EBPA is the only New England Based Third Party Administrator to develop its own successful proprietary Preferred Provider Network,CompNet. As a third party administrator with 40 years in the industry PAI has the products, services, and innovative flexibility to cater to all markets. American Plan Administrators - Contact us. General Liability Notice of Occurrence/Claim, Glossary of Health Coverage & Medical Terms, Self Funded Health Benefit Administration, Property and Casualty Administrative Services, Non-Discrimination Statement and Foreign Language Access, CAA Transparency in Coverage + Machine Readable Files, Your Rights and Protections Against Surprise Medical Bills, Behavioral health services, including substance abuse treatment, Durable medical equipment (DME) over a specified dollar amount (varies), Investigational or experimental procedures*, Procedures considered cosmetic in nature, such as blepheroplasty, reduction mammoplasty or TMJ, A one-time notification when a member is initiating outpatientchemotherapy or radiation therapy. 2023 Planned Administrators Inc. All rights reserved. 2009-2023 Zenith Insurance Company. PO Box 182223. Claims Submittal: claims@americanbenefitadministrators.com (claims can also be submitted online via the secure portal or Mobile App) Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 47 offices nationwide. Cigna shares the administration of the plan with a third party. Most CT scans, MRIs, MRAs and PET scans do not require precertification, but will not reimburse for services deemed to be investigational. By Mail Sana Benefits Claims P.O. Gain access to the solutions and support you need to offer your customers the benefit designs that best meet their needs. Fax: 406-652-5380. PO Box 804238 We appreciate hearing from you. PAI meets the requirements and is authorized to administer business in all 50 states and serves all group markets. For questions concerning your online portal, including login information, please email:helpdesk@zenith-american.com. PAI will not require that you repay the refund until PAI has concluded its review. Prefix Group Address Group Name TPA Name & Address Claims Filing Claims & Benefit Employers and employees are looking for business partners who can deliver innovative health benefits solutions with cost control opportunities. The new PAI provider portal is going live. 3333 Hesper RoadBillings, MT 59102, Local Phone: 406-245-3575 HCP Login. Benefits administration is a difficult, increasingly complex business. 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 Please use the form below to contact AMA Insurance. 1200 WILSHIRE BLVD-5TH FLOOR. Toll Free: 866.742.4900 Authorized to administer business in all 50 states, hundreds of employers across the country - and their covered employees - rely on PAI. Columbia, SC 29260. Upon securing a username and password, you will be able to verify eligibility and view the status of your claim submissions. I respect a service team that does what they say theyre going to do with quality! 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 December 2020. Access the link below for easy-to-use claim filing. 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. Zenith Insurance Company 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. Client/Employer Support:clientservices@americanbenefitadministrators.com, COBRA/Direct Billing Administration: 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. If you currentlyparticipate with the Preferred Blue Network, then you are already set up with PAI as a participating provider. 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. The cost of healthcare continues to grow at an unsustainable pace. 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 We highly recommend participants to take advantage of the direct deposit feature whenever a manual claim is filed. 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. Toll Free: 866.742.4900 Hours: 7:00 a.m. - 6:00 p.m CST. Receiving illegal calls claiming to be from American Benefits Group? Please refer to the members identification card to determine the applicable network. Many of EBPAs Employer Benefit Group Plans utilizeCompNetas their principal PPO network. 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. 24 hours a day, 365 days a year. Media Relations Contact. Billings MT 59102 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. d '7y[ f| m x06w a>g Mailing addresses for claims Important: Current claims mailing information is on the APWU Health Plan Member ID Card. I was very impressed with the questions that they asked and their follow through with carriers in what could otherwise have been a very frustrating situation working with insurance companies. We offer a state-of-the art member portal to help you make the most of your health benefits. (Zq /Y(aUUlg&dU//adikCb[/qBTwgqU2x/j|!jokBP+m`B&GDX~w4 . 1268 0 obj <>stream 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. Once logged in,you will have the ability to: EBPA encourages providers to take advantage of the online resources we have made available. PAI will not require that you repay the refund until PAI has concluded its review. For example, CT coronary angiography and CT scans of the chest for lung cancer screening are investigational. 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 . Get access to precertification requirements, drug lists, refund requests and payment information, address change information, appeals rights information, and more. 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) 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 LOS ANGELES, CA 90017-1906. 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. 1.800.426.9786. 152 0 obj <>stream Box 380844 View Map, Employee BenefitManagement Services Driving Directions. . Prior authorization varies from group to group. 2023 Planned Administrators Inc. All rights reserved. (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. 18 Heyward St. Brooklyn, NY 11249. Box 8504 Mason, OH 45040-7111 Patient Last Name (Required) Patient First Name (Required) MI Birth Date (MM/DD/YYYY) - - Street Address City State Zip Code o ID Cards include the TPA or insurer's telephone number and address(es), for eligibility, benefits, claim status and payment inquiry. First American Financial Corporation 1 First American Way Santa Ana, California 92707. Access your online portal usingthis form. 1-800-303-5242. 2023 American Benefits Group. Participant Support:support@americanbenefitadministrators.com There are two easy ways to submit claims to Sana. There you will find answers to common questions, details about your plan, and much more. Page 1 of 21 List Current As of 3/2/2023 5:00:10 AM 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. About Us; Contact; Helpful Links; Online Forms; Coordination of . Take control of your benefits. ]^^n^6R6Z+nt'`3U3xxm]UW/EY qgoM0%"sWc[T#XdIf FOP.'f/wbviQ.hP,UnPK Its a stark contrast from the individuals I spoke to at carriers when following up on enrollments. 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. Constant regulatory changes and adjustments to health care and pension plans demand more than just hard work to effectively manage. Cigna. Its almost here! Try taking a look at our. As a provider, take advantage ofour round- the- clockonline resourcesand secure portal. Notice of Privacy. Our online tools will give you all the information access you need to utilize patients health benefits to support their care. Van Nuys, CA 91409-9055, Other States: Medical Claims. New User?Please click here to register. endstream endobj 1230 0 obj <. 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. Our solutions and services allow you to tailor benefit plans to best meet the needs of you and your employees. endstream endobj startxref %%EOF Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. Ple ase send all c orrespondence and non-claim inquiries to the TPA addresses below. Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com. Who is American Plan Administrators Headquarters 18 Heyward St, Brooklyn, New York, 11249, United States Phone Number (718) 625-6300 Website www.apatpa.com Revenue $5.2M Industry Insurance Is this data correct? Help with finding network physicians or ancillary service providers, Information about our pharmacy benefit management program and other Zenith programs. AMA Insurance Agency, Inc. As may vary by group, please call the phone number listed on the member ID card. This is nothing new; however, this is a good time to remind everyone of the feature. These tools focus on quality and ensuring the best possible end result for each and every user. 2018 Zenith American Solutions, Inc. All Rights Reserved. Helping You Provide The Best Possible Care. 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. mZbqEm2dU1 (RtzEowwz{nZ/L++P@,*,&yiPQ9{KYp*GiERa&pS0\,fta1 kptdt 5P#ld[j u4wf;6qpB'Du` C0k&P"78-|;se}[bH&n )f[X2d%?%MQ.#G4ytT"5',i{+Y"+rR]Kk\EA%[X@-F FGlKZ"J8?qpZ?c8GH6*yl'yGw'fk uV{Q"U&!cq=%ib[#h9AH%D"zIA r+OhN#Ztu(O1\\!.irrZ>X_.R-vac92G#ZX>]BR92j]Y;Lu Its not easy to accomplish but it has been my experience and I am very grateful.". They are web-based or Internet-accessible solutions that facilitate seamless front office and back office operations. Authorized to administer business in all 50 states, hundreds of employers across the country and their covered employees rely on PAI. Or you can request a meeting on a specific topic, CLICK HERE to schedule.

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