List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
GHI HMO
00002
Customer Service
(877) 244-4466
WELLMARK BCBS FEP
00004
(800) 584-9242
WELLMARK BCBS FEP
00005
Provider Services
(800) 524-9242
WELLMARK BCBS FEP
00005
Customer Service
(800) 373-5348
WELLMARK BCBS
00006
Customer Service
(800) 524-9242
THE REGENCE GROUP IDAHO
00009
Customer Service
(800) 343-8915
THE REGENCE GROUP BLUE SHIELD
00010
Customer Service
(800) 343-8915
THE REGENCE GROUP UTAH
00011
Customer Service
(800) 343-8915
THE REGENCE GROUP OREGON
00012
Customer Service
(800) 343-8915
TRANSAMERICA PREMIER LIFE INS
00017
Customer Service
(800) 854-0186
CONNECTICUT GENERAL INSURANCE CO
00018
Customer Service
(800) 244-6224
HORIZON BCBS OF NEW JERSEY
00019
Customer Service
(800) 624-1110
WELLMARK BCBS OF IA
00020
Customer Service
(800) 524-9242
WELLMARK BCBS OF SD
00021
(800) 524-9242
WELLMARK BCBS OF SD
00023
(800) 524-9242
WPS-COMMERCIAL
00025
Customer Service
(888) 253-2694
WPS-COMMERCIAL
00026
Customer Service
(888) 253-2694
BCBS OF MICHIGAN
00027
Customer Service
(313) 225-9000
BCBS OF ALABAMA
00028
Customer Service
(205) 988-2200
BCBS OF SOUTH CAROLINA
00029
Customer Service
(800) 760-9290
HIGHMARK INC
00030
Customer Service
(800) 345-3806
HIGHMARK INC
00031
(800) 345-3806
GHI PPO
00032
Customer Service
(212) 501-4444
GHI PPO
00033
Customer Service
(212) 501-4444
GHI PPO
00034
Customer Service
(212) 501-4444
GHI PPO
00035
Customer Service
(212) 501-4444
GHI PPO
00036
Customer Service
(212) 501-4444
GHI PPO
00037
Customer Service
(212) 501-4444
HCSC-BCBS OF IL,OTHER B ONLY
00041
Customer Service
(888) 762-2189
HCSC-BCBS OF NM-OTHER B ONLY
00042
Customer Service
(888) 762-2189
HCSC-BCBS OF TX-OTHER B ONLY
00044
Customer Service
(888) 762-2189
BCBS OF MICHIGAN
00055
Customer Service
(313) 225-9000
AETNA, INC.
00060
Customer Service
(860) 273-0123
BCBS OF MICHIGAN
00061
Customer Service
(313) 225-9000
BLUE CARE NETWORK
00062
Customer Service
(800) 450-3680
BCBS OF MISSISSIPPI
00067
Customer Service
(800) 257-5825
BCBS OF MISSISSIPPI
00068
Customer Service
(800) 257-5825
BLUE CROSS OF NORTHEASTERN PA
00069
Cathy Stitzer
(570) 200-4540
BLUE CROSS OF NORTHEASTERN PA
00070
Cathy Stitzer
(570) 200-4540
METROPOLITAN HEALTH PLAN
00072
Marilee Moritz
(612) 543-1245
TRIPLE-S INC
00074
Nayda Cruz
(787) 749-4949
CAREFIRST DC PART A ONLY
00075
Provider Services
(410) 998-4599
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
CAREFIRST DC PART B ONLY
00076
Provider Services
(410) 998-4599
BCBS OF NORTH DAKOTA
00077
Gina Bercherl
(701) 277-2081
BCBS OF WYOMING
00078
Amber Zowada
(307) 432-2743
BCBS OF NORTH DAKOTA
00079
Gina Bercherl
(701) 277-2081
MEDICAL MUTUAL OF OHIO
00080
Sue Robinson
(216) 687-6108
BCBS OF TENNESSEE - SUPPLEMENTAL
00081
Customer Service
(800) 553-8158
UNITEDHEALTHCARE
00082
Customer Service
(866) 633-2446
UNITEDHEALTHCARE
00083
Customer Service
(866) 633-2446
GROUP HEALTH COOPERATIVE
00087
Michelle Anderson/Farmer
(206) 901-4588
BCBS OF MINNESOTA
00088
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
00089
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
00090
Customer Service
(800) 531-6686
EMPIRE BLUE CROSS BLUE SHIELD I
00091
Refer To Back Of ID Card
EMPIRE BLUE CROSS BLUE SHIELD II
00092
Refer To Back Of ID Card
BCBS OF KANSAS
00093
Customer Service
(800) 432-3990
ANTHEM BCBS CONNECTICUT
00095
Refer To Back Of ID Card
ANTHEM BCBS NEW HAMPSHIRE
00096
Refer To Back Of ID Card
ANTHEM BCBS MAINE
00097
Refer To Back Of ID Card
BLUE CROSS BLUE SHIELD OF LA
00099
Customer Service
(800) 392-4089
NORTHEAST CARPENTERS HEALTH F226
00102
Rachel Corradi
(732) 417-3900 ext. 272
MEDICA MMSI
00103
Customer Service
(800) 635-6671
WEA INSURANCE CORPORATION
00104
Rebecca Johnson
(608) 661-6620
CAREFIRST DC PART A ONLY
00105
Part A only
(410) 998-4599
CAREFIRST DC PART B ONLY
00106
Part B only
(410) 998-4599
CAREFIRST MD PART B ONLY
00107
Part B only
(410) 998-4599
EMPIRE BLUE CROSS BLUE SHIELD II
00108
Refer To Back Of ID Card
EMPIRE BLUE CROSS BLUE SHIELD II
00109
Refer To Back Of ID Card
CARPENTERS TRUSTS OF W.WASHINGTON
00110
Min-Sug (Darren) Kong
(206) 441-6514
BLUE CROSS BLUE SHIELD OF NC
00112
eSolutions Help Desk
(888) 333-8594
CAPITAL BLUE CROSS
00113
Nancy Herman
(717) 541-6274
BLUE CROSS BLUE SHIELD OF WNY
00114
Buffalo (CNY West)
(866) 638-9011
BLUE CROSS BLUE SHIELD OF WNY
00114
Albany Region II
(800) 945-0566
BLUE CROSS BLUE SHIELD OF WNY
00114
Albany (CNY East)
(800) 856-0480
BLUE CROSS BLUE SHIELD OF WNY
00115
Traditional Member
(800) 888-1238
BLUE CROSS BLUE SHIELD OF WNY
00115
Managed Care Member
(800) 459-7587
BLUE CROSS BLUE SHIELD OF WNY
00115
Provider Services
(800) 444-4552
BLUE CROSS BLUE SHIELD OF WNY
00116
Melissa Deboth
(716) 887-8443
HIGHMARK BCBS OF DELAWARE
00118
Customer Service
(302) 429-0260
HEALTH ALLIANCE PLAN
00119
Laron Gaines
(313) 664-7123
BCBS OF ARIZONA
00122
Rebecca Garcia
(602) 864-4818
ALLEGIANCE BENEFIT PLAN MANAGEMENT
00124
Customer Service
(406) 721-2222
EMPLOYEE BENEFIT MGMT CARE
00127
Customer Service
(800) 993-3262
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
ANTHEM CENTRAL - FACETS
00128
Refer To Back Of ID Card
ANTHEM NATIONAL BCBS OHIO CTRL
00131
Refer To Back Of ID Card
ANTHEM NATIONAL BCBS KY CONTROL
00134
Refer To Back Of ID Card
ANTHEM NATIONAL BCBS IN CONTROL
00136
Refer To Back Of ID Card
ANTHEM BCBS MAINE
00139
Refer To Back Of ID Card
ANTHEM BCBS NEW HAMPSHIRE
00140
Refer To Back Of ID Card
ANTHEM BCBS CONNECTICUT
00141
Refer To Back Of ID Card
ANTHEM BCBS VIRGINIA
00148
Refer To Back Of ID Card
MODA HEALTH PLAN INC
00150
EDI Department
(800) 852-5195
ARKANSAS BCBS
00151
Mia Moore
(501) 502-1686
HEALTH ADVANTAGE
00153
Dee McKee
(501) 212-8520
PITTMAN & ASSOCIATES, INC.
00156
Andy Glankler
(901) 473-3344
HEALTH ALLIANCE MEDICAL PLANS
00157
Cindy Cargo
(217) 383-8208
GRAPHIC COMMUNICATIONS NAT'L
00160
Teresa Bauer
(412) 201-2242
ANTHEM BCBS OF NEVADA
00166
Refer To Back Of ID Card
ANTHEM BCBS OF COLORADO
00168
Refer To Back Of ID Card
BLUE CROSS OF CALIFORNIA
00170
Refer To Back Of ID Card
UNICARE LIFE & HEALTH INSURANCE
00171
Refer To Back Of ID Card
HEALTH NET OF CALIFORNIA, INC.
00173
Customer Service
(800) 641-7761
INSURANCE PROGRAMMERS INC.
00180
Amy Cook
(203) 269-7741
RESERVE NATIONAL INSURANCE CO
00182
Juanita Phelps
(800) 654-9106
BLUE CROSS OF IDAHO
00184
Customer Service
(866) 482-2253
BLUE CROSS OF IDAHO
00185
Customer Service
(866) 482-2253
ALLIED BENEFIT SYSTEMS, INC
00188
Outside IL
(800) 288-2078
ALLIED BENEFIT SYSTEMS, INC
00188
IL Resident
(312) 906-8080
NGS AMERICAN, INC
00189
Customer Service
(800) 521-1555
HIGHMARK WEST VIRGINIA
00190
Customer Service
(800) 543-7822
HIGHMARK WEST VIRGINIA
00191
Customer Service
(800) 543-7822
UMR
00192
Customer Service
(800) 826-9781
PA EMPLOYEES BENEFIT TRUST FUND
00208
Rest of U.S.
(800) 522-7279
PREMERA BLUE CROSS
00209
Customer Service
(800) 722-1471
POMCO, INC
00210
Vivie Prichard
(800) 830-2528
BCBS OF MASSACHUSETTS INC.
00212
Customer Service
(800) 258-2226
HEALTHSMART
00214
BCBS OF VERMONT - SUPPLEMENTAL
00217
Chantal Parent
(802) 371-3611
OXFORD HEALTH PLANS
00220
Customer Service
(888) 201-4133
UNITEDHEALTHCARE
00224
Stewart McGehee
(336) 540-7563
C & R CONSULTING
00226
C&R Customer
(212) 819-0792
CORESOURCE, INC
00229
One Beacon Ins Grp
(866) 889-7286
CORESOURCE, INC
00229
Crompton Corp
(866) 318-7173
CORESOURCE, INC
00229
All others
(800) 223-3943
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
BCBS OF KANSAS CITY
00232
Kathy Currey
(816) 395-3877
BLUE CROSS BLUE SHIELD OF RI
00236
Customer Service
(800) 267-0439
UNITED HEALTHCARE
00237
Stewart McGehee
(336) 540-7563
MERITAIN HEALTH
00240
Customer Service
(800) 548-2041
ASURIS
00246
Rebecca Thorn
(503) 375-4341
REGENCE BLUESHIELD OF UTAH
00249
Rebecca Thorn
(503) 375-4341
REGENCE BLUESHIELD
00250
Rebecca Thorn
(503) 375-4341
REGENCE BCBS OF OREGON
00251
Rebecca Thorn
(503) 375-4341
REGENCE BLUESHIELD OF IDAHO
00252
Rebecca Thorn
(503) 375-4344
CLAIMSNET.COM, INC.
00253
Customer Service
(817) 878-3300
HCSC-BCBS OF IL-OTHER A ONLY
00254
Customer Service
(888) 762-2189
HCSC-BCBS OF NM-OTHER A ONLY
00255
Customer Service
(888) 762-2189
HCSC-BCBS OF TX-OTHER A ONLY
00256
Customer Service
(888) 762-2189
KIDNEY DISEASE PROGRAM OF MD
00259
Carol Manning
(410) 767-5004
AMALAGAMATED LIFE/ALICARE
00267
Customer Service
(212) 539-5111
HUMANA, INC.
00268
Customer Service
(866) 427-7478
THE J.P. FARLEY CORPORATION
00280
Amanda Smolka
(440) 250-4316
FEDERATED ALLIED RETIREE ASSOC
00288
Lorraine Piazza
(631) 249-0500
C&O EMPLOYEES HOSPITAL ASSOC
00295
Anna Brooks
(540) 862-5728
PIPE FITTERS WELFARE FUND
00299
CONNECTICUT GENERAL INSURANCE CO
00300
Customer Service
(800) 244-6224
PLUMBERS WELFARE FUND,LCL 130 UA
00304
NATL ELEVATOR INDUSTRY HEALTH BE
00305
BLUE CROSS BLUE SHIELD OF NC
00306
ESolutions Help Desk
(888)333-8594
ANTHEM BCBS VIRGINIA
00308
Refer To Back Of ID Card
THE LOOMIS COMPANY
00310
BCBS OF WYOMING
00312
Amber Zowada
(307) 432-2743
WEBTPA EMPLOYER SERVICES
00313
Lisa Smith
(469) 417-1854
SECURITY HEALTH PLAN OF WI, INC
00314
Ken Baur
(715) 221-9556
HCSC-BCBS OF OK -OTHER A ONLY
00317
Customer Service
(888) 762-2189
HCSC-BCBS OF OK-OTHER B ONLY
00318
Customer Service
(888) 762-2189
CAPITAL DISTRICT PHYSICIANS H P
00321
Brian Freer
(518) 641-3820
WEBTPA EMPLOYER SERVICES
00322
Lisa Smith
(469) 417-1854
LIFETIME BENEFIT SOLUTIONS, INC.
00323
Teresa Behm
(315) 448-9001
TIC - IBEW LOCAL 461 WELFARE FUN
00329
Susan Esterhai
(866) 461-4239
TIC – ELECTRICAL WORKERS FUND
00332
Jackie Neible
(317) 923-4577
BLUE CROSS OF NORTHEASTERN PA
00333
Cathy Stitzer
(570) 200-4540
BLUE CROSS OF NORTHEASTERN PA
00334
Cathy Stitzer
(570) 200-4540
BLUE CROSS OF NORTHEASTERN PA
00335
Cathy Stitzer
(570) 200-4540
BLUE CARE COOPERATIVE
00341
Cathy Stitzer
(570) 200-4540
PLUMBERS & PIPEFITTERS WELFARE
00343
Nancy Winer
(314) 355-1000
DANA NON UNION RETIREE VEBA TRUST
00352
Lorraine Piazza
(631) 249-0500
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
BLUE CROSS OF NORTHEASTERN PA
00353
Cathy Stitzer
(570) 200-4540
G.M.P. - EMPLOYERS RETIREE TRUST
00354
Debra Fulmer
(239) 936-6242
MEDICA, PART B ONLY
00360
Stephanie Kelly
(952) 992-2582
MEDICA PART A ONLY
00361
Stephanie Kelly
(952) 992-2582
CONNECTICUT GENERAL INSURANCE CO
00364
Customer Service
(800) 244-6224
VANTAGE HEALTH PLAN, INC.
00365
Shanna Waters
(318) 361-0990
BCBS OF MINNESOTA
00366
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
00367
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
00368
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
00369
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
00370
Customer Service
(800) 531-6686
AVMED HEALTH PLANS
00371
Customer Service
(800) 882-8633
PIPELINE INDUSTRY BENEFIT FUND
00372
Claims Supervisor
(918) 280-4800
THE WILLIAM C. EARHART CO., INC
00374
Ann Mott
(503) 535-1431
MID CENTRAL OPERATING ENGINEERS HEALTH & WELFARE FUND
00375
Katricia Helton
(812) 232-4384
SOUTHWEST LIFE & HEALTH INS.CO.
00377
Melinda Rodriguez
(806) 784-4378
FIRSTCARE
00378
Dahlia Kelly
(806) 784-4450
WABASH MEMORIAL HOSPITAL ASSOC.
00379
Debby Kunze
(217) 429-5246
AMERICAN BENEFIT CORPORATION
00380
Linda Sites
(304) 525-0331
TIC – NECA IBEW LOCAL 364 HEALTH
00386
Medical Claims Department
(800) 228-0048
RIGHT CHOICE BENEFIT ADMIN.
00387
Customer Service Right Choice
(800) 365-9036
BCBS OF NEBRASKA
00388
Customer Service Center
(800) 991-7392
BCBS OF NEBRASKA
00392
Customer Service Center
(800) 991-7392
ADC 1 WELFARE FUND
00406
Yolanda Alzati
(630) 617-8630
SFEW HEALTH & WELFARE TRUST
00407
Lisa Schultz
(415) 263-3670
IE SCHAFFER & CO
00411
Terri Trasatti
(609) 883-6688
C & R CONSULTING
00413
ARKANSAS BCBS
00417
Mia Moore
(501) 502-1686
COVENTRY NATIONAL ACCOUNTS
00420
Customer Service
(800) 937-6824
EMBLEMHEALTH SVC COMPANY, LLC-HIP
00423
Michele Podolak
(315) 434-2447
M.C.D.C HEALTH FUND
00425
Sandra Belot
(262) 970-5790
PLUMBERS & PIPEFITTERS LOCAL 630
00426
Amanda Ratcliff
(954) 266-6322
OE LOCAL 139 HBF
00427
Annette Kusick
(262) 549-9190
PIPE TRADES INDUSTRY H&W PLAN
00428
Megan Lucas
(812) 877-2581
HEALTH NET OF ARIZONA, INC.
00429
Healthnet Provider Service
(800) 977-7522
C&R CONSULTING
00431
BLUE SHIELD OF CALIFORNIA
00433
Tammy Rutters
(530) 351-6019
SCPT HEALTH & WELFARE FUND
00434
Marcus Chin
(213) 385-6161
LIBERTY NATL LIFE INS CO - GMS
00435
Customer Service Department
(972) 529-5085
GUNDERSEN LUTHERAN HEALTH PLAN
00436
Debra Schiffman
(608) 643-1408
SENTARA HEALTH PLANS INC.
00438
Medicare Customer Service Line
(800) 927-6048
INDIANA LABORERS WELFARE FUND
00439
Melissa Wade
(812) 238-2551
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
INDIANA LABORERS WELFARE FUND
00440
Melissa Wade
(812) 238-2551
AMERICAN BENEFIT CORPORATION
00445
Linda Sites
(304) 525-0331
BLUE CROSS BLUE SHIELD OF LA
00455
Customer Service
(800) 392-4089
HEALTH CARE SERVICE CORP, BCBS
00456
Blue Cross Blue Shield
(888) 762-2189
HEALTH CARE SERVICE CORP, BCBS
00457
Blue Cross Blue Shield
(888) 762-2189
KAISER PERMANENTE MID-ATLANTIC
00459
Member Service
(800) 777-7902
INDEPENDENCE BLUE CROSS
00460
Customer Service
(800) 645-3965
OPERATING ENGINEERS H&W FUND
00462
Elisabeth Schaefer
(626) 356-3560
TIC-NECA IBEW LCL 150 FRINGE BF
00463
Jan Smith
(877) 478-4542
DELTA HEALTH SYSTEMS
00470
Christine Dugger-Praet
(559) 228-4185
EXCELLUS HEALTH PLANS
00472
Michael Sirni
(315) 272-0121
HARRINGTON HEALTH SERVICES, INC.
00473
Customer Service
(800) 216-2166
NECA FAMILY MEDICAL CARE PLAN
00474
Jeri Hill
(877) 937-9602
BLUE CROSS/SHIELD OF GA KCSUP
00475
Refer To Back Of ID Card
BLUE CROSS/SHIELD OF GA KCSUP
00476
Refer To Back Of ID Card
EIGHTH DISTRICT ELECTRICAL BENEF
00478
Mary Kemp
(801) 973-1001
MEDICAL ASSOC HEALTH PLAN INC
00479
Laura Boge
(563) 556-8070
W MICH PLUMBERS LOCAL 174 HEALTH
00484
Customer Service
(219) 769-6944
NATIONAL BCBS GEORGIA
00485
Refer To Back Of ID Card
DESERET MUTUAL
00486
Donna Mcreavy
(801) 578-5621
REGENCE BLUE SHIELD
00489
Rebecca Thorn
(503) 374-4341
WISCONSIN PHYSICIANS SERVICE
00493
Kit Lee
(608) 226-3369
WISCONSIN PHYSICIANS SERVICE
00494
Kit Lee
(608) 226-3369
DUNN & ASSOCIATES BENEFIT ADMIN
00496
Tammy Shaw
(812) 378-9960
HEALTHLINK HMO, INC
00498
Karen Gotsch
(314) 925-6166
INDEPENDENCE BLUE CROSS
00500
Customer Service
(800) 645-3965
PEHP
00501
Josie Hall
(801) 366-7519
HEALTH CARE SERVICE CORPORATION
00502
Blue Cross/Blue Shield
(888) 762-2189
HEALTH CARE SERVICE CORPORATION
00503
Blue Cross/Blue Shield
(888) 762-2189
WELLMARK BCBS OF SD
00506
(800) 584-9242
WELLMARK BCBS OF IA
00507
(800) 584-9242
MIDWEST OPERATING ENGINEERS HEALTH
00508
Barbara Glembin
(708) 579-6603
NEW YORK ISG
00509
Refer To Back Of ID Card
NEVADA ISG
00510
Refer To Back Of ID Card
MAINE ISG
00511
Refer To Back Of ID Card
WISSONSIN ISG
00512
Refer To Back Of ID Card
KENTUCKY ISG
00513
Refer To Back Of ID Card
VIRGINIA ISG
00514
Refer To Back Of ID Card
NEW HAMPSHIRE ISG
00515
Refer To Back Of ID Card
MISSOURI ISG
00516
Refer To Back Of ID Card
OHIO ISG
00517
Refer To Back Of ID Card
CALIFORNIA ISG
00518
Refer To Back Of ID Card
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
COLORADO ISG
00519
Refer To Back Of ID Card
CONNECTICUT ISG
00520
Refer To Back Of ID Card
INDIANA ISG
00521
Refer To Back Of ID Card
CONNECTICUT WGS
00522
Refer To Back Of ID Card
INDIANA WGS
00523
Refer To Back Of ID Card
KENTUCKY WGS
00524
Refer To Back Of ID Card
MISSOURI WGS
00526
Refer To Back Of ID Card
NEW YORK WGS
00528
Refer To Back Of ID Card
OHIO WGS
00529
Refer To Back Of ID Card
VIRGINIA WGS
00530
Refer To Back Of ID Card
WISCONSIN WGS
00531
Refer To Back Of ID Card
INDEPENDENCE BLUE CROSS
00532
Customer Service
(800) 645-3965
INDEPENDENCE BLUE CROSS
00533
Customer Service
(800) 645-3965
BLUE CROSS BLUE SHIELD OF NC
00535
Nakia Harrington
(877) 258-3334
BLUE SHIELD OF CALIFORNIA
00536
Tammy Rutters
(530) 351-6109
AFTRA HEALTH FUND
00537
Karen Ortolani
(800) 562-4690
USABLE MUTUAL INS COMPANY
00542
Deb Gunter
(501) 210-9043
BCBS of MINNESOTA
00544
Customer Service
(800) 531-6686
BCBS of MINNESOTA
00545
Customer Service
(800) 531-6686
TEAMSTERS MEDICARE TRUST FOR RET.
00555
Insurance Teamsters
(314) 513-5888
ANTHEM KY
00556
Refer To Back Of ID Card
ANTHEM MO
00557
Refer To Back Of ID Card
ANTHEM WI
00558
Refer To Back Of ID Card
ANTHEM CA
00559
Refer To Back Of ID Card
ANTHEM NV
00560
Refer To Back Of ID Card
ANTHEM CO
00561
Refer To Back Of ID Card
ANTHEM VA
00562
Refer To Back Of ID Card
ANTHEM NY
00563
Refer To Back Of ID Card
ANTHEM CT
00564
Refer To Back Of ID Card
ANTHEM NH
00565
Refer To Back Of ID Card
ANTHEM GA
00566
Refer To Back Of ID Card
ANTHEM ME
00567
Refer To Back Of ID Card
ANTHEM IN
00568
Refer To Back Of ID Card
ANTHEM OH
00569
Refer To Back Of ID Card
ANTHEM GREEN
00570
Refer To Back Of ID Card
MERCER HEALTH & BENEFITS ADM. LLD
00571
Dee Green
(515) 365-6374
MONROE PLUMBERS LOCAL UNION 671
00574
Peggy Warner
(517) 327-2161
IBEW LOCAL 701 HEALTH WELFARE FUND
00575
Beverly Harrison
(630) 393-1701
KY RURAL ELEC. COOP. EMP. BENEFIT
00576
Kathy Harley
(859) 721-0799
NASI WELFARE FUND
00577
Customer Service
(301) 429-4999
NEW JERSEY EDUCATION ASSOCIATION
00578
Gabriella Merullo
(800) 257-2038
WELLMARK BCBS OF SD MED SUP
00579
(800) 584-9242
WELLMARK BCBS OF IA MED SUP
00580
(800) 584-9242
TOLEDO ELECTRICAL WELFARE FUND
00581
Customer Service
(419) 666-4450
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
GROUP HEALTH COOP OF EAU CLAIRE
00582
Krysta Zell
(715) 852-5718
UNITY HEALTH PLANS INSURANCE
00583
Debra Schiffman
(608) 643-1408
USABLE MUTUAL INS. COMPANY
00584
Kim Burgess
(501) 502-1691
INFINEUM
00585
Derek Alvarez
(813) 324-2948
IBEW LOCAL NO 1 HEALTH & WELFARE
00588
Stephanie Labanon
(314) 752-2330
NECA IBEW WELFARE TRUST FUND
00589
Kevin Cope
(217) 875-0254
SC BAPTIST CONVENTION
00591
Roney Williams
(800) 922-4966
HEALTH PARTNERS
00593
Provider Customer Service
(888) 663-6464
THE HEALTH PLAN
00603
Kim Geary
(740) 695-7616
ANTHEM INC.
00604
Refer To Back Of ID Card
TRANSAMERICA PREMIER LIFE INS
30000
Jennifer Sali
(610) 648-4990
UNITEDHEALTH GROUP
30002
Customer Service
(800) 523-5800
WELLMARK BCBS OF SD
30003
(800) 524-9242
WELLMARK BCBS OF IA
30004
Provider Services
(800) 524-9242
TRANSAMERICA PREMIER LIFE INS
30006
Jennifer Sali
(610) 648-4990
HORIZON BCBS OF NEW JERSEY
30013
Customer Service
(800) 624-1110
BCBS OF SOUTH CAROLINA
30016
Judith Murray
(803) 264-3889
HIGHMARK INC
30017
Customer Service
(800) 345-3806
HIGHMARK INC
30018
Customer Service
(800) 345-3806
GHI PPO
30019
Michele Podolak
(315) 434-2447
GHI PPO
30020
Michele Podolak
(315) 434-2447
HCSC-BCBS OF IL-NON-STD A & B
30023
Customer Service
(888) 762-2189
HCSC-BCBS OF IL-STD A & B
30024
Customer Service
(888) 762-2189
HCSC-BCBS OF NM-NON STD A & B
30025
Customer Service
(888) 762-2189
HCSC-BCBS OF NM-STD A & B
30026
Customer Service
(888) 762-2189
HCSC-BCBS OF TEXAS-NON STD A&B
30027
Customer Service
(888) 762-2189
HCSC-BCBS OF TEXAS-STD A & B
30028
Customer Service
(888) 762-2189
LIBERTY NATL LIFE INS CO - GMS
30029
Customer Service
(972) 529-5085
LIBERTY NATL LIFE INS CO - GMS
30030
Customer Service
(972) 529-5085
GLOBE LIFE & ACCIDENTAL INS CO
30032
Customer Service
(972) 529-5085
AMERICAN INCOME LIFE INS CO
30033
Customer Service
(972) 529-5085
UNITED AMERICAN INSURANCE CO
30034
Customer Service
(972) 529-5085
GLOBAL LIFE INSURANCE COMPANY NY
30035
Customer Service
(972) 529-5085
EQUI LIFE & CASUALTY INS
30036
Laura Sarle
(801) 579-3464
BCBS OF MISSISSIPPI
30039
Customer Service
(800) 257-5825
BLUE CROSS OF NORTHEASTERN PA
30040
Cathy Stitzer
(570) 200-4540
BLUE CROSS OF NORTHEASTERN PA
30041
Cathy Stitzer
(570) 200-4540
TRIPLE S, INC. - MEDIGAP
30042
Nayda Cruz
(787) 749-4949
BCBS OF WYOMING
30045
Amber Zowada
(307) 432-2743
BCBS OF NORTH DAKOTA
30046
Gina Bercherl
(701) 277-2081
BCBS OF TENNESSEE-MEDIGAP
30047
Customer Service
(800) 553-8158
UNITED COMMERCIAL TRAVELERS - MEDIGAP
30048
Jose Viri-Dunahue
(614) 487-9680
STANDARD LIFE AND ACCIDENT INS
30051
Jill Davis
(281) 538-4890
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
AM. NATIONAL LIFE INS CO OF TX
30052
Jill Davis
(281) 538-4890
LOYAL AMERICAN LIFE INSURANCE CO
30054
Customer Service
(866) 459-4272
GUARANTEE TRUST LIFE INS CO
30055
Mark Pytel
(847) 904-5375
EMPIRE BLUE CROSS BLUE SHIELD I
30056
Refer To Back Of ID Card
BCBS OF MINNESOTA
30057
MN only
(800) 531-6686
BCBS OF MINNESOTA
30058
Non-MN
(800) 531-6686
BCBS OF MINNESOTA
30059
DMERC only
(800) 531-6686
MEDICAL MUTUAL OF OHIO
30060
Sue Robinson
(216) 687-6108
BCBS OF KANSASBANKERS LIFE AND CASUALTY
30062
Customer Service
(800) 432-3990
BANKERS LIFE AD CASUALITY
30065
Customer Service
(800) 621-3724
CONSECO SERVICES, LLC
30066
Customer Service
(800) 621-3724
ANTHEM BCBS NORTHEAST REGION
30067
Refer To Back Of ID Card
CONSECO SERVICES - COLONIAL PENN
30068
Customer Service
(800) 523-4000
SANFORD HEALTH PLAN OF MINNESOTA
30069
Tami Haberer
(605) 328-6860
SANFORD HEALTH PLAN
30070
Tami Haberer
(605) 328-6860
HEALTH ALLIANCE MEDICAL PLANS
30071
Cindy Cargo
(217) 383-8208
CONTINENTAL LIFE INS OF BRENTWOO
30073
Katrina Smithson
(800) 264-4000
AMERICAN CONTINENTAL INSU.
30074
Katrina Smithson
(800) 264-4000
PHYSICIANS MUTUAL INS.CO
30075
Carolyn Brown
(402) 633-5757
DEAN HEALTH PLAN
30076
Murielle Sago
(608) 827-4432
CAREFIRST PART A ONLY
30077
Provider Services
(800) 842-5975
PARAMOUNT HEALTH CARE
30078
Donya Hensley
(419) 887-2437
UPMC HEALTH BENEFITS, INC
30080
Member Services
(866) 400-5077
CAPITAL BLUE CROSS
30087
Nancy Herman
(717) 541-6274
BLUE CROSS BLUE SHIELD OF WNY
30088
Melissa Deboth
(716) 887-8443
BLUE CROSS BLUE SHIELD OF WNY
30089
Melissa Deboth
(716) 887-8443
MUTUAL OF OMAHA INSURANCE COMP
30090
Customer Service
(800) 775-1000
MUTUAL OF OMAHA INSURANCE COMP
30091
Customer Service
(800) 775-1000
HIGHMARK BCBS OF DELAWARE
30093
Customer Service
(800) 485-2889
EVERENCE ASSN A FRATERNAL
30094
Customer Service
(574) 533-9511 ext. 380
BCBS OF ARIZONA
30095
Rebecca Garcia
(602) 864-4818
SIERRA HEALTH & LIFE INSURANCE C
30096
BCBS OF NORTH DAKOTA
30097
Gina Bercherl
(701) 277-2081
ANTHEM CENTRAL - FACETS
30098
Refer To Back Of ID Card
GUARANTEE TRUST LIFE INS CO
30103
Mark Pytel
(847) 904-5375
ANTHEM BCBS NORTHEAST - PART B
30107
Refer To Back Of ID Card
MODA HEALTH PLAN INC
30108
EDI Department
(503) 228-6554
ARKANSAS BCBS
30109
Mia Moore
(501) 502-1686
INDEPENDENCE BLUE CROSS
30110
Customer Service
(800) 645-3965
CENTRAL UNITED LIFE INSURANCE
30111
Customer Service
(800) 669-9030
AFLAC
30113
Customer Service
(800) 992-3522
AFLAC-NEW YORK
30114
Customer Service
(800) 992-3522
HIGHMARK WEST VIRGINIA
30117
Customer Service
(800) 543-7822
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
HIGHMARK WEST VIRGINIA
30124
Customer Service
(800) 543-7822
UNIFIED LIFE INSURANCE COMPANY
30129
Jana Shrum
(913) 871-7312
ANTHEM BCBS OF NEVADA
30131
Refer To Back Of ID Card
ANTHEM BCBS OF COLORADO
30135
Refer To Back Of ID Card
BLUE CROSS OF CALIFORNIA
30136
Refer To Back Of ID Card
UNICARE LIFE & HEALTH INSURANCE
30137
Refer To Back Of ID Card
RESERVE NATIONAL INSURANCE CO
30149
Juanita Phelpes
(800) 654-9106
AMERICAN INSURANCE ADMINISTRATOR
30151
Bob Fabbi
(727) 726-0726
BANKERS FIDELITY LIFE INS CO
30152
BLUE CROSS OF IDAHO
30153
Dawn Miller
(208) 331-7878
BLUE CROSS OF IDAHO
30154
Dawn Miller
(208) 331-7878
NORTH AMERICAN INSURANCE COMPANY
30155
Julie Tauber
(800) 627-4282
PEKIN LIFE INSURANCE COMPANY
30156
Customer Service
(800) 322-0160
STATE FARM AUTOMOBILE INSUR CO.
30159
Customer Service
(866) 855-1212
THRIVENT FINANCIAL FOR LUTHERANS
30166
Lisa Albertston
(920) 628-4293
THRIVENT FINANCIAL FOR LUTHERANS
30167
Lisa Albertston
(920) 628-4293
BCBS OF MASSACHUSETTS INC.
30168
Debra Wilson
(617) 246-7665
BCBS OF VERMONT - SUPPLEMENTAL
30169
Chantal Parent
(802) 371-3611
BCBS OF KANSAS CITY
30171
Kathy Currey
(816) 395-3877
AMERICAN REPUBLIC/ENTERPRISE
30176
Customer Service
(800) 247-2190
WORLD INSURANCE
30180
Customer Service
(800) 786-5443
CENTRAL STATES HEALTH & LIFE
30181
Melissa Matthys
(281) 368-7131
BLUE CROSS BLUE SHIELD OF RI
30184
Jason Furlan
(401) 459-2297
ASURIS
30187
Rebecca Thorn
(503) 375-4341
REGENCE BLUESHIELD OF UTAH
30188
Rebecca Thorn
(503) 375-4341
REGENCE BLUESHIELD
30189
Rebecca Thorn
(503) 375-4341
REGENCE BLUESHIELD OF IDAHO
30190
Rebecca Thorn
(503) 375-4341
BCBS OF FLORIDA - FEP
30192
Customer Service
(800) 352-2583
BCBS OF FLORIDA - SUPP
30193
Customer Service
(800) 352-2583
AMERI HEALTH ADMINISTRATOR
30203
Experience AH Customer
(844) 352-1706
COMMUNITYCARE LIFE & HEALTH INS.
30205
Roxanne King
(918) 594-5295
AMERICAN REPUBLIC/ENTERPRISE
30208
Customer Service
(800) 247-2190
REGENCE BCBS OF OREGON
30209
Rebecca Thorn
(503) 375-4341
BLUE CROSS BLUE SHIELD OF WI
30220
Refer To Back Of ID Card
BCBS OF WYOMING
30224
Amber Zowada
(307) 432-2743
AMERICAN REPUBLIC/ENTERPRISE
30227
Customer Service
(800) 247-2190
AMERICAN REPUBLIC/ENTERPRISE
30228
Customer Service
(800) 247-2190
ROCKY MOUNTAIN HEALTH PLANS
30229
Kris Malean
(970) 248-5056
OLD SURETY LIFE INSURANCE COMP
30231
HEALTH ALLIANCE PLAN
30232
Laron Gaines
(313) 664-7123
UNITED AMERICAN INSURANCE CO
30233
Customer Service
(972) 529-5085
MEDICO INSURANCE COMPANY
30236
Customer Service
(800) 247-2190
MEDICO INSURANCE COMPANY
30237
Customer Service
(800) 247-2190
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
MEDICO INSURANCE COMPANY
30238
Customer Service
(800) 247-2190
MEDICO INSURANCE COMPANY
30239
Customer Service
(800) 247-2190
BCBS OF MINNESOTA
30242
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
30243
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
30244
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
30245
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
30246
Customer Service
(800) 531-6686
ACTUARIAL MANAGEMENT RESOURCES
30248
Donna Coleman-Fulk
(833) 657-1452
FIRST COMMUNITY HEALTH PLAN, INC
30250
Regina Ratley
(256) 532-2786
HEALTH CARE SERVICE BCBS-STD
30253
Customer Service
(888) 762-2189
HCSC,BCBS NON-STD
30254
Customer Service
(888) 762-2189
BCBS OF NEBRASKA
30255
Customer Service Center
(800) 991-7392
BCBS OF NEBRASKA
30256
Customer Service Center
(800) 991-7392
BLUE CROSS BLUE SHIELD OF NC
30257
Nakia Harrington
(877) 258-3334
HEARTLAND NATIONAL LIFE INS., CO.
30275
Laura Sarle
(801) 579-3464
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
See Designated Group
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
Puritan Life
(866) 398-9305
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
Gerber Life Insurance
(800) 838-0080
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
Idealife Insurance Company
(866) 398-9310
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
Lincoln Heritage Life
(888) 586-8810
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
PrincipalLifeInsurance
(800) 447-4701
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
Royal Neighbors of America
(877) 815-8877
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
Shenandoah Life Insurance
(866) 322-2856
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
State Mutual Insurance
(877) 872-5500
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
Sterling Investors Life
(877) 604-5240
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
KSKJ Life
(866) 671-5755
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
Central States Indemnity Co. of Omaha (855) 664-5517
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
UNIFIED LIFE INSURANCE COMPANY
(877) 807-2143
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
AMERICO FINANCIAL LIFE AND ANNUITY
INSURANCE
(877) 212-2346
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
CSI Life Insurance Company
(855) 664-5517
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
Country Financial
(855) 304-2858
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
Everest Reinsurance Company
(844) 301-0395
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
CSI Life Insurance Company
(855) 664-5517
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
Country Financial
(855) 304-2858
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
SBLI USA Life Insurance Company
(866) 322-2856
INSURANCE ADMINISTRATIVE SOLUTIONS, LLC - MEDIGAP
30276
S. USA Life Insurance Company
(866) 322-2856
AMERICAN REPUBLIC/ENTERPRISE
30277
Customer Service
(888) 755-3064
AMERICAN REPUBLIC/ENTERPRISE
30278
Customer Service
(888) 755-3064
AMERICAN REPUBLIC/ENTERPRISE
30279
Customer Service
(888) 755-3064
AMERICAN REPUBLIC/ENTERPRISE
30280
Customer Service
(888) 755-3064
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
ASSURED LIFE ASSOCIATION
30281
Customer Service
(877) 223-4244
TUFTS INSURANCE COMPANY
30283
EDI Operations
(617) 972-9400
ARKANSAS BCBS
30285
Angela Winston
(501) 210-2074
GERBER LIFE INS. CO.
30289
Customer Service
(877) 656-5424
STANDARD LIFE AND ACCIDENT INS.
30291
Jill Davis
(281) 538-4890
UNITED NAT'L LIFE INS CO OF AMER
30292
Mark Pytel
(847) 904-5375
UNITED NATIONAL LIFE INSURANCE COMPANY
30293
Mark Pytel
(847) 904-5375
BLUE CROSS OF CALIFORNIA
30294
Refer To Back Of ID Card
BLUE CROSS OF COLORADO
30295
Refer To Back Of ID Card
BLUE CROSS OF GEORGIA
30296
Refer To Back Of ID Card
BLUE CROSS OF NEVADA
30297
Refer To Back Of ID Card
BLUE CROSS OF WISCONSIN
30298
Refer To Back Of ID Card
NEW ERA LIFE INSURANCE CO.
30299
Isabel Gonzalez
(281) 368-7108
BLUE SHIELD OF CALIFORNIA
30302
Tammy Rutters
(530) 351-6109
PRIORITY HEALTH
30305
Customer Service
(888) 386-6648
CT PINPE TRADES HEALTH
30307
Stephanie Doyle
(856) 910-9099
GPMLIFE
30308
Customer Service
(866) 865-7631
COLUMBIAN MUTUAL LIFE INSURANCE
30309
Customer Service
(866) 703-7223
AULTCARE
30313
Ty Pruette
(330) 363-4234
HARVARD PILGRIM HEALTH CARE
30317
Customer SVC Member
(877) 901-4742
BLUE CROSS BLUE SHIELD OF WNY
30319
Melissa Deboth
(716) 887-8443
GEISINGER HP/GOLD MEDICARE
30323
Joanne Minium
(570) 271-5555
COLONIAL PENN LIFE INSURANCE CO.
30326
Customer Service
(800) 621-3724
BCBS OF ALABAMA
30327
Customer Service
(205) 988-2200
HEALTH FIRST INSURANCE
30328
Angie Vazquez
(321) 434-4206
CAPITAL DISTRICT PHYSICIANS
30329
Kerri Petersen
(518) 641-3820
HARVARD PILGRIM HEALTH CARE, INC.
30330
Customer SVC Member
(877) 901-4742
PBA INC.
30331
Kathy Carpenter
(630) 655-3755
BLUE CROSS BLUE SHIELD OF GA
30332
Refer To Back Of ID Card
UNIVERSAL FIDELITY LIFE INS. CO.
30333
Becky Morris
(800) 366-8354
OLYMPIC HEALTH MNAGEMENT
30335
Bridgette Bosier
(512) 531-1421
GUARANTEE TRUST LIFE INS. CO.
30337
Mark Pytel
(847) 904-5375
GUARANTEE TRUST LIFE INS. CO.
30338
Mark Pytel
(847) 904-5375
GUARANTEE TRUST LIFE INS. CO.
30339
Mark Pytel
(847) 904-5375
NATIONAL GUARDIAN LIFE INS. CO.
30340
Mark Pytel
(847) 904-5375
NATIONAL GUARDIAN LIFE INS. CO.
30341
Mark Pytel
(847) 904-5375
NATIONAL GUARDIAN LIFE INS. CO.
30342
Mark Pytel
(847) 904-5375
MEMBERS HEALTH INSURANCE CO.
30343
Geri Cayce
(931) 560-0041
LOYAL AMERICAN LIFE INSURANCE CO.
30344
Customer Service
(866) 459-4272
AVERA HEALTH PLANS, INC.
30352
Karen Mikuska
(605) 322-4502
NCSCBF
30353
Bridget Welke
(715) 835-3174
HEALTH CARE SERVICE CORPORATION
30354
Customer Service
(888) 762-2189
HEALTH CARE SERVICE CORPORATION
30355
Customer Service
(888) 762-2189
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
SENTINEL SECURITY LIFE INS. CO
30357
Linda Jonides
(801) 478-4041
SECURE ADMINISTRATIVE SOLUTIONS
30358
Linda Jonides
(801) 478-4041
LOYAL CHRISTIAN BENEFIT ASSOC.
30359
Laura Sarle
(801) 579-3464
INDIVIDUAL ASSURANCE COMPANY
30360
Barbara Wittington
(405) 285-0838
HOMETOWN HEALTH SENIOR CARE PLUS
30362
Amy Behbehani
(775) 982-2726
GREEK CATHOLIC UNION
30363
Laura Sarle
(801) 579-3464
WELLMARK BCBS OF SD MEDIGAP
30364
Wellmark BCBS
(800) 587-9242
WELLMARK BCBS OF SD MEDIGAP
30365
Wellmark BCBS
(800) 587-9242
TN RURAL HEALTH IMPROV ASSOC.
30367
Geri Cayce
(931) 560-0041
QUALCHOICE LIFE HEALTH INSURANCE
30368
Ashley Matthews
(501) 228-7111
BCBS of Minnesota
30369
Customer Service
(800) 531-6686
BCBS of Minnesota
30370
Customer Service
(800) 531-6686
SISCO
30371
Kara Kessler
(563) 587-5204
MERCER HEALTH & BENEFITS ADM LLC
30374
Dee Green
(515) 365-6374
THE HEALTH PLAN
30375
Lori Panas
(740) 699-6208
EMI HEALTH
30376
Toni Bonza
(801) 270-2846
ACTUARIAL MANAGEMETN RESOURCES
30377
Donna Coleman-Fulk
(833) 657-1452
CHICAGO LABORS DIST COUNCIL RET. HW.
30378
Lori Williams
(708) 562-0200
CIGNA HEALTH & LIFE INS CO
30380
Customer Service
(866) 459-4272
UNITY HEALTH PLANS INSURANCE
30381
Debra Schiffman
(608) 643-1408
STERLING LIFE INSURANCE COMPANY
30382
Claudia Mouton
(512) 531-1473
UNIVERSAL FIDELITY LIFE INSURANCE CO.
30383
Becky Morris
(800) 366-8354
UNIVERSAL FIDELITY LIFE INSURANCE CO.
30384
Becky Morris
(800) 366-8354
EQUITABLE NATIONAL LIFE INS. CO. INC.
30385
Laura Sarle
(801) 579-3464
NATIONAL HEALTH INSURANCE CO
30387
Laura Sarle
(801) 579-3464
TOTAL HEALTH PLAN
30394
EDI Operations
(617) 972-6814
HEALTH PARTNERS
30396
Provider/Customer Service
(888) 663-6464
BLUE CROSS BLUE SHIELD OF ND
30402
Tracey Compson
(701) 282-1378
BLUE CROSS BLUE SHIELD OF ND
30403
Tracey Compson
(701) 282-1378
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
BANKERS LIFE AND CASUALTY
55000
Customer Service
(800) 621-3724
GLOBE LIFE & ACCIDENTAL INS CO
55001
Customer Service
(972) 529-5085
AMERICAN INCOME LIFE INSURANCE
55002
Customer Service
(972) 529-5085
GLOBAL LIFE INSURANCE COMPANY NY
55003
Customer Service
(972) 529-5085
UNITED AMERICAN INSURANCE CO
55004
Customer Service
(972) 529-5085
LIBERTY NATIONAL LIFE INSURANCE
55005
Customer Service
(972) 529-5085
GOLDEN RULE INSURANCE CO
55009
James Anderson
(317) 715-7200
ACTUARIAL MANAGEMENT RESOURCES
55010
Donna Coleman-Fulk
(833) 657-1452
SHELTER LIFE INSURANCE COMPANY
55015
Carla Lind
(573) 214-4128
WPS - TRICARE FOR LIFE
60000
Customer Service
(866) 773-0404
HORIZON BCBS OF NEW JERSEY
80003
Customer Service
(800) 624-1110
BCBS OF MICHIGAN
80004
Customer Service
(800) 482-3600
BCBS OF ALABAMA
80005
Customer Service
(205) 988-2200
BCBS OF SOUTH CAROLINA
80006
Cynthia Lagatore
(803) 264-3325
HIGHMARK INC
80007
Customer Service
(800) 345-3806
HIGHMARK INC
80008
Customer Service
(800) 345-3806
HCSC-BCBS OF IL-FEP B ONLY
80009
Customer Service
(888) 762-2189
HCSC-BCBS OF NM-FEP B ONLY
80011
Customer Service
(888) 762-2189
HCSC-BCBS OF TX-FEP B ONLY
80012
Customer Service
(888) 762-2189
CBA INC.
80013
Carol Lea
(802) 846-8038
NALC HEALTH BENEFIT PLAN
80015
David Hardesty
(703) 729-4677
BCBS OF MISSISSIPPI
80016
Customer Service
(800) 932-7724
BLUE CROSS OF NORTHEASTERN PA
80017
Carol Stitzer
(570) 200-4540
BLUE CROSS OF NORTHEASTERN PA
80018
Carol Stitzer
(570) 200-4540
BLUE CROSS OF NORTHEASTERN PA
80019
Carol Stitzer
(570) 200-4540
BLUE CROSS OF NORTHEASTERN PA
80020
Carol Stitzer
(570) 200-4540
TRIPLE S, INC. - OTHER
80021
Nayda Cruz
(787) 749-4949
BCBS OF ALABAMA
80022
Customer Service
(205) 988-2200
BCBS OF NORTH DAKOTA
80023
Shelly Stalpes
(701) 282-1476
HAWAII MEDICAL SERVICE ASSOCIATI
80024
Jenell Juarez
(808) 948-5288
HAWAII MEDICAL SERVICE ASSOCIATI
80025
Wendy Nakasone
(808) 948-5448
BCBS OF TENNESSEE - OTHER
80026
Customer Service
(800) 553-8158
HAWAII MEDICAL SERVICE ASSOCIATI
80027
Myra Ishii
(808) 948-5341
BCBS OF MINNESOTA
80029
BCBSM
(800) 531-6686
BCBS OF KANSAS
80030
Customer Service
(800) 432-3990
ANTHEM FEP INDIANA
80033
Refer To Back Of ID Card
ANTHEM FEP COLORADO
80034
Refer To Back Of ID Card
ANTHEM FEP KENTUCKY
80035
Refer To Back Of ID Card
ANTHEM FEP CONNECTICUT
80036
Refer To Back Of ID Card
ANTHEM FEP OHIO
80037
Refer To Back Of ID Card
ANTHEM FEP NEVADA
80038
Refer To Back Of ID Card
ANTHEM FEP VIRGINIA
80039
Refer To Back Of ID Card
ANTHEM FEP MAINE
80040
Refer To Back Of ID Card
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
ANTHEM FEP NEW HAMPSHIRE
80041
Refer To Back Of ID Card
STIRLING BENEFITS, INC
80042
Monica Strong
(203) 647-0630
BLUE CROSS BLUE SHIELD OF LA
80043
Customer Service
(800) 599-2583
AULTCARE
80044
Ty Pruett
(330) 363-4234
BLUE CROSS BLUE SHIELD OF NC
80046
Nakia Harington
(877) 258-3334
CAPITAL BLUE CROSS
80047
Nancy Herman
(717) 541-6274
BLUE CROSS BLUE SHIELD OF WNY
80048
Melissa Deboth
(716) 887-8443
BLUE CROSS BLUE SHIELD OF WNY
80050
Melissa Deboth
(716) 887-8443
GOV'T EMPLOYEE'S HEALTH ASSN
80054
Daryl Evans
(816) 257-5000
HIGHMARK BCBS OF DELAWARE
80057
Customer Service
(800) 485-2889
SAMBA HEALTH PLAN
80058
Customer Service
(800) 638-6589
BCBS OF ARIZONA
80059
Jennifer Daicos
(602) 864-5490
BCBS OF WYOMING
80061
Amber Zowada
(307) 432-2743
BCBS OF NORTH DAKOTA
80062
Shelly Stalpes
(701) 282-1476
AR FEDERAL EMPLOYEE PROGRAM
80065
Annette Miller
(501) 502-1344
USABLE ADMINISTRATORS
80066
Martha Campbell
(501) 378-2958
BLUE ADVANTAGE ADMIN OF ARKANSAS
80067
Martha Campbell
(501) 378-2958
USABLE LIFE
80068
Martha Campbell
(501) 378-2958
NORTHWEST ADMINISTRATORS,INC.
80070
Danielle Brenner
(206) 726-3230
BLUE CROSS OF IDAHO
80073
Dawn Miller
(208) 331-7878
BLUE CROSS OF IDAHO
80074
Dawn Miller
(208) 331-7878
APWU HEALTH PLAN - OTHER
80075
Loretta Demby
(410) 424-1544
HIGHMARK WEST VIRGINIA
80076
Member Customer Service
(888) 809-9121
HIGHMARK WEST VIRGINIA
80076
Provider Customer Service
(800) 543-7822
HIGHMARK WEST VIRGINIA
80077
Member Customer Service
(888) 809-9121
HIGHMARK WEST VIRGINIA
80077
Provider Customer Service
(800) 543-7822
CHCS SERVICES INC
80078
Insurance Service Service
(850) 435-8000
CHCS SERVICES INC
80079
Insurance Service Service
(850) 435-8000
CHCS SERVICES INC
80080
Insurance Service Service
(850) 435-8000
CHCS SERVICES INC
80081
Insurance Service Service
(850) 435-8000
BCBS OF MASSACHUSETTS INC.
80086
Customer Service
(800) 433-7766
KLAIS & COMPANY, INC
80089
Customer Service
(800) 331-1096
NATIONAL CAPITAL ADMIN SVCS
80090
Customer Service
(800) 873-5781
HEALTH SCOPE BENEFITS
80091
WC Bradley
(877) 883-5352
HEALTH SCOPE BENEFITS
80091
Neff Company
(877) 624-1325
HEALTH SCOPE BENEFITS
80091
ENPRO
(877) 616-7421
HEALTH SCOPE BENEFITS
80091
CAC
(877) 240-0139
HEALTH SCOPE BENEFITS
80091
Auto Systems
(877) 240-0136
HEALTH SCOPE BENEFITS
80091
Phillips
(877) 226-2051
HEALTH SCOPE BENEFITS
80091
KRAFT
(800) 972-3025
HEALTH SCOPE BENEFITS
80091
Emerson Svc Ctr
(800) 913-9982
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
HEALTH SCOPE BENEFITS
80091
CNAF
(800) 892-7182
HEALTH SCOPE BENEFITS
80091
Southwest Electric
(800) 851-5644
HEALTH SCOPE BENEFITS
80091
American Greetings Svc Ctr
(800) 827-7026
HEALTH SCOPE BENEFITS
80091
Whirlpool Svc Ctr
(800) 660-6212
HEALTH SCOPE BENEFITS
80091
Ball Corporation
(800) 493-9552
HEALTH SCOPE BENEFITS
80091
Alcoa Svc Ctr
(800) 426-3070
HEALTH SCOPE BENEFITS
80091
Adams
(800) 314-5366
HEALTH SCOPE BENEFITS
80091
Loews/Lorillard
(800) 262-9247
HEALTH SCOPE BENEFITS
80091
Goodrich
(800) 262-2066
HEALTH SCOPE BENEFITS - OTHER
80091
See Designated Group
BCBS OF KANSAS CITY
80092
Kathy Currey
(816) 395-3877
BENESYS, INC.
80093
Customer Service
(800) 572-2525
BENESYS, INC. - CALIFORNIA DIV.
80094
Customer Service
(800) 572-2525
BLUE CROSS BLUE SHIELD OF RI
80096
Customer Service
(800) 267-0439
PRIORITY HEALTH - OTHER
80098
Carol Nowark
(616) 575-4914
HCSC-BCSC OF IL-FEP A ONLY
80102
Customer Service
(888) 762-2189
HCSC-BCSC OF NM-FEP A ONLY
80103
Customer Service
(888) 762-2189
HCSC-BCBS OF TX-FEP A ONLY
80104
Customer Service
(888) 762-2189
PERSONALCARE INSURANCE OF ILL.
80105
Customer Service
(800) 431-1211
COMMUNITY FIRST HEALTH PLANS
80110
Lee De Luna
(210) 510-2478
EXCELLUS HEALTH PLANS
80113
Jill Kohler
(315) 272-1210
NORTHWEST ADMINISTRATORS,INC.
80114
Danielle Brenner
(206) 726-3230
ROCKY MOUNTAIN HEALTH PLANS
80116
Marci O'Gara
(970) 248-5137
COVENTRY - GROUP HEALTH PLAN,INC
80118
Customer Service
(800) 755-3901
COVENTRY - ALTIUS HEALTH PLANS
80119
Customer Service
(800) 377-4161
COVENTRY - CHC OF NEBRASKA INC.
80120
Customer Service
(800) 288-2243
COVENTRY - CHC OF IOWA, INC.
80121
Customer Service
(800) 257-4692
COVENTRY - CHC OF KANSAS, INC.
80122
Customer Service
(800) 969-3343
HSCS-BCBS OF OK-FEP A ONLY
80123
Customer Service
(888) 762-2189
HCSC-BCBS OF OK-FEP B ONLY
80124
Customer Service
(888) 762-2189
BCBS OF WYOMING
80128
Customer Service
(888) 762-2189
COVENTRY - HEALTH AMERICA OF PA
80129
Customer Service
(800) 691-9984
COVENTRY - CHC OF LOUISIANA, INC
80131
Customer Service
(800) 341-6613
COVENTRY - CHC OF GEORGIA, INC.
80132
Customer Service
(800) 395-2545
COVENTRY - CARELINK HEALTH PLAN
80133
Customer Service
(800) 348-2922
COVENTRY - SOUTHERN HEALTH SVCS.
80134
Customer Service
(800) 627-4872
COVENTRY - CHC OF DELAWARE, INC.
80135
Customer Service
(800) 833-7423
COVENTRY - WELLPATH SELECT, INC.
80136
Customer Service
(800) 735-7284
C.L. FRATES AND COMPANY
80138
Rick Franklin
(405) 290-5744
ANTHEM FEP CALIFORNIA
80140
Refer To Back Of ID Card
HEALTHSMART BENEFIT SOLUTIONS
80142
John Campbell
(214) 574-3582
BCBS MO FEP
80145
Refer To Back Of ID Card
BCBS WI FEP
80146
Refer To Back Of ID Card
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
BCBS OF MINNESOTA
80147
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
80148
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
80149
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
80150
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
80151
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
80152
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
80153
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
80154
Customer Service
(800) 531-6686
BCBS OF MINNESOTA
80155
Customer Service
(800) 531-6686
PRAIRIE STATES ENTERPRISES, INC.
80156
Kathie Horness
(920) 451-7020
INNOVATIVE HEALTHWARE SERVICES
80158
Jessica Picarde
(410) 349-3222
BENEFITS MANAGEMENT GROUP, INC.
80160
Lisa Frasco
(630) 230-3911
LIPMAN INSURANCE ADMINISTRATORS, INC.
80161
Sylvia Sanchez
(510) 796-4676
CDS GROUP HEALTH
80162
Customer Service Department
(800) 455-4236
GROUP AND PENSION ADMINISTRATORS, INC.
80163
Customer Service
(972) 238-7900
WELFARE AND PENSION ADMIN SERVICE
80165
Heidi Campbell
(206) 695-0985
MAGNACARE ADMIN SERVICES
80166
Customer Service Center
(888) 352-6465
SHASTA ADMINISTRATIVE SERVICES
80181
Sheryl Petrakis-Wood
(541) 504-2772
COVENTRY - FEDERAL PLANS
80187
Customer Service
(800) 410-7778
PREMERA BS FEP/EASTERN WA
80189
Customer Service
(800) 722-1471
PREMERA BC FEP/WASHINGTON
80190
Customer Service
(800) 722-1471
PREMERA BCBS FEP/ALASKA
80191
Customer Service
(800) 722-1471
PREMERA BCBS FEP/ALASKA
80192
Customer Service
(800) 722-1471
GROUP ADMINSITRATORS, LTD.
80193
Kim Ufkes
(847) 519-1880
AMERIBEN
80194
Carrie Hatch
(208) 947-9229
BENESYS, INC
80196
BCBS OF NEBRASKA
80197
Customer Service Center
(800) 991-7392
INDEPENDENCE BLUE CROSS
80198
Sharelle Bond
(215) 241-9227
BCBS OF NEBRASKA
80199
Customer Service Center
(800) 991-7392
KEMPTON COMPANY
80202
Dwight Berry
(405) 556-5125
BENESYS, INC
80204
GILSBAR, INC.
80209
Customer Contact Center
(888) 472-4352
GILSBAR, INC.
80210
Customer Contact Center
(888) 472-4352
WESTERN GROWERS ASSURANCE TRUST
80212
Lara Hassan
(949) 885-2309
PINNACLE CLAIMS MANAGEMENT, INC.
80213
Lara Hassan
(949) 885-2309
CHAMPVA-VA HEALTH ADMIN CTR
80214
HAC Customer Service Center
(800) 733-8387
MERITAIN HEALTH
80216
Customer Service
(800) 925-2272
ZENITH ADMINISTRATORS, U054
80219
Michelle Tenberg
(602) 526-1710
COVENTRY- CHC OF FLORIDA
80220
Customer Service
(866) 847-8235
ZENITH ADMINISTRATORS, A0033
80226
Michelle Tenberg
(602) 526-1710
ZENITH ADMINISTRATORS, A0001
80228
Michelle Tenberg
(602) 526-1710
ZENITH ADMINISTRATORS, U614
80230
Michelle Tenberg
(602) 526-1710
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
ZENITH ADMINISTRATORS, U320
80231
Michelle Tenberg
(602) 526-1710
COOPERATIVE BENEFIT ADMIN/NRECA
80232
Mikki McGuire
(402) 483-9268
ZENITH ADMINISTRATOR, N011
80233
Michelle Tenberg
(602) 526-1710
ZENITH ADMINISTRATORS, N026
80235
Michelle Tenberg
(602) 526-1710
ZENITH AMERICAN SOLUTIONS, N589
80238
Michelle Tenberg
(602) 526-1710
ZENITH ADMINISTRATORS, N115
80239
Michelle Tenberg
(602) 526-1710
ALLIED BENEFIT SYSTEMS, INC.
80240
Terry Jones
(312) 906-8080
AMA INSURANCE AGENCY, INC.
80241
Customer Service
(800) 458-5736
HEALTHCOMP
80242
Charles Johnson
(559) 499-2450
ZENITH ADMINISTRATOR, K639
80244
Michelle Tenberg
(602) 526-1710
ZENITH AMERICAN SOLUTIONS, H0185
80246
Michelle Tenberg
(602) 526-1710
CARE FIRST ADMINISTRATORS
80248
Fred Ellerbe
(877) 889-2478
BCBS GA FEP
80250
Refer To Back Of ID Card
ZENITH AMERICAN SOLUTIONS, N351
80251
Darric Sorko-Ram
(415) 536-2789
HEALTH PLANS INC.
80252
Chris Parr
(508) 475-6104
SCOTT & WHITE HEALTH PLAN
80253
CHCS SERVICES INC
80254
Insurance Service Center
(850) 435-8000
CHCS SERVICES INC
80255
Insurance Service Center
(850) 435-8000
CHCS SERVICES INC
80256
Insurance Service Center
(850) 435-8000
CHCS SERVICES INC
80257
Insurance Service Center
(850) 435-8000
CHCS SERVICES INC
80258
Insurance Service Center
(850) 435-8000
CHCS SERVICES INC
80259
Insurance Service Center
(850) 435-8000
CHCS SERVICES INC
80260
Insurance Service Center
(850) 435-8000
HEALTH CARE SERVICE CORPORATION
80261
Blue Cross Blue Shield
(888) 762-2189
HEALTH CARE SERVICE CORPORATION
80262
Blue Cross Blue Shield
(888) 762-2189
LINE CONTRUCTION BENEFIT FUND
80264
Customer Service
(800) 323-7268
APEX HEALTH SOLUTIONS
80268
Betsy Gossard
(330) 996-8400
EMPLOYEE BENEFIT MGMT SERVICES
80269
Lisa Rel
(406) 245-3575
HEALTH PLAN SYSTEMS SERVICES COR
80270
Satish Kurian
(732) 362-2011
USABLE MUTUAL INSURANCE COMPANY
80271
Martha Campbell
(501) 378-2958
STONER AND ASSOCIATES
80272
Linda Sites
(304) 525-0331
QUALCHOICE QCA HEALTH PLAN INC
80273
Ashley Matthews
(501) 228-7111
BCBS OF MINNESOTA
80274
BCBSM
(800) 531-6686
BCBS OF MINNESOTA
80275
BCBSM
(800) 531-6686
ZENITH AMERICAN SOLUTIONS, C6102
80280
Michelle Tenberg
(602) 526-1710
ZENITH AMERICAN SOLUTIONS, C1100
80282
Michelle Tenberg
(602) 526-1710
ZENITH AMERICAN SOLUTIONS, C1000
80283
Michelle Tenberg
(602) 526-1710
CHRISTIANA CARE HEALTH SYSTEM
80284
Theresa Bressi
(570) 214-3202
BENEFITS ADMIN CORP INC
80286
Courtney Reinsfelder
(443) 573-3607
PLUMBERS PIPEFITTERS MEDICAL FND
80291
Claims Department
(410) 872-9500
ZENITH AMERICAN SOLUTIONS DB32
80292
Michelle Tenberg
(602) 526-1710
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
NALC HEALTH BENEFIT PLAN
88061
David Hardesty
(703) 729-4677
BCBS OF ALABAMA
88062
Customer Service
(205) 988-2200
BCBS OF ALABAMA
88063
Customer Service
(205) 988-2200
BCBS OF ALABAMA
88064
Customer Service
(205) 988-2200
MUTUAL OF OMAHA INSURANCE COMP
88067
Customer Service
(800) 775-1000
AR FEDERAL EMPLOYEE PROGRAM
88073
Annette Miller
(501) 502-1344
USAABLE ADMINISTRATORS
88074
Martha Campbell
(501) 378-2958
BLUE ADVANTAGE ADMIN OF ARKANSAS
88075
Martha Campbell
(501) 378-2958
USABLE LIFE
88076
Martha Campbell
(501) 378-2958
ARKANSAS BCBS
88078
Mia Moore
(501) 502-1686
ARKANSAS BCBS
88079
Mia Moore
(501) 502-1686
PHYSICIANS MUTUAL INS.CO
88081
Carolyn Brown
(402) 633-1000
CORESOURCE, INC
88084
Jennifer Natalie
(717) 391-7141
NATIONAL CAPITAL ADMIN SVCS
88085
Fred Ellerbe
(800) 888-6227
OLD SURETY LIFE INSURANCE COMP
88086
THRIVENT FINANCIAL FOR LUTHERANS
88087
Lisa Albertston
(920) 620-4293
THRIVENT FINANCIAL FOR LUTHERANS
88088
Lisa Albertston
(920) 620-4293
ASURIS
88092
Rebecca Thorn
(503) 375-4341
REGENCE BCBS OF OREGON
88098
Rebecca Thorn
(503) 375-4341
REGENCE BLUESHIELD OF IDAHO
88105
Rebecca Thorn
(503) 375-4341
REGENCE BLUESHIELD OF UTAH
88110
Rebecca Thorn
(503) 375-4341
REGENCE BLUESHIELD
88117
Rebecca Thorn
(503) 375-4341
NORTH AMERICAN INSURANCE COMPANY
88121
Julie Tauber
(800) 627-4282
PEKIN LIFE INSURANCE COMPANY
88122
Customer Service
(800) 322-0160
PIPE FITTERS WELFARE FUND
88123
HEALTH ADVANTAGE
88124
Dee McKee
(501) 212-8520
MEDICO INSURANCE COMPANY
88125
Customer Service
(800) 247-2190
MEDICO INSURANCE COMPANY
88126
Customer Service
(800) 247-2190
MEDICO INSURANCE COMPANY
88127
Customer Service
(800) 247-2190
MEDICO INSURANCE COMPANY
88128
Customer Service
(800) 247-2190
AMERICAN REPUBLIC/ENTERPRISE
88129
Customer Service
(888) 755-3064
AMERICAN REPUBLIC/ENTERPRISE
88130
Customer Service
(888) 755-3064
AMERICAN REPUBLIC/ENTERPRISE
88131
Customer Service
(888) 755-3064
AMERICAN REPUBLIC/ENTERPRISE
88132
Customer Service
(888) 755-3064
AMERICAN REPUBLIC/ENTERPRISE
88133
Customer Service
(800) 247-2190
AMERICAN REPUBLIC/ENTERPRISE
88134
Customer Service
(800) 247-2190
AMERICAN REPUBLIC INSURANCE CO
88135
Customer Service
(800) 247-2190
AMERICAN REPUBLIC/ENTERPRISE
88136
Customer Service
(800) 247-2190
WORLD INSURANCE
88137
World Insurance Customer Service
(800) 786-5443
INSURANCE ADMIN SOLUTIONS, LLC
88150
Lincoln Heritage Life
(888) 586-8810
INSURANCE ADMIN SOLUTIONS, LLC
88150
State Mutual Insurance
(877) 872-5500
INSURANCE ADMIN SOLUTIONS, LLC
88150
Royal Neighbors of America
(877) 815-8877
INSURANCE ADMIN SOLUTIONS, LLC
88150
Sterling Investors Life
(877) 604-5240
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
INSURANCE ADMIN SOLUTIONS, LLC
88150
Idealife Insurance Company
(866) 398-9310
INSURANCE ADMIN SOLUTIONS, LLC
88150
Puritan Life
(866) 398-9305
INSURANCE ADMIN SOLUTIONS, LLC
88150
Shenandoah Life Insurance
(866) 322-2856
INSURANCE ADMIN SOLUTIONS, LLC
88150
Gerber Life Insurance
(800) 838-0080
INSURANCE ADMIN SOLUTIONS, LLC
88150
PrincipalLifeInsurance
(800) 447-4701
INSURANCE ADMIN SOLUTIONS, LLC
88150
KSKJ Life
(866) 671-5755
INSURANCE ADMIN SOLUTIONS, LLC
88150
Everest Reinsurance Company
(844) 301-0395
INSURANCE ADMIN SOLUTIONS, LLC
88150
CSI Life Insurance Company
(855) 664-5517
INSURANCE ADMIN SOLUTIONS, LLC
88150
Country Financial
(855) 304-2858
INSURANCE ADMIN SOLUTIONS, LLC
88150
SBLI USA Life Insurance Company
(866) 322-2856
INSURANCE ADMIN SOLUTIONS, LLC
88150
S. USA Life Insurance Company
(866) 322-2856
BCBS OF TENNESSEE-SUPPLEMENTAL
88160
Customer Service
(800) 553-8158
BCBS OF TENNESSEE-MEDIGAP
88162
Customer Service
(800) 553-8158
BCBS OF TENNESSEE-OTHER
88163
Customer Service
(800) 553-8158
CONSECO SERVICES, LLC
88174
Customer Service
(800) 621-3724
G.M.P. - EMPLOYERS RETIREE TRUST
88209
Debra Fulmer
(239) 936-6242
PA EMPLOYEES BENEFIT TRUST FUND
88210
Dave Walton
(717) 565-7410
ASSURED LIFE ASSOCIATION
88219
Customer Service
(877) 223-4244
LOYAL AMERICAN LIFE INSURANCE CO.
88221
Customer Service
(866) 459-4272
CONSECO SERVICES - COLONIAL PENN
88224
Customer Service
(800) 523-4000
NGS AMERICAN, INC
88225
Customer Service
(800) 521-1555
BANKERS LIFE AND CASUALTY
88227
Customer Service
(800) 621-3724
STATE FARM AUTOMOBILE INS. CO.
88228
Customer Service
(866) 855-1212
GILSBAR, INC.
88240
Customer Contact Center
(888) 472-4352
GILSBAR, INC.
88241
Customer Contact Center
(888) 472-4352
COLONIAL PENN LIFE INSURANCE CO.
88248
Customer Service
(800) 621-3724
BCBS OF ALABAMA
88249
Customer Service
(205) 988-2200
UNIVERSAL FIDELITY LIFE INS. CO.
88253
Becky Morris
(800) 366-8354
CARE FIRST ADMINISTRATORS
88254
Fred Ellerbe
(877) 889-2478
LOYAL AMERICAN LIFE INSURANCE CO.
88258
Customer Service
(866) 459-4272
UNITEDHEALTH GROUP
88260
Customer Service
(800) 523-5800
EMPLOYEE BENEFIT MGMT SERVICES
88285
Lisa Rel
(406) 245-3575
USABLE MUTUAL INSURANCE COMPANY
88288
Martha Campbell
(501) 378-2958
QUALCHOICE QCA HEALTH PLAN INC
88289
Ashley Matthews
(501) 228-7111
QUALCHOICE LIFE HEALTH INSURANCE
88290
Ashley Matthews
(501) 228-7111
UPREHS
89001
Tonya Hayes
(801) 595-4387
CONSOLIDATED ASSOC. OF RR EMP.
89002
Kathy Hampton
(254) 773-1330
SCOTT & WHITE HEALTH PLAN
89003
Brenda Lee
(254) 298-3391
C&O EMPLOYEES HOSPITAL ASSOC.
89004
Anna Brooks
(540) 862-5728
WABASH MEMORIAL HOSPITAL ASSOC.
89005
Debby Kunze
(217) 429-5246
HEALTHSMART BENEFITS SOLUTIONS
89006
Kathy Hansen
(214) 574-3509
MEDICAL ASSOC HEALTH PLAN INC.
89009
Laura Boge
(563) 556-8070
ROCKY MOUNTAIN HEALTH MAINTENANCE
89010
Marci O'Gara
(970) 248-5137
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
State Medicaid Agencies
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
MASSACHUSETTS HEALTH
70001
Customer Service
(800) 841-2900
MN DEPARTMENT OF HUMAN SERVICES
70002
Derik Newman
(651) 431-2287
OREGON MEDICAID - DHS
70005
Client Services
(800) 273-0557
OREGON MEDICAID - DHS
70005
Provider Services
(800) 336-6016
NJ DEPARTMENT OF HUMAN SERVICE
70006
Reeshemah Trower
(609) 631-6663
VIRGINIA DEPT OF MED ASSISTANCE
70008
Provider Helpline
(800) 552-8627
IL DEPT OF HEALTH AND FAMILY SER
70009
Rachelle Caldwell
(217) 524-7288
RHODE ISLAND DEPARTMENT OF HUMAN SERVICES
70010
ALABAMA MEDICAID AGENCY
70011
ND DEPT OF HUMAN SERVICES, MEDIC
70012
Laura Holzworth
(701) 328-4066
MISSISSIPPI MEDICAID
70014
Sheila Kearney
(601) 359-6074
KANSAS DEPT. OF HEALTH & ENVIRO
70015
EDI Help Desk
(800) 933-6593
FLORIDA MEDICAID
70016
Daniel Gray
(850) 298-7034
ARKANSAS MEDICAID PROGRAM
70017
Regina Langford
(501) 205-7657
IDAHO DEPARTMENT OF HEALTH & WELFARE MEDICAID DIVISION
70018
Phil Howard
(208) 373-1318
SOUTH DAKOTA MEDICAID
70019
Lori Lawson
(605) 773-3495
IOWA DEPARTMENT OF HUMAN SERVICES
70020
Provider Services
(800) 338-7909
STATE OF ALASKA MEDICAID PROGRAM
70021
Linda Walsh
(907) 334-2441
STATE OF CONNECTICUT,DEPARTMENT
70022
Client Info Line and Benefit Cntr
(855) 626-6632
WV MMIS - UNISYS
70024
Ellen Charlebois
(304) 348-3276
OKLAHOMA HEALTH CARE AUTHORITY
70025
Member Svcs - Sooner Care Helpline
(800) 987-7767
UTAH DEPARTMENT OF HEALTH
70026
Purita Buck
(801) 538-6477
NH DEPT HEALTH & HUMAN SERVICES
70027
Provider Relations (NH)
(800) 428-8303
NH DEPT HEALTH & HUMAN SERVICES
70027
Provider Relations (outside)
(603) 224-1747
NH DEPT HEALTH & HUMAN SERVICES
70027
Recipient Services
(800) 852-3345 ext. 4344
WISCONSIN MEDICAID
70028
Sarah Marks
(608) 421-6007
MO HEALTHNET DIVISION
70029
Technical Issuse
(573) 635-3559
MO HEALTHNET DIVISION
70029
Provider Billing
(573) 751-2896
MO HEALTHNET DIVISION
70029
Recipient Services
(800) 392-2161 or (573) 751-6527
NEVADA-DHCFP
70030
Tammy Moffitt
(775) 684-3623
COMMONWEALTH OF PENNSYLVANIA
70031
Customer Service
(866) 542-3015
DELAWARE DIV OF MEDICAID
70032
Provider Relations (DE, MD)
(800) 999-3371
DELAWARE DIV OF MEDICAID
70032
Provider RelationsOutside
(302) 454-7154
DELAWARE DIV OF MEDICAID
70032
Customer Relations
(800) 372-2022
OHIO DEPARTMENT OF MEDICAID
70033
Jo Steinert
(614) 387-8359
LOUISIANA MEDICAID
70034
Provider Relations
(800) 473-2783
INDIANA FSSA OFFICE OF MEDICAID
70035
Customer Service
(800) 577-1278
DEPT OF VERMONT HEALTH ACCESS
70036
Provider Relations
(802) 879-4450
COLORADO DEPT OF HEALTH-MEDICAID
70037
Client Support (within)
(303) 866-3513
COLORADO DEPT OF HEALTH-MEDICAID
70037
Client Support (outside)
(800) 221-3943
COLORADO DEPT OF HEALTH-MEDICAID
70037
Provider Support
(800) 237-0757
NE DHHS DIVISION OF MEDICAID
70038
Nate Meyer
(402) 471-9123
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
State Medicaid Agencies
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
GEORGIA MEDICAID
70039
Jeff Jacobs
(800) 766-4456
NYS DEPARTMENT OF HEALTH
70040
Miscany Cust. Care Center
(518) 649-4335
NC DHHS DMA
70042
Recipient Services
(919) 855-4045
NC DHHS DMA
70042
Provider Services
(800) 688-6696
BUREAU OF TENNCARE
70043
Steve Smith
(800) 523-2863
WYOMING DEPT OF HEALTH-MEDICAID
70045
Debbie Paiz
(307) 777-5378
WASHINGTON DC MEDICAID
70047
Finance Department
(202) 698-2000
NEW MEXICO HUMAN SERVICES DEPT
70048
John Padilla
(505) 827-1340
TX HEALTH & HUMAN SERVICES COMMI
70051
Customer Service
(800) 925-9126
CALIFORNIA-MEDICAID
70052
Customer Service
(800) 541-5555 opt 14 then 11
MONTANA MEDICAID
70053
Gail Briese-Zimmer
(406) 442-6093
ARIZONA MEDICAID
70054
Deborah Batz
(602) 417-4290
HAWAII MEDICAID
70055
Customer Services
(808) 952-5570 or (800) 235-4378
KENTUCKY MEDICAID
70058
Carl Ishmael
(502) 564-5472
WA STATE MEDICAID
70059
Customer Service
(800) 562-3022
MAINECARE
70067
Norman Curtis
(207) 629-4318
KENTUCKY MEDICAID
70068
Carl Ishmael
(502) 564-5472
OHANA HEALTH PLAN
70071
Eric Burns
(808) 675-7345
STATE OF MICHIGAN - MDHHS
70073
Provider/Beneficiary Hotline
(800) 292-2550
KENTUCKY MEDICAID
70074
Carl Ishmael
(502) 564-5472
KENTUCKY MEDICAID
70075
Carl Ishmael
(502) 564-5472
KENTUCKY MEDICAID
70076
Carl Ishmael
(502) 564-5472
NJ DEPARTMENT OF HUMAN SERVICE
70077
Reeshemah Trower
(609) 631-6663
NJ DEPARTMENT OF HUMAN SERVICE
70078
Reeshemah Trower
(609) 631-6663
NJ DEPARTMENT OF HUMAN SERVICE
70079
Reeshemah Trower
(609) 631-6663
NJ DEPARTMENT OF HUMAN SERVICE
70080
Reeshemah Trower
(609) 631-6663
DELAWARE DIV. OF MEDICAID
70082
Karen Matteson
(302) 781-6775
KENTUCKY MEDICAID
70083
Carl Ishmael
(502) 564-5472
KENTUCKY MEDICAID
70084
Carl Ishmael
(502) 564-5472
NJ DEPARTMENT OF HUMAN SERVICE
70085
Reeshemah Trower
(609) 631-6663
KENTUCKY MEDICAID
70086
Carl Ishmael
(502) 564-5472
EXE. OFFICE HUMAN SRVS RINHP
70087
ARIZONA MEDICAID AHCCCS
70088
Virginia Rountree
(602) 417-4122
NJ DEPARTMENT OF HUMAN SERVICE
70089
Reeshemah Trower
(609) 631-6663
OHIO MEDICAID, MOLINA
70091
Katerina Tague
(855) 665-4623
OHIO MEDICAID, AETNA BETTER HLPH
70092
Kristen Brown
(855) 364-0974
OHIO MEDICAID, BUCKEYE CHP
70093
Nicole Slee
(855) 364-0974
OHIO MEDICAID, CARESOURCE
70094
Toni Fortson-Bigby
(614) 255-4673
OHIO MEDICAID, UHC
70095
Anjenette Fenske
(614) 410-7494
CALIFORNIA DEPT. OF HEALTH CARE
70096
Customer Service
(855) 322-4075
CALIFORNIA DEPT. OF HEALTH CARE
70097
Provider Services
(800) 675-6110
MARYLAND MEDICAID
70101
Glynis Moore
(410) 767-5397
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
State Medicaid Agencies
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
IOWA MCO UHC OF RIVER VALLEY
77001
Provider Customer Service
(888) 650-3462
IOWA MCO AMERIGROUP
77002
Ameri Group
(800) 600-4441
IOWA MCO AMERIHEALTH CARITAS
77003
Tim Butler
(484) 496-7454
HUMANA FLORIDA MEDICAID
77004
Mary Bliss
(850) 298-7050
AMERIGROUP FLORIDA
77005
Mary Bliss
(850) 298-7050
MOLINA HEALTHCARE OF FLORIDA
77006
Mary Bliss
(850) 298-7050
FLORIDA MEDICAID - SFCCN, LLC
77007
Mary Bliss
(850) 298-7050
FLORIDA MEDICAID - MHS, INC, DBA MMC
77008
Mary Bliss
(850) 298-7050
FLORIDA MEDICAID - CMSMCP
77009
Mary Bliss
(850) 298-7050
NE MEDICAID,UHC COMMUNITY PLAN
77010
Customer Service
(866) 331-2243
NE MEDICAID - WELLCARE OF NE INC
77011
Tiffany Hilleary
(813) 206-1363
NE MEDICAID, TOTAL CARE
77012
Christopher Stark
(314) 725-4477
FLORIDA MEDICAID - WELLCARE OF FL
77013
Mary Bliss
(850) 298-7050
FLORIDA MEDICAID - BETTER HEALTH
77014
Mary Bliss
(850) 298-7050
FLORIDA MEDICAID - CLEAR HEALTH
77015
Mary Bliss
(850) 298-7050
FLORIDA MEDICAID - SIMPLY HP
77016
Mary Bliss
(850) 298-7050
FLORIDA MEDICAID - AETNA BHOF
77017
Mary Bliss
(850) 298-7050
DELAWARE MEDICAID - HIGHTMARK MCO
77018
Member/Provider Service
(412) 255-4201
DELAWARE MEDICAID - HIGHTMARK MCO
77019
Member/Provider Service
(412) 255-4201
FLORIDA MEDICAID - SUNSHINE HEALTH
77021
Mary Bliss
(850) 298-7050
FLORIDA MEDICAID - AHF MCO OF FL, INC.
77022
Mary Bliss
(850) 298-7050
NH MEDICAID-NH HEALTHY FAMILIES
77023
Theresa Vogt
(603) 263-7170
NH MEDICAID - WELL SENSE HEALTH
77024
Catherine Flaherty
(617) 478-3838
WI MEDICAID - CARE WISC SSI PRTSHP
77025
Deb Roever
(608) 245-3804
FL MEDICAID, TRUE HEALTH DBA PHC
77026
Mary Bliss
(850) 298-7050
FL MEDICAID, UNITEDHLTHCR. CPOF
77027
Mary Bliss
(850) 298-7050
NM MEDICAID - BCBSNM
77031
NM MEDICAID - UHC COMM PLN OF NM
77032
Christine Rein
(505) 449-4158
KS MEDICAID,AMERIGROUP KS,INC.
77033
Member Services
(855) 690-7800
KS MEDICAID - KANSAS SUNFLOWER
77034
Kelly Burns
(913) 333-4669
KS MEDICAID, UHC COM. PLAN OF KS
77035
Provider Customer Service
(888) 650-3462
WISCONSIN MEDICAID - GUNDERSEN
77037
Debra Schiffman
(608) 643-1408
WI MEDICAID - MOLINA HEALTHCARE
77039
Member & Provider Contact Center
(888) 999-2404
WI MEDICAID - PPI CORPORATION
77040
Dana Horner
(608) 417-4576
WI MEDICAID - UNITEDHEALTHCARE
77041
Provider Customer Service
(888) 650-3462
WI MEDICAID, UNITY
77042
Debra Schiffman
(608) 643-1408
WI MEDICAID,SECURITY HEALTH PLAN
77043
Ken Baur
(715) 221-9662
NM MEDICAID - PRESBYTERIAN HP
77045
Ramon Martinez
(505) 923-5001
NM MEDICAID - MOLINA HEALTHCARE
77046
Member Services
(505) 342-4600
WI MEDICAID - GHC EC
77047
Rachel Hedrington
(715) 852-2600
WI MEDICAID - COMPCARE
77048
Rachel Hedrington
(715) 852-2600
WI MEDICAID - ANTHEM
77049
Anthem Member Service
(855) 690-7800
WI MEDICAID - MHS HEALTH WI
77050
Josette Fowlkes
(414) 773-4104
WI MEDICAID - NETWORK HEALTH PLAN
77051
Josette Fowlkes
(414) 773-4104
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
State Medicaid Agencies
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
WI MEDICAID - GHC SCW
77053
Jackie Sawle
(608) 251-4156
OREGON MEDICAID, WVCH
77055
Customer Service Team
(503) 362-2818
OREGON MEDICAID - YAMHILL COUNTY
77056
Danielle Barzaga
(800) 224-4840
WI MEDICAID - DHP
77057
Michelle Olson
(802) 279-1301
OREGON MEDICAID - ALLCARE
77058
Sheila Anders
(541) 471-4106
OREGON MEDICAID - PACIFIC SC
77059
Customer Service
(800) 431-4135
OREGON MEDICAID - COLUMBIA PACIFIC
77060
Danielle Barzaga
(800) 224-4840
OREGON MEDICAID - UMPQUA HA
77061
Naomi Brazille
(541) 229-4842
OREGON MEDICAID -IHN
77062
Customer Service
(541) 768-5207
OR MEDICAID, CASCADE HA
77064
Rose Leanne
(541) 883-2947
HI MEDICAID-UHC COMMUNITY PLAN
77065
Provider Customer Service
(888) 980-8728
OR MEDICAID,JACKSON CARE CONNECT
77066
Danielle Barzaga
(800) 224-4840
OR MEDICAID, FAMILY CARE
77068
Connie Bruce
(503) 345-5935
OREGON MEDICAID - PACIFIC SG
77069
Customer Service
(800) 431-4135
OREGON MEDICAID - TRILLIUM
77070
Tracie Svingen
(541) 799-3276
OREGON MEDICAID - WOAH
77071
Sandy Warrick
(541) 269-0564
OREGON MEDICAID - HEALTHSHARE
77072
Florence Hurita
(503) 416-8090
OR MEDICAID,PRIM. HEALTH OF JC
77073
Tech Ph
(503) 362-2818
CA MEDICAID-CA HLTH AND WELLNESS
77074
Darryl Ruggiero
(877) 658-0305
MI MEDICAID-BLUE CROSS COMPLETE
77078
Miriam Twardon-Bielski
(248) 663-7442
CA MEDICAID-UHC COMMUNITY PLAN
77080
Customer Service
(866) 270-5785
MI MEDICAID-UPPER PENINSULA HP
77081
Melissa Provo
(906) 225-1175
MI MEDICAID - MOLINA HEALTHCARE
77086
Member/Provider Contact Number
(888) 898-7969
MI MEDICAID - TOTAL HEALTH CARE
77089
Angela Bradford
(313) 871-6596
MI MEDICAID - HAP MIDWEST HEALTH PLAN
77090
Shariea Franklin
(248) 663-3877
CA MEDICAID - HEALTH PLN OF SAN JOAQ
77093
Eric Rightmeier
(209) 261-2216
WI MEDICAID - CCHP
77094
Michelle Olson
(800) 279-1301
CA MEDICAID - CENTRAL CA ALLIANCE
77095
Kim McNeely
(831) 430-5648
MI MEDICAID - UHC COMMUNITY PLAN
77098
Ken Przybylowicz
(248) 331-4225
MI MEDICAID - MCLAREN HEALTH PLAN
77099
Lisa Gerlach
(810) 733-9626
VA MEDICAID - MAGELLAN HEALTH
77100
E-Business Service Center
(800) 553-8158
VA MEDICAID - OPTIMA HCC
77101
Medicare Customer Service
(844) 512-3172
VA MEDICAID - AETNA
77102
RJ Dix
(800) 279-1878
VA MEDICAID - VIRGINIA PREMIER
77103
Kisha Price
(804) 819-5151
VA MEDICAID - HEALTHKEEPERS INC.
77104
Anthem Customer Service
(855) 323-4687
AZ MEDICAID - AZ PHYSICIANS IPA
77108
Provider Customer Service
(800) 445-1638
VA MEDICAID - UNITEDHEALTH CARE
77113
Provider Customer Service
(888) 650-3462
CA MEDICAID - SAN FRANCISCO HP
77118
SFHP Customer Service
(800) 288-5555
CA MEDICAID - GOLD COAST HELATH PLAN
77120
Michael Fish
(805) 437-5572
CA MEDICAID-AETNA BETTER HEALTH
77123
Lisa Lovett
(959) 929-4011
CA MEDICAID - ANTHEM
77124
Medicaid Customer Card
(800) 407-4627
WA MEDICAID-COMM HLTH PLAN OF WA
77126
CHPW Washington Apple Health
(800) 440-1561
DC MEDICAID - AMERIHEALTH CARITAS
77127
James Christian
(202) 216-2304
PA MEDICAID - UPMC COMM HEALTH CHOICE
77128
Member Services Department
(866) 400-5077
List of Automatic Crossover Trading Partner (Insurers) In Production
Do Not Include Number Shown Below on Incoming Claims
Coordination of Benefits Agreement
National Crossover Process
Supplemental Payers and Insurers (Trading Partners)
Updated: 09/30/2018
State Medicaid Agencies
Trading Partner
Identification Number(s)
Customer Contact
Contact Number
PA MEDICAID - AMERIHEALTH CARITAS
77130
PA MEDICAID - AMERIHEALTH LC
77132
PA MEDICAID - AMERIHEALTH NE
77133
PA MEDICAID - AMERIHEALTH NW
77134
PA MEDICAID - KEYSTONE FIRST
77137
PA MEDICAID - UPMC FOR YOU
77138
Member Services Department
(866) 400-5007
PA MEDICAID - PA HEALTH AND WELLNESS
77139
Member Services
(866) 330-9368
PA MEDICAID - UHC COMM PLAN OF PA
77141
Provider Customer Service
(888) 650-3462
DE MEDICAID - AMERIHEALTH CARITAS
77143
Marycatherine Graves
(215) 937-8295
CA MEDICAID - KAISER SACRAMENTO
77144
Member Services
(800) 464-4000
CA MEDICAID - KAISER SAN DIEGO
77145
Member Services
(800) 464-4000
MN MEDICAID - ITASCA MEDICAL CARE
77146
Celeste Tarbuck
(218) 327-6118
MN MEDICAID - PRIMEWEST HEALTH
77147
Mary Winter
(320) 335-5239
MN MEDICAID - HEALTHPARTNERS
77150
Provider Customer Service
(888) 663-6464
MN MEDICAID - UCARE MINNESOTA
77151
UCare Provider Assistance
(888) 531-1493
HI MEDICAID - KAISER HAWAII
77153
Member Service
(877) 875-3805
WA STATE MEDICAID QUALITY PROJ
79000
Customer Service
(800) 562-3022
WISCONSIN MEDICAID QUALITY PROJ
79002
Sarah Marks
(608) 421-6007
WISCONSIN MEDICAID QUALITY PROJ
79003
Sarah Marks
(608) 421-6007
OREGON HEALTH MCD QUALITY PROJ
79004
Chris Coon
(503) 945-6915
IOWA MEDICAID QUALITY PROJ
79005
Provider Services
(800) 338-7909
CDHCPF MCD QUALITY PROJECT
79009
Kevin Martin
(303) 866-2842
IL DEPT OF HEALTH AND FAMILY SER
79010
Patricia Murphy
(312) 793-3505
NYS DEPT. OF HEALTH MQP
79012
Care Center
(518) 649-4335
RI MEDICAID, EXEC. OFFICE OF HS
79016