER HEALTH SYSTEMS INC PRESBYTERIAN HEALTH PLAN PRESBYTERIAN HEALTH PLAN (COMMERCIAL) NM PRESBYTERIAN SALUD PRESBYTERIAN SALUD MEDICAID PRESTIGE HEALTH CHOICE PRESTIGE HEALTH CHOICE BEGIN 5-01-2014 PRESTIGE HEALTH CHOICE THRU DOS 4-30-2014 NM Payer Type CI CI CI CI CI CI CI CI CI CI CI BL BL BL CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N Y Y N Y N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Prof Prof Inst Dental Dental Prof Inst Prof Prof Inst Prof Dental Prof Prof Prof Inst Prof Inst Prof Dental Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y N N N N N N N Y N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID PCACZ IP080 73288 PRIME PMC11 PMC11 56144 56144 63088 63088 J1673 J1673 56190 11678 61604 61604 IP079 IP079 IP079 IP079 IP079 IP079 IP079 IP079 IP079 IP079 CX014 Name PRIMARY CARE ASSOCIATES OF CALIFORNIA MEDICAL PRIMARY CARE PHYSICIANS State CA CA PRIMARY DELIVERY SYSTEM PRIMARY HEALTH NETWORK PRIMARY MEDICAL CARE PRIMARY MEDICAL CLINIC PRIMARY PHYSICIAN CARE INC PRIMARY PHYSICIANCARE, INC PRIME HEALTH PRIME HEALTH PRIME HEALTHCARE PRIME HEALTHCARE (AUTO ONLY) PRIME VISION HEALTH PLAN PRIME WEST (MEDICAID) PRIME WEST HEALTH PLAN PRIME WEST HEALTH PLAN PRIMECARE MEDICAL NETWORK CHINO PRIMECARE MEDICAL NETWORK CORONA PRIMECARE MEDICAL NETWORK HEMET PRIMECARE MEDICAL NETWORK INLAND VALLEY PRIMECARE MEDICAL NETWORK MORENO PRIMECARE MEDICAL NETWORK REDLANDS PRIMECARE MEDICAL NETWORK RIVERSIDE PRIMECARE MEDICAL NETWORK SUN CITY PRIMECARE MEDICAL NETWORK TEMECULA PRIMECARE MEDICAL NETWORK - INST PRIMECARE, WISCONSIN STATE AND FEDERAL EMPLOYEES AND MEDICAID MN MN MN CA CA CA CA CA CA CA CA CA CA Payer Type CI CI CI CI CI CI CI CI CI CI WC AM CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Inst Inst Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID PTIME PRI01 61271 61271 PRINT SPRNT 99999 99999 38217 CX014 37303 37268 38329 70259 TPC84 36331 36331 36331 59296 41163 41163 34134 34134 J1748 C1040 PR081 PROSP Name PRIMETIME HEALTH PLAN State OH PRINCETON PREMIER IPA PRINCIPAL FINANCIAL GROUP - DENTAL PRINCIPAL LIFE INSURANCE COMPANY PRINT TO PAPER PRINT TO PAPER PRINT TO PAPER - HCFA PRINT TO PAPER - UB PRIORITY HEALTH PRIORITY PARTNERS - DENTAL PRISM FIRST HEALTH PRISM HEALTH NETWORKS PRO CARE HEALTH PLAN, INC PROCARE HEALTH PLAN MEDICAID PRODUCERS HEALTH BENEFIT PLAN PROFESSIONAL BEN OAK BROOK IL PROFESSIONAL BENEFIT ADMINISTRATORS, INC PROFESSIONAL BENEFIT ADMINISTRATORS, INC (OAK BROOK, IL) PROFESSIONAL BENEFITS ADMINISTRATORS PROFESSIONAL CLAIM ADMINISTRATORS PROFESSIONAL CLAIM ADMINISTRATORS PROFESSIONAL RISK MANAGEMENT PROFESSIONAL RISK MANAGEMENT PROGRESSIVE PROPERTY AND CASUALTY CO OF HARTFORD (AUTO ONLY) PROSALUD PUERTO RICO PROSPECT MEDICAL GROUP PR CA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI AM AM CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N Y N N N N N N N N N Format Claim Status Eligibility Prof Prof Dental Prof Prof Prof Prof Inst Prof Dental Prof Prof Prof Prof Dental Inst Dental Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID PR027 J1568 J1568 70408 70408 PHP01 PHP01 PHP01 PHP00 PHP01 PHP01 PHP01 PHP01 PHP01 91131 PHPPP PHP01 PHP01 62308 62308 62308 62308 62308 68195 51032 51032 9822 Name PROSSAM PLUS State PR PROTECTIVE INSURANCE CO PROTECTIVE INSURANCE CO (AUTO ONLY) PROTECTIVE LIFE PROTECTIVE LIFE INSURANCE COMPANY (BIRMINGHAM AL) PROVIDENCE CHOICE OPTION PROVIDENCE GOOD HEALTH PLAN PROVIDENCE HEALTH PLAN PROVIDENCE HEALTH PLAN (PROVIDENCE PREFERRED PPO) PROVIDENCE HEALTH PLAN HMO PROVIDENCE MEDICAID PROVIDENCE MEDICAID OPTION PROVIDENCE MEDICARE EXTRA PROVIDENCE OPTION PROVIDENCE PREFERRED OF WASHINGTON PROVIDENCE PREFERRED(PRINT TO PAPER) PROVIDENCE TRADITIONAL OPTION PROVIDENCE TRADITIONAL OPTION PROVIDENT PROVIDENT HEALTHSOURCE PROVIDENT LIFE ACCIDENT PROVIDENT LIFE CASUALTY PROVIDENT PREFERRED NETWORK PROVIDENT PREFERRED NETWORK DENTAL PROVIDER NETWORKS OF AMERICA (PRO-NET) PROVIDER NETWORKS OF AMERICA (PRONET) PROVIDER SERVICE NETWORK MEDICAID (JMHP) OR Payer Type CI WC AM CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N Y Y Y Y Y N N N N N N N N N N N Y N N N N N N N N N N N Y Y Y N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Dental Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Dental Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 9822 48100 48100 68241 PR002 PR002 68241 PR002 60054 PR002 PR002 87056 PR002 PR002 PR002 PR002 41556 PR002 PR002 PR002 PR002 PR002 PR002 PR002 PR002 PR002 68241 Name State PROVIDER SERVICE NETWORK MEDICAID (JMHP) INST PROVIDRS CARE NETWORK - WPPA PROVIDRS CARE NETWORK - WPPA - INST KS KS PRUCARE PRUCARE ASO PRUCHOICE PRUD PRUDENTIAL PRUDENTIAL DENTAL ORGANIZATION PRUDENTIAL HEALTH CARE SYSTEMS PRUDENTIAL HEALTH INSURANCE PRUDENTIAL HEALTHDELEGATED PROVIDER GROUP PRUDENTIAL INDEMNITY PRUDENTIAL INNETWORK PRUDENTIAL MANAGED HEALTH CARE PRUDENTIAL OUTOFNETWORK PRUDENTIAL OVERALL SUPPLY - AZ, CA PRUDENTIAL PHARMACY MGT PRUDENTIAL PLUS PRUDENTIAL POINT OF SERVICE PRUDENTIAL PSYCHIATRIC MGT PRUDENTIAL RESOURCES MGT PRUDENTIAL SELECT PRUDENTIAL TRADITIONAL PRUNET PRUNET WORK PRUNETWORK CA CA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Inst Inst Prof Prof Inst Prof Dental Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID PR002 PR002 PR002 PR002 51052 SX106 91136 91136 91136 91136 42172 42172 J1485 J1483 J1486 J1487 J1488 J1489 J1490 J1484 J1609 J1609 39197 39197 39197 35174 35174 Name State PRUNETWORK PRUNETWORK PPO PRUPPO PRUPSYCH PSYCHCARE LLC PUBLIC EMPLOYEES HEALTH PROGRAMS PUGET SOUND BENEFITS TRUST PUGET SOUND BENEFITS TRUST PUGET SOUND ELECTRICAL WORKERS TRUST PUGET SOUND ELECTRICAL WORKERS TRUST PUGET SOUND HEALTH PARTNERS PUGET SOUND HEALTH PARTNERS QBE - GENERAL CASUALTY - EDEN PRAIRIE QBE - GENERAL CASUALTY - FARMERS UNION QBE - GENERAL CASUALTY - FREEPORT QBE - GENERAL CASUALTY - INDIANAPOLIS QBE - GENERAL CASUALTY - SIMSBURY QBE - GENERAL CASUALTY - SUN PRAIRIE QBE - GENERAL CASUALTY - WEST DES MOINES QBE - GENERAL CASUALTY CO OF WISCONSIN QPS EMPLOYMENT GROUP QPS EMPLOYMENT GROUP (AUTO ONLY) QUAD MED QUAD MED QUAD MED LLC (PEWAUKEE, WI) QUAL CHOICE OF ARKANSAS QUAL CHOICE OF ARKANSAS INST AR AR Payer Type CI CI CI CI CI CI CI CI CI CI CI CI WC WC WC WC WC WC WC WC WC AM CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N Y N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Dental Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 1250 QUAL CHOICE OF OHIO QMDNJ QUAL-MED NEW JERSEY QUANM QUAL-MED NEW MEXIICO QMDPH QUAL-MED PHILADELPHIA QMDCO QUAL-MED, COLORADO (CO) QMDCE QUAL-MED, COLORADO EPO QMDPO QUAL-MED, PORTLAND (PO) QMDSE QUAL-MED, SEATTLE (SE) QMDSP QUAL-MED, SPOKANE (SP) 23342 QUALCARE 23342 QUALCARE INST 41556 QUALITY CARE CONV 89461 QUALITY CARE PARTNERS (QCP) 89461 QUALITY CARE PARTNERS (QCP) - INST 41556 QUALITY HEALTH M G QHP01 QUALITY HEALTH PLANS INC QHPNY QUALITY HEALTH PLANS NEW YORK 41556 QUEEN OF ANGELS - HOLLYWOOD 73067 QUICKTRIP 73067 QUICKTRIP 37129 QUINCY HEALTH CARE MANAGEMENT INC 37129 QUINCY HEALTH CARE MANAGEMENT INC 57117 QVI RISK SOLUTIONS J1522 RALEY'S FAMILY OF FINE STORES 38512 RAMPART INSURANCE COMPANY J1663 RAMSEY COUNTY (MN) J1663 RAMSEY COUNTY (MN) (AUTO ONLY) State OH NJ NM PA CO CO OR WA WA NY Payer Type CI CI CI CI CI CI CI CI CI CI CI WC CI CI WC CI CI WC CI CI CI CI CI WC WC WC AM Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N Y N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1635 J1635 91176 41556 J1675 J1675 A0205 20044 IP122 IP120 IP123 BSUT2 UTFEP 38221 J1484 47076 47076 J1467 41556 RENGQ RLHA1 76066 12475 J1008 J1597 J1597 J1376 Name State RANCHO SANTIAGO COMMUNITY COLLEGE DISTRICT (CA) RANCHO SANTIAGO COMMUNITY COLLEGE DISTRICT (CA) (AUTO ONLY) RBMS AK RCH PROTECTIVE - SNCC RECOLOGY RECOLOGY (AUTO ONLY) RED OAK INDEPENDENT SCHOOL DISTRICT REDWOOD FIRE AND CASUALTY INSURANCE COMPANY (MEMBER OF BHHC) REGAL BAKERFIELD REGAL MEDICAL GROUP IPA REGAL VICTOR VALLEY REGENCE BCBS UTAH REGENCE BCBS UTAH FEDERAL REGENCY EMPLOYEE BENEFITS REGENT INSURANCE COMPANY - QBE DBA REGIONAL CARE, INC REGIONAL CARE, INC REGIS BRANDS REHAB CENTER OF BEVERLY HILLS RENAISSANCE GULF QUEST RENAISSANCE LIFE AND HEALTH RENAISSANCE PHYSICIANS ORGANIZATION REPUBLIC FRANKLIN INSURANCE REPUBLIC INDEMNITY COMPANY OF AMERICA REPUBLIC WESTERN INS CO REPUBLIC WESTERN INS CO (AUTO ONLY) RESCARE, INC CA CA CA UT UT Payer Type WC AM CI WC WC AM WC WC CI CI CI BL BL CI WC CI CI WC WC CI CI CI WC WC WC AM WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Dental Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 73066 73066 J1097 J1098 41556 37277 RPPG1 J1202 37270 37270 VESTA J1099 41556 J1100 74205 74205 37331 J1491 J1101 RCMG1 J1546 J1477 45281 16117 16117 16117 41556 Name State RESERVE NATIONAL RESERVE NATIONAL RESIDENTIAL SERVICES GROUP RESTAURANT REINSURANCE LIMITED RESTORATION PROF RESURRECTION HEALTH CARE HEALTH PREFERRED RESURRECTION PHYSICIAN PROVIDERS GROUP RETURN TO WORK REYNOLDS AND REYNOLDS REYNOLDS AND REYNOLDS INST RH ADMINISTRATORS - INST RHONE-POULENC,INC RICK CONCRETE CONST RIETH-RILEY CONSTRUCTION COMPA RIGHT CARE SCOTT WHITE RIGHT CARE SCOTT WHITE INST RIGHTCHOICE BENEFITS ADMINISTRATORS RISK ENTERPRISE MANAGEMENT (REM) RISK TRANSFER TECHNOLOGIES, INC RIVER CITY MEDICAL GROUP RIVERPORT INSURANCE (MN SCHOOL BOARD ASSOCIATION) RIVERPORT INSURANCE COMPANY (AGRICULTURAL ONLY) RIVERSIDE HEALTH INC RMSCO RMSCO, INC RMSCO, INC ROBSTOWN ISD CA MN Payer Type CI CI WC WC WC CI CI WC CI CI CI WC WC WC CI CI CI WC WC CI WC WC CI CI CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Prof Prof Prof Prof Prof Prof Prof Inst Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Dental Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 41625 ROCHESTER PUBLIC SCHOOLS 27065 ROCKFORD MUTUAL INSURANCE COMPANY 27065 ROCKFORD MUTUAL INSURANCE COMPANY (AUTO ONLY) 41556 ROCKWALL ISD 75196 ROCKWELL INTERNATIONAL RMHM1 ROCKY MOUNTAIN HMO RMHM1 ROCKY MOUNTAIN HMO INST TRW01 ROOFERS WATERPROOFERS LOCAL 136 HW FUND 37602 ROONEY LIFE INC 37602 ROONEY LIFE INC - INST 41556 ROSE GARDEN GUEST HO 36215 ROSEMONT OF DES PLAINES, IL 41556 ROSEWOOOD EQUIPMENT TPC85 ROSLYN TEACHERS ASSOC BENEFIT FUND 41556 ROSSI CONCRETE, INC J1516 ROTH STAFFING COMPANIES RR001 ROYAL RESOURCES J1102 RSC INSURANCE SERVICES, LTD 41556 RURAL SPECIAL DISTRICT INSURANCE PROGRAM 36339 RUSH HEALTH ASSOCIATION 36339 RUSH HEALTH ASSOCIATION 36332 RUSH HEALTH PROVIDERS 36389 RUSH PRUDENTIAL HMO 36389 RUSH PRUDENTIAL HMO 63070 RWDSU BENEFIT FUND 63070 RWDSU BENEFIT FUND J1009 RYDER SERVICES, INC State CO CO Payer Type CI WC AM WC CI CI CI CI CI CI WC CI WC CI WC WC CI WC WC CI CI CI CI CI CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Dental Prof Prof Prof Prof Prof Inst Dental Prof Inst Prof Inst Prof Dental Prof Prof Dental Prof Prof Inst Prof Prof Inst Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N Y Y N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 31441 31441 J1728 J1728 24740 CX030 J1103 35164 35164 37105 J1658 J1658 41556 J1730 J1730 66063 41556 62308 TFQ67 J1690 J1690 J1638 J1638 41556 41556 41556 41556 Name State S S HEALTHCARE STRATEGIES S S HEALTHCARE STRATEGIES SA RECYCLING, LLC SA RECYCLING, LLC (AUTO ONLY) SAFECO INSURANCE SAFEGUARD DENTAL VISION SAFETY-KLEEN CORPORATION SAGAMORE HEALTH NETWORK SAGAMORE HEALTH NETWORK SAGE TECHNOLOGIES SAINT LOUIS COUNTY (MN) SAINT LOUIS COUNTY (MN) (AUTO ONLY) SALT LAKE CITY CORPORATION SALT LAKE CITY CORPORATION SALT LAKE CITY CORPORATION (AUTO ONLY) SALUD DORADA MEDICARE SAM KANE BEEF PROCESSORS, INC SAMBA (CIGNA) SAMBA FEDERAL EMPLOYEE BENEFIT ASSOC SAN BERNARDINO COUNTY SUPERINTENDENT OF SCHOOLS (CA) SAN BERNARDINO COUNTY SUPERINTENDENT OF SCHOOLS (CA) (AUTO ONLY) SAN DIEGO COMMUNITY COLLEGE DISTRICT (CA) SAN DIEGO COMMUNITY COLLEGE DISTRICT (CA) (AUTO ONLY) SAN DIEGO HOSPICE AND THE INSTITUTE FOR PALLIATIVE MEDICINE SAN DIEGO METROPOLITAN TRANSIT SYSTEM (SCHIP LIABILITY) SAN DIEGO TRANSIT CORP SAN DIEGO TROLLEY, INC PR Payer Type CI CI WC AM WC CI WC CI CI CI WC AM WC WC AM CI WC CI CI WC AM WC AM WC WC WC WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Inst Prof Prof Prof Dental Prof Prof Inst Dental Prof Prof Prof Prof Prof Prof Prof Prof Dental Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1656 J1656 37236 41556 91184 TPC05 TPC86 TPC87 37288 37288 SBIPA 41556 10378 24077 J1518 IP027 77038 80705 73172 73172 SCAN1 SCAN1 20460 20460 TPC88 16146 J1104 Name State SAN DIEGOIMPERIAL SCHOOLS JPA (CA) SAN DIEGOIMPERIAL SCHOOLS JPA (CA) (AUTO ONLY) SAN FRANCISCO ELEC WKR HLTH SAN JOAQUIN COUNTY SANFORD HEALTH PLAN SANFORD HEALTH PLAN - DENTAL SANITATION OFFICERS RETIREE SANITATION OFFICERS SECURITY FUND SANTA BARBARA COTTAGE HOSPITAL SANTA BARBARA COTTAGE HOSPITAL SANTA BARBARA SELECT IPA MEDICAL GROUP CA CA SANTA CLARA CO OFFICE OF EDUC SANTA CLARA COUNTY IPA (SCCIPA) CA SANTA CLARA FAMILY HEALTH PLAN SANTA CLARA VALLEY TANSPORTATION AUTHORITY SANTA MARTA MEDICAL GROUP CA SANTE HEALTH SYSTEMS SANUS PPO - GREAT WEST SCAN HEALTH PLAN ARIZONA SCAN HEALTH PLAN ARIZONA - INST SCAN HEALTH PLAN CALIF SCAN HEALTH PLAN CALIF - INST SCAN LONG TERM CARE SCAN LONG TERM CARE - DENTAL SCCEA WELFARE FUND SCHC TOTAL CARE SCHLUMBERGER TECHNOLOGY AZ AZ CA CA Payer Type WC AM CI WC CI CI CI CI CI CI CI WC CI CI WC CI CI CI CI CI CI CI CI CI CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N Y N N N N N N N N N N N N Y N N Y N N N N N N Format Claim Status Eligibility Prof Prof Inst Prof Prof Dental Dental Dental Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Dental Dental Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 J1560 TLW27 J1538 SCION 88030 88030 J1049 SHPS1 SHPS1 IP112 J1499 13310 13310 J1379 TLY98 28530 28530 87726 95959 95964 COFHP 95962 95959 95959 95959 95959 Name State SCHNEIDER GAIN SCHNUCK MARKET, INC SCHOOL CLAIM SERVICES, LLC (PA) SCIF AZ SCION DENTAL SCOTT WHITE HEALTH CARE PLAN SCOTT WHITE HEALTH CARE PLAN INST TX TX SCOTTS MIRACLE-GRO COMPANY SCRIPPS HEALTH PLAN SERVICES SCRIPPS HEALTH PLAN SERVICES SEA VIEW IPA SEABRIGHT (SBIC) SEABURY SMITH SEABURY SMITH SECURA INSURANCE A MUTUAL COMPANY SECURE CARE DENTAL SECURE HEALTH PLANS OF GEORGIA SECURE HEALTH PLANS OF GEORGIA SECURE HORIZONS DIRECT FFS UNITED HEALTHCARE SECURE HORIZONS OF CALIFORNIA HMO SECURE HORIZONS OF ARIZONA HMO SECURE HORIZONS OF COLORADO SECURE HORIZONS OF COLORADO HMO SECURE HORIZONS OF OKLAHOMA HMO SECURE HORIZONS OF OREGON HMO SECURE HORIZONS OF TEXAS HMO AKA MEDICARE COMPLETE SECURE HORIZONS OF WASHINGTON HMO CA AZ CO CO OK OR TX WA Payer Type WC WC CI WC CI CI CI WC CI CI CI WC CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N Y N N N N N N N N N N N N Y Y N N N Y Y Y Y Format Claim Status Eligibility Prof Prof Dental Prof Dental Prof Inst Prof Inst Prof Prof Prof Inst Prof Prof Dental Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y N Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 42142 39045 39045 39045 J1661 J1661 TP097 41556 41556 41556 64088 64088 64088 93031 42137 42137 CX018 93031 37282 37282 23285 23285 J1446 14 14 GTPA1 KLSY1 Name State Payer Type CI CI SECURITY HEALTH PLAN DENTAL CI SECURITY HEALTH PLAN INST CI SEDGWICK CARGILL, INC WC SEDGWICK CARGILL, INC (AUTO ONLY) AM SEDGWICK CMS WC SEENO CONSTRUCTION (CHARTIS) WC SEENO HOMES WC SELA HEALTH CARE WC SELECT ADMINISTRATIVE SERVICES MS CI SELECT ADMINISTRATIVE SERVICES DENTAL CI SELECT ADMINISTRATIVE SVC SAS CI SELECT BENEFIT ADMINISTRATORS CI SELECT BENEFIT ADMINISTRATORS IA CI SELECT BENEFIT ADMINISTRATORS (DES MOINES, CI SELECT BENEFIT ADMINISTRATORS (OR) CI SELECT BENEFIT ADMINISTRATORS INC CI SELECT BENEFIT ADMINISTRATORS OF AMERICA (ASHLAND, WI) CI SELECT BENEFITS ADMINISTRATORS OF AMERICA CI SELECT HEALTH OF SOUTH CAROLINA CI SELECT HEALTH OF SOUTH CAROLINA CI SELECT STAFFING (KOOSHAREM, REAL TIME STAFFING, REMEDY, SELECTREMEDY AND WESTAFF) WC SELECTCARE CI SELECTCARE - INST CI SELECTCARE OF TX (BEAUMONT) CI SELECTCARE OF TX (KELSEY-SEYBOLD) CI SECURECARE OF IOWAINFOTRUST SECURITY HEALTH PLAN Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N Format Claim Status Eligibility Prof Prof Dental Inst Prof Prof Prof Prof Prof Prof Prof Dental Inst Prof Prof Inst Dental Inst Prof Inst Inst Prof Prof Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID SX107 12572 34131 52196 59111 36404 36404 34131 J1520 34131 41556 36426 36426 36390 36390 83035 83035 CX014 54154 54154 C1040 23249 23249 C1033 J1417 39033 39033 Name SELECTHEALTH - IHC (UHIN) State UT SELECTIVE SELF FUNDED PLANS INC DENTAL SELF FUNDING ADMINISTRATORS SELF INSURED BENEFIT ADMINISTRATORS (CLEARWATER, FL) SELF INSURED PLANS SELF INSURED PLANS LLC FL SELF-FUNDED PLANS, INC SELF-INSURED SCHOOLS OF CALIFORNIA (SISC) CA SELFFUNDED PLANS SELMAN BREITMAN SENDERO HEALTH SENDERO HEALTH INST TX TX SENIOR CARE PARTNERS SENIOR CARE PARTNERS SENIOR WHOLE HEALTH SENIOR WHOLE HEALTH SENIOR WHOLE HEALTH MASS - DENTAQUEST MA SENTARA FAMILY CARE SENTARA HEALTH MANAGEMENT SENTINEL INSURANCE COMPANY LTD SENTINEL MANAGEMENT SERVICES SENTINEL MANAGEMENT SERVICES SENTRY AUTO SENTRY INSURANCE SENTRY INSURANCE SENTRY INSURANCE PA Payer Type CI WC CI CI CI CI CI CI WC CI WC CI CI CI CI CI CI CI CI CI AM CI CI AM WC CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N Y N N N N N N N N Format Claim Status Eligibility Prof Prof Dental Inst Dental Inst Prof Inst Prof Prof Prof Prof Inst Inst Prof Inst Prof Dental Prof Inst Prof Inst Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N Y N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name State AMM07 SEOUL MEDICAL GROUP CA TPC89 SERVICE EMPLOYEES 32BJ NORTH HEALTH J1593 SERVICE LLOYDS INSURANCE CO J1593 SERVICE LLOYDS INSURANCE CO (AUTO ONLY) TSG01 SET SEG SET, INC 76056 SETON CHIP SHEBP SETON EMPLOYEE PLAN TX SHPCH SETON HEALTH PLAN CHIP TX EPNSH SETON HEALTH PLAN EXCLUSIVE PROVIDER NETWORK TX SHMAP SETON HEALTH PLAN - MAP PROGRAM TX SET22 SETON HEALTH PLAN - STAR MEDICAID STAR1 SETON STAR TX 25404 SEVEN CORNERS 25404 SEVEN CORNERS J1456 SFN GROUP (SPHERION, TECHNISOURCE, TATUM, THE MERGIS GROUP, SOURCE RIGHT) 87726 SHARE ADVANTAGE HEALTH PLAN UH005 SHARE HEALTH PLAN ILLHMO 87726 SHARE HEALTH PLAN ILXHMO IL UH006 SHARE HEALTH PLAN ILLPPO 41556 SHARYLAND INDEPENDENT SCHOOL DISTRICT 75280 SHASTA ADMINISTRATIVE SERVICES 75280 SHASTA ADMINISTRATIVE SERVICES J1468 SHAWSSTARMARKET SMW01 SHEET METAL 91 HEALTH WELFARE FUND OBASM SHEET METAL WORKERS LOCAL 263 HEALTH WELFARE FUND OBASM SHEET METAL WORKERS LOCAL 263 HEALTH AND WELFARE FUND SMW01 SHEET METAL WORKERS LOCAL 91 Payer Type CI CI WC AM CI CI CI CI CI CI CI CI CI CI WC CI CI CI CI WC CI CI WC CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Dental Prof Prof Dental Inst Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Dental Prof Prof Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name SMW99 SHEET METAL WORKERS LOCAL 91 SLI01 SHENANDOAH LIFE INSURANCE COMPANY SC359 SHERMANCHOICE HM024 SHIELD 65 TPC90 SHOPMEN IRONWORKERS WELFARE PLA 76342 SIERRA HEALTH PLAN 76342 SIERRA HEALTH PLAN - INST 41556 SIERRA NEVADA MEMORIAL 23250 SIGNIFICA BENEFIT SERVICES FKA ERIN GROUP 23250 SIGNIFICA BENEFIT SERVICES FKA ERIN GROUP 41556 SILBERBERGER ENGN 27094 SIMPLY HEALTHCARE PLANS 84076 SINCLAIR HEALTH PLAN SVH01 SIOUX VALLEY HEALTH PLAN SVH01 SIOUX VALLEY HEALTH PLAN 540 SISCO - SELF INSURED SERVICES COMPANY 41556 SKB CORPORATION 84096 SLOANS LAKE MANAGED CARE 84096 SLOANS LAKE MANAGED CARE 84096 SLOANS LAKE MANAGED CARE 2057 SMITH ADMINISTRATORS 2057 SMITH ADMINISTRATORS INST J1105 SNAP-ON INCORPORATED J1106 SOLVAY AMERICA INC J1381 SONIC AUTOMOTIVE INC E3510 SONOMA COUNTY PRIMARY CARE 94156 SONOMA FOUNDATION CAL State CA NV CA Payer Type CI CI CI CI CI CI CI WC CI CI WC CI CI CI CI CI WC CI CI CI CI CI WC WC WC CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N Y N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Dental Prof Prof Dental Prof Inst Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Inst Prof Prof Prof Inst Prof Prof Prof Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 41556 AMS01 AMS01 91131 91131 TPC11 23266 32266 J1731 J1731 SX142 25147 25147 86068 STGEB SEI01 SEI99 37318 37318 SCP01 BPA01 J1690 J1690 56131 25128 J1648 Name State SONOMA VALLEY HEALTHCARE DISTRICT SONOMA VALLEY HLTH SONORAN DESERT HEALTH SOONER HEALTH NETWORK SOUND HEALTH MT SOUND HEALTH (NOW KNOWN AS FIRST CHOICE SOUTH CAROLINA HEALTHY CONNECTIONS DENTAL SOUTH CENTRAL PREFERRED SOUTH CENTRAL PREFERRED SOUTH COAST AREA TRANSIT (CA) SOUTH COAST AREA TRANSIT (CA) (AUTO ONLY) SOUTH INDIANA HEALTH ORG (SIHO) IN SOUTHCARE HEALTHCARE PREFERRED SOUTHCAREHEALTHCARE PREFERRED SOUTHEAST IOWA HEALTH PLAN SOUTHEAST TEXAS GOVT EMPLOYEE BENEFITS IA TX SOUTHEASTERN SERVICE EMPLOYEE INTERNATIONAL UNION (SEIU) SOUTHEASTERN SERVICE EMPLOYEES INTERNATIONAL UNION SOUTHERN BENEFIT SERVICES LLC SOUTHERN BENEFIT SERVICES LLC SOUTHERN CAL PHYSICIANS MANAGED SOUTHERN CALIFORNIA LUMBER SOUTHERN CALIFORNIA RISK MANAGEMENT SOUTHERN CALIFORNIA RISK MANAGEMENT (AUTO ONLY) SOUTHERN GROUP ADMINISTRATORS SOUTHERN HEALTH SERVICES COVENTRY SOUTHERN TEXTILE RECYCLING, INC (CA) CA Payer Type WC WC CI CI CI CI CI CI CI WC AM CI CI CI CI CI CI CI CI CI CI CI WC AM CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Inst Dental Prof Prof Prof Prof Prof Prof Inst Prof Prof Dental Prof Inst Prof Prof Prof Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1648 SIPA1 SSGAB IP113 J1233 41556 37266 37266 60054 68241 PR002 PR002 PR002 52190 52190 41556 773 41556 48117 48117 22240 22240 35199 35199 37264 37264 68033 Name State SOUTHERN TEXTILE RECYCLING, INC (CA) (AUTO ONLY) SOUTHLAND IPA SOUTHLAND SAN GABRIEL VALLEY MEDICAL GROUP CA SOUTHWEST ADMINISTRATORS SOUTHWEST AIRLINES (SWA) SOUTHWEST GAS CORPORATION SOUTHWEST SERVICE LIFE SOUTHWEST SERVICE LIFE TX SOUTHWESTERN BELL SOUTHWESTERN BELL SOUTHWESTERN BELL SOUTHWESTERN BELL EXEC CUSTOM CARE SOUTHWESTERN BELL EXEC SOUTHWESTERN BELL SPECIAL RISK INTERNATIONAL SPECIAL RISK INTERNATIONAL SPECIALTY COFFEE SPECTERA UNITED HEALTHCARE VISION SPOONER'S WOODWORKS SSM EXCLUSIVE CHOICE (CORESOURCE) SSM EXCLUSIVE CHOICE (CORESOURCE) - INST ST BARNABAS SYSTEM HEALTH PLAN ST BARNABAS SYSTEM HEALTH PLAN ST CATHERINE HOSPITAL PHO (MDWISE) ST FRANCIS HEALTH NETWORK ST JOHNS CLAIMS ADMINIS ST JOHNS CLAIMS ADMINISTRATION ST JOSEPH HEALTH FOUNDATION OF NO CA IN Payer Type AM CI CI CI WC WC CI CI CI CI CI CI CI CI CI WC CI WC CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Inst Prof Dental Inst Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Inst Prof Prof Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID STJOE IP106 88029 41556 37116 37116 STM01 PDT01 J1118 41556 86304 86304 J1385 J1107 59225 59225 61425 61425 STR01 35076 STMSS J1548 J1548 31053 31053 J1553 J1553 Name ST JOSEPH HERITAGE HEALTHCARE State CA ST JUDE ST MARYS HEALTH PLAN ST ROSE HOSPITAL ST THERESE PHYSICIAN ASSOCIATES IL ST THERESE PHYSICIAN ASSOCIATION ST THOMAS MEDICAL NETWORK (GULFQUEST) ST VINCENT IPA CA STANDARD FORWARDING STANDARD FRUIT AND VEG STANDARD SECURITY LIFE STANDARD SECURITY LIFE INST STANLEY WORKS, INC STANT CORPORATION STAR HRG - STARBRIDGE PHOENIX PO BOX STAR HRG - STARBRIDGE PHOENIX PO BOX INST STARMARK STARMARK STARMOUNT LIFE INSURANCE COMPANY STATE COMPENSATION INSURANCE FUND (SCIF) STATE EMPLOYEES MISSISSIPPI STATE FARM STATE FARM (AUTO ONLY) STATE FARM GROUP MEDICAL INDIV HEALTH STATE FARM GROUP MEDICAL INDIV HEALTH INST STATE FUND MUTUAL STATE FUND MUTUAL (AUTO ONLY) MS Payer Type CI CI CI WC CI CI CI CI WC WC CI CI WC WC CI CI CI CI CI WC CI WC AM CI CI WC AM Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Prof Prof Prof Inst Prof Inst Dental Prof Prof Prof Prof Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N Y N Y Y N N Y N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID MERIT 69140 J1555 J1555 J1659 J1659 J1418 14163 14163 91151 91151 67829 41556 6089 31121 31121 31121 15752 41556 58128 TPC91 74227 74227 68381 74227 35199 CX014 Name STATE MERIT GEORGIA State GA STATE MUTUAL LIFE ASSUR CO AM STATE OF MINNESOTA - DOER STATE OF MINNESOTA - DOER (AUTO ONLY) STATE OF NORTH CAROLINA STATE OF NORTH CAROLINA (AUTO ONLY) STATE OFFICE OF RISK MANAGEMENT STAYWELL - STAYWELL HEALTHY KIDS STAYWELL HEALTH PLAN STERLING OPTION 1 STERLING OPTION 1 STERLING PARTNERS PPO STIMSON LUMBER COMPANY - MT, OR, WA STIRLING AND STIRLING BENEFITS STONER ASSOCIATES (CINCINNATI, OH) STONER AND ASSOCIATES (CINCINNATI, OH) STONER AND ASSOCIATES (CINCINNATI, OH) STONES RIVER REGIONAL IPA (SRRIPA) WINDSOR STONINGTON C CLUB STOWE ASSOCIATES (ATLANTA, GA) STRUCTURAL STEEL BRIDGE PAINTERS STUDENT INSURANCE - MID-WEST NATIONAL LIFE STUDENT INSURANCE - THE MEGA LIFE HEALTH STUDENT INSURANCE DENTAL STUDENT INSURANCE DIVISION SUBURBAN HEALTH ORGANIZATION SUFFOLK COUNTY FL Payer Type CI CI WC AM WC AM WC MC MC CI CI CI WC CI CI CI CI CI WC CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N Y N N Format Claim Status Eligibility Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Dental Prof Inst Prof Prof Prof Dental Inst Inst Dental Prof Prof Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 11325 95202 95202 86071 37301 37301 J1108 J1437 31147 J1610 J1610 68241 PR002 68069 41556 68057 68057 J1584 J1584 41556 23218 23218 31117 SHP11 39188 39188 41556 Name State SUFFOLK HEALTH PLAN OF NEW YORK (NHP) SUMMACARE HEALTH PLAN SUMMACARE HEALTH PLAN INST SUMMERLIN LIFE HEALTH HI SUMMIT AMERICA INSURANCE SERVICES LC SUMMIT AMERICA INSURANCE SERVICES LC SUMMIT HEALTH LTD SUMMIT HOLDINGS SUMMITCORP (OHIO BWC) OH SUN MAR HEALTHCARE SUN MAR HEALTHCARE (AUTO ONLY) SUN TRUST BANK SUN TRUST BANK SUNFLOWER STATE HEALTH PLAN KANSAS KS SUNRISE COUNTRY CLUB SUNSHINE STATE HEALTH PLAN SUNSHINE STATE HEALTH PLAN INST FL FL SUNZ INSURANCE COMPANY SUNZ INSURANCE COMPANY (AUTO ONLY) SUPERIOR ACCESS INS SERVICES SUPERIOR BENEFITS SUPERIOR BENEFITS SUPERIOR DENTAL CARE SUPERIOR HEALTH PLAN SUPERIOR HEALTH PLAN TEXAS SUPERIOR HEALTH PLAN TEXAS INST SUPERIOR INDUSTRIES INTERNATIONAL, INC TX TX TX Payer Type CI CI CI CI CI CI WC WC CI WC AM CI CI CI WC CI CI WC AM WC CI CI CI CI CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N Y N Y N N N N N N N N Y N N Format Claim Status Eligibility Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Inst Dental Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N Y N Y Y N N N N N N Y Y Y N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 CPPSW 29076 29076 TPC92 TPC93 CX088 IP100 IP090 HM057 IP092 HM059 IP099 HM062 IP091 HM058 IP131 HM066 IP130 J1512 PR002 J1109 SYMED SYMED TALMG 88067 88067 Name State SUPERIOR READY MIX SUPERIORSTAR PREGNANT WOMEN SUPERMED PPO - 1ST MEDICAL SUPERMED PPO -1ST MEDICAL SUPREME COURT REPORTERS (ACTIVE) SUPREME COURT REPORTERS (RETIREE) SURENCY LIFE AND HEALTH DENTAL SUTTER CONNECT DELTA CLAIMS SUTTER CONNECT SANTA ROSA NETWORK CLAIMS SUTTER CONNECT SANTA ROSA NETWORK ENCOUNTERS SUTTER CONNECT SIP CLAIMS SUTTER CONNECT SIP ENCOUNTERS SUTTER CONNECT SOLANO REGIONAL MEDICAL GROUP CLAIMS SUTTER CONNECT SOLANO REGIONAL MEDICAL GROUP ENCOUNTERS SUTTER CONNECT SUTTER GOULD MEDICAL FOUNDATION CLAIMS SUTTER CONNECT SUTTER GOULD MEDICAL FOUNDATION ENCOUNTERS SUTTER CONNECT CENTRAL VALLEY CLAIMS SUTTER CONNECT CENTRAL VALLEY ENCOUNTERS SUTTER EAST BAY MEDICAL FOUNDATION CA CA CA CA CA CA CA CA CA CA CA CA SUTTER HEALTH SW BELL SWIFT TRANSPORTATION SYNERMED SYNERMED - INST TALBERT MEDICAL GROUP TALL TREES ADMINISTRATORS TALL TREES ADMINISTRATORS CA CA Payer Type WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI WC CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Dental Inst Prof Dental Dental Dental Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N Y Y Y Y Y Y N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 37228 J1533 39157 41556 ADSL1 75139 75133 75133 75216 36215 36215 36215 WT008 88054 94304 94304 TPC97 TPC94 TPC95 TPC96 MC390 MC390 37293 37293 GTPA1 HPN11 Name State TAN MEDICAL GROUP TARRANT HEALTH SERVICES TX TAYLOR CORPORATION (MURPHY AND BEANE) TBG ADMINISTRATIVE SERVICES WI TD TILE TEAM CHOICE - ALPHA CARE GOLD TEAM CHOICE GOLD TEAM CHOICE PPO TEAM CHOICE PPO TEAM CHOICE UMC TEAMCARE TEAMCARE TEAMCARE TEAMSTER CONSTRUCTION INDUSTRY WELFARE TRUST TEAMSTERS (UTIDMT) GROUP BENEFIT ADMIN TEAMSTERS BENEFIT TRUST TEAMSTERS BENEFIT TRUST TEAMSTERS LOCAL 1205 WELFARE FU TEAMSTERS LOCAL 531 TEAMSTERS LOCAL 945 TEAMSTERS LOCAL 966 TENNCARE BLUECARE MEDICAID TENNCARE BLUECARE MEDICAID INST TN TN TENNESSEE BENEFIT ADMINISTRATORS TENNESSEE BENEFIT ADMINISTRATORS, LLC TEXAN PLUS (BEAUMONT) TEXAN PLUS (HOUSTON) TX TX Payer Type WC CI WC CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI MC MC CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Prof Prof Dental Prof Inst Prof Dental Dental Dental Dental Prof Inst Prof Inst Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID HPN11 KLSY1 A0235 A0234 J1581 J1581 76048 76048 TXCSM 45210 45210 77045 TX1ST TOPA1 TOPA1 13185 86916 THS01 THS01 TMA11 74214 22945 A0245 TXP11 J1676 J1676 J1110 Name TEXAN PLUS (INTEGRANET) TEXAN PLUS (KELSEY-SEYBOLD) State TX TX TEXAS A AND M TEXAS ASSOCIATION OF SCHOOL BOARDS TEXAS BUILDERS INSURANCE CO TEXAS BUILDERS INSURANCE CO (AUTO ONLY) TEXAS CHILDRENS HEALTH PLAN TEXAS CHILDRENS HEALTH PLAN TEXAS CHILDRENS STAR MEDICAID TX TX TX TEXAS CHRISTUS TEXAS CHRISTUS - MEDICAID TX TEXAS COMMUNITY CARE THRU DOS 12-31-2012 TEXAS FIRST HEALTH PLANS TEXAS FIRST HEALTH PLANS (TIOPA) INST TEXAS FIRST HEALTH PLANS (TIOPA) TX TX TX TEXAS FIRST HEALTH PLANS NORTH TX TEXAS HEALTH STEPS TEXAS HEALTHSPRING TEXAS HEALTHSPRING INST TX TX TX TEXAS MEDICAL ASSN INSURANCE TRUST TEXAS MUNICIPAL LEAGUE TML (COMMERCIAL) TX TEXAS MUTUAL INSURANCE TEXAS MUTUAL LEAGUE (TML) TEXAS PLAN ADMINISTRATORS TPA CONTACT DEBBIE MORALES AT TEXAS ROADHOUSE, INC TEXAS ROADHOUSE, INC (AUTO ONLY) TEXAS SMALL BUSINESS POOL TX Payer Type CI CI WC WC WC AM CI CI MC CI CI CI CI CI CI CI MC CI CI CI CI WC WC CI WC AM WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N Y N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID TTCEC TTCEC TTCEC UPGUT 68423 59223 74227 74227 TDN01 TDN02 28777 28777 J1671 J1671 16126 J1422 20356 34150 34150 35206 35206 58200 58200 23223 59227 59221 74227 Name TEXAS TRUE CHOICE TEXAS TRUE CHOICE TEXAS TRUE CHOICE INST TEXAS UNIVERSITY HEALTH PLAN UPG COMMERCIAL THE CARE NETWORK AKA SAVANNAH BUSINESS GROUP THE CHESAPEAKE LIFE INS THE CHESAPEAKE LIFE INSURANCE COMPANY THE CHESAPEAKE LIFE INSURANCE COMPANY - STUDENT INSURANCE THE DENTAL NETWORK (IN STATE DENTISTS ONLY) THE DENTAL NETWORK (OUT OF STATE DENTISTS -- NOT IN MD OR DC) THE EPOCH GROUP THE EPOCH GROUP THE GAP, INC THE GAP, INC (AUTO ONLY) THE GUARDIAN CHOICE THE HARTFORD THE HEALTH EXCHANGE THE HEALTH PLAN THE HEALTH PLAN THE HEALTHCARE GROUP THE HEALTHCARE GROUP THE INTEGRITY BENEFIT GROUP, INC THE INTEGRITY BENEFIT NETWORK, INC (MARRIETA, GA) THE LOOMIS COMPANY - TPA (IHS GATEWAY) THE MEGA LIFE HEALTH - OKLAHOMA CITY THE MEGA LIFE HEALTH INS CO THE MEGA LIFE HEALTH INSURANCE COMPANY - State TX TX TX TX Payer Type CI CI CI CI CI CI CI CI CI CI CI CI WC AM CI WC CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N Format Claim Status Eligibility Prof Prof Inst Prof Prof Inst Inst Dental Dental Dental Inst Prof Prof Prof Inst Prof Prof Inst Prof Inst Prof Inst Prof Prof Prof Inst Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 74227 59227 59221 J1615 J1615 70491 70491 70491 63092 13522 67814 CX025 68241 J1472 J1111 38200 38200 13269 THERA COTHE 6131 6131 SC315 SC315 J1746 J1746 41556 Name State THE MEGA LIFE HEALTH INSURANCE COMPANY - STUDENT INSURANCE THE MEGA LIFE HEALTH INSURANCE COMPANY-OKC THE MEGA LIFE AND HEALTH INSURANCE THE MEN'S WEARHOUSE, INC THE MEN'S WEARHOUSE, INC (AUTO ONLY) THE MUTUAL GROUP THE MUTUAL GROUP (US) THE MUTUAL GROUP TMG LIFE INSURANCE GROUP THE OATH HEALTH PLAN FOR ALABAMA AL THE PERFECT HEALTH INSURANCE COMPANY THE PHOENIX THE PHYSICIANS ASSURANCE CORP - TPAC THE PRUDENTIAL THE SALVATION ARMY THE SCOTTS COMPANY THE WELLNESS PLAN THE WELLNESS PLAN THE ZENITH THERAPHYSICS THERAPHYSICS PACIFICARE COLORADO ONLY THIRD PARTY CLAIMS THIRD PARTY CLAIMS MANAGEMENT THOMAS COOPER AND CO - BCBSSC THOMAS COOPER AND CO - BCBSSC - INST THOMAS MCGEE THOMAS MCGEE (AUTO ONLY) THOMAS STAFFING SERVICES, INCVENTURI STAFFING CO Payer Type CI CI CI WC AM CI CI CI CI CI CI CI CI WC WC CI CI WC CI CI CI CI CI CI WC AM WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N Y N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Dental Inst Prof Prof Prof Prof Inst Prof Prof Inst Inst Prof Inst Prof Prof Prof Inst Prof Prof Prof Inst Prof Prof Inst Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID MP340 THRIV TIC99 TIC01 J1392 J1392 39065 70491 74214 74214 WITH1 WITH1 48055 48055 TOPTN TOPTN AFL01 92620 92620 61425 61425 J1537 41556 THIPA THIPA TCARE TCS01 Name State THREE RIVERS PREFERRED THRIVENT FINANCIAL TIC INTERNATIONAL TIC INTERNATIONAL, INC TIDEWATER MARINE WESTERN TIDEWATER MARINE WESTERN (AUTO ONLY) TIME INS CO FORTIS BENEFITS INS COMPANY TMG LIFE INSURANCE COMPANY TML INTERGOVERNMENTAL EMPLOYEE BENEFIT POOL TML INTERGOVERNMENTAL EMPLOYEE BENEFITS POOL TX TX TODAYS HEALTH TODAYS HEALTH TODAYS OPTION - PYRAMID BENEFITS TODAYS OPTION - PYRAMID BENEFITS - INST TODAYS OPTIONS MEDICARE ADVANTAGE (PYRAMID LIFE) TODAYS OPTIONS MEDICARE ADVANTAGE (PYRAMID LIFE) INST TOLEDO PUBLIC SCHOOLS TONGASS TIMBER TRUST AK TONGASS TIMBER TRUST - INST TOOLING MANUFACTURING ASSOCIATION TOOLING AND MANUFACTURING ASSOCATION TOPA INSURANCE COMPANY CA TOPANGA ROSCOE CORP TORRANCE HOSPITAL IPA TORRANCE HOSPITAL IPA TOTAL CARE NEW YORK TOTAL CLAIMS SOLUTIONS CA CA NY Payer Type CI CI CI CI WC AM CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC WC CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N Y Y N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Dental Prof Prof Prof Inst Inst Prof Inst Prof Prof Inst Prof Inst Prof Prof Inst Inst Prof Prof Prof Inst Prof Prof Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y N N N Y Y N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID TCS99 TCS99 38201 38201 38202 39202 J1112 41202 41202 13402 23856 23856 J1604 J1604 40134 69493 J1668 J1668 TXP11 37230 37230 J1505 59222 TFLIC TLIN2 TLIN3 59222 Name State TOTAL CLAIMS SOLUTIONS TOTAL CLAIMS SOLUTIONS TOTAL HEALTH CARE MICHIGAN TOTAL HEALTH CARE MICHIGAN INST TOTAL HEALTH CHOICE FLORIDA TOTAL HEALTH CHOICE FLORIDA INST MI MI FL FL TOTAL PETROLEUM, INC TOTAL PLAN SERVICES TOTAL PLAN SERVICES INST TOUCHSTONE HEALTH HEALTH NET SMART CHOICE TOUCHSTONE PSO TOUCHSTONE PSO INST TOWER ENERGY GROUP TOWER ENERGY GROUP (AUTO ONLY) TOWER INSURANCE COMPANY (FORMERLY SUA INSURANCE) TOWER LIFE INSURANCE CO TOWN OF COLMA (CA) TOWN OF COLMA (CA) (AUTO ONLY) TPA (TEXAS PLAN ADMINISTRATORS) TX TR PAUL INC TR PAUL, INC TRACTOR SUPPLY COMPANY TRANSAMERICA TRANSAMERICA FINANCIAL LIFE INS CO TRANSAMERICA LIFE INS CO (HURST TX) TRANSAMERICA LIFE INS CO (LOUISVILLE KY) TRANSAMERICA LIFE INSURANCE CO KY Payer Type CI CI CI CI CI CI WC CI CI CI CI CI WC AM WC CI WC AM CI CI CI WC CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N Y Format Claim Status Eligibility Prof Prof Prof Inst Prof Inst Prof Prof Inst Prof Prof Inst Prof Prof Prof Inst Prof Prof Prof Inst Prof Prof Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID TOLI2 20807 37284 37284 37284 TRAN1 19046 C1032 87726 87726 4284 41556 41556 J1477 20538 39181 73117 CX002 TDFIC TDFIC 38520 38520 38520 99726 99726 WESTR WESTR Name State TRANSAMERICA OCCIDENTAL LIFE INS CO TRANSCHOICE - FIRST SERVICE ADMINISTRATORS TRANSCHOICE KBA TRANSCHOICE KEY BENEFIT ADMINISTRATORS TRANSCHOICE-KEY BENEFIT ADMINISTRATORS TRANSWESTERN TRAVELERS TRAVELERS AUTO TRAVELERS HEALTH NETWORK TRAVELERS INST TRAVELERSCGT TRI-CITY HEALTHCARE DISTRICT TRI-CITY LINEN SUPPL TRI-STATE INSURANCE COMPANY TRI-VALLEY MEDICAL GROUP TRIAD HEALTHCARE TRIBUTE SELECTCARE OF OKLAHOMA TRICARE DENTAL PLAN (UCCI) TRICARE FOR LIFE TRICARE FOR LIFE - INST TRICARE NORTH AND SOUTH REGION - INST TRICARE NORTH REGION - PGBA TRICARE SOUTH REGION - PGBA TRICARE WEST - UHC TRICARE WEST - UHC - INST TRICARE WEST REGION INST THRU DOS 03-31-2013 TRICARE WEST REGION THRU DOS 03-31-2013 OK Payer Type CI CI CI CI CI CI WC AM CI CI CI WC WC WC CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y Y Y N N N Format Claim Status Eligibility Prof Prof Prof Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Dental Prof Inst Inst Prof Prof Prof Inst Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N Y Y Y Y Y Y Y Y Y N N N N N N N N Y Y N N N N N N N N Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 J1442 J1674 J1674 62777 62777 IP060 C1030 11983 PR973 973MA 12M15 AMS01 31144 34185 34185 C1034 37875 37875 TCUSA TCUCH C1040 91078 91078 91078 61425 61425 Name State TRICITY UNIFORM TRIDENT INSURANCE TRILLIUM STAFFING SOLUTIONS TRILLIUM STAFFING SOLUTIONS (AUTO ONLY) TRILOGY NETWORK TRILOGY NETWORK INST TRINIDAD RANCHERIA CA TRINITY UNIVERSAL INSURANCE TRIPLE A (AUTO ONLY) TRIPLE-S (BCBS PUERTO RICO) TRIPLE-S MEDICARE ADVANTAGE (AHM) TRISPAN HEALTH SERVICES TRISTATE TRISTATE BENEFIT SOLUTIONS TRISURANT - FKA HAS TRISURANT - FKA HAS TRUCK INSURANCE EXCHANGE (AUTO ONLY) TRUE BENEFIT ADMIN TRUE BENEFIT ADMIN INST TRUE CHOICE USA TRUE CHOICE USA-CHRISTUS HEALTH PLAN TRUMBALL INSURANCE COMPANY TRUSTEED PLANS SERVICE CORPORATION TRUSTEED PLANS SERVICE CORPORATION TRUSTEED PLANS SERVICE CORPORATION (TACOMA, WA) TRUSTMARK INSURANCE - INST TRUSTMARK INSURANCE INCL STARMARK PR PR MO Payer Type WC WC WC AM CI CI CI AM AM CI MB CI CI CI CI CI AM CI CI CI CI AM CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Format Claim Status Eligibility Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Inst Prof Prof Prof Inst Prof Prof Inst Prof Prof Prof Prof Inst Dental Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N Y Y N N N N N N Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 76054 76054 41556 4298 C1040 76048 UPGUT 75206 62308 OBAPL PAPER PAPER 87726 68241 52629 CX014 52629 TPC98 65006 UFW01 A5205 UFC01 UFC02 99026 87726 87726 86049 Name State TTPA COMM TTPA COMM TUCSON UNIFIED SCHOOL DIST WC TUFTS ASSOCIATED HEALTH PLAN TWIN CITIES FIRE INSURANCE CO TX CHILDREN HEALTH PLAN TX UNIVERSITY HEALTH PLAN UPG COMMERCIAL TXEN ALTPROS TX TX TX TYSON FOODS UA 125 HEALTH AND WELFARE PLAN UB04 PRINT TO PAPER WITH MHS IDS UB92 PRINT TO PAPER UBH UNITED BEHAVIORAL HEALTH UC CARE UCARE MINNESOTA MN UCARE MINNESOTA DENTAL UCARE MINNESOTA INST MN UCE OF FIT WELFARE FUND UCSFCSL PULMONARY UFCW LOCAL 1 UFCW LOCAL 400-5205 UFCW OF CENTRAL OHIO UFCW OF CLEVELAND UHA - UNIVERSITY HEALTH ALLIANCE HAWAII HI UHC - UNITED HEALTHCARE UHC MIDWEST MEDICARE COMPLETE UHC OF PENNSYLVANIA FKA AMERICHOICE PA MEDICAID PA Payer Type CI CI WC CI AM CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N Y N N N Y N N N N N N N N N N N Y Y N N N N Y N N N N N N N N N N Y N N N N N N N N N Y N N Format Claim Status Eligibility Prof Inst Prof Prof Prof Prof Prof Prof Inst Prof Inst Inst Prof Inst Prof Dental Inst Dental Prof Dental Dental Dental Dental Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N Y N N N Y N Y N Y N N N N N N Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 75240 UICI - ADMINISTRATORS 75245 UICI ADMINISTRATORS 75245 UICI-ADMINISTRATORS - ST OF NEVADA 41206 ULTRA BENEFITS INC 75130 UMC HEALTH PLAN 95266 UMR - HARRINGTON 95266 UMR - HARRINGTON 95266 UMR - HARRINGTON BENEFIT SERVICES (COLUMBUS) 62061 UMR - KANSAS FKA FISERV HEALTH 62061 UMR - KANSAS FKA FISERV HEALTH 79480 UMR - MIDWEST SECURITIES 79480 UMR - MIDWEST SECURITIES INST 39026 UMR - WAUSAU BENEFITS - INST 39026 UMR - WAUSAU BENEFITS - UHIS - INST 39026 UMR - WAUSAU BENEFITS INC 39026 UMR WAUSAU DENTAL 52180 UMWA HEALTH RETIREMENT FUND 52180 UMWA HEALTH RETIREMENT FUND - INST TP108 UNDERWRITERS SAFETY AND CLAIMS 80314 UNICARE 80314 UNICARE UNICAREUNICARE DENTAL 80314 UNICARE DENTAL 80314 UNICARE GIC INDEMNITY PLAN 80314 UNICARE MEDICAID 80314 UNICARE OF TEXAS HMO 80314 UNICARE OF TEXAS HMO State NV Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI CI CI CI MC CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N Y Y N N N Y Y Y N N N N N N N N N N N N N N Y N N N N N Y N N N N N N Format Claim Status Eligibility Inst Inst Prof Prof Prof Inst Prof Prof Inst Prof Prof Inst Inst Inst Prof Dental Prof Inst Prof Inst Prof Dental Dental Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y Y Y N Y Y N Y Y N N N Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID TX314 35198 35198 TLA03 62170 62170 34638 75243 75243 J1484 52133 J1629 J1629 PR046 J1274 25844 C1029 87042 87042 70408 52133 25175 25175 CX014 UAGBT 87726 87726 Name UNICARE TEXAS HEALTH STEPS State TX UNIFIED GROUP SERVICES UNIFIED GROUP SERVICES UNIFIED GROUP SERVICES DENTAL UNIFIED HEALTH SERVICES UNIFIED HEALTH SERVICES UNIFIED PHYSICIANS NETWORK UNIFORM MEDICAL PLAN UNIFORM MEDICAL PLANHARRINGTON BENEFIT UNIGARD INSURANCE COMPANY - QBE DBA UNIMERICA DENTAL UNION CONSTRUCTION WORKERS' COMP PROGRAM UNION CONSTRUCTION WORKERS' COMP PROGRAM (AUTO ONLY) UNION DE CARPINTEROS PR UNION INSURANCE COMPANY UNION INSURANCE COMPANY OF PROVIDENCE UNION INSURANCE COMPANY OF PROVIDENCE UNION PACIFIC RAILROAD EMPLOYEES UNION PACIFIC RAILROAD EMPLOYEES HEALTH SYSTEM UNION SECURITY INSURANCE UNIQUE DENTACARE UNISON - THREE RIVERS HEALTH PLAN THRU 2-28-2014 UNISON DENTAL UNISON HEALTH PLAN UNITED AGRICULTURAL BENEFIT TRUST UNITED BEHAVIORAL HEALTH UNITED BEHAVIORAL HEALTH CA Payer Type MC CI CI CI CI CI CI CI CI WC CI WC AM CI WC WC AM CI CI CI CI CI CI CI CI CI CI Real Time Real Time Y N N N N N N N N N N N N N N N N N N N N Y N N N Y Y N N N N N N N N N N N N N N N N N N Y Y N N N N N Y N Format Claim Status Eligibility Prof Inst Prof Dental Inst Prof Prof Prof Inst Prof Dental Prof Prof Prof Prof Prof Prof Inst Prof Prof Dental Prof Dental Dental Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N Y N N N Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 59069 59069 20090 CX002 CX013 CB865 Z9901 CX007 41556 70408 J1048 J1401 J1401 21850 UFWIF 87726 52133 87726 87726 87726 87726 87726 87726 87726 87726 87726 87726 Name State UNITED BENEFITS UNITED BENEFITS INST UNITED CLAIM SOLUTIONS UNITED CONCORDIA (TRICARE FMDP) UNITED CONCORDIA DENTAL PLUS UNITED CONCORDIA- FEDERAL CLAIMS (CB865) UNITED CONCORDIA- NON-PAR UNITED CONCORDIA-FEE FOR SERVICE UNITED CONVALESCENT UNITED DENTAL - TEXAS TX UNITED DOMINION REALTY TRUST UNITED FIRE UNITED FIRE (AUTO ONLY) UNITED FOOD COMMERCE WRKRS LOCAL 1529 UNITED FURNITURE WORKERS INSURANCE UNITED HEALTHCARE UNITED HEALTHCARE -- DENTAL UNITED HEALTHCARE FKA JOHN DEERE HEALTH CARE TN UNITED HEALTHCARE GROUP UNITED HEALTHCARE GROUP UNITED HEALTHCARE HERITAGE UNITED HEALTHCARE INST UNITED HEALTHCARE MEDICARE COMPLETE UNITED HEALTHCARE OF COLORADO UNITED HEALTHCARE OF FLORIDA UNITED HEALTHCARE OF GEORGIA UNITED HEALTHCARE OF NEW YORK CO FL GA NY Payer Type CI CI CI CI CI CI CI CI WC CI WC WC AM CI CI CI CI CI CI CI CI CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N Y N N Y Y N Y Y N Y Y N N N N N N N N N N N N N N N N Y N N Y Y N Y Y N N N N Format Claim Status Eligibility Prof Inst Prof Dental Dental Dental Dental Dental Prof Dental Prof Prof Prof Prof Prof Prof Dental Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y Y Y Y Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 87726 87726 87726 87726 87726 CX014 31107 33108 31107 71412 MUT 71412 TEMU1 84132 41194 81108 J1113 13545 13193 J1235 J1235 87726 25175 3432 3432 25175 87726 Name UNITED HEALTHCARE OF OHIO State OH UNITED HEALTHCARE OF THE MIDATLANTIC UNITED HEALTHCARE OF THE MIDLANDS HMO UNITED HEALTHCARE OF THE MIDWEST CHOICE UNITED HEALTHCARE OF UTAH UT UNITED HEALTHCARE OF WISCONSIN UNITED MEDICAL RESOURCES - UMR UNITED MEDICAL RESOURCES - UMR - DENTAL UNITED MEDICAL RESOURCES - UMR - INST UNITED OF OMAHA UNITED OF OMAHA UNITED OF OMAHA UNITED OF OMAHA (MUST HAVE UCCI LISTED ON BACK OF ID CARD) UNITED PHYSICIANS OF NORTHERN COLORADO UNITED RESOURCES NETWORK UNITED SECURITY LIFE AND HEALTH UNITED STATES COLD STORAGE UNITED STATES LIFE INSURANCE COMPANY UNITED TEACHER ASSOC INSURANCE COMPANY - MEDICARE SUPPLEMENTAL UNITED WISCONSIN INSURANCE COMPANY UNITED WISCONSIN INSURANCE COMPANY (AUTO ONLY) UNITEDHEALTHCARE COMMUNITY PLAN UNITEDHEALTHCARE COMMUNITY PLAN (UNISON) THRU 2-28-2014 UNITEDHEALTHCARE COMMUNITY PLAN AZ (APIPA) UNITEDHEALTHCARE COMMUNITY PLAN AZ (APIPA) - INST UNITEDHEALTHCARE COMMUNITY PLAN DE,PA (UNISON) THRU 2-28-2014 UNITEDHEALTHCARE COMMUNITY PLAN DE,PA BEG 03-01-2014 AZ AZ Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI WC AM CI CI CI CI CI CI Real Time Real Time Y N Y Y Y N N N N N N N N N N N N N N N N Y Y Y N N Y N N N N N N N N N N N N N N N N N N N N N Y N Y N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Dental Prof Dental Inst Inst Inst Prof Dental Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Inst Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y N Y N Y N N N N N N N N N N N N Y Y Y Y Y Y For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 87726 87726 96385 96385 87726 87726 86047 86047 95378 95378 87726 87726 87726 87726 81400 C1030 C1030 16063 C1030 66705 AMS01 16107 16107 UNINW 16105 33001 33001 Name State UNITEDHEALTHCARE COMMUNITY PLAN DE,PA BEG 03-01-2014 UNITEDHEALTHCARE COMMUNITY PLAN IOWA HAWK-I UNITEDHEALTHCARE COMMUNITY PLAN KANSAS (KANCARE) UNITEDHEALTHCARE COMMUNITY PLAN KANSAS (KANCARE) INST UNITEDHEALTHCARE COMMUNITY PLAN MISSISSIPPI UNITEDHEALTHCARE COMMUNITY PLAN NEW YORK UNITEDHEALTHCARE COMMUNITY PLAN NJ - INST UNITEDHEALTHCARE COMMUNITY PLAN NJ FKA AMERICHOICE UNITEDHEALTHCARE COMMUNITY PLAN TN TENNCARE UNITEDHEALTHCARE COMMUNITY PLAN TN TENNCARE - INST UNITEDHEALTHCARE OF THE RIVER VALLEY IA KS KS MS NY NJ NJ TN TN TN UNITEDHEALTHCARE OF THE RIVER VALLEY - INST UNITEDHEALTHCARE WEST (FKA PACIFICARE AZ, CO) UNITEDHEALTHCARE WEST (FKA PACIFICARE CA, OK, OR, TX, WA) UNITEDHEALTHONE UNITRIN AUTO AND HOME INSURANCE UNITRIN DIRECT AUTO INSURANCE UNITRIN DIRECT PROPERTY AND CASUALTY COMPANY (AUTO ONLY) UNITRIN SAFEGUARD INSURANCE UNITY HEALTH INSURANCE UNITY PRECISION HEALTH PLANS UNIVERA HEALTHCARE HMO UNIVERA HEALTHCARE HOS UNIVERA HEALTHCARE PPO UNIVERA OF NEW YORK UNIVERSAL CARE CALIFORNIA UNIVERSAL CARE - CALIFORNIA CA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI AM AM AM AM CI CI CI CI CI CI CI CI Real Time Real Time Y N N N N Y N N N N N N N N N N N N N N N N N N N N N Y N Y N N N N Y Y N Y N Y Y Y N N N N N Y N N N N N N Format Claim Status Eligibility Prof Prof Prof Inst Prof Prof Inst Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Dental Prof Inst Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N Y N Y N N N Y Y Y N Y Y Y Y Y Y Y Y Y Y Y N N N N N N Y N Y N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 9830 9830 58248 58248 CX014 58247 7503 41556 87043 SX155 91136 91136 76053 23281 23281 38337 38337 TPC99 93092 USFHP 13407 J1114 60054 50383 41556 J1115 J1396 Name UNIVERSITY FAMILY CARE - UNIV OF ARIZONA UNIVERSITY FAMILY CARE - UNIV OF ARIZONA INST State AZ AZ UNIVERSITY HEALTH PLAN UNIVERSITY HEALTH PLAN UNIVERSITY HEALTH PLAN (DORAL) UNIVERSITY HEALTH PLAN MEDICAID INST UNIVERSITY HEALTHCARE GROUP - UNIV OF ARIZONA AZ UNIVERSITY OF COLORADO UNIVERSITY OF MISSOURI CHOICE - COVENTRY UNIVERSITY OF UTAH HEALTH PLANS MO UT UNIVERSITY OF WASHINGTON STUDENTS GRADUATE UNIVERSITY OF WASHINGTON STUDENTS GRADUATE APPTS UPG CHIP UPMC HEALTH PLAN UPMC HEALTH PLAN INST UPPER PENINSULA HEALTH PLAN UPPER PENINSULA HEALTH PLAN UPSEU CARLE PLACE SCHOOL DISTRICT US BENEFITS US FAMILY HEALTH PLAN (USFHP) - TEXAS AND LOUISIANA US FAMILY HEALTH PLAN - NEW JERSEY US FOODSERVICE, INC US HEALTHCARE - AETNA US IMAGING NETWORK - NY US MOBILE WIRELESS US NATIONAL RESOURCES (AIGRM) US STEEL OR Payer Type CI CI CI CI CI CI CI WC CI CI CI CI CI CI CI CI CI CI CI CI CI WC CI CI WC WC WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N N N N Y N N N N N N N N Y N N N N Format Claim Status Eligibility Prof Inst Prof Inst Dental Inst Prof Prof Prof Prof Inst Prof Inst Prof Inst Inst Prof Dental Prof Prof Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N Y Y N N N N N N N Y N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 74095 74095 76031 13407 23217 J1534 UTICA C1027 EXC02 25976 43478 36369 UHSCH 41556 12115 12115 VPN01 WT001 41556 82238 82420 82420 41556 TPC19 41556 41556 VHP01 Name State USAA (UNITED STATES AUTOMOBILE ASSOCIATION) USAA LIFE INSURANCE USABLE LIFE USFHP - ST VINCENT CATHOLIC MEDICAL CENTERS OF NY USI ADMINISTRATORS USS-POSCO INDUSTRIES CA UTICA UTICA (AUTO ONLY) UTICA BLUE CROSS UTICA MUTUAL INSURANCE CO UTICA NATIONAL INSURANCE CO OF TEXAS UTILIMED UTMB- CHOICEONE CHIP TX V AND M RESTORATION VA FEE BASIS PROGRAMS VA FEE BASIS PROGRAMS - INST VA PREMIER HEALTH PLAN INC VA SMILES FOR CHILDREN VALENZUELA ENG INC VALLEY BAPTIST ADVANTAGE VALLEY BAPTIST HEALTH PLAN VALLEY BAPTIST HEALTH PLAN INST VALLEY CASEWORK INC VALLEY CENTRAL TEACHERS ASSOCIATION VALLEY HARVESTING AND PACKING, INC VALLEY HEALTH CARE MANAGEMENT SERVICES, LLC VALLEY HEALTH PLAN (COMMERCIAL) CA Payer Type CI CI CI CI CI WC CI AM CI WC WC CI CI WC CI CI MC CI WC CI CI CI WC CI WC WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N Y N N N N N N N N N N N N Format Claim Status Eligibility Inst Prof Dental Inst Prof Prof Prof Prof Dental Prof Prof Prof Prof Prof Prof Inst Prof Dental Prof Prof Prof Inst Prof Dental Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N Y N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID VHP02 41556 41556 IP044 23253 V1001 V1001 V1005 V1006 V1003 V1004 V1002 23173 21172 72128 72128 PPM01 PPM02 68241 60054 73288 53172 41556 75256 75256 J1118 41556 Name VALLEY HEALTH PLAN (MEDI-CAL) State CA VALLEY HEALTH SYSTEM VALLEY MEMORIAL HOSPITAL VALLEY OF THE MOON CA VALLEY PREFERRED PPO FKA SPECTRUM ADMIN VALUE OPTIONS COMMERCIAL VALUE OPTIONS COMMERCIAL VALUE OPTIONS KANSAS VALUE OPTIONS MARYLAND PUBLIC MENTAL HEALTH VALUE OPTIONS MASS BEHAVIORAL HEALTH (MBHP) VALUE OPTIONS PENN BEHAVIORAL HEALTH VALUE OPTIONS TEXAS NORTHSTAR KS MD MA PA TX VANDERBILT - VHP COMMUNITY CARE VANLINERS INSURANCE COMPANY VANTAGE HEALTH PLAN VANTAGE HEALTH PLAN - INST VANTAGE MEDICAL GROUP VANTAGE MEDICAL GROUP - ENCOUNTERS VARIAN HEALTH CARE VARIAN HEALTH CARE PLAN VENCOR VENTANA HEALTH SYSTEMS VENTURE PAC DEVELOP VERITY NATIONAL GROUP VERITY NATIONAL GROUP VERMEER VERTICAL CONCRETE CA CA Payer Type CI WC WC CI CI CI CI CI CI CI CI CI CI WC CI CI CI CI CI CI CI CI WC CI CI WC WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Prof Prof Prof Prof Inst Prof Prof Prof Claim Enrollment Required ERA Enrollment Required Y N N N N Y Y Y Y Y Y Y N N N N N N N N N N N N N N N N N N N N Y Y Y Y Y Y Y N N N N N N N Y N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID VESTA VAPC3 VAP5A VAP5B VAPC6 23173 J1533 J1403 J1116 J1118 41556 VFP11 BVVP1 54176 CX014 J1404 J1404 37297 86079 55248 55248 41556 63114 63114 77073 59266 J1750 Name State VESTA CARE VETERANS AFFAIRS PCCC REGION 3 (TRIWEST) VETERANS AFFAIRS PCCC REGION 5A (TRIWEST) VETERANS AFFAIRS PCCC REGION 5B (TRIWEST) VETERANS AFFAIRS PCCC REGION 6 (TRIWEST) VHP COMMUNITY CARE VIACOM (MURPHY AND BEANE) VIAD CORP VICORP RESTAURANTS, INC VICTOR PLASTICS VICTORIA ISD VILLAGE FAMILY PRACTICE VIPA VIRGINIA PREMIER HEALTH PLAN VIRGINIA SMILES FOR CHILDREN VIRGINIA SURETY COMPANY, INC VIRGINIA SURETY COMPANY, INC (AUTO ONLY) VISION CARE INCORPORATED VISTA DEL SOL HEALTH CARE VISTA HEALTH PLAN - COVENTRY FLORIDA VISTA HEALTH PLAN - MEDICAID VISTA HILLS C CLUB VIVA HEALTH PLAN VIVA MEDICARE PLUS VNS CHOICE MEDICARE VOLUSIA HEALTH NETWORK VONS SAFEWAY FL Payer Type CI CI CI CI CI CI WC WC WC WC WC CI CI CI CI WC AM CI CI CI CI WC CI CI CI CI WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N Y Y N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Prof Dental Prof Prof Prof Prof Inst Prof Prof Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N Y Y Y Y N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y Y N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1750 J1405 22264 22264 41556 85256 85256 J1004 41556 37294 41556 WC001 OBALB 73155 73155 58082 58082 41556 41556 39026 41556 62111 39151 39151 75261 75261 36337 Name State VONS SAFEWAY (AUTO ONLY) VOUGHT AIRCRAFT INDUSTRIES VYTRA NY VYTRA - INST W CO RADIOLOGY CNTR WABASH MEMORIAL HOSPITAL ASSOCIATION WABASH MEMORIAL HOSPITAL ASSOCIATION WAL-MART WASHINGTON COUNTY WASHINGTON EMPLOYERS TRUST WASHINGTON HOSPITAL WASHINGTON LABOR AND INDUSTRY WA WATERLOO MUNICIPAL EMPLOYEES HEALTH PLAN WATERSTONE BENEFIT ADMINISTRATOR (OKLAHOMA) WATERSTONE BENEFIT ADMINISTRATORS (OKLAHOMA) WATKINS ASSOCIATED INDUSTRIES WATKINS ASSOCIATED INDUSTRIES, INC WATKINS MANUFACTURING CORPORATION WATTSHEALTH FOUNDATION, INC (SNCC) WAUSAU BENEFITS WAWONA PACKING WC BEELER COMPANY WEA INSURANCE GROUP WEA INSURANCE GROUP WEB TPA WEBTPACOMMUNITY HEALTH ELECTRONIC WEISS HEALTH PROVIDERS TN Payer Type AM WC CI CI WC CI CI WC WC CI WC WC CI CI CI CI CI WC WC CI WC CI CI CI CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N Y N N Format Claim Status Eligibility Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Inst Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N Y N N N N N N N N N N N N N N Y N N N N N N N N N N N Y N N N N N N N Y N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID Name 13337 WELL SENSE HEALTH PLAN (BMCHP) WELL4 WELLCARE CMO GA MEDICAID WELL4 WELLCARE CMO GA MEDICAID INST 14163 WELLCARE CONNECTICUT CX014 WELLCARE DENTAL 14163 WELLCARE HEALTH PLAN 59354 WELLCARE HEALTH PLAN ENCOUNTER 14163 WELLCARE HMO 14163 WELLCARE MANAGEMENT GROUP 14163 WELLCARE OF CONNECTICUT 14163 WELLCARE OF NEW YORK 77072 WELLCARE PFFS MEDICARE 77072 WELLCARE PFFS MEDICARE FAMR1 WELLMARK ADMIN FAMR1 WELLMARK SD ADMIN INC WELM2 WELLMED (CLAIMS) WELM2 WELLMED (CLAIMS) - INST 12053 WELLNET DENTAL 25711 WELLNET HEALTH PLAN 22334 WELLPATH OF CAROLINA INC HOS 87815 WELLS FARGO TPA 87815 WELLS FARGO TPA - INST 22925 WELS BENEFIT PLAN OFFICE 41556 WESLACO INDEPENDENT SCHOOL DISTRICT 41556 WEST COAST HOSPITALS, INC 91136 WEST COAST STATIONARY ENGINEERS HEALTH WCMG1 WEST COVINA MEDICAL GROUP State GA GA CT CT NY SD SD CA Payer Type CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI CI WC WC CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N Y N N N N N N N N N N N N N N Y N N N N N N Format Claim Status Eligibility Prof Prof Inst Prof Dental Prof Prof Inst Prof Prof Prof Inst Prof Inst Inst Prof Inst Dental Prof Inst Prof Inst Prof Prof Prof Inst Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N Y N Y N Y Y Y Y N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 80942 41556 75196 41556 IP026 24735 24735 24735 24735 WEST 37247 37247 J1569 J1569 J1586 J1586 J1495 J1495 31048 31048 91068 IP023 J1453 90560 38232 33711 Name State WEST OSO ISD WEST SUBURBAN HEALTH PLAN (WSHP) WEST TEXAS RURAL COUNTIES ASSOCIATION PREFERRED RISK POOL - WC WEST VIRGINIA STATE EMPLOYEES WV WESTAMERICAPHIL LONG DEALERSHIPS WESTERN ARIZONA REGIONAL PHYSICIANS AZ WESTERN GROWERS ASSURANCE TRUST WESTERN GROWERS ASSURANCE TRUST WESTERN GROWERS INSURANCE COMPANY WESTERN GROWERS INSURANCE COMPANY WESTERN HEALTH PROVIDERS WESTERN MUTUAL INSURANCE WESTERN MUTUAL INSURANCE WMITPA WESTERN NATIONAL ASSURANCE WESTERN NATIONAL ASSURANCE (AUTO ONLY) WESTERN NATIONAL INSURANCE PIONEER SPECIALTIES WESTERN NATIONAL INSURANCE PIONEER SPECIALTIES (AUTO ONLY) WESTERN NATIONAL INSURANCE GROUP WESTERN NATIONAL INSURANCE GROUP (AUTO ONLY) WESTERN SOUTHERN FINANCIAL GROUP (CINCINNATI, WESTERN SOUTHERN FINANCIAL GROUP (CINCINNATI, OH) WESTERN TEAMSTER WELFARE TRUST WESTGROVE MEDICAL GROUP WESTGUARD INSURANCE COMPANY - GUARD DBA WESTLAKE FINANCIAL GROUP INC WEYCO - MERITIAN HEALTH WILLAMETTE VALLEY COMM HEALTH PLAN CCO CA Payer Type WC CI WC CI WC CI CI CI CI CI CI CI CI WC AM WC AM WC AM CI CI CI CI WC CI CI CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Inst Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID 41556 98010 98010 J1473 62061 41556 41095 41095 62153 62153 27327 39200 J1408 J1408 41556 WOA99 J1500 20333 20333 75276 75276 34080 235 23710 23710 J1117 CX014 Name State WILLAMETTE VIEW WILLIAM J SUTTON COMPANY WILLIAM J SUTTON COMPANY, LTD (TORONTO) WILLIAMS SONOMA WILLIS ADMINISTRATIVE SERVICES (UMR KANSAS) WILMER-HUTCHINS ISDDALLAS ISD WILSON MCSHANE WILSON MCSHANE INST WINDSOR MEDICARE EXTRA DOS THRU 4-30-2014 WINDSOR MEDICARE EXTRA INST - DOS THRU 4-30-2014 WINHEALTH PARTNERS WISCONSIN AUTO AND TRUCK DEALERS WOODLAND FARMS WOODLAND FARMS (AUTO ONLY) WOODLAND PARK WEST WOODMAN OF THE WORLD OMAHA WOODMAN WORKFORCE SAFETY AND INSURANCE (WSI) WORKSITE BENEFIT SERVICES - GA WORKSITE BENEFIT SERVICES - GA GA GA WORLD INSURANCE COMPANY WORLD INSURANCE COMPANY WPPN WPS COMMERCIAL WRITERS GUILD - INDUSTRY HEALTH PLAN WRITERS GUILD INDUSTRY HEALTH PLAN WYMAN-GORDON COMPANIES XANTUS HEALTH PLAN-TENNESSEE (NASHVILLE, TN) WI Payer Type WC CI CI WC CI WC CI CI CI CI CI CI WC AM WC CI WC CI CI CI CI CI CI CI CI WC CI Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N Y N Y N N N N Format Claim Status Eligibility Prof Prof Inst Prof Prof Prof Prof Inst Prof Inst Prof Prof Prof Prof Prof Prof Prof Inst Prof Inst Prof Inst Prof Inst Prof Prof Dental Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N Y N N N N For questions, please contact EDI Support at [email protected] FOXFIRE SYSTEMS GROUP PAYER LIST Payer ID J1628 J1628 J1412 J1055 60646 41556 J1421 J1421 34083 30120 J1409 J1015 16535 Name XCEL ENERGY XCEL ENERGY (AUTO ONLY) XCHANGING, INC XL ENVIRONMENTAL, INC YALE UNIV HEALTH PLAN YMCA YORK CLAIM SERVICES YORK CLAIM SERVICES (AUTO ONLY) YOUNGSTOWN ELEC FUND HOSP Z-NAT INSURANCE (ZENITH NATIONAL) ZACHRY CONSTRUCTION ZURICH FARMERS ZURICH INSURANCE NA State Payer Type WC AM WC WC CI WC WC AM CI WC WC WC WC Real Time Real Time N N N N N N N N N N N N N N N N N N N N N N N N N N Format Claim Status Eligibility Prof Prof Prof Prof Prof Prof Prof Prof Inst Prof Prof Prof Prof Claim Enrollment Required ERA Enrollment Required N N N N N N N N N N N N N N N N N N N N N N N N N N
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