%PDF-1.6 % P.O. I was very impressed with American Benefits Group after separation from my employer. *Out-of-network form submission deadlines may vary by plan. Client/Employer Support:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. 1254 0 obj <>/Filter/FlateDecode/ID[]/Index[1229 40]/Info 1228 0 R/Length 122/Prev 219460/Root 1230 0 R/Size 1269/Type/XRef/W[1 3 1]>>stream View the drug lists thatapply to members with PAIs pharmacy benefit coverage with OptumRx. (1) Allegiance Benefit Plan Management is responsible for administering various aspects of this patient's plan, which may include claim processing, utilization management or eligibility verification. You can request prior authorization for these services by calling 1-800-652-3076, or fax requests to 803-264-5131. Whether you are a two-person startup group, a 30,000-employee enterprise, a public school system or a labor union, we have products and services that can meet your population needs and group priorities. Contact; Log In; Hit enter to search or ESC to close. The new PAI provider portal is going live. Toll Free: 1.800.854.3643 Local: 1.714.250.3000. Cigna. To be complete, a claim must include a claim form that has been signed and dated by the account holder, and the following five pieces of information: Claims must be accompanied with receipts for the services rendered - for HRA claims an Explanation of Benefits (EOB) is required to show that the expense was applied to the insurance deductible. Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. There are two easy ways to submit claims to Sana. Medical Claims. support@americanbenefitadministrators.com, clientservices@americanbenefitadministrators.com. As may vary by group, please call the phone number listed on the member ID card. Log in to your account to confirm your specific . Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. Claim Number Email Date of Service Phone Your Message Additional Contact Information Phone 1-888-627-5880 Business Hours 8 am - 5 pm CT, Monday - Friday Email AMA Insurance claims@amainsure.com Claims Mailing Address AMA Insurance Agency, Inc. PO Box 804238 Chicago, IL 60680-4104 We will quickly get back to you with the information you need. This team was incredibly patient, kind, and helpful. General Liability Notice of Occurrence/Claim, Glossary of Health Coverage & Medical Terms, Self Funded Health Benefit Administration, Property and Casualty Administrative Services, Non-Discrimination Statement and Foreign Language Access, CAA Transparency in Coverage + Machine Readable Files, Your Rights and Protections Against Surprise Medical Bills. M-F Try taking a look at our. Quick Benefit Lookup, no log in required-Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate. For general inquiries or to file a claim, visit our Submitting a Claim page. Its almost here! PAI We offer a state-of-the art member portal to help you make the most of your health benefits. When you incur a reimbursable expense and are ready to file a claim you can do one of the following: Securely Email: claims@amben.com - sendsecure.amben.com. Box 1558 P.O. Zenith American Solutions has invested in a world class PMO (Project Management Office) that works to ensure each new implementation, enhancement, or change is managed to ensure a quality on time delivery. Our online tools will give you all the information access you need to utilize patients health benefits to support their care. Fill out our Request for Proposal Form. This team is diligent and kind. Changes made will not be reflected on all impacted systems for up to 2 business days. Phone Number. For group-specific prior authorization information, please log in to the MyPAI Provider Portal above and review the members health benefit plan document. Zenith Insurance Company Authorized to administer business in all 50 states, hundreds of employers across the country and their covered employees rely on PAI. endstream endobj startxref Return the completed form and your itemized paid receipts to: First American Administrators, Inc. Attn: OON Claims P.O. For assistance with portal registration or portal password assistance, please call 877-777-0031. Employees. Toll Free: 866.742.4900 Hours: 7:00 a.m. - 6:00 p.m CST. Register at launch to take advantage of the enhanced functionality launch date will be announced soon. . Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. American Insurance Administrators 1200 Wilshire Blvd-5th Floor Los Angeles, CA 90017-1906 1-800-303-5242. PAI will not require that you repay the refund until PAI has concluded its review. About Us; Contact; Helpful Links; Online Forms; Coordination of . Several payers that DO receive claims electronically have been placed on this list for having poor services available. Together with the TPA, our goal is to educate members so they can make better, more informed health care decisions. P.O. Types of services that generally require precertification: *Any drugs, services, treatment or supplies that the managed care medical staff for PAI determines, with appropriate consultation, to be experimental, investigational or unproven are not covered services. 1229 0 obj <> endobj The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. Please Be Advised. Prior authorization varies from group to group. Helping You Provide The Best Possible Care. Fax: 406-652-5380. Columbia, SC 29260. Need answers now? Please contact our Provider Relations team at 800-440-5020 (option 3) or by email at providergroup@thezenith.com if you need: Submit bills, reports, and other medically-related correspondence by mail or fax: California: PAI will not require that you repay the refund until PAI has concluded its review. hYkO+-*T}B1ha4.$&&v,~SU $g )_xULXI0e21kF&W#q?JNOdilQ1&hWg Jst#nrmMLK{f)g667(8zjdpy'83>AyNG@y}W (e?99gayXXrzOOgLk gE7yWM~NaV{a(YSUGwL0f1h6o8^qgNP\4z!n81Ves|\H{kjbBGem>)GW~[4OpW2C3lWp&zgMIj]E6U __N[O&3_], Y+2-K>..SJ-3aRidtjMK2qT9}QCHAuVf&Iw*SFi*$9waOuoA5D=#9|(4 %PDF-1.6 % All Rights Reserved. If you have questions about a claim, eligibility or verification of benefits please call and speak with a LIVE representative at800-578-3272. hb``` eaXm.; `Umap@LDPpN jM*,BDu|m_(2*u x y-a`b` #; Client/Employer Support:cobraclientservices@americanbenefitadministrators.com, COBRA/Direct Billing, FSA, DCA, Transit & Parking, HSA, HRA, POP, Compliance and Identity Guard with Watson Access your online portal usingthis form. Please contact our Provider Relations team at 800-440-5020 (option 3) or by email at providergroup@thezenith.com if you need: Help with finding network physicians or ancillary service providers; Information about our pharmacy benefit management program and other Zenith programs Title Claims Contact. %%EOF SBMA offers Affordable ACA Compliant Benefits for employers who want fast, reliable benefits administration that their employees can afford. Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. Toll Free: 866.742.4900 LOS ANGELES, CA 90017-1906. endstream endobj startxref Register at launch to take advantage of the enhanced functionality launch date will be announced soon. American Plan Administrators - Contact us. For further information, please contact the precertification number located on the members identification card. AllCare Health Plan MRIPA N N/A Address - Some payers have multiple locations, but claims go to the same electronic location *Indicates claim is routed by paper. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. Staff Photography by Jessica Marie Photography Inc. Its been my privilege to work with PAI for a couple decades now PAI has done a good job of making us feel like we are their only client. Need answers now? The original entity of Zenith American Solutions has been in business since 1944. *As part of our effort in achieving a 100% paperless office we encourage you to receive your reimbursements directly into your bank account. As a TPA, Zenith American Solutions must keep up with the technology trends and innovations to continue providing best-in-class services to our clients and their members. Please contact the TPA with questions on these topics. 24 hours a day, 365 days a year. Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. Box 855 Arnold, MD 21012 P.O. Corporate Headquarters. PAI P.O. Login to your account. Phonee: 718-625-6300. Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) To request reimbursement, please complete and sign the itemized claim form. Get tools and flyers to share with your clients Dental Network Together, we can build a solution that's right for your clients For more information, email CignaPayerSolutions@cigna.com or call 1 (888) 284-6851. endstream endobj 84 0 obj <> endobj 85 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/Properties<>/XObject<>>>/Rotate 0/TrimBox[9.0 9.0 621.0 801.0]/Type/Page>> endobj 86 0 obj <>stream 37 Industrial Drive, Exeter, NH 03833 | 800-258-7298 | TTY Number Dial711, 46 Bowdoin Street, South Burlington, VT 05407-2365 | 800-525-8788 | TTY Number Dial711, Security & Terms of Use This is nothing new; however, this is a good time to remind everyone of the feature. 2018 Zenith American Solutions, Inc. All Rights Reserved. Notice of Privacy. The cost of healthcare continues to grow at an unsustainable pace. The company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. 2023 American Benefits Group. PSIP Reimbursement Rates for 2020/ . American Benefits Group (ABG) Navigating the Road to Consumer Directed Healthcare 2.0, American Benefits Group (ABG) Upping the Benefits Administration Game, Login to your account and find the Main Menu (top left) choose, Enter your claim information, then either: Upload the receipts via the portal or fax it with supporting documentation to 877-723-0147, Reimbursements for completed eligible claims received in our office by noon on Fridays, typically will be processed and checks sent the following Tuesday (during our busy time your reimbursement may be processed the following week), Claims Submission Including Receipt Upload. (888) 505-7724 updates@sbmamec.com Birmingham, AL 35238, 2023 American Benefit Administrators. Its not easy to accomplish but it has been my experience and I am very grateful.". Cigna shares the administration of the plan with a third party. Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. Many of EBPA's Employer Benefit Group Plans utilize CompNet as their principal PPO network. Locations: For a full list of Zenith American Solutions office locations: Click Here Corporate Headquarters: Zenith American Solutions, Inc. Two Harbor Place 302 Knights Run Avenue, Suite 1100 Tampa, FL 33602 (813) 666-6900 Provider Address Change Fax an updated W-9 to (803) 264-9089 hb```f``Z`qA2l,1`c(.`Wb4kE/'fLBmlm>x2faTn`9w]B@/.Se~i Ip2) iF r,`qRf`@ 1 American Plan Administrators. For general assistance, please call your Client Services representative or your Customer Care team. PAI's preferred pharmacy benefit manager is OptumRx, a pharmacy care services company that creates smarter health care connections to help more than 65 million Americans realize improved care, lower costs, and a better overall experience. To learn more about our customized solutions: If you are a Participant, Employer, Trustee or Provider: For questions concerning your online portal, including login information, please email. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. Access the link below for easy-to-use claim filing. If you are a participatingCompNetprovider seeking to manage addresses and staffing changes, you may do sohere. 0 hbbd```b``@$Df/i #D2lE``vd@ "@,iZ R R2H{v# k All rights reserved. By Mail Sana Benefits Claims P.O. Lucent Health helps benefits brokers deliver a superior solution that directly and effectively addresses the needs of the self-insured . AMERICAN INSURANCE ADMINISTRATORS. Driving Directions. o Each card also includes the paper and electronic claims submission addresses. 3333 Hesper Road The original entity of Zenith American Solutions has been in business since 1944. These tools focus on quality and ensuring the best possible end result for each and every user. 0 While some groups require prior authorization for all of these services, others may require prior authorization for more or less than the procedures specified below. %%EOF Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. 83 0 obj <> endobj We strive to provide service excellence and a smooth experience to all our health care providers as they navigate our system to provide care. 1200 WILSHIRE BLVD-5TH FLOOR. Take control of your benefits. The PAI Provider Portal provides complete benefit information, including deductibles and patient liability. You would need to reimburse yourself and then pay your provider directly. As a health care provider, you are an integral part of our team. We are proud to offer our own unique Claims processing and Benefit administration solutions. Copyright 2016 AMA Insurance, Inc. All rights reserved. Ple ase send all c orrespondence and non-claim inquiries to the TPA addresses below. remington pro1 flat iron; out-of-state broker commission texas; July 7, 2022. american plan administrators claim mailing address As the result, many self-administered Taft-Hartley trust funds and third-party administrators like Zenith American need easy-to-use, cost-effective, data-driven systems for a new era of administration. We appreciate hearing from you. You will need an Employer ID when you register. AMA Insurance Agency, Inc. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. 2009-2023 Zenith Insurance Company. M-F Email: Login to your Secure Online Access portal and click on Contact Us Benefit Account Administration: Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) Claims paid under PSIP Program are subject to county audit. Attention: Refund Analyst If youre interested in improving your benefit plan and improving lives, drop us a line. o ID Cards include the TPA or insurer's telephone number and address(es), for eligibility, benefits, claim status and payment inquiry. Box 6927 Columbia, SC 29260 Provider's Refund Request Right of Appeal If you receive a request for refund, you have the right to an appeal, if you do so within 30 days of the refund request. EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network, CompNet. First NameLast NameEmailI am a:BrokerEmployer/Plan SponsorMemberProviderOtherReason for contacting--Select--Donation inquiriesGeneralMedia inquiriesMember comment or concernNew business inquiriesMessage, Monday-Thursday Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. Home; About; Advantages; Solutions/Services; Resources; Contact us 2023 Planned Administrators Inc. All rights reserved. This field is for validation purposes and should be left unchanged. ABA is committed and confident it will provide the same level of service. As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. Its almost here! Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. Chicago, IL 60680-4104. You will receive a response within 2 business days. Please note that Credit Card receipts or cancelled checks are not valid documentation, Claims for personal hygiene items and cosmetics are not eligible expenses, Vitamins and supplements are not eligible without a doctors prescription, Massage therapy and weight-loss programs are only allowable to the extent that they are prescribed for a chronic condition or existing disease and supported by a doctors note submitted with the claim, We will keep doctors note on file but they must be renewed at the beginning of each plan year, Click here for a list of qualifying expenses. Email: Login to your Secure Online Access portal and click on Contact Us, Benefit Account Administration: Please use the form below to contact AMA Insurance. If your employer offers the ability to have reimbursements deposited to your bank account, you can set-up direct deposit by logging-in to your account, click Reimbursement Settings under the Claims tabwithin the WealthCare Portal. Try taking a look at our Frequently Asked Questions page. The long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. For questions concerning your online portal, including login information, please email:helpdesk@zenith-american.com. Submitthe request via email to PAI Provider Maintenance at paiprovmtn@paisc.com. First American Financial Corporation 1 First American Way Santa Ana, California 92707. When I would call, I would reach an individual very quickly and they were always very willing to help and get on the phone with me when I called some of the carriers who were not reflecting my coverage. Participant Inquiries: cobra@americanbenefitadministrators.com 7:00 a.m. 8:00 p.m. MST, Monday-Thursday Both American Benefit Plan Administrators and Zenith Administrators were strong TPAs prior to the merger, but by combining resources, best practices and scale, the new organization is even stronger and better than before. As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. The team uses PMI standards and project management tools along with IT industry best practices. 18 Heyward St. Brooklyn, NY 11249. If you currentlyparticipate with the Preferred Blue Network, then you are already set up with PAI as a participating provider. 6:00 a.m. 8:00 p.m. MST, Corporate Office 119 0 obj <>/Filter/FlateDecode/ID[<38C6DB5AA9170743B09053647D1A6BD2>]/Index[83 70]/Info 82 0 R/Length 156/Prev 301728/Root 84 0 R/Size 153/Type/XRef/W[1 3 1]>>stream Our combined focus is providing the technologies, services, systems and support methodology to self-funded benefit plans so they get the solutions they need for increasingly complex regulatory changes and cost effective solutions. Box 380844 Employees. Also, customers and vendors may be requested to provide electronic payment options for invoices. For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. Cigna. Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM The new PAI provider portal is going live. PO Box 21367 Billings, MT 59104 Local Phone: 406-245-3575 Phone: 800-777-3575 Fax: 406-652-5380 Contact Us Education Campaigns for HSA and Health FSA, Caution: Fradulent Calls Impersonating American Benefits Group, Health Reimbursement Arrangements Answers, How To File A Claim - Spanish (download PDF), How To Add/Edit Direct Deposit Information. Receiving illegal calls claiming to be from American Benefits Group? Fax an updated W-9 to (803) 264-9089 Enter your claim information, then either: Upload the receipts via the portal or fax it with supporting documentation to 877-723-0147 File a Claim Online using the ABG Smart Mobile App for smart phones and tablets Find out more about our mobile app Securely Email: claims@amben.com - sendsecure.amben.com The Reimbursements Process General Liability Notice of Occurrence/Claim, Glossary of Health Coverage & Medical Terms, Self Funded Health Benefit Administration, Property and Casualty Administrative Services, Non-Discrimination Statement and Foreign Language Access, CAA Transparency in Coverage + Machine Readable Files, Your Rights and Protections Against Surprise Medical Bills, Behavioral health services, including substance abuse treatment, Durable medical equipment (DME) over a specified dollar amount (varies), Investigational or experimental procedures*, Procedures considered cosmetic in nature, such as blepheroplasty, reduction mammoplasty or TMJ, A one-time notification when a member is initiating outpatientchemotherapy or radiation therapy. PO Box 182223. If you receive a request for refund, you have the right to an appeal, if you do so within 30 days of the refund request. Dental Claim Form; Medical Claim Form; Vision Claim Form; 953 American Lane, Suite 100 Schaumburg, IL 60173 Phone: (847) 519-1880 Toll-Free: (800) 323-1683 contactus@groupadministrators.com . If you are a participating CompNet provider seeking to manage addresses and . Benefits administration is a difficult, increasingly complex business. If you are a Medicare member, you may use the Out-Of-Network claim form or submit a written request with all information listed above and mail to: First American Admisinstrator, Inc. Att: OON Claims, PO Box 8504, Mason OH, 45040-7111. Zenith Insurance Company Media Relations Contact. Chattanooga, TN 37422-7223. Contact the Customer Service number on the member ID card if you need assistance. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. Its a stark contrast from the individuals I spoke to at carriers when following up on enrollments. Or you can request a meeting on a specific topic, CLICK HERE to schedule. Dental Claims. 1 (800) 244-6224. endstream endobj 1230 0 obj <. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit 2022 Employee Benefit Management Services, LLC. . Billings MT 59102 Please let us know if you experience any trouble or if you need help using the AMA Insurance Verification of Benefits Portal. As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. Electronically Electronic/Payor ID: 50114. December 2020. Email: sales@americanbenefitadministrators.com, American Benefit Administrators