The First Health® Network MICHIGAN Payor Information Report

Transcription

The First Health® Network
MICHIGAN Payor Information Report
PAYOR NAME
66 FEDERAL CREDIT UNION
Affiliated With: SELECT BENEFIT
ADMINISTRATORS, INC.
Plan Type: Group Health
CLAIMS SUBMISSION
SELECT BENEFIT
3001 Westown Pkwy.
WEST DES MOINES IA 50266
ELIGIBILIT/ BENEFITS/
COMPENSABILITY
SELECT BENEFIT
UTILIZATION REVIEW
SELECT BENEFIT
(800) 397-0427
(800) 397-0427
A & D MANAGEMENT CO INC
Affiliated With: SISCO/Cottingham &
Butler
BUTLER BENEFIT SERVICES
PO Box 3310
Davenport IA 52808-3310
(563) 327-2240
CHECK BENEFIT CARD
(563) 327-2240
A C HOUSTON LUMBER
THE LOOMIS COMPANY
Affiliated With: THE LOOMIS COMPANY PO Box 7011
WYOMISSING PA 19610-6011
THE LOOMIS COMPANY
UM NOT APPLICABLE
(800) 346-1223
(800) 346-1223
A G ADMINISTRATORS
Affiliated With: A G ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
A L GILBERT COMPANY
Affiliated With: DELTA HEALTH
SYSTEMS
DELTA HEALTH SYSTEMS
1234 W OAK ST
STOCKTON CA 95201
(209) 939-3403
DELTA TEAM CARE
(800) 336-0123
AMERA-NET
AMERA-NET
CHECK BENEFIT CARD
(209) 939-3403
A&G/AMERA-NET
Affiliated With: AMERA-NET
AMERA-NET
A1 COPELAND INVESTMENTS
Affiliated With: AMERICAN
ADMINISTRATIVE GROUP
American Administrative Group Inc.
PO Box 93670
LUBBOCK TX 79493-3670
(800) 221-4582
2805 Dallas Pkwy STE 140
PLANO TX 75093
(800) 221-4582
• Patients using benefit cards with any AFFORDABLE logo should be recognized as having access to The First Health®
Network.
• * Indicates payor information has been revised since the last reporting period.
• Providers may not be eligible for participation in certain Coventry or First Health network products due to client
requirements or restrictions. Patient eligibility, benefits and compensability coverage MUST be confirmed by calling the
telephone numbers and/or employer indicated under the "Eligibility/Benefits/Compensability" section.
Info as of 12/24/2007
Page PIRMI-1
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PAYOR NAME
ABACUS PROJECT MANAGEMENT
INC
Affiliated With: ADVANCED BENEFIT
SOLUTIONS LLC
ABETIC CORPORATION
Affiliated With: EMPLOYEE BENEFIT
MANAGEMENT CORP
ABFB CORPORATION DBA THE
WHITE MARKET
Affiliated With: GROUP INSURANCE
SERVICE CENTER
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
EBMC
EBMC
CHECK BENEFIT CARD
4789 Rings Rd
Dublin OH 43017-1599
(614) 766-5800
CLAIMS SUBMISSION
CHECK BENEFIT CARD
(614) 766-5800
GROUP INSURANCE SERVICE
CENTER
CENTER
20 WINTER ST
PEMBROKE MA 02359
(800) 242-4472
GISC TOTALCARE
(866) 598-3973
(800) 242-4472
ABRAHAM BALDWIN AGRICULTURAL PEARCE ADMINISTRATION
COLLEGE AIH0057867
PO Box 2271
Affiliated With: MAKSIN MANAGEMENT Florence SC 29503
CORP #14005
(843) 622-6001
PEARCE ADMINISTRATION
ABRAHAM BALDWIN AGRICULTURAL PEARCE ADMINISTRATION
COLLEGE AIH0057877
PO Box 2271
CORP #14005
(843) 622-6001
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
ABRAHAM BALDWIN AGRICULTURAL
COLLEGE UNDERGRAD MANDATORY
Affiliated With: MAKSIN MANAGEMENT
CORP
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
Network.
Info as of 12/24/2007
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PAYOR NAME
ABTREX INDUSTRIES
Affiliated With: ASSURECARE
CLAIMS SUBMISSION
ASSURECARE
4040 HUNSAKER STE 110
LANSING MI 38823
COMPENSABILITY
ASSURECARE
UTILIZATION REVIEW
(800) 968-6616
CARELINE
(763) 383-4800
(800) 968-6616
ACADEMY OF ART COLLEGE
Affiliated With: ADMINISTRATIVE
CONCEPTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ACCESS
Affiliated With: PREFERRED CARE
PREFERRED CARE, INC.
6 Neshaminy Interplex #205
TREVOSE PA 19053
(215) 639-6208
(215) 639-6208
ACCESS ADMINISTRATORS , INC
Affiliated With: NATIONAL HEALTH
BENEFITS CORPORATION (NHBC)
ACCESS NURSES INC
SYSTEMS
ACCO Management
Affiliated With: American Administrative
Group
NHBC
NHBC
8990 E. Raintree Dr.
Scottsdale AZ 85260
(888) 621-7900
CHECK BENEFIT CARD
(888) 621-7900
PO Box 80
Stockton CA 95201
(800) 807-0820
DELTA TEAM CARE
(800) 356-2395
(800) 807-0820
American Administrative Group
PO Box 93670
(800) 877-7474
First Health
(800) 346-3220
(800) 877-7474
Network.
Info as of 12/24/2007
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PAYOR NAME
ACCOR NORTH AMERICA, INC.
Affiliated With: P5 E HEALTH SVCS,
INC. (MOTEL 6 & RED ROOF INNS)
ACE DISPOSAL COMPANY
Affiliated With: TALL TREE
ADMINISTRATORS
ACE INTERNATIONAL UNIVERSITY
OF NORTH TEXAS
Affiliated With: ACADEMIC RISK
MANAGEMENT
Term Effective: 8/31/2007
CLAIMS SUBMISSION
P5 E HEALTH SERVICES, INC.
2455 E. Parleys Way #300
Salt Lake City UT 84109
COMPENSABILITY
(800) 397-3685
UTILIZATION REVIEW
P5 PROVIDER REVIEW
(200) 633-1988
(800) 397-3685
TALL TREE ADMINISTRATORS
802 E WINCHESTER RD STE 205
SALT LAKE CITY UT 84107
(801) 274-8100
CORVEL
(801) 269-8723
TRUE CHOICE USA
TRUE CHOICE USA
CHECK BENEFIT CARD
PO Box 700307
DALLAS TX 75370
(800) 785-2446
(801) 274-8100
(800) 785-2446
ACE USA
ACE USA
ACE USA
Plan Type: Workers' Compensation
950 Cottage Grove Road (North
Building)
Bloomfield CT 06002
(860) 731-6868
ACE USA
(860) 731-6868
(860) 731-6868
ACKERMAN MCQUEEN
Affiliated With: MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
Oklahoma City OK 73123-3096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
ACMG
Affiliated With: GLOBALCARE, INC.
GLOBALCARE, INC.
GLOBALCARE, INC.
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
Network.
Info as of 12/24/2007
Page PIRMI-4
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PAYOR NAME
ACROM PUBLISHING
CLAIMS SUBMISSION
ASSURECARE
1742 GEORGETOWN RD STE E
HUDSON OH 44224
COMPENSABILITY
ASSURECARE
UTILIZATION REVIEW
(800) 422-2026
Careline UR
(763) 383-4800
HEALTH INTERNATIONAL
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 422-2026
ACS HEALTH ADVANTAGE PLAN
REWARDS ADMINISTRATION
CENTER
PO Box 10219
SCOTTSDALE AZ 85271
ACTARIS
Affiliated With: CORPORATE
BENEFITS SERVICE INC
CHECK BENEFIT CARD
Acterna Corp Administrators, Inc.
Affiliated With: Gallagher Benefit
Administrators, Inc.
CHECK BENEFIT CARD
CHECK BENEFIT CARD
FCE BENEFIT ADMINISTRATORS INC
FCE BENEFIT ADMINISTRATORS INC CHECK BENEFIT CARD
4615 WALZEN RD STE 300
SAN ANTONIO TX 78218
(800) 899-9355
* ADA S MCKINLEY
Affiliated With: FCE BENEFIT
ADMINISTRATORS INC #10388
ADAMS-REMCO
8002779476
CHECK BENEFIT CARD
(800) 899-9355
ASSURECARE
ASSURECARE
LANSING MI 38823
(800) 968-6616
CARELINE
(763) 383-4800
(800) 968-6616
ADCO PRODUCTS
Affiliated With: PREFERRED HEALTH
PLANS, INC.
PREFERRED HEALTH PLANS INC.
10160 LINN STATION RD
LOUISVILLE KY 40223
(800) 832-8212
PHCS Utilization Management
(888) 551-7427
(800) 832-8212
Network.
Info as of 12/24/2007
Page PIRMI-5
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PAYOR NAME
ADKNOWLEDGE, INC
Affiliated With: FMH BENEFIT
SERVICES, A DIVISION OF
CORESOURCE
ADVANCE AMERICA CASH ADVANCE
Affiliated With: MARSH ADVANTAGE
AMERICA
ADVANCE MANUFACTURING
COMPANY WRAP JMS
Affiliated With: COMPREHENSIVE
BENEFIT ADMINISTRATORS INC
(EBPA)
ADVANCED FINANCIAL TECHNOLOGY
ADMINISTRATORS
CLAIMS SUBMISSION
FMH BENEFIT SERVICES INC
COMPENSABILITY
UTILIZATION REVIEW
(800) 990-9058
HCM
(800) 990-9058
MARSH ADVANTAGE AMERICA
CHECK BENEFIT CARD
ONE W. THIRD ST #900
TULSA OK 74103
(800) 426-9786
PO Box 25946
OVERLAND PARK KS 66225-5946
(800) 990-9058
(800) 949-5945
EBPA
EBPA
PO Box 2365
SOUTH BURLINGTON VT 05403
(800) 525-8788
CHECK BENEFIT CARD
(802) 846-8060
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
ADVANCED SERVICES, INC.
Affiliated With: PITTMAN &
ASSOCIATES, INC.
PITTMAN & ASSOCIATES, INC.
ADVANCED SYSTEMS TECHNOLOGY
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
CHECK BENEFIT CARD
PO Box 42096
(800) 825-3540
PO Box 111047
MEMPHIS TN 38111
(800) 825-3540
Network.
Info as of 12/24/2007
Page PIRMI-6
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PAYOR NAME
ADVANSTAFF
Affiliated With: SIERRA HEALTH &
LIFE / HEALTH PLAN OF NEVADA
CLAIMS SUBMISSION
SIERRA HEALTH & LIFE/HEALTH
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
ADVANSTAFF TRAVEL
Affiliated With: SIERRA HEALTH & LIFE
/ HEALTH PLAN OF NEVADA
SIERRA HEALTH & LIFE / HEALTH
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Advantage
Affiliated With: ADVANTAGE
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Advantage Consulting Services
Affiliated With: ADVANTAGE
CONSULTING SERVICES
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ADVANTAGE GASES AND TOOLS
Affiliated With: HEALTH PLANS, INC.
HEALTH PLAN INC
HEALTH PLAN INC
PO Box 5199
WESTBOROUGH MA 01581
(508) 752-2480
CARE MANAGEMENT
SERVICES
(866) 325-1550
(508) 752-2480
ADVENTIST HEALTH SYSTEM / WEST- ADVENTIST HEALTH SYSTEM WEST
CORPORATE OFFICE
PO Box 619031
Affiliated With: ADVENTIST HEALTH
ROSEVILLE CA 95661-9002
SYSTEM/WEST
ADVENTIST HEALTH SYSTEM WEST CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-7
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PAYOR NAME
CLAIMS SUBMISSION
ADVENTIST RISK MANAGEMENT, INC. ADVENTIST RISK MANAGEMENT,
INC.
Affiliated With: ADVENTIST RISK
MANAGEMENT, INC.
PO Box 4759
Silver Spring MD 20914
COMPENSABILITY
ADVENTIST RISK MANAGEMENT,
INC.
UTILIZATION REVIEW
CHECK BENEFIT CARD
(888) 276-4732
(888) 276-4732
INC.
CHECK BENEFIT CARD
Advocate Case Management
CHECK BENEFIT CARD
809 S Agnew Ste H
Oklahoma City OK 73108
(405) 601-2498
PARAGON BENEFITS, INC.
PO Box 12288
COLUMBUS GA 31917
(703) 279-9218
AMERICAN HEALTH HOLDINGS
(703) 279-9218
AFFILIATED HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ADVENTSOURCE
MANAGEMENT, INC.
INC.
Affiliated With: CompIQ
AEROTRON AIRPOWER
Affiliated With: PARAGON BENEFITS
INC
11291 Pierce St.
RIVERSIDE CA 92515-8007
(703) 279-9218
AFFILIATED HEALTH CARE INC DIRECT PEPM BUSINESS
Affiliated With: AFFILIATED HEALTH
CARE INC
AFFILIATED HEALTHCARE INC TRAVEL PEPM BUSINESS
CARE INC
2 GREENWAY PLAZA STE 502
HOUSTON TX 77046
HOUSTON TX 77046
Network.
Info as of 12/24/2007
Page PIRMI-8
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PAYOR NAME
AFS INSURANCE SERVICES INC
Affiliated With: AFS INSURANCE
SERVICES INC
AFS Insurance Services, Inc.
Affiliated With: AFS Insurance Services,
Inc.
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
AFS Insurance Services, Inc
AFS Insurance Services, Inc
PO Box 10895
Scottsdale AZ 85271-0895
(800) 464-7425
(801) 978-8336
UTILIZATION REVIEW
CHECK BENEFIT CARD
Western Grocers Employee
Benefit Trust
(800) 777-3602
(800) 464-7425
(801) 978-8336
AG SUPPLY
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 422-2026
AGIA INC
Affiliated With: HEALTHCOMP
ADMINISTRATORS INC
CHECK BENEFIT CARD
AGRI-CEL INC
Affiliated With: EMPLOYEE BENEFITS
ADMINISTRATION & MANAGEMENT
EMPLOYEE BENEFIT ADMIN. &
MGMT. (EBA&M)
MGMT. (EBA&M)
PO Box 5079
WESTLAKE VILLAGE CA 91359
(714) 668-8920
8004427247
HINES & ASSOCIATES
(800) 528-2498
(714) 668-8920
AGRI-FAB, INC.
Affiliated With: CONSOCIATE, INC.
CONSOCIATE, INC. C/O CCN
CHECK BENEFIT CARD
PO Box 3000
SCOTTSDALE AZ 85271-3000
Network.
Info as of 12/24/2007
Page PIRMI-9
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PAYOR NAME
CLAIMS SUBMISSION
AGUA CALIENTE BAND OF CAHUILLA PRINCIPAL FINANCIAL GROUP
INDIANS
PO Box 5319
Affiliated With: PRINCIPAL FINANCIAL
TAMPA FL 33675-5319
GROUP
(800) 533-5044
AHI - BUNKIE GENERAL HOSPITAL
CARE INC
AHI - CHEM AIR INC
CARE INC
AHI - CITY OF OPELOUSAS
CARE INC
AHI - DEEP SOUTH
CARE INC
AHI - GRAY AND COMPANY, INC
CARE INC
COMPENSABILITY
PRINCIPAL FINANCIAL GROUP
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 533-5044
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
CHECK BENEFIT CARD
(713) 914-3400
HOUSTON TX 77046
(713) 914-3400
(713) 914-3400
CHECK BENEFIT CARD
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
(713) 914-3400
(713) 914-3400
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
CHECK BENEFIT CARD
(713) 914-3400
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-10
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PAYOR NAME
AHI - LOST HIGHWAY
CARE, INC.
AHI - ST MARTIN PARISH SCHOOL
BOARD
CARE INC
AHI - TEMBEC USA
CARE INC
AHI ABBEVILLE GENERAL HOSPITAL
CARE INC
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
CLAIMS SUBMISSION
UTILIZATION REVIEW
HOUSTON TX 77046
(713) 914-3400
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
CHECK BENEFIT CARD
(713) 914-3400
HOUSTON TX 77042
(713) 914-3400
CHECK BENEFIT CARD
(713) 914-3400
AHI ADAMS DIST CO INC
Affiliated With: AFFILIATED
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI AIR EVAC EMS
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-11
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI ARIZONA TRAILS INC
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI ARKANSAS DENTAL
ASSOCIATION
CARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI ASBESTOS WORKERS LOCAL
NO 53 WELFARE FUND
CARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI BEAUREGARD MEMORIAL
HOSPITAL
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI BOBCAT INC
HEALTHCARE INC
11200 WESTHEIMER
HOUSTON TX 77042
7139143400
7139143400
PAYOR NAME
AHI AMERICAN INSURANCE CO OF
TEXAS
CARE INC
UTILIZATION REVIEW
7139143400
Network.
Info as of 12/24/2007
Page PIRMI-12
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CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI CALVERT OIL CO
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI CAMERON PARISH POLICE JURY
HEALTHCARE, INC
CHECK BENEFIT CARD
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
PAYOR NAME
AHI CALCASIEU PARISH POLICE
JURY AND THE PORT OF ST
CHARLES
HEALTHCARE INC
UTILIZATION REVIEW
(713) 914-3400
AHI CASE ASSOCIATES
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI CHAMBERS LIBERTY COUNTIES
NAVIGATION
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI CHUGACH DEVELOPMENT
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-13
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PAYOR NAME
AHI CITY OF MONROE
CARE INC
CLAIMS SUBMISSION
HOUSTON TX 77046
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(713) 914-3400
(713) 914-3400
AHI CITY OF RUSTON
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI CITY OF WEST MONROE
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI CLETEX TRUCKING
HEALTHCARE, INC.
CHECK BENEFIT CARD
HOUSTON TX 77046
(713) 914-3400
(713) 914-3400
AHI COACH USA
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI COLUMBIA LIGHTHOUSE FOR
THE BLIND
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-14
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CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI CRISTI CLEANING SERVICES
LIMITED
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI DATS
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI DUSTPRO INC
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI ENERGY DYNAMICS INDUSTRIES
INC
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI FCE BENEFIT ADMINISTRATORS
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PAYOR NAME
AHI COMBINED UNDERWRITERS
HEALTHCARE INC
Network.
UTILIZATION REVIEW
Info as of 12/24/2007
Page PIRMI-15
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI FLINT OIL CO INC
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI FRANK W MURPHY
MANUFACTURE
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI FREEDOM LIFE INSURANCE
COMPANY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI GREENS PRESSURE TESTING
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI GROWERS OIL CO
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PAYOR NAME
AHI FEDERAL HOME PRODUCTS
HEALTHCARE INC
UTILIZATION REVIEW
HEALTHCARE INC
Network.
Info as of 12/24/2007
Page PIRMI-16
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CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI GULF COAST ENTERPRISES
MAJOR
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI HARRIS GALVESTON COASTAL
SUBSIDENCE DIST
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI HITNEY SOLAR PRODUCTS
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI INDUSTRIAL INSULATION GROUP
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI INDUSTRIAL SPECIALTY
CONTRACTORS
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PAYOR NAME
AHI GULF COAST ENTERPRISES
HEALTHCARE INC
Network.
UTILIZATION REVIEW
Info as of 12/24/2007
Page PIRMI-17
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CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI JOHN H CARTER CO INC
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI JUDD AUTO SERVICE
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI K TEK LLC
HEALTHCARE
CHECK BENEFIT CARD
HOUSTON TX 77046
(800) 722-3372
PAYOR NAME
AHI INTERMOUNTAIN REFINING
HEALTHCARE INC
UTILIZATION REVIEW
(800) 722-3372
AHI LAMB SERVICES
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI LIFE OF AMERICA
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-18
www.firsthealth.com
PAYOR NAME
AHI LIFESHARE BLOOD CENTER
HEALTHCARE INC
AHI LIVINGSTON PARISH SHERIFF'S
OFFICE
CARE INC
AHI M A PATOUT & SON LTD
HEALTHCARE INC
AHI MATLOCK GAS AND EQUIPMENT
CO
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
HOUSTON TX 77046
(713) 914-3400
(713) 914-3400
CHECK BENEFIT CARD
HOUSTON TX 77046
(713) 914-3400
(713) 914-3400
(713) 914-3400
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
HOUSTON TX 77042
(713) 914-3400
HEALTHCARE INC
AHI MCDONALD'S B. R.
MANAGEMENT CO.
CARE INC
AHI MCNEECE BROS OIL
HEALTHCARE INC
(713) 914-3400
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-19
www.firsthealth.com
PAYOR NAME
AHI METRO AVIATION
CARE INC
CLAIMS SUBMISSION
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
HOUSTON TX 77046
AHI MISC KILLMER
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI MMR GROUP
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI NATCHITOCHES REGIONAL
MEDICAL CENTER
CARE INC
CHECK BENEFIT CARD
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
(713) 914-3400
AHI NATIONAL FOUNDATION LIFE
INSURANCE COMPA
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI NEIL CORPORATION
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-20
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI PARKER OIL CO
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI PORT TERMINAL RAILROAD
ASSOC EBPT
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI RACELAND RAW SUGAR CORP
HEALTHCARE INC
CHECK BENEFIT CARD
HOUSTON TX 77046
(713) 914-3400
PAYOR NAME
AHI OUTDOOR CAP COMPANY INC
HEALTHCARE INC
UTILIZATION REVIEW
(713) 914-3400
AHI REPUBLIC AMERICAN LIFE
INSURANCE CO
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI SCHMELZIA OIL COMPANY
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-21
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI SHANNON HARDWARE COMPANY AFFILIATED HEALTHCARE INC
CARE INC
HOUSTON TX 77042
(713) 914-3400
CHECK BENEFIT CARD
AHI SHAY OIL CO
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI SHEARMAN COMPANY, LLC
HEALTHCARE, INC
CHECK BENEFIT CARD
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
PAYOR NAME
AHI SECURIGUARD
HEALTHCARE INC
AHI SERVICE SOURCE
HEALTHCARE INC
AHI SIA MANAGEMENT
HEALTHCARE INC
UTILIZATION REVIEW
(713) 914-3400
(713) 914-3400
HOUSTON TX 77046
(713) 914-3400
CHECK BENEFIT CARD
(713) 914-3400
Network.
Info as of 12/24/2007
Page PIRMI-22
www.firsthealth.com
PAYOR NAME
AHI ST JAMES PARISH SCHOOL
BOARD
CARE INC
AHI STAR SERVICES
CARE INC
AHI STEIN LLC
CARE INC
AHI STERLING SUGARS INC
Affiliated With: AFFILIATE
HEALTHCARE INC
CLAIMS SUBMISSION
COMPENSABILITY
HOUSTON TX 77046
UTILIZATION REVIEW
(713) 914-3400
(713) 914-3400
HOUSTON TX 77046
(713) 914-3400
CHECK BENEFIT CARD
(713) 914-3400
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
CHECK BENEFIT CARD
(713) 914-3400
LIFEWISE HEALTH PLAN OF
OREGON
2 GREENWAY STE 502
HOUSTON TX 77046
CHECK BENEFIT CARD
(713) 914-3400
(713) 914-3400
AHI STULLER INC
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI SUN WEST CONTAINER CO
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-23
www.firsthealth.com
PAYOR NAME
AHI SUNBELT INDUSTRIES
HEALTHCARE INC
AHI THE NEUROMEDICAL CENTER
INC
HEALTHCARE INC
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
(713) 914-3400
AHI TRIPLEX INC
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI VERNON PARISH POLICE JURY
CARE INC
CHECK BENEFIT CARD
HOUSTON TX 77042
(713) 914-3400
(713) 914-3400
AHI VOCATIONAL GUIDANCE
SERVICES
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI VOCATIONAL TRAINING
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-24
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI WILL STAFF WORLDWIDE INC
HEALTHCARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AHI-ABELL CORPORATION
CARE INC
CHECK BENEFIT CARD
AHI-AMITE FOUNDRY & MACHINE INC
CARE INC
CHECK BENEFIT CARD
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
PAYOR NAME
AHI WEST CALCASIEU CAMERON
HOSPITAL
HEALTHCARE INC
UTILIZATION REVIEW
2 GREENWAY STE 502
HOUSTON TX 77046
(713) 914-3400
AIG Claim Services Inc
Affiliated With: Genex Services, Inc.
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
AIG Claims Services
Affiliated With: AIG Claims Services
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Network.
Info as of 12/24/2007
Page PIRMI-25
www.firsthealth.com
PAYOR NAME
Air Force The
AIR TERMINAL INC
Affiliated With: QUALIFIED BENEFIT
SERVICES
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
COMPENSABILITY
CONTACT EMPLOYER
UTILIZATION REVIEW
CONTACT EMPLOYER
QUALIFIED BENEFIT SERVICES LLC
QUALIFIED BENEFIT SERVICES LLC UM NOT APPLICABLE
PO Box 5000
SPRINGVILLE UT 84663
(800) 853-3234
(800) 853-3234
DAN R. WAGNON & ASSOCIATES,
INC.
DAN R. WAGNON &
ASSOCIATES, INC.
PREFERRED BENEFIT
ADMINISTRATORS INC
PREFERRED BENEFIT
ADMINISTRATORS INC
HINES AND ASSOCIATES
(800) 866-0105
PO Box 916188
LONGWOOD FL 32791-6188
(407) 786-2777
AK-CHIN INDIAN COMMUNITY/FARMS
Affiliated With: DAN R. WAGNON &
ASSOCIATES, INC.
INC.
AKIMEKA, LLC
Affiliated With: PREFERRED BENEFIT
3825 N. 24th St.
PHOENIX AZ 85016
(407) 786-2777
AL TYLER & SONS, INC.
Affiliated With: MEDICAL CLAIMS
SERVICE, INC.
ALAMEDA HOSPITAL
Affiliated With: HEALTHCOMP TPA
MEDICAL CLAIMS SERVICES
MEDICAL CLAIMS SERVICES
ONE WALL ST STE 2A
RAVENSWOOD WV 26164
8882250522
INTRACORP
(972) 302-2700
(800) 557-1755
HEALTHCOMP
HEALTHCOMP
PO Box 45018
Fresno CA 93718
(800) 442-7247
HEALTHCOMP
(800) 755-7247
(800) 442-7247
Network.
Info as of 12/24/2007
Page PIRMI-26
www.firsthealth.com
PAYOR NAME
* Alamo Cement (TRAVEL)
Affiliated With: GROUP & PENSION
ADMINISTRATORS
CLAIMS SUBMISSION
GROUP & PENSION
ADMINISTRATORS
12770 MERIT DR STE 200
DALLAS TX 75251
COMPENSABILITY
GROUP & PENSION
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 827-7223
(800) 827-7223
ALAMO NAVAJO SCHOOL BOARD
Affiliated With: SRT
SRT ADMINISTRATORS, INC.
CHECK BENEFIT CARD
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
ALBANY (STRATTON) VA MEDICAL
CENTER 3520
Affiliated With: HEALTH NET FEDERAL
SERVICES
CENTER
Attn: FEE BASIS 136E
113 HOLLAND AVE
ALBANY NY 12208
CENTER
CHECK BENEFIT CARD
ALBANY COUNTY SCHOOL DISTRICT
1
Affiliated With: MBA OF
WYOMING/MERRILL BOSTROM
ASSOCIATES
MBA OF WYOMING C/O CCN
ALBANY STATE UNIV AIH0057887
CORP #14005
CHECK BENEFIT CARD
PO Box 2271
Florence SC 29503
(843) 622-6001
* Albany
Affiliated With: New York State
Insurance Fund
PO Box 25160
PO Box 3000
SCOTTSDALE AZ 85271
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-27
www.firsthealth.com
PAYOR NAME
ALBANY STATE UNIV AIH0058897
CORP #14005
ALBANY STATE UNIVERSITY
UNDERGRAD MANDATORY
CORP
CLAIMS SUBMISSION
PO Box 2271
Florence SC 29503
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
(843) 622-6001
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
ALBUQUERQUE VAMC 3170
SERVICES
ALBUQUERQUE VAMC
Attn: FMS-04
1501 SAN PEDRO SE
ALBUQUERQUE NM 87108
ALBUQUERQUE VAMC
CHECK BENEFIT CARD
ALDEN SHOE
Affiliated With: NORTH AMERICAN
ADMINISTRATORS - NY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ALEUT CORPORATION
Affiliated With: RISK AND BENEFIT
MANAGEMENT SERVICES, LLC
RBMS, LLC
RBMS, LLC
510 L STREET, STE 650
ANCHORAGE AK 99501
(907) 561-3740
MRC
(509) 328-9700
ALEUTIAN SPRAY FISHERIES
Affiliated With: TRUSTEED PLANS
SERVICE CORPORATION
(907) 561-3740
TRUSTEED PLANS SERVICE GROUP
PO Box 1894
TACOMA WA 98406-1705
TRUSTEED PLANS SERVICE GROUP QUALIS
(800) 783-8606
(800) 345-8563
(800) 426-9786
Network.
Info as of 12/24/2007
Page PIRMI-28
www.firsthealth.com
PAYOR NAME
ALEXANDRIA MOULDING INC
Affiliated With: MERCER
ADMINISTRATION
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UTILIZATION REVIEW
ALEXANDRIA VAMC 3102
SERVICES
ALEXANDRIA VAMC
Attn: FEE BASIS - BLDG 5, Rm 225
SHREVEPORT HWY
ALEXANDRIA LA 71306
ALEXANDRIA VAMC
CHECK BENEFIT CARD
ALICE PECK DAY HEALTH SYSTEMS
JMS
(EBPA)
EBPA
EBPA
CHECK BENEFIT CARD
PO Box 2365
(802) 846-8060
(802) 846-8060
ALICO INC
Affiliated With: SELF INSURED PLANS
LLC
Plan Type: Auto
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ALL AMERICAN BOTTLING CO
Affiliated With: THE KEMPTON GROUP
INC
KEMPTON GROUP
ADMINISTRATORS INC
KEMPTON GROUP
ADMINISTRATORS INC
QUANTUM CARE
(866) 412-8252
PO Box 54889
OKLAHOMA CITY OK 73154
(405) 521-1711
(405) 521-1711
* ALL STAR GAS
Affiliated With: ULTRABENEFITS, INC.
ULTRABENEFITS INC
ULTRABENEFITS INC
PO Box 763
(866) 858-7223
CHECK BENEFIT CARD
(508) 438-0007
Network.
Info as of 12/24/2007
Page PIRMI-29
www.firsthealth.com
PAYOR NAME
ALL TECH INSPECTIONS, INC.
TRAVEL
ADMINISTRATORS
ALLEN SAMUELS AUTO GROUP
ADMINISTRATORS
CLAIMS SUBMISSION
GROUP & PENSION
ADMINISTRATORS
DALLAS TX 75251
COMPENSABILITY
GROUP & PENSION
ADMINISTRATORS
UTILIZATION REVIEW
HEALTH WATCH
(972) 238-7900
(800) 827-7223
(800) 827-7223
GROUP & PENSION
ADMINISTRATORS INC
GROUP & PENSION
ADMINISTRATORS INC
DALLAS TX 75251
(800) 827-7223
HEALTH WATCH
(972) 238-7900
(972) 238-7900
ALLENS, INC
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
3121 QUAIL SPRINGS PKWY
(800) 825-3540
MUTUAL ASSURANCE
ADVANTAGE
(800) 825-3540
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 825-3540
ALLIED HOLDING INC
Affiliated With: MIDWEST SECURITY
ADMINISTRATORS INC
CHECK BENEFIT CARD
ALLIED NATIONAL INC
Affiliated With: ALLIED NATIONAL INC
GLOBALCARE, INC.
ALLIED NATIONAL
6875 SHILOH RD E
ALPHARETTA GA 30005
(800) 825-7531
6087838700
CHECK BENEFIT CARD
(800) 825-7531
ALLSTATE POWER VAC
Affiliated With: BENEFIT CONCEPTS
INC
BENEFIT CONCEPTS, INC.
1021 W 8TH AVE
KING OF PRUSSIA PA 19406
(610) 491-4992
(215) 773-2023
(610) 491-4992
Network.
Info as of 12/24/2007
Page PIRMI-30
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
ALLTRADE, INC.
AFFORDABLE BENEFIT
Affiliated With: AFFORDABLE BENEFIT ADMINISTRATORS, INC.
ADMINISTRATORS, INC. (ABA)
PO Box 10787
BURBANK CA 91510
Alpha Review Corporation
Affiliated With: Alpha Review Corporation 1807 Diehl Rd
Naperville IL 60563
COMPENSABILITY
AFFORDABLE BENEFIT
(630) 305-8108
UTILIZATION REVIEW
AFFORDABLE BENEFIT
(630) 305-8108
(630) 305-8108
Alpha Review Corporation Auto
Affiliated With: Alpha Review Corporation 1807 Diehl Rd
Plan Type: Auto
Naperville IL 60563
(630) 305-8108
(630) 305-8108
(630) 305-8108
ALPINE RESOURCES GROUP INC
Affiliated With: REGIONAL CARE INC
19254
ALSCO
Affiliated With: AMERIBEN SOLUTIONS
REGIONAL CARE INC
REGIONAL CARE INC
905 W 27th St
Scottsbluff NE 69361
(308) 635-2260
HINES ASSOCIATES
(308) 635-2260
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
CHECK BENEFIT CARD
PO Box 7186
BOISE ID 83707
(800) 953-1801
(308) 635-2260
(800) 953-1801
ALTA BATES SUMMIT MEDICAL
CENTER
Affiliated With: BENEFIT AND RISK
MANAGEMENT SERVICES
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-31
www.firsthealth.com
PAYOR NAME
ALTA HEALTHCARE SYSTEM LLC
Affiliated With: ZENITH
ADMINISTRATORS INC PHOENIX
OFFICE
ALTOM TRANSPORT INC
Affiliated With: BENEFIT
ADMINISTRATIVE SYSTEMS #10329
CLAIMS SUBMISSION
ALTA HEALTHCARE SYSTEMS, LLC
COMPENSABILITY
ALTA HEALTHCARE SYSTEMS, LLC
2001 W. Camelback Rd. #350
PHOENIX AZ 85015
BENEFIT ADMINISTRATIVE
SYSTEMS
SYSTEMS
17475 Jovanna Dr. STE 1B
HOMEWOOD IL 60430
(708) 647-3433
UTILIZATION REVIEW
ALTA HEALTHCARE SYSTEMS,
LLC
CHECK BENEFIT CARD
(708) 647-3433
ALTOONA VAMC 3122
SERVICES
ALTOONA VAMC
Attn: FEE BASIS (14F)
2907 PLEASANT VALLEY BLVD
ALTOONA PA 16602
ALTO-SHAAM INC
Affiliated With: HEALTH DATA
SERVICES
EMPLOYEE BENEFIT CONSULTANTS EMPLOYEE BENEFIT CONSULTANTS CHECK BENEFIT CARD
PO Box 928
(800) 523-5789
FINDLAY OH 45839
ALTOONA VAMC
CHECK BENEFIT CARD
(800) 523-5789
ALUSUISSE COMPOSITES, INC.
ASSOCIATES, INC.
Alutiiq, LLC
Affiliated With: RBMS LLC
RBMS, LLC
RBMS, LLC
ANCHORAGE AK 99501
(907) 561-3740
MEDICAL REHABILITATION
CONSULTANTS
(800) 827-5058
PO Box 111047
MEMPHIS TN 38111
(907) 561-3740
Network.
Info as of 12/24/2007
Page PIRMI-32
www.firsthealth.com
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
PAYOR NAME
CLAIMS SUBMISSION
ALVERNO CLINICAL LABORATORIES, CHECK BENEFIT CARD
INC.
GROUP
ALVERNO INFORMATION SERVICES
GROUP
UTILIZATION REVIEW
(800) 533-5044
ALVORD UNIFIED SCHOOL DISTRICT
Affiliated With: ALVORD UNIFIED
SCHOOL DISTRICT
RIVERSIDE FOUNDATION FOR
MEDICAL CARE
Amalgamated Clothing Fund
Affiliated With: Amalgamated Life
Insurance Co.
Amalgamated Clothing Fund
MEDICAL CARE
MEDICAL CARE
Amalgamated Life Insurance Co. Clothing Fund
Amalgamated Life Insurance
Co. - Clothing Fund
(800) 332-5426
3993 Jurupa
RIVERSIDE CA 92506
PO Box 11008
ECS Payor ID 13550
(212) 539-5105
(212) 539-5105
Amalgamated Cotton Fund
Insurance Co.
Amalgamated Cotton Fund
PO Box 11007
ECS Payor ID 13550
Amalgamated Life Insurance Co. Cotton Fund
(212) 539-5100
Amalgamated Life Insurance
Co. - Cotton Fund
(800) 332-5426
(212) 539-5100
Amalgamated Industrial Service
Workers Benefit Fund
Insurance Co.
Amalgamated Industrial Service
Workers Benefit Fund
PO Box 8507
ECS Payor ID 13550
ALICO
(212) 539-5112
ALICO
(800) 332-5426
(212) 539-5112
Network.
Info as of 12/24/2007
Page PIRMI-33
www.firsthealth.com
PAYOR NAME
Amalgamated Retail Fund
Insurance Co.
CLAIMS SUBMISSION
99 University Pl
New York NY 10003
ECS Payor ID 13550
COMPENSABILITY
Amalgamated Life Insurance Co.
(800) 543-4723
UTILIZATION REVIEW
(800) 332-5426
(800) 543-4723
AMALGAMATED RETIREE HEALTH
AND WELFARE TRUST
SOLUTIONS LLC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ADVANCED BENEFITS
SOLUTIONS
AMARILLO VAMC 3171
SERVICES
AMARILLO VAMC
Attn: FEE 136
6010 AMARILLO BLVD WEST
AMARILLO TX 79106
AMARILLO VAMC
CHECK BENEFIT CARD
AMBEC
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
(800) 422-2026
AMC PPO FOR TCGH-BASED
EMPLOYEES
SYSTEMS / WEST
American Administrative Group (AAG)
Group
ADVENTIST HEALTH
SYSTEMS/WEST
ADVENTIST HEALTH
SYSTEMS/WEST
2100 DOUGLAS
ROSEVILLE CA 95661
(800) 441-2524
UM NOT APPLICABLE
(800) 441-2524
PO Box 34297
San Antonio TX 78265
ECS Payor ID 37283
(800) 877-7474
First Health
(800) 346-3220
(800) 877-7474
Network.
Info as of 12/24/2007
Page PIRMI-34
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
American Alternative Insurance Company CONTACT EMPLOYER
Attn:
AMERICAN ASPHALT & GRADING
COMPANY
AMERICAN ASPHALT & GRADING
COMPANY TRAVEL
American Baptist
Affiliated With: International Medical
Group, Inc.
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
UTILIZATION REVIEW
CONTACT EMPLOYER
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AMERICAN COMMUNITY MUTUAL
INSURANCE
INSURANCE
CHECK BENEFIT CARD
39201 Seven Mile Rd
Livonia MI 48152
(734) 591-4695
International Medical Group, Inc.
407 N Fulton St
Indianapolis IN 46202-3684
(317) 655-4500 Outside US
(800) 628-4664 Inside US
AMERICAN COMMUNITY - JMS
CHECK BENEFIT CARD
Affiliated With: AMERICAN COMMUNITY
INSURANCE COMPANY
COMMUNITY MUTUAL INSURANCE
COMPANY
COMPENSABILITY
CONTACT EMPLOYER
(734) 591-4695
Network.
Info as of 12/24/2007
Page PIRMI-35
www.firsthealth.com
PAYOR NAME
AMERICAN DEHYDRATED FOODS,
INC.
Affiliated With: THE EPOCH GROUP,
L.C.
AMERICAN EDUCATION CENTERS
Affiliated With: PERSONAL
INSURANCE ADMINISTRATORS
CLAIMS SUBMISSION
THE EPOCH GROUP
COMPENSABILITY
EPOCH GROUP LC THE
UTILIZATION REVIEW
CHECK BENEFIT CARD
PO Box 12170
OVERLAND PARK KS 66282
PERSONAL INSURANCE
ADMINISTRATORS
PERSONAL INSURANCE
ADMINISTRATORS
30401 Agoura Rd #250
Agoura Hills CA 91376
(800) 468-4343
CHECK BENEFIT CARD
(800) 468-4343
AMERICAN EMPLOYERS BENEFIT
TRUST
MANAGEMENT SERVICES, INC.
EMPLOYEE BENEFIT MANAGEMENT
SERVICES, INC.
EMPLOYEE BENEFIT MANAGEMENT CHECK BENEFIT CARD
SERVICES, INC.
PO Box 21367
BILLINGS MT 59104-1367
8007773575
8007773575
AMERICAN EMPLOYMENT GROUP
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AMERICAN FARMERS AND
RANCHERS MUTUAL INSURANCE
COMPANY
Affiliated With: C L FRATES &
COMPANY
C.L. FRATES AND COMPANY
CHECK BENEFIT CARD
PO Box 26967
OKLAHOMA CITY OK 73126-0967
(405) 290-5696
AMERICAN GREETINGS
Affiliated With: HEALTHSCOPE
BENEFITS, INC
(405) 290-5696
HEALTHSCOPE BENEFITS INC
27 CORPORATE HILL DR
LITTLE ROCK AR 72205
(866) 885-4944
(501) 218-7691
(800) 560-4664
Network.
Info as of 12/24/2007
Page PIRMI-36
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
AMERICAN HEALTH CENTERS
WAUSAU BENEFITS, INC.
AFFILIATED COMPANIES
Attn: LeAnn Fichtner
Affiliated With: WAUSAU BENEFITS INC PO Box 8046
WAUSAU WI 54401-8046
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(715) 841-7802
(715) 841-7802
AMERICAN HEALTHCARE ALLIANCE
HEALTHCARE ALLIANCE
AMERICAN HEALTHCARE ALLIANCE OUT OF AREA
HEALTHCARE ALLIANCE 13780
AMERICAN MARITIME OFFICERS
HEALTHCARE ALLIANCE
AMERICAN HEALTHCARE ALLIANCE CHECK BENEFIT CARD
PO Box 8530
KANSAS CITY MO 64114-0530
(800) 870-6252
(800) 870-6252
AMERICAN HEALTHCARE ALLIANCE CHECK BENEFIT CARD
PO Box 8530
KANSAS CITY MO 64114-0530
(800) 870-6252
(800) 870-6252
AMO MEDICAL PLAN
AMO MEDICAL PLAN
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 35
Dania FL 33004
(800) 348-6515
AMERICAN MISSIONARY
FELLOWSHIP
Affiliated With: BROKERAGE
CONCEPTS BENEFIT CONCEPTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AMERICAN REFRIGERATION
SUPPLIES INC
SOLUTIONS
ADVANCED BENEFITS SOLUTIONS,
INC.
ADVANCED BENEFITS SOLUTIONS, ARIZONA FOUNDATION FOR
MEDICAL CARE
INC.
(602)
417-2337
8884191094
PO Box 71490
PHOENIX AZ 85050
8884191094
Network.
Info as of 12/24/2007
Page PIRMI-37
www.firsthealth.com
PAYOR NAME
AMERICAN REPUBLIC INDIVIDUALS
Affiliated With: AMERICAN REPUBLIC
INSURANCE COMPANY
CLAIMS SUBMISSION
AMERICAN REPUBLIC INSURANCE
COMPANY
PO Box 2975
CLINTON IA 52733
COMPENSABILITY
AMERICAN REPUBLIC INSURANCE
COMPANY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 247-2190
(800) 247-2190
American Republic Insurance Company
Affiliated With: American Republic
Insurance Company
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AMERICAN SEAFOODS COMPANY
Affiliated With: HEALTHCARE
MANAGEMENT ADMINISTRATORS
INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AMERICAN SECURITY LIFE
INSURANCE COMPANY
INTERNATIONAL MANAGED CARE
SERVICES C/O CCN
SERVICES C/O CCN
CHECK BENEFIT CARD
Affiliated With: INTERNATIONAL
MANAGED CARE SERVICES
PO Box 5190
TAMPA FL 33675-5190
AMERICAN SENTINEL SPORTS &
ATHLETIC SERIES 600
Affiliated With: PREFERRED CARE,
INC.
CHECK BENEFIT CARD
TREVOSE PA 19053
(800) 222-3085
AMERICAN SENTINEL SPORTS &
ATHLETIC SERIES 800
Affiliated With: PREFERRED CARE,
INC.
(800) 222-3085
TREVOSE PA 19053
(800) 222-3085
CHECK BENEFIT CARD
(800) 222-3085
Network.
Info as of 12/24/2007
Page PIRMI-38
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
AMERICAN SERVICES TECHNOLOGY FISERV HEALTH TENNESSEE
Affiliated With: CAROLINA BENEFIT
PO Box 530
ADMINISTRATORS
PUEBLO CO 81002-0530
(800) 255-8109
AMERICAN TRUETSCHLER
Affiliated With: JSL ADMINISTRATORS
INC
AMERICAN TRUETZSCHLER
INC
COMPENSABILITY
FISERV HEALTH TENNESSEE
(800) 255-8109
JSL ADMINISTRATORS, INC.
201 HAY STREET, STE 302
FAYETTEVILLE NC 28301
(910) 480-3100
UTILIZATION REVIEW
INTRACORP
(800) 866-8899
DOCTORS DIRECT
HEALTHCARE
(910) 485-0510
(910) 480-3100
(910) 480-3100
MEDCOST
(800) 443-9178
(910) 480-3100
AMERICAN TRUST ADMINISTRATORS
Affiliated With: AMERICAN TRUST
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
AMERICAN WEST DEVELOPMENT
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
American Youth Hostels
Affiliated With: Benesight
Benesight
Benesight
PO Box 360
Pueblo CO 81002-0360
(800) 464-5488
CHECK BENEFIT CARD
(407) 661-4242
Network.
Info as of 12/24/2007
Page PIRMI-39
www.firsthealth.com
PAYOR NAME
AMERIHEALTH ADMINISTRATORS
Affiliated With: AMERIHEALTH
ADMINISTRATORS
CLAIMS SUBMISSION
C/O CCN
COMPENSABILITY
C/O CCN
UTILIZATION REVIEW
CHECK BENEFIT CARD
PO Box 5190
TAMPA FL 33675-5190
AMERIMAX FABRICATED PRODUCTS WAUSAU BENEFITS, INC.
Affiliated With: WAUSAU BENEFITS INC Attn: LeAnn Fichtner
PO Box 8046
CHECK BENEFIT CARD
(715) 841-7802
(715) 841-7802
AMERIRESOURCE GROUP
Affiliated With: EQUITABLE PLAN
SERVICES
EQUITABLE PLAN SERVICES
PO Box 720460
(405) 755-2929
CHECK BENEFIT CARD
(405) 755-2929
AMERISURE
Affiliated With: SOLUTIONS4
Solutions4
AMERITEC CORP.
ADMINISTRATION & MGMT. (EBA&M)
CDN
AMF
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
CDN
HINES & ASSOCIATES
(800) 528-2498
CONTACT EMPLOYER
CONTACT EMPLOYER
701 TECHNOLOGY DR STE 201
CANONSBURG PA 15317
PO Box 10999
SCOTTSDALE AZ 85271
Network.
Info as of 12/24/2007
Page PIRMI-40
www.firsthealth.com
PAYOR NAME
AMG INC
Affiliated With: BUSINESS
ADMINISTRATORS AND
CONSULTANTS
AMGRAPH PACKAGING
Affiliated With: TR PAUL GROUP
SERVICES INC
AMHERST COLLEGE
Affiliated With: PIONEER
MANAGEMENT SYSTEMS
AMOSKEAG BEVERAGES, INC
Affiliated With: HEALTH PLANS INC
CLAIMS SUBMISSION
BUSINESS ADMINISTRATORS &
CONSULTANTS INC
6331 E LIVINGSTON AVE
REYNOLDSBURG OH 43068
COMPENSABILITY
CONSULTANTS INC
UTILIZATION REVIEW
BAC
(801) 954-8010
(614) 863-8780
(614) 863-8780
T R PAUL INC.
T R PAUL INC.
PO Box 5508
NEWTOWN CT 06470
7139143400
HINES & ASSOCIATES
(727) 530-3444
PIONEER MANAGEMENT SYSTEMS
CHECK BENEFIT CARD
123 INTERSTATE DR
W SPRINGFIELD MA 01090
(877) 868-9060
(800) 678-8161
(877) 868-9060
HEALTH PLAN INC
HEALTH PLAN INC
1500 WEST PARK DR STE 330
(508) 752-2480
CMS
(866) 325-1550
(508) 752-2480
AmTrust
Affiliated With: FairPay Solutions
FairPay Solutions
Attn: Jon Peebles
14295 Midway Rd Ste 300
Addison TX 75001
FairPay Solutions
(972) 715-8000
FairPay Solutions
(972) 715-8000
AMX INTERNATIONAL INC
Affiliated With: SMITH
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-41
www.firsthealth.com
PAYOR NAME
AN DERINGER INC WRAP JMS
(EBPA)
CLAIMS SUBMISSION
COMPREHENSIVE BENEFITS
ADMINISTRATOR INC
PO Box 2365
COMPENSABILITY
ADMINISTRATOR INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 525-8788
(802) 846-8060
ANA MARIA COLLEGE SPORTS
CONCEPTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ANCHOR CAPITAL
ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ANCHOR INDUSTRIES
Affiliated With: MERITIAN HEALTH
MERITAIN HEALTH
MERITAIN HEALTH
CHECK BENEFIT CARD
111 SE THIRD ST STE 404
EVANSVILLE IN 47708
(812) 455-1938
(812) 455-1938
ANDOVER NEWTON THEOLOGICAL
SCHOOL
Affiliated With: UnitedHealthcare
StudentResources #11689
ANGELO STATE UNIVERSITY
MANAGEMENT
STUDENT RESOURCES
STUDENT RESOURCES
2301 W. PLANO PKWY #300
PLANO TX 75075
(800) 237-0903 Ext 6352
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
TRUE CHOICE
TRUE CHOICE
PO Box 700307
DALLAS TX 75370
(800) 251-9665
UM NOT APPLICABLE
(800) 251-9665
Network.
Info as of 12/24/2007
Page PIRMI-42
www.firsthealth.com
PAYOR NAME
ANGELS BASEBALL
SOLUTIONS LLC
CLAIMS SUBMISSION
ADVANCED BENEFIT SOLUTIONS
LLC
PO Box 71490
PHOENIX AZ 85050
COMPENSABILITY
LLC
UTILIZATION REVIEW
(888) 419-1094
ARIZONA FOUNDATION FOR
MEDICAL CARE
(602) 417-2337
(888) 419-1094
ANN ARBOR VA MEDICAL CENTER
3152
SERVICES
Attn: FEE BASIS CHIEF RESOURCE
OFFICER (20)
2215 FULLER
ANN ARBOR MI 48105
CHECK BENEFIT CARD
ANNA MARIA COLLEGE
MANAGEMENT SYSTEMS
INC
INC
330 WHITNEY AVE
HOLYOKE MA 01041
8004234586
PIONEER MANAGEMENT
SYSTEMS INC
8004234586
8004234586
ANNIE E CASEY FOUNDATION, THE
ADMINISTRATORS - NY
NORTH AMERICAN
ADMINISTRATORS-NY
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 9501
AMHERST NY 14226
(800) 828-6922
NORTH AMERICAN
ADMINISTRATORS-NY
(800) 828-6922
(800) 828-6922
ANRITSU COMPANY
Affiliated With: BENESIGHT INC
BENESIGHT INC
BENESIGHT INC
PO Box 399
PUEBLO CO 81002
(888) 339-7280
VALUECHECK
(214) 920-9076
(888) 339-7280
ANTELOPE VALLEY UNION HIGH
Affiliated With: K-12 STUDENT
INSURANCE, A DIVISION OF UICI
STUDENT INSURANCE A DIVISION
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
Network.
Info as of 12/24/2007
Page PIRMI-43
www.firsthealth.com
PAYOR NAME
APACHE CORPORATION
Affiliated With: BENEFIT PLANNERS
LTD
APA-THE ENGINEERED WOOD
ASSOCIATION
SERVICE CORPORATION
APCO EQUIPMENT
CLAIMS SUBMISSION
CHECK BENEFIT CARD
PO Box 1894
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
TRUSTEED PLANS SERVICE GROUP AMERICAN HEALTH HOLDING
(888) 877-7994
(800) 426-9786
(800) 426-9786
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
APEA AFT HEALTH & WELFARE
TRUST
Affiliated With: RBMS, LLC
APLICARE, INC.
Affiliated With: T.R. PAUL, INC.
RBMS, LLC
RBMS, LLC
ANCHORAGE AK 99501
(907) 561-3740
MEDICAL REHABILITATION
CONSULTANTS
(800) 827-5058
(907) 561-3740
T R PAUL INC.
T R PAUL INC.
PO Box 5508
NEWTOWN CT 06470-5508
(800) 678-8161 Ext 239
CHECK BENEFIT CARD
(800) 678-8161 Ext 239
A-PLUS BENEFITS, INC.
Affiliated With: EVEREST
EVEREST ADMINISTRATORS, INC.
C/O CCN
C/O CCN
CHECK BENEFIT CARD
PO Box 3000
Network.
Info as of 12/24/2007
Page PIRMI-44
www.firsthealth.com
PAYOR NAME
APPALACHIAN BENEFIT
ADMINSTRATORS
CLAIMS SUBMISSION
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
COMPENSABILITY
GLOBALCARE, INC.
UTILIZATION REVIEW
8008601111
MedWatch
(800) 432-8421
MBA
MBA
6783411722
APPLE STEEL RULE DIE
MBA
PO Box 909991
MILWAUKEE WI 53209
APPLETON MCGILL ELECTRIC
SWITCH
Affiliated With: MCGILL ELECTRIC
SWITCH PRODUCT GROUP
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Applied Underwriters
Affiliated With: Applied Underwriters
PO Box 3804
Omaha NE 68103
(402) 827-3424
(402) 827-3424
THE LOOMIS COMPANY
CHECK BENEFIT CARD
(800) 293-3131
ARAMARK
THE LOOMIS COMPANY
Affiliated With: THE LOOMIS COMPANY 850 N PARK RD
WYOMISSING PA 19610
(800) 782-0392
(800) 782-0392
ARAZ
Affiliated With: AMERICAS TPA
America's TPA
America's TPA
PO Box 398220
Bloomington MN 55439
(866) 478-6268
CHECK BENEFIT CARD
(952) 896-1255
ARC IMPERIAL VALLEY
ADMINISTRATION & MGMT (EBA&M)
MGMT. (EBA&M)
MGMT. (EBA&M)
PO Box 5079
(805) 497-4581
HINES & ASSOCIATES
(800) 528-2498
(805) 497-4581
Network.
Info as of 12/24/2007
Page PIRMI-45
www.firsthealth.com
PAYOR NAME
ARCA XYTEC SYSTEMS INC
SERVICE CORPORATION
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
8004269786
ARCO INC
Affiliated With: MANAGED BENEFITS
ADMINISTRATOR AND INSURANCE
CONSU
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ARDENT HEALTH SERVICES
Affiliated With: HARRINGTON BENEFIT
SERVICES INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ARETE ASSOCIATES
Affiliated With: AFFORDABLE BENEFIT
AFFORDABLE BENEFIT
AFFORDABLE BENEFIT
AFFORDABLE BENEFIT
ARGOSY UNIVERSITY
CONCEPTS INC
ADMINISTRATIVE CONCEPTS, INC.
Attn: Customer Service Dept
CHECK BENEFIT CARD
PO Box 10787
BURBANK CA 91510
(610) 293-9229
997 Old Eagle School Rd. #215
WAYNE PA 19087-1706
(610) 293-9229
ARGOSY UNIVERSITY
PERSONAL INSURANCE
ADMINISTRATORS
PERSONAL INSURANCE
ADMINISTRATORS
(800) 468-4343
CHECK BENEFIT CARD
(800) 468-4343
Network.
Info as of 12/24/2007
Page PIRMI-46
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
ARISTOCRATS TRAVEL PLAN
Affiliated With: SIERRA HEALTH & LIFE PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
ARIZONA STRUCTURE
GLOBALCARE
GLOBALCARE
6875 Shiloh Rd E
ALPHARETTA GA 30005
(678) 341-1811
HINES & ASSOCIATES
(800) 670-7718
ECOM PPO ADVISORS, INC
CHECK BENEFIT CARD
(678) 341-1811
ARKANSAS BEST CORPORATION
Affiliated With: ECOM PPO ADVISORS
INC
Attn: ACCOUNTING
8350 N. CENTRAL EXPWY, STE 600
DALLAS TX 75206
(479) 785-6178
(479) 785-6178
ARKANSAS MILL SUPPLY CO
Affiliated With: ADMINONE
CORPORATION
RESOURCEONE ADMINSTRATORS
Attn: Mary Shepherd
PO Box 489
BUCKEYSTOWN MD 21717
(800) 967-2077
MEDCAREONE CORP
(800) 816-1206
ARM, LTD.
ARM, LTD.
CHECK BENEFIT CARD
10200 S.W. Nimbus Ave. Ste G-5
PORTLAND OR 97223
(503) 968-6831
ADMINONE CORPORATION
(800) 967-2077
ARM, LTD.
Affiliated With: ALTERNATIVE RISK
MANAGEMENT LTD NORTHWEST
ARMFIELD HARRISON & THOMAS
(877) 544-1770
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
(800) 422-2026
Network.
Info as of 12/24/2007
Page PIRMI-47
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
ARMSTRONG ATLANTIC STATE
UNIVERSITY AIH0057907
PO Box 2271
CORP #14005
(843) 622-6001
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
PO Box 2271
CORP #14005
(843) 622-6001
UNIVERSITY UNDERGRAD
Attn: WHIT WALTERS
MANDATORY
419 S. COIT ST
FLORENCE SC 29501
CORP
(800) 222-6491
ARNETT HEALTH PLANS
GLOBALCARE, INC.
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
8008601111
Arnett Health Plans
(765) 448-7725
MGMT. (EBA&M)
MGMT. (EBA&M)
HINES & ASSOCIATES
(800) 528-2498
PO Box 5079
(805) 497-4581
CHECK BENEFIT CARD
(843) 622-6001
UM NOT APPLICABLE
(800) 222-6491
6783411722
ARNOLD MAGNETICS
(805) 497-4581
Arrowpoint Capital Corp.
CHECK BENEFIT CARD
Affiliated With: Royal Indemnity Company
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-48
www.firsthealth.com
PAYOR NAME
ART CENTER COLLEGE OF DESIGN
CLAIMS SUBMISSION
PERSONAL INSURANCE
ADMINISTRATORS, (PIA)
COMPENSABILITY
PERSONAL INSURANCE
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 226-5116
(800) 226-5116
ART INSTITUTE OF AMERICA
PERSONAL INSURANCE
ADMINISTRATORS
PERSONAL INSURANCE
ADMINISTRATORS
(800) 468-4343
CHECK BENEFIT CARD
(800) 468-4343
ART INSTITUTE OF AMERICA
CONCEPTS INC
WAYNE PA 19087-1706
CHECK BENEFIT CARD
(610) 293-9229
(610) 293-9229
ARVEST BANK GROUP INC
MANAGEMENT INC
ASARCO AZ
Affiliated With: MARITAIN HEALTH
BENEFIT MANAGEMENT INC.
PO BOX 3767
BARTLESVILLE OK 74006
(800) 824-5034
CHECK BENEFIT CARD
(800) 824-5034
NORTH AMERICAN
ADMINISTRATORS
Attn: Claims Dept
PO Box 853921
Richardson TX 75085-3921
NORTH AMERICAN
ADMINISTRATORS
(800) 397-2122
NORTH AMERICAN
ADMINISTRATORS
(800) 397-2122
(800) 397-2122
ASH BROKERAGE
ADMINISTRATORS - NEW YORK
NORTH AMERICAN
ADMINISTRATORS-NY
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 730
AMHERST NY 14226
(800) 397-2122
NORTH AMERICAN
ADMINISTRATORS
(800) 828-6922
(800) 397-2122
Network.
Info as of 12/24/2007
Page PIRMI-49
www.firsthealth.com
PAYOR NAME
ASH BROKERAGE CORPORATION
HEALTHCARE ALLIANCE
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UTILIZATION REVIEW
ASHEVILLE VAMC 3134
SERVICES
ASHVILLE VAMC
Attn: FEE BASIS 136
1100 TUNNEL RD
ASHVILLE NC 28805
ASHVILLE VAMC
CHECK BENEFIT CARD
ASHLEY
ASSURECARE
ASSURECARE
LANSING MI 38823
(800) 968-6616
CARELINE
(763) 383-4800
(800) 968-6616
ASIA FOUNDATION
Affiliated With: GALLAGHER BENEFIT
ADMINISTRATORS INC
GALLAGHER BENEFIT
ADMINISTRATORS INC
GALLAGHER BENEFIT
ADMINISTRATORS INC
PO Box 34297
(630) 493-3849
GALLAGHER BENEFIT
ADMINISTRATORS INC
(630) 493-3842
Mountain States Administrative
Services
Services
Hines and Associates
(847) 214-2780
7202 E ROSEWOOD STE 200
TUCSON AZ 85710
(520) 722-7133
(800) 877-7474
ASML
Affiliated With: MOUNTAIN STATES
ADMINISTRATIVE SERVICES
(520) 722-7133
ASMO MANUFACTURING
BENEFITS, INC
(866) 885-4944
(501) 218-7691
(800) 560-4664
Network.
Info as of 12/24/2007
Page PIRMI-50
www.firsthealth.com
PAYOR NAME
ASPEN EDUCATION
LTD
Assemblies of God (AG10000036598)
Group, Inc.
ASSETS, INC
Affiliated With: HEALTH & WELFARE
BENEFIT SYSTEMS
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
407 N Fulton St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
(317) 655-4500 Outside US
(800) 628-4664 Inside US
HEALTH AND WELFARE BENEFIT
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
Associated Food Stores, Inc.
Affiliated With: Associated Food Stores,
Inc.
AFS Insurance
AFS Insurance
1850 W 2100 S
(800) 464-7425
AFS Insurance
(801) 973-4400
(801) 978-8336
(800) 464-7425
(801) 978-8336
ASSOCIATED GENERAL
CONTRACTORS (AGC)
CONSOCIATE, INC.
ASSOCIATED PLAN
ADMINISTRATORS
Affiliated With: GLOBALCARE
CHECK BENEFIT CARD
CONSOCIATE, INC.
CONSOCIATE, INC.
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 1068
DECATUR IL 62521
6783411722
Network.
Info as of 12/24/2007
Page PIRMI-51
www.firsthealth.com
PAYOR NAME
ASSUMPTION COLLEGE SPORTS
CONCEPTS INC
ASSUMPTION GRAIN COOPERATIVE
GRAIN COMPANY
Affiliated With: NORTH AMERICA
ADMINISTRATORS LP TENNESSEE
ASSURANT HEALTH PREFERRED
PLAN
Affiliated With: FORTIS BENEFITS
INSURANCE COMPANY
ASSURECARE
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
NORTH AMERICA
ADMINISTRATORS, L.P.
NORTH AMERICA
MED-CERT
(800) 356-7126
PO Box 1984
NASHVILLE TN 37202
(800) 411-3650
UTILIZATION REVIEW
(800) 411-3650
KEY BENEFIT ADMINISTRATORS
8330 ALLISON POINT TRAIL
INDIANAPOLIS IL 46250
(866) 387-0489
FORTIS BENEFITS
INSURANCE COMPANY
(866) 387-3407
(317) 284-7649
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
(800) 422-2026
ASSURED SOURCE
SERVICE CENTER
ASTELLAS PHARMA
Affiliated With: ASTELLAS PHARMA
ACCOUNT EXECUTIVE
ACCOUNT EXECUTIVE
20 WINTER ST
PEMBROKE MA 02359
(800) 242-4472
GISC OPTIMUM CARE /
AMERICAN HEALTH
(800) 290-4698
(800) 242-4472
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-52
www.firsthealth.com
PAYOR NAME
ASTEN JOHNSON
Affiliated With: PRIMARY PHYSICIAN
CARE INC
ATASCADERO UNIFIED SCHOOL
DISTRICT
* Atascosa County (TRAVEL)
ADMINISTRATORS
CLAIMS SUBMISSION
PPC
PO Box 11088
CHARLOTTE NC 28220
COMPENSABILITY
PPC
(800) 446-5439
UTILIZATION REVIEW
PRIMARY PHYSICIANCARE,
INC.
7045232758
(800) 446-5439
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
DALLAS TX 75251
(800) 827-7223
CHECK BENEFIT CARD
(800) 827-7223
ATCO RUBBER PRODUCTS INC
ADMINISTRATORS INC
GROUP & PENSION
ADMINISTRATORS INC
GROUP & PENSION
ADMINISTRATORS INC
PO Box 749075
DALLAS TX 75374-9075
(800) 827-7223
GPA/HEALTH WATCH
(972) 587-1402
(972) 587-2311
Athens Administrators
CompIQ Corporation
CompIQ Corporation
35 Tesla Way #100
Irvine CA 92618
(800) 293-3131
CompIQ Corporation
(800) 293-3131
CHECK BENEFIT CARD
PO Box 2271
Florence SC 29503
(843) 622-6001
(800) 293-3131
ATLANTA METRO AIH0057927
CORP #14005
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-53
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
ATLANTA METRO COLLEGE
UNDERGRAD MANDATORY
Attn: WHIT WALTERS
Affiliated With: MAKSIN MANAGEMENT 419 S. COIT ST
CORP
FLORENCE SC 29501
(800) 222-6491
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(800) 222-6491
ATLANTA VAMC 3545
SERVICES
ATLANTA VAMC
Attn: FEE BASIS 508/16
1670 CLAIRMONT RD
DECATUR GA 30033
ATLANTA VAMC
CHECK BENEFIT CARD
ATLANTIC BROADBAND
Affiliated With: INSURANCE
ADMINISTRATOR OF AMERICA, INC.
(IAA)
INSURANCE ADMINISTRATORS OF
AMERICA INC
AMERICA INC
1934 OLNEY AVE STE 200
CHERRY HILL NJ 08003
8885991515
HEALTHCARE STRATEGIES
INC
8885991515
8885991515
Atlantic Charter Insurance Co
Affiliated With: GENEX Services, Inc
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Atlantic Medical Insurance Company LTD
Affiliated With: Colonial Group
International LTD
Atlantic Medical Insurance Company
LTD
Atlantic Medical Insurance Company
LTD
First Health
(800) 423-9130
Atlantic House 2nd Ter and Collins Ave
PO Box SS-5915
Nassau, Bahamas, NP
(242) 326-8191
(242) 326-8191
ATLANTIC MUTUAL
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
Network.
Info as of 12/24/2007
Page PIRMI-54
www.firsthealth.com
PAYOR NAME
ATLANTIC UNION COLLEGE
MANAGEMENT SERVICES
ATLAS AMERICA
Affiliated With: CORESOURCE
CLAIMS SUBMISSION
PO Box 9040
WEST SPRINGFIELD MA 01090
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(413) 539-9900
(413) 539-9900
CORESOURCE
CORESOURCE
PO Box 2920
CLINTON OH 52733-2920
(800) 354-5233
UM NOT APPLICABLE
(800) 354-5233
Attenta
Affiliated With: Attenta
CONTACT EMPLOYER
ATWOOD DISTRIBUTING
MANAGEMENT SERVICES
INSURANCE MANAGEMENT
SERVICES
INSURANCE MANAGEMENT
SERVICES
PO Box 15688
AMARILLO TX 79105
(800) 687-5944
Attenta
(800) 580-1642
Attenta
(800) 580-2273
CHECK BENEFIT CARD
(800) 687-5944
ATWOOD MOBILE PRODUCTS INC
Affiliated With: NGS AMERICAN INC
NGS AMERICAN, INC.
NGS AMERICAN, INC.
PO Box 7676
DETROIT MI 48080
8005211555
UM NOT APPLICABLE
8005211555
AUBURN UNIVERSITY
AUGUSTA - EXTERNAL AFFAIRS 3715
SERVICES
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 767-0700
AUGUSTA - EXTERNAL AFFAIRS
Attn: EXTERNAL AFFAIRS (112E)
950 15TH ST Rm 1D-103
AUGUSTA GA 30901
AUGUSTA - EXTERNAL AFFAIRS
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-55
www.firsthealth.com
COMPENSABILITY
AUGUSTA - FEE BASIS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 2271
Florence SC 29503
(843) 622-6001
PAYOR NAME
CLAIMS SUBMISSION
AUGUSTA - FEE BASIS 3542
AUGUSTA - FEE BASIS
Affiliated With: HEALTH NET FEDERAL Attn: FEE BASIS 116
SERVICES
950 15TH ST
AUGUSTA GA 30901
AUGUSTA STATE UNIV AIH0057947
CORP #14005
AUGUSTA STATE UNIV AIH0057957
CORP #14005
AUGUSTA STATE UNIVERSITY
UNDERGRAD MANDATORY
CORP
UTILIZATION REVIEW
(843) 622-6001
PO Box 2271
Florence SC 29503
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
AUSTIN COLLEGE
MANAGEMENT
AUTOMOBILES OF ITALY INC
ADMINISTRATORS
TRUE CHOICE
TRUE CHOICE
PO Box 700307
DALLAS TX 75370
(800) 251-9665
UM NOT APPLICABLE
(800) 251-9665
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
Network.
Info as of 12/24/2007
Page PIRMI-56
www.firsthealth.com
PAYOR NAME
AVALON BENEFIT SERVICES
BENEFIT CORPORATION NHBC
#12717
AVALON CORRECTIONAL SERVICES
INC
Affiliated With: WATERSTONE
BENEFITS ADMINISTRATORS, INC.
AVALON HEALTHCARE
ADMINISTRATORS
AVALON HEALTHCARE - INSURANCE
COMPANY
Affiliated With: HEALTH NETWORK
AMERICA
CLAIMS SUBMISSION
NHBC
Scottsdale AZ 85260
COMPENSABILITY
NHBC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(888) 621-7900
(888) 621-7900
WATERSTONE BENEFIT
WATERSTONE BENEFIT
4013 NW EXPRESSWAY STE 575
(405) 440-8888
CHECK BENEFIT CARD
(405) 843-9551
(405) 440-8888
SMITH ADMINISTRATORS
3761 S. 700 E.
(801) 261-5511
SERVICE ASSOCIATES
(801) 261-5511
(801) 261-5511
HEALTH NETWORK AMERICA
246 INDUSTRIAL WAY WEST
EATONTOWN NJ 07724
(732) 676-2637
(732) 676-2637
(732) 676-2637
AVANT - INTERNATIONAL EMPLOYEE
BENEFIT SERVICES
Affiliated With: AVANT INTERNATIONAL EMPLOYEE
BENEFIT SERVICES
AVANT-INT'L EMPLOYEE BENEFIT
SERVICES/ALPHA AMERIC
AVANT-INT'L EMPLOYEE BENEFIT
SERVICES/ALPHA AMERIC
AVANT-INT'L EMPLOYEE
BENEFIT SERVICES/ALPHA
AMERIC
AVI RESORT & CASINO
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
700 B Smithridge Dr. #104
RENO NV 89502
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-57
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
AWANA CLUBS INTERNATIONAL, INC ALLIED BENEFIT SYSTEMS, INC
Affiliated With: ALLIED BENEFIT
208 S. LASALLE STREET
SYSTEMS INC
CHICAGO IL 60604
3129068080
AZCONA HARVESTING LLC
Affiliated With: TRANSWESTERN
INSURANCE ADMINISTRATORS INC
COMPENSABILITY
ALLIED BENEFIT SYSTEMS, INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
3129068080
TRANSWESTERN INSURANCE
PO Box 45019
Fresno CA 93718
8002218942
CHECK BENEFIT CARD
8002218942
AZUSA PACIFIC UNIVERSITY
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
BABB, INC
INTRACORP
MGMT. (EBA&M) C/O CCN
EMPLOYEE BENEFIT
ADMINISTRATION & MGMT
CHECK BENEFIT CARD
(800) 786-7930
BABB, INC
BABB, INC
850 RIDGE AVE
PITTSBURGH PA 15212
Refer to Intercorp
(412) 237-2139
BACHEM, INC.
BADEN SPORT
MANAGEMENT ADMINISTRATORS,
INC
HEALTHCARE MANAGEMENT
ADMINISTRATORS INC
ADMINISTRATORS INC
PO Box 85016
Bellevue WA 98015-8516
(800) 869-7093
PO Box 3000
(800) 869-7093
Network.
Info as of 12/24/2007
Page PIRMI-58
www.firsthealth.com
PAYOR NAME
BAINBRIDGE COLLEGE AIH0057967
CORP #14005
BAINBRIDGE COLLEGE UNDERGRAD
MANDATORY
CORP
CLAIMS SUBMISSION
PO Box 2271
Florence SC 29503
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
(843) 622-6001
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
BAKER COMPANY
Affiliated With: PATIENT ADVOCATE
LLC
PATIENT ADVOCATES LLC
Baldwin and Lyons
BALL ENTERPRISES, INC.
ADMINISTRATORS
* Ball Horticultureal
Affiliated With: PROFESSIONAL
CHECK BENEFIT CARD
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
428 E WINCHESTER ST, STE 200
(801) 261-5511
SERVICE ADVOCATES
(877) 261-5511
PO Box 1959
Gray ME 04039
(801) 261-5511
PROFESSIONAL BENEFIT
ADMINISTRATORS
ADMINISTRATORS
900 Jorie Blvd Ste 250
Oakbrook IL 60523
(630) 655-3755
UM NOT APPLICABLE
(630) 655-3755
Network.
Info as of 12/24/2007
Page PIRMI-59
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
BALLY TECHNOLOGY - TRAVEL
Affiliated With: SIERRA HEALTH & LIFE PLAN
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
BANK OF COMMERCE
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8007867930
8007867930
BARBER FOODS
LLC
CHECK BENEFIT CARD
BAREFOOT GOLF RESORT
Affiliated With: CNIC HEALTH
SOLUTIONS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
BARGREEN ELLINGSON INC
SERVICE CORPORATION
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
BARONA BAND OF MISSION INDIANS
Affiliated With: CENBEN USA INC
CENBEN USA
Attn: Melissa Joseph
4079 Executive Pkwy
Westerville OH 43081
CENBEN USA
CHECK BENEFIT CARD
PO Box 1959
Gray ME 04039
(614) 797-5204
(614) 797-5204
BARTLETT-COLLINS
Affiliated With: MEDBEN
WINTERBROOK/CCN
WINTERBROOK/CCN
PO Box 568800
(405) 843-9551 Ext 106
CHECK BENEFIT CARD
(405) 843-9551 Ext 106
Network.
Info as of 12/24/2007
Page PIRMI-60
www.firsthealth.com
PAYOR NAME
BASIC AMERICAN FOODS
CLAIMS SUBMISSION
AMERIBEN SOLUTIONS
COMPENSABILITY
AMERIBEN SOLUTIONS
UTILIZATION REVIEW
(800) 953-1801
AUM
(800) 388-3193
CompIQ Corporation
CompIQ Corporation
CONTACT EMPLOYER
2 South Pointe
Lake Forest CA 92630
(800) 293-3131
PO Box 7186
BOISE ID 83707
(800) 953-1801
Bass and Babb
(800) 293-3131
Bass and Babb Auto
Plan Type: Auto
CompIQ Corporation
CompIQ Corporation
2 South Pointe
(800) 293-3131
CHECK BENEFIT CARD
(800) 293-3131
BATAVIA VAMC 4001
SERVICES
CENTER
113 HOLLAND AVE
ALBANY NY 12208
HEALTH NET FEDERAL SERVICES
Bates College
Affiliated With: CONSOLIDATED
HEALTH PLANS
CONSOLIDATED HEALTH PLANS
195 STAFFORD ST
SPRINGFIELD MA 01104
(800) 633-7867
UM NOT APPLICABLE
(972) 550-2836
UM NOT APPLICABLE
(800) 633-7867
BATH VAMC 4002
SERVICES
CENTER
113 HOLLAND AVE
ALBANY NY 12208
BATTLE CREET VAMC 3153
SERVICES
BATTLE CREEK VAMC
Attn: FEE BASIS (136)
5500 ARMSTRONG RD
BATTLE CREEK MI 49015
BATTLE CREEK VAMC
UM NOT APPLICABLE
(972) 550-2836
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-61
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PAYOR NAME
BAY INDUSTRIES INC
Butler
BAY MEDICAL CENTER
Affiliated With: CADENT
ADMINISTRATORS INC
* Bay Path College
MANAGEMENT SYSTEMS
CLAIMS SUBMISSION
SISCO
PO Box 389
DUBUQUE IA 52004-0389
COMPENSABILITY
SISCO
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 547-4726
(800) 547-4726
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UM NOT APPLICABLE
123 INTERSTATE DR
(413) 534-8658
(413) 534-8658
BAY PINES VA MEDICAL CENTER
3144
Affiliated With: HEALTH NET
FEDERALSERVICES
BAY PINES RD
Attn: FEE BASIS 136A
10000 BAY PINES RD
BAY PINES FL 33744
BAY PINES RD
CHECK BENEFIT CARD
BAYLOR UNIVERSITY
MANAGEMENT
TRUE CHOICE USA
TRUE CHOICE USA
CHECK BENEFIT CARD
PO Box 700307
DALLAS TX 75370
(800) 785-2446
BBP CONCRETES CONSTRUCTION
Affiliated With: ELDORADO CLAIMS
SERVICES, INC.
(800) 785-2446
Zenith Administrators
CHECK BENEFIT CARD
2001 CAMELBACK
PHOENIX AZ 85014
Network.
Info as of 12/24/2007
Page PIRMI-62
www.firsthealth.com
PAYOR NAME
BCLG CORPORATION
SOLUTIONS, INC.
BDS MARKETING, INC.
Affiliated With: WAUSAU BENEFITS
CLAIMS SUBMISSION
ADMINISTRATIVE SOLUTIONS INC
PO Box 2490
ALPHARETTA GA 30023
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(678) 339-0211
(678) 339-0211
PO Box 8046
(715) 841-7802
(800) 808-4424
(715) 841-7802
BEACH MOLD & TOOL
PLANS, INC.
BEACON GROUP
BENEFIT SYSTEMS
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
(800) 832-8212
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
Bear Cat Inc.
Affiliated With: QVI Risk Solutions Inc
ASSURECARE
QVI RISK SOLUTIONS INC
1011 SW EMKAY DR STE 209
BEND OR 97702
(541) 312-8512
CASCADE COMPREHENSIVE
CARE
(541) 883-2947
(541) 312-8512
BEAULIEU OF AMERICA HOLLYTEX
Affiliated With: S AND S HEALTHCARE
STRATEGIES LTD
S AND S HEALTHCARE
STRATEGIES
S AND S HEALTHCARE
STRATEGIES
PO Box 141097
CINCINNATI OH 45250
(800) 717-2872
CHECK BENEFIT CARD
(800) 717-2872
Network.
Info as of 12/24/2007
Page PIRMI-63
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CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
BECHTEL NEVADA
LTD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
BECKER COLLEGE
MANAGEMENT SERVICES
CHECK BENEFIT CARD
PO Box 9040
(413) 539-9900
PAYOR NAME
BEAVER RUN RESORT
SOLUTIONS
BECKER COLLEGE - SPORTS
CONCEPTS INC
BECKETT MEDIA
ADMINISTRATION
BECKLEY SINGLETON TRAVEL
UTILIZATION REVIEW
(413) 539-9900
997 OLD EAGLE SCHOOL
WAYNE PA 19087-1706
(888) 293-9229
CHECK BENEFIT CARD
(888) 293-9229
MERCER ADMINISTRATION
701 Market St Ste 1350
St Louis MO 63101
(314) 982-5622
UM NOT APPLICABLE
(314) 982-5622
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-64
www.firsthealth.com
PAYOR NAME
BECKLEY VAMC 3547
SERVICES
CLAIMS SUBMISSION
BECKLEY VAMC
COMPENSABILITY
BECKLEY VAMC
CHECK BENEFIT CARD
UTILIZATION REVIEW
200 VETERANS AVE
BECKLEY WV 23667
BEDFORD VA MEDICAL CENTER 3111
SERVICES
BEDFORD VA MEDICAL CENTER
Attn: FEE BASIS - (518-136B)
200 SPRINGS RD
BEDFORD MA 01730
BEDFORD VA MEDICAL CENTER
CHECK BENEFIT CARD
BEEHIVE CREDIT UNION
ADMINISTRATORS
(801) 274-8100
CORVEL
(801) 269-8723
(801) 274-8100
Behavior Management
Affiliated With: Rapid City Regional
Hospital DBA Western Health
Western Health
Western Health
529 Kansas City St Ste 200
Rapid City SD 57701
(605) 719-4600 or (888) 3411766
Western Health
(605) 719-4640 or (800) 2290892
BELDEN WIRE AND CABLE
GROUP
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
BELL CARTER FOODS INC
SYSTEMS
(800) 533-5044
PO Box 1147
STOCKTON CA 95201
(209) 474-5647
CHECK BENEFIT CARD
(209) 474-5647
Network.
Info as of 12/24/2007
Page PIRMI-65
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PAYOR NAME
BELLA VISTA VILLAGE
LTD
BELLARMINE UNIVERSITY
CORP
BELMAR INTERNATIONAL
Affiliated With: FISERV HEALTH KANSAS
BELMARK, INC
CONSULTANTS
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 292-5386
MAKSIN MANAGEMENT CORP
2500 McClellan Ave
Pennsauken NJ 08109
(800) 220-1123
UM NOT APPLICABLE
(800) 220-1123
FISERV HEALTH KANSAS
PO Box 520
(800) 235-7160
TRUSTMARK LIFE INSURANCE
CO.
(800) 725-6566
(800) 235-7160
PO Box 928
(800) 558-7798
FINDLAY OH 45839
(800) 558-7798
BENEFIRST LLC
Affiliated With: BENEFIRST LLC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
BENEFIT AND RISK MANAGEMENT
SERVICES WRAP
MANAGEMENT SERVICES
BRMS
BRMS
PO Box 2650
RANCHO CORDOVA CA 98401
(888) 326-2555
BRMS
(800) 368-0767
(888) 326-2555
Network.
Info as of 12/24/2007
Page PIRMI-66
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PAYOR NAME
BENEFIT MANAGEMENT SYSTEMS
BENEFIT PLAN SERVICES INC
BENEFITSOURCE, INC
BENEFIT CORPORATION NHBC
#12717
CLAIMS SUBMISSION
NHBC
Scottsdale AZ 85260
COMPENSABILITY
NHBC
(888) 621-7900
(888) 621-7900
NHBC
NHBC
Scottsdale AZ 85260
(888) 621-7900
CHECK BENEFIT CARD
(888) 621-7900
NHBC
NHBC
Scottsdale AZ 85260
(888) 621-7900
CHECK BENEFIT CARD
(888) 621-7900
BENICORP INSURANCE COMPANY
Benicorp Insurance Company
Affiliated With: BENICORP INSURANCE PO Box 68917
COMPANY
(317) 290-1205
PO Box 68917
(800) 837-1205
Affiliated With: Benicorp Insurance
Company
UTILIZATION REVIEW
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(317) 290-1205
Individualized Care Management
(888) 448-1864
(800) 837-1205
-Network participation is contingent upon
proper member identification. The First
Health® Network Logo must be on the
benefit card.
Benicorp Travel Access
Affiliated With: Benicorp Insurance
Company
PO Box 68917
(800) 837-1205
(888) 448-1864
(800) 837-1205
Network.
Info as of 12/24/2007
Page PIRMI-67
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PAYOR NAME
BENTLY PRESSURIZED BEARING
COMPANY
ADMINISTRATORS INC
BERING SEA ECCOTECH, INC
Affiliated With: ALTERNATIVE RISK
MANAGEMENT LTD NORTHWEST
BERKLEY RISK ADMINISTRATORS
Affiliated With: PREFERREDONE
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
8009607247
ARM, LTD.
ARM, LTD.
10200 S.W. Nimbus Ave. Ste G-5
PORTLAND OR 97223
(877) 544-1770
HINES & ASSOCIATES
(888) 437-9927
(877) 544-1770
PREFERREDONE ADMINISTRATIVE
SERVICES
PO Box 59212
MINNEAPOLIS MN 55459
PREFERREDONE ADMINISTRATIVE PREFERREDONE
SERVICES
(800) 997-1750
(800) 997-1750
(800) 997-1750
BERKSHIRE CORPORATION
SERVICE CENTER INC
CENTER INC
CENTER INC
20 INDUSTRIAL PARK DR
PEMBROKE MA 02359
(800) 242-4472
GISC TOTALCARE
(800) 242-4472
(800) 242-4472
BERLIN-GORHAM OPERATIONS
NORTH AMERICAN
ADMINISTRATORS-NY
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 9501
AMHERST NY 14226
(800) 397-2122
NORTH AMERICAN
ADMINISTRATORS-NY
(800) 397-2122
(800) 397-2122
BERRY HINCKLEY INDUSTRIES
SYSTEMS
Attn: Tish Asuncion
PO Box 692590
STOCKTON CA 95269
(866) 547-1714
DELTA TEAM CARE
3129068080
(866) 547-1714
Network.
Info as of 12/24/2007
Page PIRMI-68
www.firsthealth.com
PAYOR NAME
BEST CHAIRS, INC.
PLANS, INC.
BEST HEALTH PLANS, LLC
Affiliated With: BEST HEALTH PLANS,
LLC
CLAIMS SUBMISSION
LOUISVILLE KY 40223
COMPENSABILITY
UTILIZATION REVIEW
(800) 832-8212
(888) 551-7427
CHECK BENEFIT CARD
BEST LIFE AND HEALTH
CHECK BENEFIT CARD
(800) 832-8212
2505 McCabe Way
IRVINE CA 92614-6243
Affiliated With: BEST LIFE AND HEALTH PO Box 19721
Irvine CA 92623-9721
(800) 433-0088
(800) 433-0088
Best Life and Health Insurance (IAC)
Affiliated With: INSURERS
ADMINISTRATIVE CORP
Insurers Administrative Corp
PO Box 828
Park Ridge IL 60068-0828
(800) 964-4948
Med-Valu
(800) 522-2161
(602) 906-6263
Best Life and Health Insurance
Company
PPC
PPC
PO Box 11088
CHARLOTTE NC 28220
(800) 446-5439
PPC
(704) 523-2758
BEST LIFE AND HEALTH INSURANCE
COMPANY
Affiliated With: BEST LIFE AND
HEALTH INSURANCE COMPANY
Best Life and Health Insurance
Company
BETCO, INC
Affiliated With: PRIMARY PHYSICIAN
CARE
PO Box 19721
IRVINE CA 92713-9721
(800) 446-5439
Network.
Info as of 12/24/2007
Page PIRMI-69
www.firsthealth.com
PAYOR NAME
BETHEL FARMS LTD
Affiliated With: HERITAGE
CONSULTANTS INC
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
9419674139
BETTERAVIA FARMS
ADMINISTRATORS INC
CHECK BENEFIT CARD
BH INC. & A & D HACKING INC.
Affiliated With: MANAGED BENEFIT
ADMINISTRATORS & INSURANCE
MANAGED BENEFITS
ADMINISTRATOR & INSURANCE
CONSULTANTS
MANAGED BENEFITS
CONSULTANTS
PO Box 651109
SALT LAKE CITY UT 84165-1109
(800) 877-3727
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8002666311
CRITIQUE
(800) 666-5551
(800) 877-3727
BIANCHI INTERNATIONAL
Affiliated With: TRIDENT PLAN
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
BICARA, LTD.
EMPLOYEE BENEFIT
BIG HORN COUNTY
ASSOCIATES
MOUNTAIN STATES REVIEW
MBA OF WYOMING
MBA OF WYOMING
PO Box 3000
PO Box 94
WORLAND WY 82401
Network.
Info as of 12/24/2007
Page PIRMI-70
www.firsthealth.com
PAYOR NAME
BIG HORN FEDERAL
ASSOCIATES
CLAIMS SUBMISSION
MBA OF WYOMING
COMPENSABILITY
MBA OF WYOMING
MBA OF WYOMING
UTILIZATION REVIEW
PO Box 98
WORLAND WY 82401
BIG SPRINGS VAMC 3172
SERVICES
BIG SPRING VAMC
Attn: FEE BASIS
300 VETERANS BLVD
BIG SPRING TX 79720
BIG SPRING VAMC
CHECK BENEFIT CARD
BIG TEX TRAILERS PRIMARY
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
HEALTH WATCH
(972) 238-7900
DALLAS TX 75251
(800) 827-7223
(800) 827-7223
BIG TEX TRAILERS TRAVEL
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
DALLAS TX 75251
(800) 827-7223
HEALTH WATCH
(972) 238-7900
(800) 827-7223
BINGHAM EQUIPMENT COMPANY
* Binghampton
Insurance Fund
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8002218942
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
Network.
CONTACT EMPLOYER
Info as of 12/24/2007
Page PIRMI-71
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
BINIONS
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
BIOLA UNIVERSITY
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
(800) 786-7930
BIRMINGHAM VAMC 3538
SERVICES
BIRMINGHAM VAMC
Attn: FEE BASIS - 136E
700 S 19TH ST
BIRMINGHAM AL 35233
BIRMINGHAM VAMC
CHECK BENEFIT CARD
BLACK AND COMPANY
Affiliated With: CONSOCIATE INC
CONSOCIATE, INC.
CONSOCIATE, INC.
PO Box 1068
DECATUR IL 62525
(800) 798-2422
NATIONAL HEALTH SERVICES
(800) 558-4353
CHECK BENEFIT CARD
(800) 798-2422
BLACK HILLS HCS 3710
SERVICES
VA BLACK HILLS HCS (3710)
500 NORTH 5TH STREET, FEE BUS13
HOT SPRINGS SD 57747
(916) 985-1259
Black Hills Workshop and Training
Center Inc
Western Health
Western Health
Rapid City SD 57701
(605) 719-4600 or (888) 3411766
Western Health
(605) 719-4640 or (800) 2290892
(605) 719-4600 or (888) 3411766
Network.
Info as of 12/24/2007
Page PIRMI-72
www.firsthealth.com
PAYOR NAME
BLACK MESA PIPELINE
AMERICA
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
9185867926
BLACKFOOT MEDICAL
ASSOCIATES
MANAGED BENEFITS
CONSULTANTS
CRITIQUE
CHECK BENEFIT CARD
BLACKHAWK CREDIT UNION
ADMINISTRATORS INC.
MIDWEST SECURITY
MIDWEST SECURITY
Q-REVIEW
(608) 783-8706
2700 MIDWEST DR
ONALASKA WI 54650
(800) 542-6642
PO Box 651109
(800) 542-6642
BLUE BELLCREAMERIES USA
Affiliated With: BLUE BELL BENEFIT
TRUST
BLUEGRASS FAMILY HEALTH
BLUE BELL BENEFIT TRUST
BLUE BELL BENEFIT TRUST
PO Box 605
BRENHAM TX 77834
(979) 830-7388
CHECK BENEFIT CARD
(979) 830-7388
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CONTACT EMPLOYER
CONTACT EMPLOYER
Bluegrass Health Network
CONTACT EMPLOYER
Affiliated With: Bluegrass Health Network Attn:
Network.
Info as of 12/24/2007
Page PIRMI-73
www.firsthealth.com
PAYOR NAME
BOHLIN CYWINSKI JACKSON
ADMINISTRATORS
BOISE STATE UNIVERSITY
CORP
CLAIMS SUBMISSION
720 BLAIR MILL RD.
HORSHAM PA 19044
COMPENSABILITY
(215) 793-3223
UTILIZATION REVIEW
AMERIHEALTH
ADMINISTRATORS
(215) 793-3223
(215) 793-3223
2500 McClellan Ave
Pennsauken NJ 08109
(800) 220-1123
UM NOT APPLICABLE
(800) 220-1123
BOISE VAMC 3177
SERVICES
BOISE VAMC
Attn: MAS 136
500 W FORT ST
BOISE ID 83702
BOISE VAMC
CHECK BENEFIT CARD
BOLLINGER, INC.
Affiliated With: BOLLINGER, INC.
BOLLINGER, INC.
BOLLINGER, INC.
BOLLINGER, INC.
830 Morris Turnpike
SHORT HILLS NJ 07078
(973) 467-8005 Ext 1007
(973) 467-8005 Ext 1007
BONHAM VA 3168
SERVICES
VA BONHAM
Attn: BRENDA MAGNASS
1201 E 9TH ST
BONHAM TX 75048
VA BONHAM
CHECK BENEFIT CARD
BOOTHCREEK SKI HOLDING JMS
(EBPA)
EBPA
EBPA
CHECK BENEFIT CARD
PO Box 2365
(802) 846-8060
(802) 846-8060
Network.
Info as of 12/24/2007
Page PIRMI-74
www.firsthealth.com
PAYOR NAME
BOOTZ MANUFACTORING CO
PLAN INC 962550088
BORDER FOODS COMPANIES
CLAIMS SUBMISSION
LOUISVILLE KY 40223
COMPENSABILITY
(800) 832-8212
UTILIZATION REVIEW
(888) 551-7427
(502) 992-4535
SERVICES
PO Box 59212
SERVICES
(800)
997-1750
(800) 997-1750
(800) 997-1750
BORREGO PASS SCHOOL
SRT ADMINISTRATORS
SRT ADMINISTRATORS
CHECK BENEFIT CARD
BOSKOVICH FARMS
INSURANCE ADMINISTRATORS, INC.
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
BOSSARD METRICS INC
Benesight
Benesight
PO Box 310
PUEBLO CO 81002
8009928354
Benesight
8009928354
CHECK BENEFIT CARD
WAYNE PA 19087-1706
(888) 293-9229
PO Box 25160
8009928354
BOSTON BAPTIST COLLEGE
CONCEPTS INC
(888) 293-9229
Network.
Info as of 12/24/2007
Page PIRMI-75
www.firsthealth.com
PAYOR NAME
BOSTON COLLEGE
Affiliated With: KLAIS AND COMPANY
BOSTON COLLEGE
Affiliated With: KLAIS & COMPANY
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
KLAIS & COMPANY INC
KLAIS & COMPANY INC
CHECK BENEFIT CARD
1867 W MARKET ST
AKRON OH 44313
(330) 867-8443
UTILIZATION REVIEW
(330) 867-8443
BOSTON HIGASHI SCHOOL
SERVICES, INC.
BOSTON VA MEDICAL CENTER 3118
SERVICES
MEDICAL CLAIMS SERVICES, INC.
ONE WALL ST STE 2A
RAVENSWOOD WV 26164
(888) 225-0522
AMERICAN HEALTH
HOLDINGS INC
(886) 614-4244
(888) 225-0522
Attn: FEE BASIS 136F
150 S HUNTINGTON AVE
BOSTON MA 02130
CHECK BENEFIT CARD
(214) 387-3232
(214) 387-3232
BOTHWELL SAXTON RESTAURANTS,
LLC
Affiliated With: GILSBAR INC
BOULDER ADMINISTRATIVE
SERVICES
12717
GILSBAR
GILSBAR
2100 COVINGTON CENTRE
COVINGTON LA 70433
(888) 215-9841
MED COM CARE MGT
(985) 898-1505
NHBC
NHBC
CHECK BENEFIT CARD
Scottsdale AZ 85260
(888) 621-7900
(888) 215-9841
(888) 621-7900
Network.
Info as of 12/24/2007
Page PIRMI-76
www.firsthealth.com
PAYOR NAME
BOWDOIN COLLEGE
MANAGEMENT SERVICES
BOYD COUNTERTOPS INC
BRADLEY DIXIE COMPANIES
Affiliated With: PARAGON BENEFITS,
INC.
BRADY INDUSTRIES
CLAIMS SUBMISSION
PO Box 9040
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(413) 539-9900
(413) 539-9900
PO Box 520
(800) 235-7160
CO.
(800) 725-6566
(800) 235-7160
Bradley/Dixie Company
Bradley/Dixie Company
PO Box 12288
COLUMBUS GA 31904
(866) 360-7926
QUANTUM HEALTH
(800) 257-2038
(866) 360-7926
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
BRANDEIS UNIVERSITY
KLAIS & COMPANY INC
KLAIS & COMPANY INC
1867 W MARKET ST
AKRON OH 44313
(800) 331-1096
CHECK BENEFIT CARD
(800) 331-1096
BRASSELER USA
Affiliated With: HOLDEN & COMPANY
HOLDEN & COMPANY C/O CCN
HOLDEN & COMPANY C/O CCN
CHECK BENEFIT CARD
PO Box 5190
TAMPA FL 33675-5190
Network.
Info as of 12/24/2007
Page PIRMI-77
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
BRATTLEBORO MEMORIAL HOSPITAL CHECK BENEFIT CARD
(EBPA)
BREG, INC.
CENBEN USA
4079 Executive Pkwy
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CENBEN USA
CHECK BENEFIT CARD
UTILIZATION REVIEW
(614) 797-5204
(614) 797-5204
Brokerage Concepts, Inc.
PO Box 61553
6104914911
(215) 773-3722
BRENTWOOD INDUSTRIES INC
CHECK BENEFIT CARD
Affiliated With: THE LOOMIS COMPANY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
BRENTWOOD VOLVO
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
BRENNAN TRANSPORTATION
SERVICE
CONCEPTS BENEFITS CONCEPTS
INC
6104914911
(702) 242-7700
BREVARD ACHIEVEMENT CENTER
BENEFIT SYSTEMS
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
Network.
Info as of 12/24/2007
Page PIRMI-78
www.firsthealth.com
PAYOR NAME
BREWER YACHT YARD GROUP
Affiliated With: DIVERSIFIED
ADMINISTRATION CORPORATION
CLAIMS SUBMISSION
DIVERSIFIED ADMINISTRATION
CORPORATION
PO Box 299
MARLBOROUGH CT 06447
COMPENSABILITY
CORPORATION
(888) 322-2524
UTILIZATION REVIEW
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
BRIDGES WTC, INC.
BENEFIT SYSTEMS
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
BRIDGESTONE
Affiliated With: ASSURECAREE
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
(800) 422-2026
BRIDGESTONE FIRESTONE
333 East Lake Street
Bloomingdale IL 60108
(630) 259-9126
(630) 259-9126
(630) 259-9126
British Caymanian Insurance
International LTD
BRITZ COMPANIES ET AL
ADMINISTRATORS INC
British Caymanian Insurance
Colonial Medical Insurance Company
PO Box 11518
(345) 949-8699
First Health
(800) 423-9130
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(441) 296-3200
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-79
www.firsthealth.com
PAYOR NAME
Broadspire, A Crawford Company
Affiliated With: Broadspire, A Crawford
Company
BRONCO DRILLING
ADMINISTRATORS
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
COMPENSABILITY
Crawford & Company
(404) 256-0830
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
(405) 607-2694
UTILIZATION REVIEW
Crawford & Company
(404) 256-0830
CHECK BENEFIT CARD
(405) 607-2694
BRONCO DRILLING COMPANY INC
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
BRONX VA MEDICAL CENTER 3121
SERVICES
BRONX VA MEDICAL CENTER
Attn: FEE BASIS 00AM
130 W KINGSBRIDGE RD
BRONX NY 10468
BRONX VA MEDICAL CENTER
CHECK BENEFIT CARD
BROOKLYN VA MEDICAL CENTER
3521
SERVICES
Attn: FEE BASIS 136
800 POLY PLACE
BROOKLYN NY 11209
CHECK BENEFIT CARD
BROTHERS TRADING CO INC AND
INVENTORY HANDLERS INC
Affiliated With: UNDERWRITERS
SAFETY & CLAIMS
UNDERWRITERS SAFETY & CLAIMS
UNDERWRITERS SAFETY & CLAIMS HEALTH SERVICE REVIEW
(800) 334-6468
(800) 678-1536
PO Box 23507
Louisville KY 40223-0507
(800) 678-1536
Network.
Info as of 12/24/2007
Page PIRMI-80
www.firsthealth.com
PAYOR NAME
BROULIMS SUPERMARKETS
ADMINISTRATORS
CLAIMS SUBMISSION
CHECK BENEFIT CARD
BROWARD CORRECTIONAL
INSTITUTION/SITE #360
Affiliated With: PRISON HEALTH
SERVICES, INC.
PRISON HEALTH SERVICES, INC.
BROWN MACKIE COLLEGE
CONCEPTS INC
WAYNE PA 19087-1706
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
PRISON HEALTH SERVICES,
INC.
CHECK BENEFIT CARD
105 W Park Dr STE 300
BRENTWOOD TN 37027
(610) 293-9229
(610) 293-9229
BROWN MACKIE COLLEGE
CONCEPTS INC
ADMINISTRATIVE CONCEPTS INC
WAYNE PA 19087-1706
UM NOT APPLICABLE
(610) 293-9229
(610) 293-9229
* Brown University
HEALTH PLANS
BRUTGER EQUITIES, INC
195 STAFFORD ST
(800) 517-4791
UM NOT APPLICABLE
(800) 633-7867
SERVICES
PO Box 59212
SERVICES
(800)
997-1750
(800) 997-1750
(800) 997-1750
Network.
Info as of 12/24/2007
Page PIRMI-81
www.firsthealth.com
PAYOR NAME
BSI INC
Affiliated With: INTEGRITY HEALTH
SERVICES
BUCKINGHAM COMPANIES
Affiliated With: COMMERCE BENEFITS
GROUP
BUEHLER HOME
Affiliated With: OSF HEALTHPLANS
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
COMMERCE BENEFITS GROUP
33479 LAKE RD
AVON LAKE OH 44012
(800) 223-9941
UTILIZATION REVIEW
CHECK BENEFIT CARD
CARDINAL UTILIZATION
MANAGEMENT
(877) 272-7040
(800) 223-9941
OSF HealthPlans, Inc.
PO Box 5128
PEORIA IL 61601-5128
(877) 677-8222
CHECK BENEFIT CARD
(877) 677-8222
* Buffalo
Insurance Fund
BUFFALO CHINA
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
UM NOT APPLICABLE
(800) 422-2026
BUFFALO VAMC 4003
SERVICES
CENTER
113 HOLLAND AVE
ALBANY NY 12208
Builders Insurance Group
PO Box 723099
Atlanta GA 31139-0099
(678) 309-4000
(972) 550-2836
(678) 309-4172
(678) 309-4172
Network.
Info as of 12/24/2007
Page PIRMI-82
www.firsthealth.com
PAYOR NAME
BUILDER'S SUPPLY INC
SOLUTIONS GROUP INC
CLAIMS SUBMISSION
HEALTHCARE SOLUTIONS GROUP,
INC.
PO Box 1309
MUSKOGEE OK 74402
COMPENSABILITY
INC.
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 749-1422
(800) 749-1422
Bunch & Associates Inc.
Affiliated With: Bunch & Associates Inc.
Bunch & Associates Inc
PO Box 32045
Lakeland FL 33802
(888) 853-4735
(888) 853-4735
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(888) 853-4735
BURLINGTON RESOURCES
LTD
CHECK BENEFIT CARD
BURRELL PROFESSIONAL LABS
Affiliated With: J.F. MOLLOY &
ASSOCIATES, INC.
J.F. MOLLOY & ASSOCIATES, INC.
C/O CCN
BUTLER BENEFIT SERVICES INC
BUTLER VAMC 3123
SERVICES
(800) 292-5386
J F MOLLOY AND ASSOCIATES INC
J F MOLLOY AND ASSOCIATES
INC
NHBC
NHBC
CHECK BENEFIT CARD
Scottsdale AZ 85260
(888) 621-7900
PO Box 5190
TAMPA FL 33675-5190
(888) 621-7900
BUTLER VAMC
325 NEW CASTLE RD
BUTLER PA 16001
BUTLER VAMC
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-83
www.firsthealth.com
PAYOR NAME
BUTTE CO. JAIL/BUTTE JUVENILE
HALL
SERVICES, INC.
C L FRATES AND COMPANY
COMPANY
C T I INC
CLAIMS SUBMISSION
COMPENSABILITY
BRENTWOOD TN 37027
UTILIZATION REVIEW
INC.
PO Box 268967
(405) 290-5696
(800) 669-1815
Services
Services
(847) 214-2780
TUCSON AZ 85710
(520) 722-7133
(405) 290-5696
(520) 722-7133
CABLE AMERICA
ADMINISTRATORS
CABLE COMMUNICATIONS
ADMINISTRATORS
CABRILLO COLLEGE
CHECK BENEFIT CARD
3800 SANDSHELL DR STE 260
FT. WORTH TX 76134
(817) 335-2582
SERVICE ADVOCATES
(801) 261-5511
2001 CAMELBACK
PHOENIX AZ 85014
(817) 335-2582
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
(800) 786-7930
Network.
Info as of 12/24/2007
Page PIRMI-84
www.firsthealth.com
PAYOR NAME
CADDOCK ELECTRONICS, INC.
CAINS FOODS LP
Affiliated With: ULTRABENEFITS INC
CLAIMS SUBMISSION
EBA&M
PO Box 8572
WEST LAKE VILLAGE CA 91359
COMPENSABILITY
EBA&M
UTILIZATION REVIEW
CHECK BENEFIT CARD
(714) 668-8920
(714) 668-8920
ULTRABENEFITS INC
ULTRABENEFITS INC
29 EAST MOUNTAIN ST
WORCESTER MA 01606
(866) 858-7223
(614) 818-3222
PO Box 1147
STOCKTON CA 95201
(209) 948-8483 Ext 3327
(866) 858-7223
CAJON VALLEY UNION SCHL
DIST/ACTIVE EES
Affiliated With: CAJON VALLEY UNION
SCHOOL DISTRICT
CALAIS REGIONAL HOSPITAL WRAP
JMS
(EBPA)
CALDWELL FREIGHT LINES
INC
CALIFORNIA BAPTIST UNIVERSITY
(209) 948-8483 Ext 3327
EBPA
EBPA
PO Box 2365
(802) 846-8060
CHECK BENEFIT CARD
(802) 846-8060
J SMITH LANIER & CO
J SMITH LANIER & CO
(910) 480-3100
CHECK BENEFIT CARD
(910) 480-3100
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
(800) 786-7930
Network.
Info as of 12/24/2007
Page PIRMI-85
www.firsthealth.com
PAYOR NAME
CALIFORNIA INSTITUTE OF
INTEGRAL STUDIES
INSURANCE ADMINISTRATORS PIA
CLAIMS SUBMISSION
PERSONAL INSURANCE
ADMINISTRATORS
COMPENSABILITY
PERSONAL INSURANCE
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 468-4343
(800) 468-4343
CALIFORNIA INSTITUTE OF
TECHNOLOGY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CALIFORNIA IRONWORKERS FIELD
WELFARE PLAN
CALIFORNIA IRONWORKERS FIELD
WELFARE PLAN
CALIFORNIA IRONWORKERS FIELD CALIFORNIA IRONWORKERS
FIELD WELFARE PLAN
WELFARE PLAN
Affiliated With: CALIFORNIA
IRONWORKERS FIELD WELFARE
PLAN
131 N. El Molina Ave. #330
PASADENA CA 91101
CALIFORNIA LUTHERAN UNIVERSITY
Affiliated With: SUMMIT AMERICA
INSURANCE SERVICES
SUMMIT AMERICA INSURANCE
SERVICES
CALIFORNIA STATE UNIVERSITY LOS ANGELES
CALIFORNIA STATE UNIVERSITY AT
DOMINGUEZ HILLS
Affiliated With: THE LEWER AGENCY,
INC.
CHECK BENEFIT CARD
SERVICES
SERVICES
OF UICI
OF UICI
CHECK BENEFIT CARD
PLANO TX 75075
(800) 767-0700
5001 College Blvd., #216
LEAWOOD KS 66211
(800) 237-0903 Ext 6352
THE LEWER AGENCY, INC.
THE LEWER AGENCY
THE LEWER AGENCY
4534 WORNAL
KANSAS CITY MO 64111
Network.
Info as of 12/24/2007
Page PIRMI-86
www.firsthealth.com
PAYOR NAME
CALIFORNIA STEEL INDUSTRIES
SYSTEMS
CALISE AND SONS
SERVICE CENTER
CALLIDUS TECHNOLOGIES INC
CLAIMS SUBMISSION
PO Box 80
Stockton CA 95201
COMPENSABILITY
(800) 807-0820
UTILIZATION REVIEW
DELTA TEAM CARE
(209) 939-3438
(800) 807-0820
GISC, INC
GISC, INC
20 WINTER ST
PEMBROKE MA 02359
(800) 242-4472
GISC TOTALCARE
(800) 999-1077
GILSBAR
GILSBAR
CHECK BENEFIT CARD
PO Box 2947
COVINGTON LA 70434
(800) 445-7227
(800) 242-4472
(800) 445-7227
CALLISONS INC - PEPM
SERVICE CORPORATION
CAMBERLEY HOTEL CO
ADMINISTRATORS
Cambridge Integrated Services/Allied
Automotive Group
PO Box 1894
(888) 877-7994
(800) 426-9786
(800) 426-9786
FT. WORTH TX 76134
(817) 335-2582
SERVICE ADVOCATES
(877) 261-5511
CONTACT EMPLOYER
CONTACT EMPLOYER
(817) 335-2582
CONTACT EMPLOYER
Attn:
Network.
Info as of 12/24/2007
Page PIRMI-87
www.firsthealth.com
PAYOR NAME
Cambridge Life Insurance Company
Affiliated With: First Health Life and
Health Insurance Company
CAMCO, INC.
CLAIMS SUBMISSION
First Health
PO Box 44199
Las Vegas NV 89116
COMPENSABILITY
Health Plan Services
(800) 681-0056
UTILIZATION REVIEW
First Health
(800) 639-9157
(800) 681-0056
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
CAMERON UNIVERSITY
MANAGEMENT
* CANADIAN MEDICAL NETWORK
Affiliated With: CANADIAN MEDICAL
NETWORK
TRUE CHOICE
TRUE CHOICE
PO Box 700307
DALLAS TX 75370
(800) 251-9665
UM NOT APPLICABLE
(800) 251-9665
Canadian Medical Network
AVIDYN HEALTH
(866) 802-1328
140 Renfrew Dr. Ste 103
Ontario, Canada L3R 6B3
DBA: Care Management Network
CANADIAN PIPE & SUPPLY CO INC
Affiliated With: FISERV HEALTH
KANSAS
FISERV HEALTH INC
FISERV HEALTH INC
PO Box 520
(800) 235-7160
CANADIAN VALLEY ELECTRIC CO-OP
Affiliated With: NATIONAL RURAL
ELECTRIC COOPERATIVE
ASSOCIATION
COOPERATIVE BENEFIT
ADMINISTRATOR
COOPERATIVE BENEFIT
ADMINISTRATOR
PO Box 6249
LINCOLN NE 68506-0249
(402) 483-9200
CHECK BENEFIT CARD
(402) 483-9200
Network.
Info as of 12/24/2007
Page PIRMI-88
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
CANANDAIGUA VAMC 4004
Affiliated With: HEALTH NET FEDERAL CENTER
SERVICES
113 HOLLAND AVE
ALBANY NY 12208
CANCER TREATMENT CENTERS OF
AMERICA INC
GROUP
Cannon Cochran Management Services,
Inc.
Affiliated With: Stratacare
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(972) 550-2836
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
Cannon Cochran Management
Services Inc
Cannon Cochran Management
Services Inc
Town Centre Bldg 2 East Main St Ste
208
Danville IL 61832
(800) 252-5059
CONTACT EMPLOYER
(800) 277-6512
CAPITAL FULFILLMENT GROUP
SERVICE CENTER
CHECK BENEFIT CARD
CHECK BENEFIT CARD
APS HEALTHCARE
(406) 327-7250
CAPITAL INTERNATIONAL
MANAGEMENT
INC
Attn: ACCOUNTING
UM NOT APPLICABLE
FISERV HEALTH INC
AVIDYN HEALTH
(800) 808-4424
DALLAS TX 75206
CAPITAL LUMBER COMPANY
FISERV HEALTH INC
Affiliated With: WAUSAU BENEFITS INC PO Box 450
(800) 826-9781
(800) 826-9781
Network.
Info as of 12/24/2007
Page PIRMI-89
www.firsthealth.com
PAYOR NAME
CAPITOL ROOFING SERVICES
ADMINISTRATORS
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MBA OF WYOMING
MBA OF WYOMING
UTILIZATION REVIEW
CARBON COUNTY HOLDING CO
ASSOCIATES
CARDIOVASCULAR CONSULTANTS
PC
Affiliated With: THE EPOCH GROUP
10469
THE EPOCH GROUP, LC
THE EPOCH GROUP, LC
PO Box 12170
(913) 362-0040
THE EPOCH GROUP, LC
(913) 362-0040
GROUP & PENSION
ADMINISTRATORS INC
GROUP & PENSION
ADMINISTRATORS INC
HEALTH WATCH
(972) 238-7900
DALLAS TX 75251
(800) 827-7223
CARDON HEALTHCARE
ADMINISTRATORS
PO Box 94
WORLAND WY 82401
(913) 362-0040
(972) 238-7900
CAREER EDUCATION CORPORATION
KLAIS & COMPANY INC
KLAIS & COMPANY INC
1867 W MARKET ST
AKRON OH 44313
(800) 331-1096
CHECK BENEFIT CARD
(800) 331-1096
CARESYS AUTO
Affiliated With: MCMC LLC
Plan Type: Auto
MCMC LLC
MCMC LLC
701 Technology Dr Ste 100
Canonsburg PA 15317
(888) 350-1150 Ext 228
Network.
MCMC LLC
(888) 350-1150 Ext 228
Info as of 12/24/2007
Page PIRMI-90
www.firsthealth.com
PAYOR NAME
CareWorks
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
(800) 627-0065
CareWorks
(800) 627-0065
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Attn: Mary Shepherd
PO Box 489
MEDCAREONE CORP
(800) 816-1206
CareWorks
COMPENSABILITY
CareWorks
CAREY JOHNSON OIL COMPANY
Affiliated With: RESOURCEONE
ADMINISTRATORS
(800) 967-2077
(800) 967-2077
CARLING TECHNOLOGIES INC.
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
Carlson Restaurants Worldwide Platinum and Gold
Affiliated With: Carlson Holdings Inc.
First Health
First Health
PO Box 8400
London KY 40742
(800) 654-5321
First Health
(800) 654-5321
(800) 654-5321
Exclude all freestanding psych/cd
facilities.
Carlson Restaurants Worldwide - Silver
Affiliated With: Carlson Holdings Inc.
First Health
First Health
PO Box 8400
London KY 40742
(800) 654-5321
First Health
(800) 654-5321
(800) 654-5321
CARR PRINTING COMPANY, INC.
ADMININSTRATORS
(801) 274-8100
CORVEL
(801) 269-8723
(801) 274-8100
Network.
Info as of 12/24/2007
Page PIRMI-91
www.firsthealth.com
PAYOR NAME
CARRIAGE INC
SYSTEMS INC
CARROLL DISTRIBUTING COMPANY
Affiliated With: CORESOURSE
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
CORESOURCE
CORESOURCE
5200 77 CENTER DR STE 400
CHARLOTTE NC 28217
(800) 327-5462
CORESOURCE
(866) 794-0770
SELECT BENEFIT
SELECT BENEFIT
CHECK BENEFIT CARD
(800) 327-5462
CARSTAR
SELECT BENEFIT
ADMINISTRATORS, INC. C/O CCN
CARVILL AMERICA INC
Affiliated With: T R PAUL INC.
T R PAUL INC.
T R PAUL INC.
PO Box 5508
NEWTON CT 06470-5508
8006788161 Ext 244
PO Box 3000
8006788161 Ext 244
CAS - Claims Administrative Services
Affiliated With: STRATACARE
Claims Administrative Services, Inc.
Claims Administrative Services, Inc.
501 Shelley Dr
Tyler TX 75711
(800) 765-2412
Forte
(800) 580-4567
(800) 765-2412
CASCADE AUTOMOTIVE, INC.
Affiliated With: QVI RISK SOLUTIONS,
INC.
CASHMAN EQUIPMENT
ASSURECARE
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-92
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
CASHMAN PHOTO ENTERPRISES OF SIERRA HEALTH & LIFE / HEALTH
NEVADA - TRAVEL
PLAN
Affiliated With: SIERRA HEALTH & LIFE PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
CATA
COMPENSABILITY
PLAN
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
ASSURECARE
ASSURECARE
LANSING MI 38823
(800) 968-6616
CARELINE
(763) 383-4800
MBA OF WYOMING
MBA OF WYOMING
CHECK BENEFIT CARD
(800) 968-6616
CATHEDRAL HOMES FOR CHILDREN
ASSOCIATES
CATHOLIC DIOCESE OF PEORIA
Affiliated With: OSF HEALTHPLANS
INC #20714
PO Box 5128
(800) 673-5222
PO Box 94
WORLAND WY 82401
(309) 677-8356
CATHOLIC HEALTHCARE WEST CHW
ARIZONA
Affiliated With: SCHALLER ANDERSON
HEALTHCARE LLC
SCHALLER ANDERSON
HEALTHCARE INC. LLC
SCHALLER ANDERSON
HEALTHCARE INC. LLC
CHECK BENEFIT CARD
CAVLIER TELEPHONE
Affiliated With: AMERICAS CHOICE
HEALTHPLAN
AMERICAS CHOICE HEALTHPLANS
AMERICAS CHOICE HEALTHPLANS
13111 Northwest Fwy, Ste 510
Houston TX 77040
(800) 633-4226
HEALTHCARE SOLUTIONS
GROUP, INC.
(800) 582-1535
PO Box 62735
PHOENIX AZ 85082-2735
(800) 633-4226
Network.
Info as of 12/24/2007
Page PIRMI-93
www.firsthealth.com
PAYOR NAME
Cayman Islands
Group, Inc.
CAYUCOS ELEMENTARY SCHOOL
CLAIMS SUBMISSION
407 N Fulton St
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(317) 655-4500 Outside US
(800) 628-4664 Inside US
(317) 655-4500 Outside US
(800) 628-4664 Inside US
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
CBCA Administrators, Inc.
CBCA Administrators Inc
Affiliated With: CBCA Administrators, Inc. 1979 Marcus Ave Ste C101
Lake Success NY 11042
(800) 831-7783
Capp Care
(800) 937-2277 or (714) 2512200
(800) 831-7783
CCASAPE
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
CCASAPE/Clark County School District TRAVEL
CCN ELECTRONIC DIRECTORY GH
Affiliated With: CCN ELECTRONIC
DIRECTORY FORMERLY POW
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-94
www.firsthealth.com
PAYOR NAME
CCN ELECTRONIC DIRECTORY
INTERNATIONAL
Affiliated With: CCN ELECTRONIC
DIRECTORY FORMERLY POW
CCSD SUPPORT STAFF
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
UTILIZATION REVIEW
CHECK BENEFIT CARD
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
CEDAR HAMMOCK FIRE CONTROL
DISTRICT
LLC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SELF INSURED PLANS LLC
Cedar Hill Insurance
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
CEGA GROUP
Affiliated With: STAR HEALTHCARE
NETWORK INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CENTER IMT
Affiliated With: CREATIVE PLAN
CREATIVE PLAN ADMINISTRATORS
CREATIVE PLAN ADMINISTRATORS AMERICAN HEALTH HOLDINGS
(866) 648-5554
(301) 695-0480
PO Box 734
(301) 695-0480
Network.
Info as of 12/24/2007
Page PIRMI-95
www.firsthealth.com
PAYOR NAME
CENTRAL CALIFORNIA ELECTRICAL
WORKERS (CCEW)
Affiliated With: HEALTHCOMP THIRD
PARTY ADMINISTRATORS
CLAIMS SUBMISSION
HEALTHCOMP TPA
PO Box 45018
Fresno CA 93718
COMPENSABILITY
HEALTHCOMP TPA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 442-7247
(800) 442-7247
PO Box 520
(800) 235-7160
AVIDYN / VALUE CHECK
(866) 802-1328
CENTRAL ILLINOIS CARPENTERS
HEALTH AND WELFARE TRUST FUND HEALTH AND WELFARE TRUST
FUND
200 MADIGAN
LINCOLN IL 62656
HEALTH AND WELFARE TRUST
FUND
CENTRAL ILLINOIS
CARPENTERS HEALTH AND
WELFARE TRUST FUND
CENTRAL IOWA HCS 3708
SERVICES
CENTRAL IOWA HCS (3708)
Attn: FEE OAS-D
3600 30TH STREET
DES MOINES IA 50310
CENTRAL IOWA HCS (3708)
CHECK BENEFIT CARD
CENTRAL METHODIST UNIVERSITY
CORP
UM NOT APPLICABLE
2500 McClellan Ave
Pennsauken NJ 08109
(800) 220-1123
* CENTRAL DETROIT DIESEL ALLISON INC
CENTRAL PROCESSING
CORPORATION
Affiliated With: WAUSAU BENEFITS,
INC.
(800) 220-1123
PO Box 8046
CHECK BENEFIT CARD
(715) 841-7802
(715) 841-7802
Network.
Info as of 12/24/2007
Page PIRMI-96
www.firsthealth.com
COMPENSABILITY
CERES HEALTH CARE INC
CENTRAL STATES INDUSTRIAL
HCH ADMINISTRATION INC
EQUIPMENT & SERVICE, INC
PO Box 1986
Affiliated With: HEALTH DATA SERVICE PEORIA IL 61656
(877) 876-5969
CHECK BENEFIT CARD
CENTRAL VALLEY GENERAL
HOSPITAL
SYSTEM/WEST
ADVENTIST HEALTH SYSTEM/WEST
C/O CCN
CENTRAL VALLEY TRUST
ADMINISTRATORS INC
CHECK BENEFIT CARD
CENTRALIA SCHOOL DISTRICT
Affiliated With: CBIZ/SCEET
THE PLAN HANDLERS, INC.
CENTURY FOODS
Butler
PAYOR NAME
CENTRAL RESERVE LIFE
INSURANCE COMPANY
INSURANCE CO.
CLAIMS SUBMISSION
UTILIZATION REVIEW
17800 ROYALTON RD
STONGSVILLE OH 44136
(877) 876-5969
PO Box 3000
CHECK BENEFIT CARD
CHECK BENEFIT CARD
5594992450
SISCO
SISCO
CHECK BENEFIT CARD
PO Box 389
(800) 547-4726
930 Canterbury Pl.
ESCONDIDO CA 92025
(800) 547-4726
Network.
Info as of 12/24/2007
Page PIRMI-97
www.firsthealth.com
PAYOR NAME
CENTURY WESTPORT
CLAIMS SUBMISSION
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 9501
AMHERST NY 14226
COMPENSABILITY
NORTH AMERICAN
ADMINISTRATORS-NY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 397-2122
(800) 397-2122
CENTURY WORKERS COMP
(866) 266-9236
(866) 266-9236
2400 Corporate Exchange Dr. Suite 290
Columbus OH 43231
CERES c/o World Insurance
CHECK BENEFIT CARD
PO Box 2804
Clinton IA 52733
(800) 786-7557
(866) 266-9236
CERES GROUP - CRS100 FH
INSURANCE CO.
CERSOSIMO INDUSTRIES, INC
(800) 786-7557
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
CERSOSIMO LUMBER COMPANY, INC
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
CFI
CFI
CFI
(417) 623-5229
CFI
(417) 623-5229
4701 East 32nd Street
Joplin MO 64803
CHECK BENEFIT CARD
PO Box 2804
Clinton IA 52733
(800) 253-4641
(417) 623-5229
CGI MAJOR MEDICAL CRS100 CCN
INSURANCE CO.
(800) 253-4641
Network.
Info as of 12/24/2007
Page PIRMI-98
www.firsthealth.com
PAYOR NAME
CHADWICK MEDICAL ASSOCIATES,
P.C.
CHALLENGE ENTERPRISES OF
NORTH FLORIDA
BENEFIT SYSTEMS
CHARLESTON AUTO PARTS
CLAIMS SUBMISSION
ULTRABENEFITS INC
PO Box 763
WESTBORO MA 01581
COMPENSABILITY
ULTRABENEFITS INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(866) 858-7223
(866) 858-7223
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
CHARLESTON COUNTY DETENTION
CENTER
SERVICES, INC.
INC.
BRENTWOOD TN 37027
CHARLESTON SOUTHERN
UNIVERSITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHARLESTON VAMC (RALPH H
JOHNSON VA) 3539
SERVICES
JOHNSON)
109 BEE ST
CHARLESTON SC 29401
JOHNSON)
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-99
www.firsthealth.com
PAYOR NAME
CHARTER SCHOOLS
Affiliated With: UNITED BENEFITS
DIVISION
CHATHAM COUNTY DETENTION
CENTER
SERVICES, INC.
* CHATHAM STEEL CORP
Affiliated With: WELLS FARGO THIRD
PARTY ADMINISTRATOR
CHECK CITY
Affiliated With: MANAGED BENEFIT
ADMINISTRATORS & INSURANCE
CLAIMS SUBMISSION
BROWN & BROWN, INC.
COMPENSABILITY
BROWN & BROWN, INC.
UTILIZATION REVIEW
CHECK BENEFIT CARD
PO Box 2480
DAYTONA BEACH FL 32115-2480
INC.
ACORDIA NATIONAL C/O CCN
ACORDIA NATIONAL C/O CCN
CHECK BENEFIT CARD
PO Box 3262
CHARLESTON WV 25332
(888) 685-7774
105 Westpark Dr STE 300
BRENTWOOD TN 37027
(888) 685-7774
MBA
MBA
PO Box 651109
(800) 877-3727
CRITIQUE
(800) 666-5551
(800) 877-3727
CHELMSFORD AUTO
Plan Type: Auto
MCMC LLC
MCMC LLC
Canonsburg PA 15317
(888) 350-1150 Ext 228
MCMC LLC
(888) 350-1150 Ext 228
CHEMEKETA COMMUNITY COLLEGE
Affiliated With: STUDENT ASSURANCE
SERVICES INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
6514397098
Network.
Info as of 12/24/2007
Page PIRMI-100
www.firsthealth.com
PAYOR NAME
Cherokee Insurance
Affiliated With: Cherokee Insurance
* CHESAPEAKE ENERGY
CORPORATION
BENEFITS
COMPENSABILITY
CONTACT EMPLOYER
CONTACT EMPLOYER
CHECK BENEFIT CARD
(800) 560-4664
CLAIMS SUBMISSION
CONTACT EMPLOYER
UTILIZATION REVIEW
(800) 560-4664
Chevron Corporation
Affiliated With: Chevron Corporation
Chevron
CHEYENNE VAMC 3531
SERVICES
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHEYENNE VAMC
Attn: FEE BASIS
WILLIAM ST off HWY 12 WEST
FORT HARRISON MT 59636
CHEYENNE VAMC
CHECK BENEFIT CARD
CHICAGO (JESSE BROWN VAMC)
3160
SERVICES
JESSE BROWN VAMC
Attn: FEE 136E
820 S DAMEN AVE 5210
CHICAGO IL 60612
JESSE BROWN VAMC
CHECK BENEFIT CARD
CHICAGO MCGILL ELECTRIC SWITCH
Affiliated With: MCGILL ELECTRIC
SWITCH PRODUCT GROUP
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
6001 Bollinger Canyon Rd Ste E
San Ramon CA 94583-2324
Network.
Info as of 12/24/2007
Page PIRMI-101
www.firsthealth.com
PAYOR NAME
CHICAGO-VEGAS HOLDING
COMPANY, INC
Affiliated With: PREMIER CLAIMS
UTILIZATION REVIEW
CLAIMS SUBMISSION
COMPENSABILITY
PREMIER CLAIMS ADMINISTRATORS PREMIER CLAIMS ADMINISTRATORS UNIVERSAL HEALTH
NETWORK
PO Box 19338
7753245644
(702) 356-1159
RENO NV 89511
7753245644
CHICK PACKAGING
SERVICE CENTER
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHICKSAW HOLDING COMPANY
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
CHECK BENEFIT CARD
PO Box 42096
(800) 825-3540
(800) 825-3540
CHILDRENS HEART CENTER LV TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
LAS VEGAS NV 89114
(702) 242-7700
(702) 242-7700
CHILES RESTAURANT GROUP
LLC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHILLICOTHE VA MEDICAL CENTER
3524
SERVICES
CHILLICOTHE VA MEDICAL CENTER
Attn: 136 BLD 27 RM 17
17273 STATE RT 104
CHILLICOTHE OH 45601
CHILLICOTHE VA MEDICAL CENTER CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-102
www.firsthealth.com
PAYOR NAME
CHITTENDEN CORPORATION JMS
(EBPA)
CLAIMS SUBMISSION
EBPA
PO Box 2365
COMPENSABILITY
EBPA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(802) 846-8060
(802) 846-8060
CHJ, INC.
SUPERIOR INSURANCE SERVICES
Affiliated With: SUPERIOR INSURANCE 3741 Merced Dr. #K
SERVICES
RIVERSIDE CA 92503
SUPERIOR INSURANCE SERVICES
SUPERIOR INSURANCE
SERVICES
CHOCTAW ELECTRIC COOPERATIVE
INC
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
CHECK BENEFIT CARD
PO Box 42096
(800) 825-3540
(800) 825-3540
UPSTATE ADMINISTRATIVE
SERVICES C O CHOICE PLUS OF
VERMONT
CHECK BENEFIT CARD
PO Box 1090
GREAT BEND KS 67530
(800) 290-1368
MedWatch
(800) 432-8421
CHOICE PLUS OF VERMONT
Affiliated With: UPSTATE
ADMINISTRATIVE SERVICES C O
UPSTATE ADMINISTRATIVE
SERVICES C O CHOICE PLUS OF
VERMONT
CHOICE SOLUTIONS, INC
MANAGEMENT INC
CH'OOSHGAI COMMUNITY SCHOOL
PO Box 6589
SYR NY 13217-6589
(800) 290-1368
PO Box 25160
SRT ADMINISTRATORS, INC C/O
CCN
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-103
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PAYOR NAME
CHRISTENSEN & GRIFFITH
CONSTRUCTION
ADMINISTRATORS
CHRISTIAN BROTHERS EMPLOYEE
BENEFIT TRUST
GROUP
CLAIMS SUBMISSION
(801) 274-8100
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 522-2161
(801) 274-8100
(800) 533-5044
INC.
CHROMA TECH WRAP JMS
(EBPA)
CHROMALLOY
Affiliated With: CDS GROUP HEALTH
UTILIZATION REVIEW
CORVEL
(801) 269-8723
CHRISTIAN RECORD SERVICES
MANAGEMENT, INC.
CHROMA TECH WRAP VST
(EBPA)
COMPENSABILITY
INC.
CHECK BENEFIT CARD
ADMINISTRATOR INC
ADMINISTRATOR INC
CHECK BENEFIT CARD
PO Box 2365
(800) 525-8788
11291 Pierce St.
(802) 846-8060
ADMINISTRATOR INC
ADMINISTRATOR INC
PO Box 2365
(800) 525-8788
CHECK BENEFIT CARD
(802) 846-8060
CDS Group Health
CDS Group Health
1625 E PRATER WAY BLDG C STE
101
SPARKS NV 89461
(775) 352-6951
UNIVERSAL HEALTH REVIEW
(775) 355-0921
(775) 352-6951
Network.
Info as of 12/24/2007
Page PIRMI-104
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PAYOR NAME
Chrysler
Affiliated With: Medical Mutual of Ohio
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
Medical Mutual of Ohio
UTILIZATION REVIEW
(800) 892-6200
(800) 258-2873
CIMARRON ELECTRIC COOPERATIVE Cimarron Electric c/o First Health
PO Box 5215
Tampa FL 33675
(877) 202-6379 Ext 2530
Cincinnati Reds
Affiliated With: Underwriters Safety &
Claims Inc.
Underwriters Safety & Claims, Inc.
PO Box 23507
(800) 678-1536
(800) 264-5702
CIGNA SPORTS AND ATHLETIC
PROGRAMS
TREVOSE PA 19053
(800) 658-9777
(800) 678-1536
CINCINNATI VA MEDICAL CENTER
3197
SERVICES
3200 VINE ST
CINCINNATI OH 45220
CHECK BENEFIT CARD
CITIZEN PUBLISHING - PEPM
HEALTH PLAN INC
HEALTH PLAN INC
PO Box 5199
(508) 752-2480
CARE MANAGEMENT
SERVICES
(886) 325-1550
(508) 752-2480
Network.
Info as of 12/24/2007
Page PIRMI-105
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PAYOR NAME
CITIZENS BANK AND TRUST OF
ARDMORE
CLAIMS SUBMISSION
FISERV HEALTH INC
COMPENSABILITY
FISERV HEALTH INC
UTILIZATION REVIEW
PO Box 530
(800) 235-7160
AVIDYN HEALTH
(214) 647-6194
CITIZENS FIRST BANK
DIVISION
BROWN & BROWN BENEFITS, INC.
BROWN & BROWN BENEFITS, INC.
CHECK BENEFIT CARD
CITIZENS UTILITIES
BENEFITS NETWORK, INC.
NORTH AMERICAN BENEFITS
NETWORK, INC. C/O CCN
NETWORK, INC. C/O CCN
CHECK BENEFIT CARD
CITY OF CALEXICO
Affiliated With: PINNACLE CLAIMS
MANAGEMENT INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CITY OF CARUTHERSVILLE
Affiliated With: GROUP BENEFIT
SERVICES, INC.
GROUP BENEFIT SERVICES, INC.
GROUP BENEFIT SERVICES,
INC.
CITY OF CASPER
ASSOCIATES
MBA OF WYOMING
MBA OF WYOMING
PO Box 2480
PO Box 5190
TAMPA FL 33675-5190
1736 E. Sunshine #200
SPRINGFIELD MO 65804
PO Box 94
WORLAND WY 82401
Network.
Info as of 12/24/2007
Page PIRMI-106
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PAYOR NAME
CITY OF CHICKASHA
SERVICES
CLAIMS SUBMISSION
PO Box 720460
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(405) 755-2929
(405) 755-2929
MANAGED BENEFITS
CONSULTANTS
CHECK BENEFIT CARD
PREFERRED BENEFIT
ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
FISERV HEALTH INC
FISERV HEALTH INC
PROFESSIONAL CLAIMS MGMT
CHECK BENEFIT CARD
16 W 455 S FRONTGATE RD STE 216
BURR RIDGE IL 60527
(630) 655-1001
CITY OF CHUBBUCK
ASSOCIATES
MANAGED BENEFITS
CONSULTANTS
CITY OF CLERMONT
PREFERRED BENEFIT
ADMINISTRATORS INC
CITY OF DECATUR
CITY OF DOWNEY
Affiliated With: BENESIGHT, INC.
FISERV HEALTH INC
CITY OF GARY
CLAIMS MANAGEMENT
PO Box 651109
PO Box 916188
PO Box 3000
PO Box 29050
PHOENIX AZ 85038
(630) 655-1001
Network.
Info as of 12/24/2007
Page PIRMI-107
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PAYOR NAME
CITY OF GRANBURY TRAVEL
ADMINISTRATORS
CLAIMS SUBMISSION
GROUP & PENSION
ADMINISTRATORS INC
DALLAS TX 75251
COMPENSABILITY
GROUP & PENSION
ADMINISTRATORS INC
UTILIZATION REVIEW
HEALTH WATCH
(972) 238-7900
(800) 827-7223
(972) 238-7900
CITY OF HAZLEHURST
INC
CITY OF HOBART
CONSULTANTS INC
CITY OF JACKSONVILLE
PO Box 12288
COLUMBUS GA 31917
(706) 327-9218
(706) 327-9218
(706) 327-9218
EMPLOYEE BENEFIT CONSULTANTS EMPLOYEE BENEFIT CONSULTANTS UM NOT APPLICABLE
(800) 367-9939
PO Box 928
(866) 296-4002
FINDLAY OH 45839
(866) 296-4002
(910) 480-3100
DOCTORS DIRECT
HEALTHCARE
(910) 485-0510
(910) 480-3100
City of Long Beach
Affiliated With: Tristar
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
City of Los Angeles
Affiliated With: Fair Isaac Corp /
Diversified HealthCare Services
CITY OF LOS ANGELES
CITY OF LOS ANGELES
700 E. Temple St Rm 210
Los Angeles CA 90012
(213) 847-9712
CITY OF LOS ANGELES
(213) 847-9712
CITY OF MICHIGAN CITY
(213) 847-9712
ASSURECARE
ASSURECARE
LANSING MI 38823
(800) 968-6616
CARELINE
(763) 383-4800
(800) 968-6616
Network.
Info as of 12/24/2007
Page PIRMI-108
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PAYOR NAME
CITY OF MIDWEST CITY
Affiliated With: GROUP
ADMINISTRATORS LTD
CITY OF MOORE
COMPANY
CITY OF NORMAN
CLAIMS SUBMISSION
GROUP ADMINISTRATORS, LTD.
PO Box 95600
HOFFMAN ESTATES IL 60195
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 749-1422
(800) 749-1422
PO Box 26967
(405) 290-5696
(800) 669-1815
Benefit Planners
Benefit Planners
CHECK BENEFIT CARD
PO Box 690450
(800) 292-5386
(405) 290-5696
(800) 292-5386
CITY OF OKLAHOMA FALLS
INC.
1011 SW EMKAY DR
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
CITY OF PADUCAH
Affiliated With: EBC MID-AMERICA
EBC MID-AMERICA
CITY OF PERRY
SOLUTIONS, INC.
EBC MID-AMERICA
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 2490
ALPHARETTA GA 30023
(678) 339-0211
9200 Shelbyville Rd Ste 500
LOUISVILLE KY 40222-5134
(678) 339-0211
Network.
Info as of 12/24/2007
Page PIRMI-109
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PAYOR NAME
CITY OF PLANO
SERVICES, INC.
CITY OF PONCA CITY
HEALTHPLANS
CITY OF POPLER BLUFF
INC
CITY OF PUYALLUP
INC
CLAIMS SUBMISSION
EMPLOYEE BENEFIT SERVICES SHREVEPORT
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
PO Box 70100
SHREVEPORT LA 71137-0100
AHC CHOICE HEALTH PLANS
AHC CHOICE HEALTH PLANS
PO Box 922009
HOUSTON TX 77292-2009
(800) 559-1322
CHECK BENEFIT CARD
(800) 559-1322
THE EPOCH GROUP, LC
THE EPOCH GROUP, LC
10795 Watson Rd
St. Louis MO 63129
(800) 365-9036
CHECK BENEFIT CARD
(800) 365-9036
220 120TH Ave NE Bldg D
Bellevue WA 98005
(800) 700-7153
2094992000
MBA OF WYOMING
MBA OF WYOMING
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 700-7153
CITY OF RAWLINS
ASSOCIATES
MBA OF WYOMING
CITY OF SAN RAMON
Affiliated With: COASTAL TPA INC
CHECK BENEFIT CARD
PO Box 98
WORLAND WY 82401
Network.
Info as of 12/24/2007
Page PIRMI-110
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PAYOR NAME
CITY OF SCOTTSDALE
Affiliated With: MAYO MANAGEMENT
SERVICES INC
CITY OF SIERRA VISTA
Affiliated With: THIRD PARTY
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
THIRD PARTY ADMINISTRATIVE
SERVICES
SERVICES
THIRD PARTY
7493 N Oracle Rd Ste 200
Tucson AZ 85704
(520) 670-0227
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
(520) 670-0227
CITY OF VALPARAISO
CONSULTANTS INC
CIVIL TOWN OF CLARKSVILLE
PLANS, INC.
(800) 367-9939
PO Box 928
(866) 296-4002
FINDLAY OH 45839
(866) 296-4002
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
(800) 832-8212
Claims Control
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Claims Indemnity Services Inc
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
CLAIMS TECHNOLOGY INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
6783411722
Network.
Info as of 12/24/2007
Page PIRMI-111
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PAYOR NAME
CLARCOR, INC
SYSTEMS INC
CLAREMONT FLOCK CORPORATION
CLAIMS SUBMISSION
208 S LASALLE ST STE 1300
CHICAGO IL 60604
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(312) 906-8080 Ext 259
(312) 906-8080 Ext 259
HEALTH PLAN INC
HEALTH PLAN INC
(508) 752-2480
CMS
(866) 325-1550
KHS, A KMG AMERICA COMPANY
CHECK BENEFIT CARD
210 S WHITE ST
LANCASTER SC 29720
(800) 822-1274
(508) 752-2480
CLAREMONT RESTAURANT GROUP,
LLC
Affiliated With: KHS A KMG AMERICA
COMPANY
(800) 822-1274
CLARK COUNTY
THE LOOMIS COMPANY
THE LOOMIS COMPANY
CHECK BENEFIT CARD
(800) 346-1223
(800) 346-1223
CLARK COUNTY MISSOURI
SERVICES
Clark District Co. of Versailles
Claims Inc.
1736 E. Sunshine Ste 200
Springfield MO 65804
(517) 631-3469
HEALTHLINK
(314) 989-6115
(800) 995-3569
PO Box 23507
(800) 678-1536
(800) 264-7502
(800) 678-1536
Network.
Info as of 12/24/2007
Page PIRMI-112
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PAYOR NAME
CLARKSBURG VA MEDICAL CENTER
3663
SERVICES
CLAIMS SUBMISSION
5504 HILL HEAVEN CT
FRISCO TX 75035
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(214) 387-3232
(214) 387-3232
CLAYTON COLLEGE & STATE UNIV
AIH0057987
PO Box 2271
CORP #14005
(843) 622-6001
CLAYTON COLLEGE & STATE UNIV
AIH0057997
PO Box 2271
Florence SC 29503
(843) 622-6001
CORP #14005
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
CHECK BENEFIT CARD
CLAYTON COLLEGE & STATE
Attn: WHIT WALTERS
MANDATORY
419 S. COIT ST
FLORENCE SC 29501
CORP
(800) 222-6491
CLAYTON COUNTY GORGIA
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UM NOT APPLICABLE
(800) 222-6491
CLAYTON STATE UNIVERSITY ICS
AII61217
PO Box 2271
CORP #14005
(843) 622-6001
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-113
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PAYOR NAME
Clements and Company - USAID
Group, Inc.
CLEMENTS FOOD COMPANY
ADMINISTRATORS
CLAIMS SUBMISSION
407 N Fulton St
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(317) 655-4500 Outside US
(800) 628-4664 Inside US
(317) 655-4500 Outside US
(800) 628-4664 Inside US
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
CLEMSON UNIVERSITY
CORP #14005
PO Box 2437
Florence SC 29503-2437
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
CLEVELAND VA MEDICAL CENTER
3196
SERVICES
Attn: FEE BASIS 136BF
10000 BRECKSVILLE RD
BRECKSVILLE OH 44141
CHECK BENEFIT CARD
CLICK BOND, INC
SYSTEMS
PO Box 80
Stockton CA 95201
(209) 474-5421
UNIVERSAL HEALTH
NETWORK
(800) 776-6959
CLINICA DE SALUD DEL PUEBLO
ADMINISTRATORS
(209) 474-5421
(801) 274-8100
CORVEL
(810) 269-8723
(801) 274-8100
Network.
Info as of 12/24/2007
Page PIRMI-114
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PAYOR NAME
CLINICAL RADIOLOGISTS
ADMINISTRATORS L P
CLAIMS SUBMISSION
NORTH AMERICA
PO Box 1984
NASHVILLE TN 37202
COMPENSABILITY
NORTH AMERICA
UTILIZATION REVIEW
CHECK BENEFIT CARD
6152563561 Ext 147
(800) 411-3650
CLINICAS DEL CAMINO REAL
ADMINISTRATORS
EMPLOYEE BENEFIT
ADMINISTRATORS
EMPLOYEE BENEFIT
ADMINISTRATORS
424 N. First Ave.
ARCADIA CA 91006-2804
(626) 294-2800
CHECK BENEFIT CARD
(818) 842-0147
(626) 294-2800
CLOTHESTIME STORES, INC.
Affiliated With: CORESOURCE, MN
CORESOURCE MN
CLOUGHERTY PACKING COMPANY
CHECK BENEFIT CARD
CLOVIS UNIFIED SCHOOL DISTRICT
MANAGEMENT
PINNACLE CLAIMS MANAGEMENT
PO Box 2220
NEWPORT BEACH CA 92658
(800) 649-9121
CM ALMY AND SONS - %
CORESOURCE MN
CORESOURCE MN
CHECK BENEFIT CARD
CHECK BENEFIT CARD
7830 BROADWAY
TUCSON AZ 85710
8002218942
CHECK BENEFIT CARD
(800) 649-9121
HEALTH PLAN INC
HEALTH PLAN INC
(508) 752-2480
CHECK BENEFIT CARD
(508) 752-2480
CM ALMY AND SONS INC
HEALTH PLAN INC
HEALTH PLAN INC
PO Box 5199
(800) 343-7674
CARE MANAGEMENT
SERVICES
8663251550
(800) 343-7674
Network.
Info as of 12/24/2007
Page PIRMI-115
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PAYOR NAME
CM PRODUCTS
SYSTEMS, INC.
CLAIMS SUBMISSION
CHICAGO IL 60604
COMPENSABILITY
UTILIZATION REVIEW
(312) 906-8080 Ext 259
AMERICAN HEALTH HOLDING
(312) 906-8080 Ext 259
(312) 906-8080 Ext 259
CMH FLOORING PRODUCTS INC
Affiliated With: KHS A KMG AMERICA
COMPANY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CNA Commerical Insurance
Affiliated With: Crawford and Company
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
FCE BENEFIT ADMINISTRATORS
CHECK BENEFIT CARD
(800) 899-9355
Accessed through Crawford and
Company, name does not appear on the
Payor List as a separate payor
COAST COMMUNITY COLLEGE
DISTRICT
SYSTEMS
COAST JANITORIAL
ADMINISTRATORS
COAST UNIFIED SCHOOL DISTRICT
(800) 899-9355
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
Network.
Info as of 12/24/2007
Page PIRMI-116
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PAYOR NAME
COASTAL CAROLINA UNIVERSITY
CORP #14005
COASTAL GEORGIA COMMUNITY
ACTION AUTHORITY
INC
CLAIMS SUBMISSION
PO Box 2437
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
(843) 622-6001
PARAGON BENEFITS
PARAGON BENEFITS
PO Box 12288
COLUMBUS GA 31917
(706) 327-9218
(877) 417-3363
COLLEGE AIH0058007
PO Box 2271
CORP #14005
(843) 622-6001
CHECK BENEFIT CARD
COLLEGE AIH0058017
PO Box 2271
CORP #14005
(843) 622-6001
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
COLLEGE UNDERGRAD MANDATORY
CORP
(706) 327-9218
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
Coastal International Security
ADMINISTRATORS INC
(800) 899-9355
UM NOT APPLICABLE
(800) 899-9355
Network.
Info as of 12/24/2007
Page PIRMI-117
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PAYOR NAME
COATES FIELD SERVICE
SERVICES
CLAIMS SUBMISSION
PO Box 720460
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(405) 755-2929
(405) 755-2929
COATESVILLE VAMC 3124
SERVICES
COATESVILLE VAMC
Attn: FEE BASIS - 115E
1400 BLACKHORSE HILL RD
COATSVILLE PA 19320
COATESVILLE VAMC
CHECK BENEFIT CARD
Coca Cola
Western Health
Western Health
Rapid City SD 57701
(605) 719-4600 or (888) 3411766
Western Health
(605) 719-4640 or (800) 2290892
COCA COLA BOTTLERS
IntraCorp
ASSOCIATION THE
1111 MARKET
Affiliated With: COCA COLA BOTTLERS CHATTANOOGA TN 37402-3306
ASSOCIATION THE
IntraCorp
CIGNA HEALTHCARE
CODALE ELECTRIC SUPPLY INC
Affiliated With: P5 HEALTH PLAN
SOLUTIONS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
COGBURN HEALTH SERVICES
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(605) 719-4600 or (888) 3411766
Network.
Info as of 12/24/2007
Page PIRMI-118
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PAYOR NAME
COHEN BROTHERS, INC.
Affiliated With: BENEFIT SREVICES
INC.
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CORESOURCE MN
CORESOURCE MN
HEALTH WATCH
(972) 238-7900
COLD SPRINGS GRANITE COMPANY
CORESOURCE MN
COLDWELL BANKER UNITED,
REALTORS
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS INC
GROUP & PENSION
ADMINISTRATORS INC
DALLAS TX 75251
(800) 827-7223
COLLEGE OF CHARLESTON
CORP #14005
UTILIZATION REVIEW
7830 BROADWAY
TUCSON AZ 85710
(972) 238-7900
PO Box 2437
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
COLLEGE VIEW ACADEMY
MANAGEMENT, INC.
INC.
COLLEY MCCOY MANAGEMENT
GROUP WRAP JMS
PLAN ADMINISTRATORS
EBPA
Attn: Denise Oberg
INC.
CHECK BENEFIT CARD
EBPA
CHECK BENEFIT CARD
11291 Pierce St.
(800) 578-3272
PO Box 2000
Exeter NH 03833
(800) 578-3272
Network.
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Page PIRMI-119
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PAYOR NAME
COLLINS PRODUCTS LLC
Affiliated With: QVI RISK SOLUTIONS
INC
COLONIAL GROUP
Affiliated With: PRIMARY
PHYSICIANCARE INC
International LTD
COLONY RESORT TRAVEL
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
PRIMARY PHYSICIAN CARE
PO Box 11088
CHARLOTTE NC 28220
(704) 527-8102
UTILIZATION REVIEW
CHECK BENEFIT CARD
(704) 523-2758
(704) 527-8102
PO Box 11519
(441) 296-3200
First Health
(800) 356-0810
(441) 296-3200
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
COLORADO STATE UNIVERSITY
INSURANCE SERVICES LC
SERVICES
Attn: VIVIAN PAUL
7400 COLLEGE BLVD STE 100
SERVICES
CHECK BENEFIT CARD
(877) 246-6997
(877) 246-6997
COLUMBIA (DORN VAMC) 3540
SERVICES
COLUMBIA - DORN VAMC
Attn: FEE BASIS - 136F
COLUMBIA - DORN VAMC
CHECK BENEFIT CARD
6439 GARNERS FERRY RD
COLUMBIA SC 29209
Network.
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Page PIRMI-120
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COMPENSABILITY
HARRY S TRUMAN VAMC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 2437
(843) 622-6001
PAYOR NAME
CLAIMS SUBMISSION
COLUMBIA (HARRY S TRUMAN
HARRY S TRUMAN VAMC
VAMC) 3525
Attn: BUSSINESS OFFICE ADMN FEE
Affiliated With: HEALTH NET FEDERAL 800 HOSPITAL DR
SERVICES
COLUMBIA MO 65201
COLUMBIA COLLEGE AMH9038017
CORP #14005
COLUMBIA COLLEGE JOHO482842
CORPORATION
UTILIZATION REVIEW
(843) 622-6001
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
CHECK BENEFIT CARD
(843) 622-6001
(843) 622-6001
* COLUMBIA LIGHTHOUSE FOR THE
BLIND
FCE BENEFIT ADMINISTRATORS INC UM NOT APPLICABLE
(800) 899-9355
(800) 899-9355
COLUMBUS HOUSING AUTHORITY
Affiliated With: PARAGON BENEFITS,
INC.
COLUMBUS STATE UNIV AIH0058027
CORP #14005
CHECK BENEFIT CARD
PO Box 2271
Florence SC 29503
(843) 622-6001
2221 Manchester Expressway
COLUMBUS GA 31904
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-121
www.firsthealth.com
PAYOR NAME
COLUMBUS STATE UNIV AIH0058037
CORP #14005
COLUMBUS STATE UNIVERSITY
UNDERGRAD MANDATORY
CORP
CLAIMS SUBMISSION
PO Box 2271
Florence SC 29503
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
(843) 622-6001
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
COLUMBUS VA OPC 3195
SERVICES
COLUMBUS VA OPC
Attn: FEE BASIS 136B2
543 TAYLOR AVE
COLUMBUS OH 43203
COLUMBUS VA OPC
CHECK BENEFIT CARD
COMANCHE COUNTY MEMORIAL
HOSPITAL
WATERSTONE BENEFIT
WATERSTONE BENEFIT
CHECK BENEFIT CARD
(888) 440-0971
(888) 440-0971
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 900
ELYRIA OH 44036
(440) 930-7500
(440) 930-7500
COMMENCEMENT BAY CORRUGATED CHECK BENEFIT CARD
SERVICE CORPORATION
COMMERCE BENEFITS GROUP PEPM
GROUP
(440) 930-7500
Network.
Info as of 12/24/2007
Page PIRMI-122
www.firsthealth.com
PAYOR NAME
COMMERCE BENEFITS
GROUP/BUCKEYE PREFERRED
GROUP
COMMERCIAL ENVIRONMENT
SYSTEMS
ADMINISTRATORS
COMMERCIAL SEWING INC
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
PO Box 900
ELYRIA OH 44036
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
CORPORATE MANAGEMENT
HEALTH SERVICES
(800) 423-5597
(888) 322-2524
COMMUNICATIONS INTERNATIONAL,
INC.
PREFERRED BENEFIT
ADMINISTRATORS INC
COMMUNITY ADMINISTRATORS
Affiliated With: THE COMMUNITY
HEALTH GROUP
* COMMUNITY BANK OF NEVADA
PREFERRED BENEFIT
ADMINISTRATORS INC
CHECK BENEFIT CARD
COMMUNITY
ADMINISTRATORS
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
PO Box 916188
PO Box 1177
CHULA VISTA CA 91912
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-123
www.firsthealth.com
PAYOR NAME
COMMUNITY COLLEGE OF DENVER
#15255
CLAIMS SUBMISSION
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
COMMUNITY HEALTH GROUP HMO
Affiliated With: THE COMMUNITY
HEALTH GROUP
COMMUNITY HOSPITAL OF THE
MONTEREY PENINSULA
COMMUNITY HOSPITAL OF THE
MONTEREY PENINSULA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 953-1801
(800) 953-1801
COMMUNITY DENTAL
Affiliated With: COMMUNITY HEALTH
GROUP
COMMUNITY HEALTH SERVICES
COMPENSABILITY
AMERIBEN SOLUTIONS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 1177
(800) 838-2869
PO Box 1177
(800) 838-2869
NHBC
NHBC
8990 East Raintree Dr
Scottsdale AZ 85751
(888) 621-7900
CHECK BENEFIT CARD
(888) 621-7900
COASTAL TPA, INC.
COASTAL TPA, INC.
PO Box 80308
SALINAS CA 93912
(800) 564-7475
CHECK BENEFIT CARD
(800) 564-7475
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-124
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
PLAN OF NEVADA
Community One Federal Credit Union Travel
LAS VEGAS NV 89114
(702) 242-7700
COMNET COMMUNICATIONS
T R PAUL INC.
Comp IQ - ASP
Comp IQ - ASP AUTO
Plan Type: Auto
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
MANAGED CARE STRATEGIES
CompIQ Corporation
CompIQ Corporation
UM NOT APPLICABLE
35 Tesla Way #100
Irvine CA 92618
(800) 293-3131
CompIQ Corporation
CompIQ Corporation
35 Tesla Way #100
Irvine CA 92618
(800) 293-3131
PO Box 5508
UM NOT APPLICABLE
(800) 293-3131
Companion Life Insurance Company
Affiliated With: Insurers Administrative
Corporation
COMPANION LIFE INSURANCE
COMPANY
ADMINISTRATIVE CORPORATION
#11337
PO Box 828
(800) 964-4948
Med-Valu
(800) 522-2161
Insurers Administrative Corporation
(IAC)
(IAC)
Med-Valu
(800) 522-2161
PO Box 828
(800) 843-3106
(602) 906-6263
(800) 843-3106
Network.
Info as of 12/24/2007
Page PIRMI-125
www.firsthealth.com
PAYOR NAME
Compass Rose Benefit Group
Affiliated With: Compass Rose Benefit
Group
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
GLOBALCARE
(GLOBALCARE/WEYCO)
GLOBALCARE
(GLOBALCARE/WEYCO)
UM NOT APPLICABLE
COMPIQ
Affiliated With: GLOBAL EMERGENCY
MEDICAL SERVICES, INC. (GEMS)
GLOBALCARE
(GLOBALCARE/WEYCO)
CompIQ
Affiliated With: CompIQ #13910
CompIQ Corporation
CompIQ Corporation
35 Tesla Way #100
Irvine CA 92618
(800) 293-3131
UTILIZATION REVIEW
2001 Westside Pkwy. #120
ALPHARETTA GA 30004
(800) 293-3131
COMPLETE BENEFITS SOLUTIONS
LLC
CompMed Advantage / City of Peekskill
Affiliated With: CompMed Advantage
NHBC
NHBC
8990 East Raintree Dr
Scottsdale AZ 85751
(888) 621-7900
CHECK BENEFIT CARD
(888) 621-7900
Network Adjusters
Network Adjusters
PO Box 6008
Garden City NY 11530
(516) 750-1319
CONTACT EMPLOYER
(516) 750-1319
COMPONE SERVICES LTD
KEMPTON GROUP
ADMINISTRATORS INC
KEMPTON GROUP
ADMINISTRATORS INC
PO Box 54889
(405) 521-1711
CHECK BENEFIT CARD
(405) 521-1711
Network.
Info as of 12/24/2007
Page PIRMI-126
www.firsthealth.com
PAYOR NAME
COMPREHENSIVE BENEFIT
ADMINISTRATOR INC JMS
(EBPA)
CLAIMS SUBMISSION
EBPA
PO Box 2365
COMPENSABILITY
EBPA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(802) 846-8060
(802) 846-8060
CONCENTRA / FOCUS (Part of NHR)
720 Cool Springs Blvd., #300
Franklin TN 37067
(800) 243-2336
CONCENTRA / FOCUS (Part of
NHR)
(800) 243-2336
(800) 243-2336
CONCORD HOSPITALITY
ENTERPRISES COMPANY
PARTY ADMINISTRATOR
CONCORDIA HOMES OF NEVADA
ACORDIA NATIONAL
ACORDIA NATIONAL
PO Box 3262
CHARLESTON WV 25332
(888) 685-7774
CHECK BENEFIT CARD
(888) 685-7774
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
CONGREGATION OF THE SISTERS
OF ST JOSEPH OF BOSTON
ADMINISTRATORS - NY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CONNECTICUT COLLEGE
CONCEPTS INC
CHECK BENEFIT CARD
WAYNE PA 19087-1706
(888) 293-9229
(888) 293-9229
Network.
Info as of 12/24/2007
Page PIRMI-127
www.firsthealth.com
PAYOR NAME
CONNECTICUT STEEL WRAP JMS
(EBPA)
CLAIMS SUBMISSION
EBPA
PO Box 2365
COMPENSABILITY
EBPA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 525-8788
(802) 846-8060
CONNECTICUT VA HEALTHCARE
SYSTEM
CHECK BENEFIT CARD
CONNOLLY BOVE LODGE & HUTZ LLP BENEFIT CONCEPTS, INC.
1021 W 8TH AVE
CONCEPTS BENEFIT CONCEPTS, INC. KING OF PRUSSIA PA 19406
(800) 883-2000
CONSOLIDATED CASTING TRAVEL
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
HEALTH WATCH
(972) 238-7900
DALLAS TX 75251
(800) 827-7223
SYSTEM 3113
SERVICES
SYSTEM
555 WILLIARD AVE
NEWINGTON CT 06111
(800) 827-7223 Ext 2325
Consolidated Electrical Supply Co.
Affiliated With: First Health
First Health
First Health
PO Box 671248
Houston TX 77267-1248
(800) 231-3337
First Health
(800) 525-2394
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 231-3337
CONSOLIDATED GRAPHICS
LTD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-128
www.firsthealth.com
PAYOR NAME
CONSOLIDATED HEALTH PLAN
CORPORATION
CLAIMS SUBMISSION
Attn: Mary Shepherd
PO Box 489
COMPENSABILITY
UTILIZATION REVIEW
(800) 967-2077
MEDCAREONE CORP
(800) 816-1206
PREFERRED BENEFIT
ADMINISTRATORS INC
PREFERRED BENEFIT
ADMINISTRATORS INC
HEALTHCHOICE
(407) 481-7125
PO Box 916188
(407) 786-2777
(800) 967-2077
CONSOLIDATED MINERALS INC
ADMINISTRATORS
(407) 786-2777
CONSOLIDATED RESOURCES INC
ADMINISTRATION #10442
CONSTRUCTION DATA COMPANY
DIVISION
CONSTRUCTION PROTECTIVE
SERVICES INC
* Consumer Credit Services Inc Travel
PO Box 1520
IOWA CITY IA 52244
8005624023
CARE ALLIES
(972) 307-2700
8005624023
ULTRABENEFITS INC
ULTRABENEFITS INC
PO Box 2480
(800) 323-4890
INTRACORP
(800) 875-5315
(800) 323-4890
PO Box 45019
Fresno CA 93718
5594992000
CHECK BENEFIT CARD
8002218942
8002218942
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-129
www.firsthealth.com
PAYOR NAME
CONSUMER'S CHOICE/USA
Affiliated With: AMERICAS HEALTH
CARE BENEFIT PLAN
CLAIMS SUBMISSION
(IAC)
PO Box 39119
Phoenix AZ 85069-9119
COMPENSABILITY
(IAC)
(602) 906-6263
UTILIZATION REVIEW
Insurers Administrative
Corporation (IAC)
(602) 395-7096
(602) 906-6263
CONSUMERS INTERSTATE
CORPORATION
CONTACT-RURAL METRO
HEALTHCARE
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
SCHALER ANDERSON HEALTHCARE
SCHALER ANDERSON HEALTHCARE CHECK BENEFIT CARD
4645 E. COTTON CENTER BLVD
BLDG 1 #200
PHOENIX AZ 85040
(602) 659-1403
(602) 659-1403
CONTINENTAL GENERAL
INSURANCE COMPANY
CONTINENTAL GENERAL
INSURANCE COMPANY
CONTINENTAL GENERAL
INSURANCE COMPANY
INSURANCE CO.
PO Box 247007
OMAHA NE 68124
CONTINENTAL RESOURCES
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
CHECK BENEFIT CARD
PO Box 42096
(800) 825-3540
(800) 825-3540
Continental Western Group
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
Network.
CONTACT EMPLOYER
Info as of 12/24/2007
Page PIRMI-130
www.firsthealth.com
PAYOR NAME
CONTRACT LUMBER
ADMNISTRATORS & CONSULTANTS
INC
CLAIMS SUBMISSION
BAC
COMPENSABILITY
BAC
(614) 863-8780
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(614) 863-8780
CONTRACTORS BONDING AND
INSURANCE COMPANY
Affiliated With: EBMS EMPLOYEE
BENEFIT MANAGEMENT SERVICES
CHECK BENEFIT CARD
CONTROL DEVICES INC DBA FIRST
TECHNOLOGY
HEALTH PLAN INC
HEALTH PLAN INC
(508) 752-2480
CONTROL TECHNOLOGIES JMS
(EBPA)
CONTROL TECHNOLOGIES WRAP
JMS
(EBPA)
Cook County Arrestees
Affiliated With: Martin Boyer/Cambridge
UTILIZATION REVIEW
BAC
(614) 863-8780
8007773575
CARE MANAGEMENT
SERVICES
(866) 325-1550
(508) 752-2480
EBPA
EBPA
PO Box 2365
(802) 846-8060
CHECK BENEFIT CARD
(802) 846-8060
ADMINISTRATOR INC
ADMINISTRATOR INC
PO Box 2365
(800) 525-8788
CHECK BENEFIT CARD
(802) 846-8060
MARTIN BOYER / CAMBRIDGE
175 W JACKSON
CHICAGO IL 60604
MARTIN BOYER / CAMBRIDGE
(312) 381-8326
(312) 381-8326
Network.
Info as of 12/24/2007
Page PIRMI-131
www.firsthealth.com
PAYOR NAME
* COOPER CAMERON CORPORATION
CLAIMS SUBMISSION
Benefit Planners
PO Box 690450
COMPENSABILITY
Benefit Planners
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 292-5386
(800) 292-5386
COOPER STANDARD AUTOMOTIVE
INC
Affiliated With: HEALTH DESIGN PLUS
COOPER TIRE & RUBBER COMPANY
Health Design Plus
Health Design Plus
1755 GEORGETOWN ROAD
HUDSON OH 44236
(877) 286-3559
Health Design Plus
(800) 385-7085
(877) 286-3559
Health Design Plus
Health Design Plus
HUDSON OH 44236
(877) 286-3559
Health Design Plus
(800) 385-7085
Employee Benefit Management Corp
(EBMC)
(EBMC)
ACMS
(800) 831-6677
4789 Rings Rd
(614) 766-5800
(877) 286-3559
COOPERATIVE GROUP BENEFITS
PLAN
MANAGEMENT CORP
COPE PLASTICS
ADMINISTRATIVE SYSTEMS INC
(614) 766-5800
SYSTEMS
SYSTEMS
6 EXECUTIVE DR, SUITE ONE
FAIRVIEW HEIGHTS IL 62208
(800) 737-0878
CHECK BENEFIT CARD
(800) 737-0878
CORBIS CORPORATION
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8007773575
Network.
Info as of 12/24/2007
Page PIRMI-132
www.firsthealth.com
PAYOR NAME
CORE CARRIER CORPORATION
ADMINISTRATORS LP
CLAIMS SUBMISSION
NORTH AMERICA
PO Box 1984
NASHVILLE TN 37202
COMPENSABILITY
NORTH AMERICA
UTILIZATION REVIEW
MED-CERT
(800) 356-7126
(800) 411-3650
(800) 411-3650
CORE INNOVATIVE SOLUTIONS, LLC
SERVICES, INC
QUALIFIED BENEFIT SERVICES LLC CHECK BENEFIT CARD
691 W 1200 N, Suite 200
SPRINGVILLE UT 84663
(801) 853-1300
(801) 853-1300
CORESLAB STRUCTURES
THE LOOMIS COMPANY
Wyomissing PA 19610
(877) 634-9814
HINES & ASSOCIATES
(888) 826-5769
THE LOOMIS COMPANY
(877) 634-9814
CORNISH COLLEGE OF THE ARTS
CONCEPTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CORONET MANUFACTURING CO INC
SERVICE CENTER
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CORPORATE BENEFIT SERVICES OF
AMERICA (CBSA)
Affiliated With: CORPORATE BENEFIT
SERVICES OF AMERICA (CBSA)
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-133
www.firsthealth.com
PAYOR NAME
CORPORATE RESOURCE
MANAGEMENT INC
Affiliated With: AMERICAN STERLIN
CORPORATE WINGS
PARTY ADMINISTRATOR
CORRPRO COMPANIES
Affiliated With: ENTRUST INC
CLAIMS SUBMISSION
AMERICAN STERLIN
PO Box 26103
COMPENSABILITY
AMERICAN STERLIN
UTILIZATION REVIEW
CHECK BENEFIT CARD
(877) 292-6037
(877) 292-6037
ACORDIA NATIONAL
ACORDIA NATIONAL
PO Box 3262
CHARLESTON WV 25332
(888) 685-7774
ACORDIA NATIONAL
(304) 353-8743
(888) 685-7774
ENTRUST INC
ENTRUST INC
14701 ST MARY'S LN STE 150
HOUSTON TX 77079
(281) 368-7878
MEDICAL HELPLINE
(877) 463-3435
(281) 368-7878
COTKIN, COLLINS & GINSBURG
Affiliated With: AMERICAN INSURANCE
ADMINISTRATORS
AMERICAN INSURANCE
ADMINISTRATORS
AMERICAN INSURANCE
ADMINISTRATORS
13191 CROSSROADS PARK NORTH
STE 205
CITY OF INDUSTRY CA 91746-3434
(800) 654-7900
CHECK BENEFIT CARD
(800) 654-7900
Cottingham and Butler SISCO
Affiliated With: Fair Isaac Corporation
SISCO
SISCO
PO Box 28
Dubuque IA 52004
(563) 587-5175
SISCO
(563) 587-5175
(563) 587-5175
COTTON ELECTRIC COOPERATIVE
INC
KEMPTON GROUP
ADMINISTRATORS INC
KEMPTON GROUP
ADMINISTRATORS INC
PO Box 54889
(405) 521-1711
CHECK BENEFIT CARD
(405) 521-1711
Network.
Info as of 12/24/2007
Page PIRMI-134
www.firsthealth.com
PAYOR NAME
Council on International Educational
Exchange (CIEE)
Group, Inc.
COUNTY OF KERN POS PLAN
ADMINISTRATORS
CLAIMS SUBMISSION
407 N Fulton St
COMPENSABILITY
(317) 636-4721
UTILIZATION REVIEW
Check Benefit Card
CUNA Mutual Insurance Society
PO Box 1648
Madison WI 52701 or
(317) 636-4721
GALLAGHER BENEFIT
ADMINISTRATORS INC
GALLAGHER BENEFIT
ADMINISTRATORS INC
PO Box 5227
LISLE IL 60532
(888) 478-2650
GALLAGHER BENEFIT
ADMINISTRATORS INC
(630) 493-3925
(888) 478-2650
COUNTY OF KERN PPO PLAN
ADMINISTRATORS
GALLAGHER BENEFIT
ADMINISTRATORS INC
GALLAGHER BENEFIT
ADMINISTRATORS INC
PO Box 5227
LISLE IL 60532
(888) 478-2650
GALLAGHER BENEFIT
ADMINISTRATORS INC
(630) 493-3925
(888) 478-2650
COUNTY OF KINGS
SYSTEMS
County Of Los Angeles
Affiliated With: Diversified HealthCare
Services
COUNTY OF MENDOCINO
SYSTEMS
PO Box 1147
STOCKTON CA 95201
(800) 556-5918
DELTA TEAMCARE
(877) 464-1441
(800) 556-5918
COUNTY OF LOS ANGELES
3333 Wilshire Blvd Ste 1000
Los Angeles CA 90010
(213) 637-0822
(213) 637-0822
(213) 637-0822
PO Box 1147
STOCKTON CA 95201
(209) 474-5647
HEALTH CARE EVALUATION
(209) 951-6711
(209) 474-5647
Network.
Info as of 12/24/2007
Page PIRMI-135
www.firsthealth.com
PAYOR NAME
COUNTY OF MUSKEGON SHERIFF S
DEPARTMENT
Affiliated With: COUNTY OF
MUSKEGON SHERIFF S DEPARTMENT
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UTILIZATION REVIEW
County of Santa Barbara
Affiliated With: Stratacare
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
COUNTY OF SANTA CLARA - DEPT
OF CORRECTIONS
Affiliated With: COUNTY OF SANTA
CLARA
VALLEY HEALTH PLAN
VALLEY HEALTH PLAN
2325 Enborg Lane #290
San Jose CA 95128
(408) 885-4582
VALLEY HEALTH PLAN
(888) 421-8444
COUNTY OF SANTA CLARA UNSPONSORED PROGRAMS
CLARA
COUNTY OF SANTA CLARA DBA:
SANTA CLARA VALLEY HEALTH &
HOSPITAL SYSTEM
CLARA
COURTESY AUTOMOTIVE GROUP
TRAVEL
(408) 885-4582
VALLEY HEALTH PLAN
VALLEY HEALTH PLAN
San Jose CA 95128
(408) 885-4582
VALLEY HEALTH PLAN
(888) 421-8444
(408) 885-4582
VALLEY HEALTH PLAN
VALLEY HEALTH PLAN
San Jose CA 95128
(888) 421-8444
VALLEY HEALTH PLAN
(888) 421-8444
(888) 421-8444
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-136
www.firsthealth.com
PAYOR NAME
COURTNEY & PHARR
ADMINISTRATORS
CLAIMS SUBMISSION
CAROLINA BENEFIT
ADMINISTRATORS
333 SOUTH PINE ST
SPARTANBURG SC 29302
COMPENSABILITY
CAROLINA BENEFIT
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 476-2295
(800) 476-2295
Coventry Health Care
Affiliated With: Coventry Health Care
Coventry HealthCare of Louisiana, Inc.
PO Box 7707
London KY 40742
Coventry HealthCare of Louisiana, Inc. Coventry HealthCare of
Louisiana, Inc.
(800) 708-9355
(800) 708-9355
(800) 341-6613
COVENTRY OF KANSAS CITY
Affiliated With: COVENTRY HEALTH
CARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CPR HEARTPLACE
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS INC
GROUP & PENSION
ADMINISTRATORS INC
HEALTH WATCH
(972) 238-7900
DALLAS TX 75251
(800) 827-7223
(972) 238-7900
Cracker Barrel
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
CRAFTSMEN INDUSTRIES INC
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH & LIFE /
HEALTH PLAN
(702) 242-7345
(702) 242-7700
Crawford & Company
Plan Type: Auto
CONTACT EMPLOYER
Attn:
Crawford & Company
(888) 382-0039
Network.
Crawford & Company
(800) 241-2541
Info as of 12/24/2007
Page PIRMI-137
www.firsthealth.com
PAYOR NAME
CRAWFORD / ISP
CLAIMS SUBMISSION
CRAWFORD/ISP
1361 Alts Road
Wayne NJ 07470
COMPENSABILITY
CRAWFORD/ISP
UTILIZATION REVIEW
(973) 628-3148
CRAWFORD/ISP
(973) 628-3148
(973) 628-3148
Crawford and Company
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
CREATIVE MANAGEMENT
TECHNOLOGY INC
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CREATIVE OFFICE PAVILLION
Affiliated With: BENEFIT PLAN
MANAGEMENT
BENEFIT PLAN MANAGEMENT
CONTACT EMPLOYER
PO Box 536
ROCKLAND MA 02370
(781) 753-7559
CREDIT ONE TRAVEL PLAN
(781) 753-7559
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
CREEL PRINTING
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-138
www.firsthealth.com
PAYOR NAME
CRESCENT ELECTRIC SUPPLY CO
Affiliated With: SELF INSURED
SERVICES COMPANY
CLAIMS SUBMISSION
SELF INSURED SERVICES
COMPANY (SISCO)
PO Box 28
Dubuque IA 52004
COMPENSABILITY
COMPANY (SISCO)
UTILIZATION REVIEW
HEALTHCORP
(800) 457-4726
(800) 457-4726
(800) 457-4726
CRISTI CLEANING
CRL MAJOR MEDICAL CRS100 POK
INSURANCE CO.
CROCODILES NOT WATERLILIES
ADMINISTRATORS
(800) 899-9355
(800) 899-9355
PO Box 2804
Clinton IA 52733
(800) 247-2190
CHECK BENEFIT CARD
(800) 247-2190
CHECK BENEFIT CARD
CROWN EQUIPMENT
DIRECT CARE AMERICA
Affiliated With: THE CHANDLRE GROUP PO Box 2090 C
STOW OH 44224
CHECK BENEFIT CARD
CHECK BENEFIT CARD
DIRECT CARE AMERICA
CHECK BENEFIT CARD
(800) 266-5896
(800) 266-5896
CROWN POINT CABINETRY
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
Network.
Info as of 12/24/2007
Page PIRMI-139
www.firsthealth.com
PAYOR NAME
CRUM ELECTRIC
ASSOCIATES
CLAIMS SUBMISSION
COMPENSABILITY
MBA OF WYOMING
MBA OF WYOMING
UTILIZATION REVIEW
PO Box 94
WORLAND WY 82401
CSU LOS ANGELES INTL STUDENT
SRVCS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CSU SCHOOLS
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
CHECK BENEFIT CARD
PO Box 7186
BOISE ID 83707
(800) 953-1801
(800) 953-1801
CUMBERLAND HEALTHCARE
CUMMINS CONSTRUCTION COMPANY
ADMINISTRATORS
NHBC
NHBC
Scottsdale AZ 85260
(888) 621-7900
CHECK BENEFIT CARD
(888) 621-7900
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
CUMMINS CUMBERLAND
PLAN INC 962550088
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
(502) 992-4535
Network.
Info as of 12/24/2007
Page PIRMI-140
www.firsthealth.com
PAYOR NAME
CURA Group The
CUSTOM DESIGN BENEFITS - NEFF
PACKAGING
Affiliated With: GLOBALCARE INC
CUSTOMATION
COMPENSABILITY
CONTACT EMPLOYER
CONTACT EMPLOYER
GLOBALCARE, INC.
GLOBALCARE, INC.
UM NOT APPLICABLE
6875 Shiloh Rd E
ALPHARETTA GA 30005
(678) 341-1922
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
UTILIZATION REVIEW
(678) 341-1922
ASSURECARE
ASSURECARE
LANSING MI 38823
(800) 968-6616
CARELINE
(763) 383-4800
GLOBALCARE
GLOBALCARE
CHECK BENEFIT CARD
6875 Shiloh Rd E
ALPHARETTA GA 30005
(678) 341-1811
(800) 968-6616
CYPRESS-CREATIVE FORMING
(678) 341-1811
DAHL - CHASE PATHOLOGY
ASSOCIATES
DAHL-CHASE DIAGNOSTIC SERVICES
NORTH AMERICAN
ADMINISTRATORS-NY
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 9501
AMHERST NY 14226
(800) 397-2122
CHECK BENEFIT CARD
(800) 397-2122
NORTH AMERICAN
ADMINISTRATORS-NY
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 9501
AMHERST NY 14226
(800) 397-2122
CHECK BENEFIT CARD
(800) 397-2122
Network.
Info as of 12/24/2007
Page PIRMI-141
www.firsthealth.com
PAYOR NAME
DAK AMERICAS LLC
DALLAS BAPTIST
MANAGEMENT
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
8002779476
TRUE CHOICE USA
TRUE CHOICE USA
PO Box 700307
DALLAS TX 75370
(800) 785-2446
CHECK BENEFIT CARD
(800) 785-2446
DALLAS NATIONAL
GENEX SERVICES, INC.
Affiliated With: GENEX SERVICES, INC. 440 E. SWEDESFORD RD STE 3050
WAYNE PA 19087
Dallas National Insurance Company
CompIQ Corporation
CompIQ Corporation
CHECK BENEFIT CARD
35 Tesla Way #100
Irvine CA 92618
(949) 923-4021
(949) 923-4021
DALLAS THEOLOGICAL SEMINARY
MANAGEMENT
DALLAS VA MEDICAL CENTER 3168
SERVICES
TRUE CHOICE USA
TRUE CHOICE USA
PO Box 700307
DALLAS TX 75370
(800) 785-2446
CHECK BENEFIT CARD
(800) 785-2446
DALLAS VA MEDICAL CENTER
4500 S LANCASTER
DALLAS TX 75216
DALLAS VA MEDICAL CENTER
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-142
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
DALTON STATE COLLEGE
UNDERGRAD MANDATORY
Attn: WHIT WALTERS
CORP
FLORENCE SC 29501
(800) 222-6491
DALTON STATE UNIV AIH0058047
CORP #14005
DALTON STATE UNIV AIH0058057
CORP #14005
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(800) 222-6491
PO Box 2271
Florence SC 29503
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
PO Box 2271
Florence SC 29503
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
DANA CORPORATION
Affiliated With: AMERICAN HEALTH
GROUP
AMERICAN HEALTH GROUP
DANA NON UNION RETIREE VEBA
TRUST
Affiliated With: INTERPLAN HEALTH
GROUP
INTERPLAN HEALTH GROUP
Attn: Supervisor of the Claims Dept
(800) 266-5896
(888) 610-0082
DANVILLE VA MEDICAL CENTER
CHECK BENEFIT CARD
570 Longbow
MAUMEE OH 43537
PO Box 2388 C
STOW OH 44224
(800) 266-5896
DANVILLE VA MEDICAL CENTER 3154
SERVICES
DANVILLE VA MEDICAL CENTER
Attn: FEE BASIS (136A7)
1900 E MAIN ST
DANVILLE IL 61832
Network.
Info as of 12/24/2007
Page PIRMI-143
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
DARTON COLLEGE UNDERGRAD
MANDATORY
Attn: WHIT WALTERS
CORP
FLORENCE SC 29501
(800) 222-6491
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(800) 222-6491
DAVE KINGSTON PRODUCE
AFFILIATED COMPANIES
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
DAVIDSON HOTEL COMPANIES
LTD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
DAYTON SUPERIOR
KANSAS - 11297
FISERV HEALTH INC
FISERV HEALTH INC
PO Box 520
(800) 235-7160
AVIDYN HEALTH
(214) 647-6194
CHECK BENEFIT CARD
1021 W. 8TH AVE STE 200
(800) 220-2600
Dayton Superior Corporation
Affiliated With: Brokerage Concepts
Inc/Benefit Concepts Inc
DAYTON VA MEDICAL CENTER 3194
SERVICES
(800) 235-7160
(800) 220-2600
DAYTON VA MEDICAL CENTER
Attn: FEE BASIS 136
4100 W 3RD ST
DAYTON OH 45428
DAYTON VA MEDICAL CENTER
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-144
www.firsthealth.com
PAYOR NAME
DAYWEST HEALTHCARE SERVICES
ADMINISTRATORS
CLAIMS SUBMISSION
(801) 274-8100
UTILIZATION REVIEW
CORVEL
(801) 269-8723
(801) 274-8100
DBSI REALTY CORPORATION
MANAGEMENT SERVICES
EBMS
DCI BIOLOGICALS, INC
SERVICE OF AMERICA
* DCR Services Inc.
INC
COMPENSABILITY
EBMS
EBMS CARELINK
(406) 245-3575
MERITAIN HEALTH
MERITAIN HEALTH
PO Box 1065
AMHERST NY 14226
(877) 777-6076
GUIDED2HEALTH
(952) 593-6447
CHECK BENEFIT CARD
PO BOX 71489
Newnan GA 30271
(770) 683-1024
PO Box 21367
(877) 777-6076
(770) 683-1024
MACHIGONNE BENEFIT
ADMINISTRATORS
CHECK BENEFIT CARD
ADMINISTRATOR INC
ADMINISTRATOR INC
HEALTH CARE STRATEGIES
8005821535
PO Box 2365
(800) 587-3272
DEAD RIVER COMPANY
(EBPA)
MACHIGONNE BENEFIT
ADMINISTRATORS
DEAD RIVER COMPANY
(EBPA)
PO BOX 3859
PORTLAND ME 04104-3859
(800) 587-3272
Network.
Info as of 12/24/2007
Page PIRMI-145
www.firsthealth.com
PAYOR NAME
DEAD RIVER COMPANY JMS
(EBPA)
CLAIMS SUBMISSION
EBPA
PO Box 2365
COMPENSABILITY
EBPA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(802) 846-8060
(802) 846-8060
GROUP & PENSION
ADMINISTRATORS INC
CHECK BENEFIT CARD
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
CHECK BENEFIT CARD
PO Box 42096
(800) 825-3540
DEALERS ELECTRICAL SUPPLY
COMPANY
GROUP & PENSION
ADMINISTRATORS INC
DEAN A MCGEE EYE INSTITUTE
ADMINISTRATORS
PO Box 749075
(800) 825-3540
DEARDEN'S
AFFORDABLE BENEFIT
DEBRUCE GRAIN
SERVICES INC A DIVISION OF
CORESOURCE
DECATHLON USA FORMALLY MVP
SPORTS
Affiliated With: AMERICA'S CHOICE
HEALTHPLANS LLC
AFFORDABLE BENEFIT
AFFORDABLE BENEFIT
FMH BENEFIT SERVICES, INC. A
DIVISION OF CORESOURCE, INC.
HCM
(800) 990-9058
PO Box 25946
(800) 990-9058
PO Box 10787
BURBANK CA 91510
(800) 990-9058
AMERICA'S CHOICE HEALTHPLANS,
LLC
Houston TX 77040
AMERICA'S CHOICE HEALTHPLANS, AMERICAN HEALTH
HOLDINGS INC
LLC
(888)
578-1812
(877) 224-3627
(877) 224-3627
Network.
Info as of 12/24/2007
Page PIRMI-146
www.firsthealth.com
PAYOR NAME
DECATUR PARK DISTRICT
Affiliated With: CONSOCIATE GROUP
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UTILIZATION REVIEW
DECATUR PUBLIC SCHOOL DISTRICT
DECO PAPER PRODUCTS
PLAN INC 962550088
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
UM NOT APPLICABLE
PO Box 3000
(502) 992-4535
Definiti / P G & E
Affiliated With: COMP IQ
Definiti
Definiti
77 Beale St
San Francisco CA 94105
(415) 973-8017
DEFT, INC
Affiliated With: EBA&M
EBA&M
EBA&M
PO Box 5079
(800) 776-1545
HINES & ASSOCIATES
(800) 528-2498
THE EPOCH GROUP
THE EPOCH GROUP
UM NOT APPLICABLE
(800) 776-1545
DELAVAL INC
L.C.
THE EPOCH GROUP
DELAWARE VALLEY COLLEGE
CONCEPTS, INC.
WAYNE PA 19087-1706
PO Box 12170
(888) 293-9229
(888) 293-9229
Network.
Info as of 12/24/2007
Page PIRMI-147
www.firsthealth.com
PAYOR NAME
DELTA FOREMOST CHEMICAL
ASSOCIATES, INC.
CLAIMS SUBMISSION
COMPENSABILITY
CHECK BENEFIT CARD
(800) 264-7502
PO Box 111047
MEMPHIS TN 38111
DEMIRCO COMPANY
Desa International
Claims Inc.
PO Box 23507
(800) 678-1536
Deseret Mutual Benefit Administrators
Affiliated With: Deseret Mutual Benefit
Administrators
UTILIZATION REVIEW
PO Box 3000
(800) 678-1536
Deseret Healthcare
Deseret Healthcare
PO Box 45530
Salt Lake City UT 84145-0530
(800) 777-3622
Deseret Mutual Benefit
Administrators
(800) 777-3622
(800) 777-3622
(801) 533-3420
DESERT LUMBER
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
DESERT ORTHOPAEDIC TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-148
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
DESERT RADIOLOGIST - TRAVEL
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
* DESJARDIN
NETWORK INC
* DESOTO COUNTY DBA SORRELLS
BROTHERS PACKING CO.
CONSULTANTS INC
STAR HEALTHCARE NETWORK
850 Seventh Ave STE 803
New York NY 10019
(212) 581-8228
UM NOT APPLICABLE
(212) 581-8228
HERITAGE CONSULTANTS INC
PO Box 1730
AUBURNDALE FL 33823
8639674139
8639674139
8639674139
DETROIT VA MEDICAL CENTER 3155
SERVICES
DETROIT VA MEDICAL CENTER
Attn: FEE BASIS 001B-SS
4646 JOHN R
DETROIT MI 48201
DETROIT VA MEDICAL CENTER
CHECK BENEFIT CARD
DEVON ENERGY
Benefit Planners
Benefit Planners
CHECK BENEFIT CARD
PO Box 690450
(800) 292-5386
(800) 292-5386
DHS INC
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-149
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
DHSI - California Pacific Medical Center CONTACT EMPLOYER
(CPMC)
Affiliated With: Fair Isaac Corp /
Diversified Healthcare Systems
COMPENSABILITY
CONTACT EMPLOYER
CHECK BENEFIT CARD
UTILIZATION REVIEW
DHSI - Creative Risk Funding
Affiliated With: Diversified Healthcare
Systems
CONTACT EMPLOYER
CONTACT EMPLOYER
CHECK BENEFIT CARD
DIAGNOS-TECHS, INC
Affiliated With: ALTERNATIVE
INSURANCE RESOURCES
ALTERNATIVE INSURANCE
RESOURCES
ALTERNATIVE INSURANCE
RESOURCES
CHECK BENEFIT CARD
PO Box 660787
BIRMINGHAM AL 35266
(202) 871-3229
(202) 871-3229
DICKINSON COLLEGE
CONCEPTS, INC.
WAYNE PA 19087-1706
UM NOT APPLICABLE
(888) 293-9229
(888) 293-9229
DIGESTIVE HEALTH SPECIALISTS
INC.
DILCON COMMUNITY SCHOOL
ADMINISTRATORS INC
ADMINISTRATORS INC
PO Box 85008
BELLEVUE WA 98015
(800) 869-7093
ADMINISTRATORS INC
(425) 289-5142
CHECK BENEFIT CARD
(800) 869-7093 Ext 117
PO Box 25160
Network.
Info as of 12/24/2007
Page PIRMI-150
www.firsthealth.com
PAYOR NAME
DINGLEY PRESS IPN
(EBPA)
DINGLEY PRESS JMS
(EBPA)
DINGLEY PRESS SCAN DIRECT
(EBPA)
DIOCESE OF CHEYENNE
Affiliated With: MBA OF WYOMING
13039
DIPLOMATIC PAINTING & BUILDING
SERVICES COMPANY
ADMINISTRATORS
DIPLOMATIC PAINTING & BUILDING
SERVICES COMPANY
CLAIMS SUBMISSION
ADMINISTRATOR
PO Box 2365
COMPENSABILITY
ADMINISTRATOR
UTILIZATION REVIEW
(800) 582-1535
(800) 846-8060
(800) 846-8060
ADMINISTRATOR
ADMINISTRATOR
PO Box 2365
(800) 846-8060
(800) 582-1535
(800) 846-8060
ADMINISTRATOR
ADMINISTRATOR
PO Box 2365
(800) 846-8060
(800) 582-1535
(800) 846-8060
MBA OF MARYLAND
MBA OF MARYLAND
PO Box 98
WORLAND WY 82401
(307) 347-6151
(307) 347-7979
UM NOT APPLICABLE
(800) 899-9355
(307) 347-6151
(800) 899-9355
(800) 899-9355
(800) 899-9355
Network.
Info as of 12/24/2007
Page PIRMI-151
www.firsthealth.com
PAYOR NAME
DIRECT MEDIA, INC.
Affiliated With: T R PAUL INC
CLAIMS SUBMISSION
T R PAUL INC.
PO Box 5508
NEWTON CT 06470-5508
COMPENSABILITY
T R PAUL INC.
UTILIZATION REVIEW
CHECK BENEFIT CARD
8006788161 Ext 244
8006788161 Ext 244
DISMAS CHARITIES INC
PLANS, INC.
DIVERSIFIED ADMIN. CORP.
PO Box 437017
Louisville KY 40253
(800) 832-8212
CHECK BENEFIT CARD
(800) 832-8212
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
DIVERSIFIED COMMUNICATIONS
Affiliated With: COURESOURCE, INC
CORESOURCE, INC.
CORESOURCE, INC.
PO Box 83301
LANCASTER PA 17608-3301
(800) 223-3843
CORESOURCE, INC.
(800) 223-3843
(800) 223-3843
DIVERSIFIED CONTRACTORS, INC.
INC.
Diversified Health Care Service (DHSI)
Affiliated With: Diversified Health Care
Service
DIVERSIFIED HEALTHCARE
SERVICES, INC.
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
Diversified Health Care Services, Inc.
Diversified Health Care Services, Inc.
201 East Sandpointe, Suite 320
Santa Ana CA 92707
(714) 918-2590 Ext 104
Diversified Health Care Services,
Inc.
(714) 918-2590 Ext 104
(714) 918-2590 Ext 104
SERVICES, INC.
SERVICES, INC.
201 East Sandpointe, Suite 320
Santa Ana CA 92707
(714) 918-2590 Ext 104
SERVICES, INC.
(714) 918-2590 Ext 104
(714) 918-2590 Ext 104
Network.
Info as of 12/24/2007
Page PIRMI-152
www.firsthealth.com
PAYOR NAME
Diversified Healthcare Systems
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
COMPENSABILITY
CONTACT EMPLOYER
CONTACT EMPLOYER
UTILIZATION REVIEW
DIXON BROS, INC
Affiliated With: WESTERN HEALTH
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
DLZ CORPORATION
ADMINISTRATORS AND
CONSULTANTS
BAC
BAC
(614) 863-8780
BAC
(614) 863-8780
CONTACT EMPLOYER
CONTACT EMPLOYER
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
CHECK BENEFIT CARD
PO Box 42096
(800) 825-3540
DMI
(614) 863-8780
CompIQ Corporation
35 Tesla Way #100
Irvine CA 92618
(800) 293-3131
DOLESE BROS CO
ADMINISTRATORS
(800) 825-3540
HINES & ASSOCIATES
(800) 528-2498
Health Design Plus
Health Design Plus
PO Box 2582
HUDSON OH 44236
(877) 230-0990
CHECK BENEFIT CARD
(800) 434-1305
DONAHUE SCHRIBER
Donatos Pizzeria Corporation
Affiliated With: Health Design Plus
PO Box 3000
(877) 230-0990
Network.
Info as of 12/24/2007
Page PIRMI-153
www.firsthealth.com
PAYOR NAME
DORKS UNLIMITED JMS
PLAN ADMINISTRATORS
CLAIMS SUBMISSION
EBPA
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
COMPENSABILITY
EBPA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 578-3272
(800) 578-3272
DORKS UNLIMITED WRAP % JMS
PLAN ADMINISTRATORS
EBPA
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
EBPA
CHECK BENEFIT CARD
(800) 578-3272
(800) 578-3272
DOUG ANDRUS DISTRIBUTING
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
DOUGLAS COUNTY SCHOOL
DISTRICT
HEALTHCOMP TPA
HEALTHCOMP TPA
CHECK BENEFIT CARD
PO Box 45018
Fresno CA 93718
(800) 442-7247
(800) 442-7247
DOUGLASS FERTILIZER CHEMICAL
INC
CONSULTANTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
DOW ELECTRONICS, INC.
Affiliated With: ALL RISK
ADMINISTRATORS
ALL RISK ADMINISTRATORS
8010 Blind Pass Rd.
PASS A GRILL BEACH FL 33706
Network.
Info as of 12/24/2007
Page PIRMI-154
www.firsthealth.com
PAYOR NAME
DOWELL ENTERPRISES INC
DOWN EAST TOYOTA BUICK
CLAIMS SUBMISSION
PO Box 520
COMPENSABILITY
(800) 235-7160
UTILIZATION REVIEW
CO.
(800) 725-6566
(800) 235-7160
NORTH AMERICAN
ADMINISTRATORS-NY
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 9501
AMHERST NY 14226
(800) 397-2122
CHECK BENEFIT CARD
(800) 397-2122
DOWNEAST COMMUNITY HOSPITAL
Affiliated With: PATIENT ADVOCATES
DR SYSTEMS
CENBEN USA
4079 Executive Pkwy
CENBEN USA
CHECK BENEFIT CARD
PO Box 1959
Gray ME 04039
(614) 797-5204
(614) 797-5204
DRIVERS CHOICE
Affiliated With: CONSUMER HEALTH
SOLUTIONS
DRIVETIME AUTOMOTIVE
LTD
CONSUMER HEALTH SOLUTIONS
CONSUMER HEALTH SOLUTIONS
333 SOUTH PINE ST
(877) 573-9541
CHECK BENEFIT CARD
(877) 573-9541
BENEFIT PLANNERS LTD
PO Box 690450
(800) 218-1004
(800) 218-1004
(800) 218-1004
Network.
Info as of 12/24/2007
Page PIRMI-155
www.firsthealth.com
PAYOR NAME
DRYWALL SYSTEMS PLUS
PLANS, INC.
CLAIMS SUBMISSION
PO Box 437017
Louisville KY 40253
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 832-8212
(800) 832-8212
DUBLIN VAMC 3546
SERVICES
DUBLIN VAMC
Attn: FEE BASIS 04
1826 VETERANS BLVD
DUBLIN GA 31021
DUBLIN VAMC
CHECK BENEFIT CARD
Duhamel Broadcasting Enterprises
Western Health
Western Health
Rapid City SD 57701
(605) 719-4600 or (888) 3411766
Western Health
(605) 719-4640 or (800) 2290892
DUNCAN EQUIPMENT COMPANY
ADMINISTRATORS
(605) 719-4600 or (888) 3411766
Attn: Mary Shepherd
PO Box 489
(800) 967-2077
MEDCAREONE CORP
(800) 816-1206
(800) 967-2077
DUNCAN EQUIPMENT COMPANY
THE EPOCH GROUP
THE EPOCH GROUP
6717 SHAWNEE MISSION PARKWAY
(800) 255-6065
THE EPOCH GROUP
(800) 255-6065
(800) 255-6065
DUNCAN-PARNELL
PHYSICIANCARE INC
PRIMARY PHYSICIANCARE, INC.
PO Box 11088
CHARLOTTE NC 28220
(704) 527-8102
INC.
(704) 523-2758
(704) 527-8102
Network.
Info as of 12/24/2007
Page PIRMI-156
www.firsthealth.com
UTILIZATION REVIEW
CLAIMS SUBMISSION
COMPENSABILITY
DUNELAND SCHOOL CORPORATION EMPLOYEE BENEFIT CONSULTANTS EMPLOYEE BENEFIT CONSULTANTS UM NOT APPLICABLE
(800) 367-9939
PO Box 928
(866) 296-4002
CONSULTANTS INC
FINDLAY OH 45839
(866) 296-4002
PAYOR NAME
DURA AUTOMOTIVE
Affiliated With: NGS AMERICAN
NGS AMERICAN, INC.
NGS AMERICAN
PO Box 7676
DETROIT MI 48080
8005211555
NGS AMERICAN
8005211555
8005211555
DURHAM EXCHANGE CLUB
INDUSTRIES
BENEFIT SYSTEMS
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
DURHAM VAMC
CHECK BENEFIT CARD
DUVAL ASPHALT
CHECK BENEFIT CARD
Affiliated With: UNITED BENEFITS, INC.
CHECK BENEFIT CARD
CHECK BENEFIT CARD
DYNAMIC POWER SOURCE, LLC
PLANS, INC.
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
DURHAM VAMC 3135
SERVICES
(800) 283-4927
DURHAM VAMC
Attn: FEE BASIS
508 FULTON ST
DURHAM NC 27705
(800) 832-8212
Network.
Info as of 12/24/2007
Page PIRMI-157
www.firsthealth.com
PAYOR NAME
DYNAPOWER CORPORATION JMS
(EBPA)
DYNAPOWER CORPORATION WRAP
JMS
(EBPA)
DYNATEC CORP USA
ADMINISTRATORS
DYSON KYSSNER MORAN
CORPORATION
ADMINISTRATORS - NY
DZILTH NA DITH HLE SCHOOL
Affiliated With: SRT ADMINISTRATORS
INC
E GADS
CLAIMS SUBMISSION
EBPA
PO Box 2365
COMPENSABILITY
EBPA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(802) 846-8060
(802) 846-8060
ADMINISTRATOR INC
ADMINISTRATOR INC
PO Box 2365
(800) 525-8788
CHECK BENEFIT CARD
(802) 846-8060
(801) 274-8100
CORVEL
(801) 269-8723
(801) 274-8100
NORTH AMERICAN
ADMINISTRATORS INC
NORTH AMERICAN
ADMINISTRATORS INC
PO Box 1065
AMHERST NY 14226
(877) 777-6076
AMERICAN HEALTH
HOLDINGS INC
(800) 337-0506
(877) 777-6076
SRT ADMINISTRATORS
SRT ADMINISTRATORS
PO Box 25160
(888) 690-2020
HINES & ASSOCIATES
(800) 944-9401
(888) 690-2020
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-158
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
E GADS TRAVEL
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
E H OFTEDAL & SONS INC
CONSULT
MANAGED BENEFITS
CONSULTANTS
MANAGED BENEFITS
CONSULTANTS
PO Box 98
WORLAND WY 82401
(307) 347-6151
(307) 347-7979
(307) 347-6151
EAGLE GROUP
* Eagle Pass ISD (Travel)
ADMINISTRATORS
EBMS
EBMS
PO Box 21367
(406) 245-3575
EBMS CARELINK
(406) 245-3575
(406) 245-3575
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
DALLAS TX 75251
(800) 827-7223
CHECK BENEFIT CARD
(800) 827-7223
EAST BALT COMM
SERVICES COMPANY SISCO
COMPANY (SISCO)
COMPANY (SISCO)
CHECK BENEFIT CARD
EAST CAROLINA UNIVERSITY
CORP #14005
UM NOT APPLICABLE
PO Box 2408
(888) 722-1668
PO Box 389
(888) 722-1668
Network.
Info as of 12/24/2007
Page PIRMI-159
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
EAST CENTRAL COLLEGE
STUDENT ASSURANCE SERVICES
Affiliated With: STUDENT ASSURANCE INC
SERVICES INC
333 N. MAIN STREET
STILLWATER MN 55082
COMPENSABILITY
INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 328-2739
(800) 328-2739
EAST CENTRAL ILLINOIS PIPE
TRADES H & W FUND
Affiliated With: MORRIS ASSOCIATES
MORRIS ASSOCIATES
MORRIS ASSOCIATES
9045 E 59TH ST
INDIANAPOLIS IN 46250
(800) 950-6789
CHECK BENEFIT CARD
(800) 950-6789
EAST GEORGIA COLLEGE AIH0058087 PEARCE ADMINISTRATION
Affiliated With: MAKSIN MANAGEMENT PO Box 2271
CORP #14005
Florence SC 29503
(843) 622-6001
EAST GEORGIA COLLEGE AIH0058097 PEARCE ADMINISTRATION
Affiliated With: MAKSIN MANAGEMENT PO Box 2271
CORP #14005
Florence SC 29503
(843) 622-6001
EAST ORANGE VA MEDICAL CENTER
3119
SERVICES
EAST ORANGE VA MEDICAL
CENTER
Attn: FEE BASIS 04
385 TREEMONT AVE
EAST ORANGE NJ 07018
EAST ORANGE VA MEDICAL
CENTER
CHECK BENEFIT CARD
Eastern Alliance
Affiliated With: Eastern Alliance
Insurance Group
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CHECK BENEFIT CARD
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-160
www.firsthealth.com
PAYOR NAME
EASTERN BENEFIT SYSTEMS, INC.
CLAIMS SUBMISSION
200 Freeway Dr, East
East Orange 07018
COMPENSABILITY
(800) 524-0227
UTILIZATION REVIEW
BEECH STREET
(800) 227-7464
(800) 524-0227
CHECK BENEFIT CARD
EASTERN COLORADO VA HCS 3532
SERVICES
EASTERN COLORADO VA HC
SYSTEM
EASTERN NAZARENE COLLEGE
HEALTH PLANS INC
CONSOLIDATED HEALTH PLANS INC
CONSOLIDATED HEALTH PLANS INC CHECK BENEFIT CARD
195 STAFFORD ST
(800) 633-7867
EASTERN COLORADO VA HC
SYSTEM
1055 CLERMONT ST
DENVER CO 80220
(800) 633-7867
EASTERN OREGON UNIVERSITY
USI ADMINISTRATORS
Affiliated With: FIRST UNDERWRITERS PO Box 3357
INC
FORT WORTH TX 76113
USI ADMINISTRATORS
USI ADMINISTRATORS
EASTERN OREGON UNIVERSITY
INTERNATIONAL AND DOMESTIC
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
EASTPOINT PROPERTIES
Affiliated With: HEALTH PLANS, INC.
(800) 786-7930
HEALTH PLAN INC
HEALTH PLAN INC
5087522480
CMS INC
(866) 325-1550
EATON CORPORATION
EATON CORPORATION
CHECK BENEFIT CARD
PO Box 8400
London KY 40742
(800) 891-6506
5087522480
Eaton Corporation
Affiliated With: Eaton Corporation
(800) 891-6506
Network.
Info as of 12/24/2007
Page PIRMI-161
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
EBMS EMPLOYEE HEALTH PLAN
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
EDWARD HINES JR VAMC 3162
SERVICES
EDWARD HINES JR VAMC
Attn: FEE SERVICES
5TH AVE & ROOSEVELT RD
HINES IL 60141
EDWARD HINES JR VAMC
CHECK BENEFIT CARD
EDWARD M BERSTEIN &
ASOCIATES - TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
PAYOR NAME
EATON METAL PRODUCTS
SOLUTIONS
EFFICIENT ENTERPRISES TRAVEL
UTILIZATION REVIEW
8007773575
(702) 242-7700
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
EIGHTH DISTRICT ELECTRICAL
BENEFIT FUND / ID MT WY
Affiliated With: EIGHTH DISTRICT
ELECTRICAL BENEFIT FUND
COMPUSYS
COMPUSYS
2156 W 2200 S
(800) 628-6562
UM NOT APPLICABLE
(800) 628-6562
Network.
Info as of 12/24/2007
Page PIRMI-162
www.firsthealth.com
PAYOR NAME
EIGHTH DISTRICT ELECTRICAL
BENEFIT FUND/ CO UT
Affiliated With: EIGHTH DISTRICT
ELECTRICAL BENEFIT FUND
EL CENTRO REGIONAL MEDICAL
CENTER
ADMINISTRATORS
EL PASO FIRST HEALTH PLANS
EL PASO VAMC 3174
SERVICES
* Elastic Therapy Inc.
INC
Electric Insurance Company
CLAIMS SUBMISSION
COMPUSYS
2156 W 2200 S
COMPENSABILITY
COMPUSYS
UTILIZATION REVIEW
UM NOT APPLICABLE
(800) 628-6562
(800) 628-6562
8774534201
UM NOT APPLICABLE
8774534201
NHBC
NHBC
Scottsdale AZ 85260
(888) 621-7900
CHECK BENEFIT CARD
(888) 621-7900
EL PASO VAMC
Attn: FEE BASIS - 04
EL PASO VAMC
CHECK BENEFIT CARD
PO Box 2857
(910) 480-3100
DOCTORS DIRECT
HEALTHCARE
(910) 485-0510
5001 N PEIDRAS
EL PASO TX 79930
(910) 480-3100
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
Network.
CONTACT EMPLOYER
Info as of 12/24/2007
Page PIRMI-163
www.firsthealth.com
PAYOR NAME
Electric Insurance Company
Affiliated With: Electric Insurance
Company
CLAIMS SUBMISSION
First Health
COMPENSABILITY
CONTACT EMPLOYER
First Health
UTILIZATION REVIEW
PO Box 11930
Tucson AZ 85734
Electrical Construction Industry Health
and Welfare Fund
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ELECTRICAL WHOLESALE SUPPLY
CO., INC.
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
ELECTROLUX HOME PRODUCTS INC DIRECT CARE AMERICA
GEORGIA
PO Box 2090 C
Affiliated With: THE CHANDLER GROUP STOW OH 44224
(800) 266-5896
DIRECT CARE AMERICA
ELIZABETH CITY STATE UNIVERSITY
CORP #14005
PO Box 2408
(888) 722-1668
ELK HILLS SCHOOL
CHECK BENEFIT CARD
(800) 266-5896
CHECK BENEFIT CARD
(888) 722-1668
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
Network.
Info as of 12/24/2007
Page PIRMI-164
www.firsthealth.com
PAYOR NAME
ELKVIEW GENERAL HOSPITAL
INC
ELLA
CLAIMS SUBMISSION
THE KEMPTON GROUP
PO Box 54889
COMPENSABILITY
THE KEMPTON GROUP
UTILIZATION REVIEW
CHECK BENEFIT CARD
(405) 521-1711
(405) 521-1711
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 767-0700
ELM ELECTRIC WRAP JMS
(EBPA)
ELWYN, INC
ADMINISTRATOR INC
ADMINISTRATOR INC
PO Box 2365
(800) 525-8788
CHECK BENEFIT CARD
(802) 846-8060
(800) 899-9355
(800) 899-9355
EM Management
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
EMERGENCY MEDICINE PHYSICIANS
Affiliated With: CORESOURCE INC
CORESOURCE INC
CORESOURCE INC
PO Box 2920
(866) 682-3152
CORESOURCE INC
(866) 831-5677
(866) 682-3152
Network.
Info as of 12/24/2007
Page PIRMI-165
www.firsthealth.com
PAYOR NAME
EMERITUS ASSISTED LIVING
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
8007773575
EMERSON ELECTRIC CO. FOR INSINK-ERATOR
Affiliated With: EMERSON ELECTRIC
CO. FOR IN-SINK-ERATOR
EMERSON TELECOMMUNICATION
PRODUCTS INC
Affiliated With: THE EPOCH GROUP L
C
CHECK BENEFIT CARD
EMINENCE SPEAKER, LLC
PLANS, INC.
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
(IAC)
(IAC)
Med-Valu
(800) 522-2161
PO Box 828
(800) 843-3106
EMPIRE FIRE & MARINE
#11337
Empire Fire and Marine
Corporation
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 8013
8003659036
(800) 832-8212
(800) 843-3106
Benefits/Eligibility
PO Box 39119
Phoenix AZ 85069-9119
(800) 843-3106
CHECK BENEFIT CARD
(800) 843-3106
Network.
Info as of 12/24/2007
Page PIRMI-166
www.firsthealth.com
PAYOR NAME
EMPLOYEE BENEFIT CLAIMS OF WI,
INC.
SERVICES, INC.
CLAIMS SUBMISSION
FIRST ADMINISTRATORS INC
PO Box 8150
RAPID CITY SD 57709-8150
COMPENSABILITY
IntraCorp
UTILIZATION REVIEW
IntraCorp
8004687299 Ext 23320
8004687299 Ext 23320
EMPLOYEE BENEFIT MANAGEMENT
SERVICES
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
EMPLOYEE BENEFIT PLAN
ADMINISTRATION IPN
PLAN ADMINISTRATION
ADMINISTRATION
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
ADMINISTRATION
(800) 582-1535
(800) 268-7298
(603) 773-4521
ADMINISTRATION JMS
PLAN ADMINISTRATION
ADMINISTRATION
Attn: Denise Oberg
PO Box 2000
ADMINISTRATION
(800) 582-1535
(800) 268-7298
Exeter NH 03833
(603) 773-4521
ADMINISTRATION NATIONAL WRAP
SCANDIRECT
(EBPA)
ADMINISTRATION
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
ADMINISTRATION
(800) 582-1535
(800) 268-7298
(603) 773-4521
ENCINITAS UNION SCHOOL DISTRICT THE PLAN HANDLERS, INC.
Affiliated With: CBIZ/SCEET
930 Canterbury Pl.
ESCONDIDO CA 92025
Network.
Info as of 12/24/2007
Page PIRMI-167
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
ENCORE PRODUCTIONS
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
ENCORE PRODUCTIONS - TRAVEL
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
ENDICOTT COLLEGE
MANAGEMENT SYSTEMS
INC
INC
330 WHITNEY AVE
HOLYOKE MA 01041
8004234586
PIONEER MANAGEMENT
SYSTEMS INC
8004234586
ENERGY LABORATORIES/EBMS
MANAGEMENT SERVICES
ENERGY WEST
PARTY ADMINISTRATOR
ENGINEERED DATA PRODUCTS
HOLDINGS LLC
Affiliated With: CINC HEALTH
SOLUTIONS
EBMS
EBMS
PO Box 21367
(800) 777-3575
CHECK BENEFIT CARD
(800) 777-3575
ACORDIA NATIONAL
ACORDIA NATIONAL
CHECK BENEFIT CARD
(888) 685-7774
(888) 685-7774
CNIC HEALTH SOLUTIONS
PO Box 3559
ENGLEWOOD CO 80155-3559
(800) 426-7453
(800) 426-7453
(800) 426-7453
Network.
Info as of 12/24/2007
Page PIRMI-168
www.firsthealth.com
PAYOR NAME
ENGINEERED QUALITY PLASTICS
C
CLAIMS SUBMISSION
CHECK BENEFIT CARD
ENGLEWOOD AREA FIRE CONTROL
DISTRICT
LLC
ENNIS, INC
ADMINISTRATORS
ENSIGN US DRILLING %
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
MedWatch
(800) 432-8421
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS INC
HEALTH WATCH
(800) 827-7223
DALLAS TX 75251
(800) 827-7223
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
1016 COLLIER CENTER STE 200
NAPLES FL 34103
CHECK BENEFIT CARD
(800) 786-7930
ENSIGN US DRILLING PEPM
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
CHECK BENEFIT CARD
(800) 786-7930
ENVIROSOURCE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-169
www.firsthealth.com
PAYOR NAME
ENZYMATIC THERAPY, INC
ADMINISTRATORS
CLAIMS SUBMISSION
MIDWEST SECURITY
ADMINISTRATORS INC
2700 Midwest Dr.
ONALASKA WI 54650
COMPENSABILITY
MIDWEST SECURITY
ADMINISTRATORS INC
UTILIZATION REVIEW
UM NOT APPLICABLE
(608) 783-8718
(608) 783-8718
EOSCS (TMC 2)
EOSCS (TMC 2)
EOSCS (TMC 2)
(714) 245-4762
EOSCS (TMC 2)
(714) 245-4762
230 N. Golden Circle, Suite 103
Santa Ana CA 92705
(714) 245-4762
Epic
Affiliated With: Innovative Risk
Management
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
EPISCOPAL CHURCH HOME
PLANS, INC.
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
(800) 832-8212
EPT MCGILL BEARING
#10469
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ERIE VAMC 3125
SERVICES
ERIE VAMC
135 E 38TH ST
ERIE PA 16504
ERIE VAMC
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-170
www.firsthealth.com
PAYOR NAME
* ERLANGER TUBULAR CORP
Affiliated With: UNITED MEDICAL
RESOURCES
Eskaton
CLAIMS SUBMISSION
UNITED MEDICAL RESOURCES
PO Box 145804
CINCINNATI OH 45250
COMPENSABILITY
UNITED MEDICAL RESOURCES
UTILIZATION REVIEW
CHECK BENEFIT CARD
(513) 619-3227
(513) 619-3227
HEALTHCOMP
HEALTHCOMP
PO Box 45018
Fresno CA 93718
(559) 499-2450
HEALTHCOMP
(559) 499-2450
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
(559) 499-2450
ESKAY CORPORATION
GROUP
(800) 533-5044
Estes Express Lines
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
EVANGELICAL BENEFIT TRUST FUND
(EBT)
Affiliated With: MBA OF MARYLAND
CONTACT EMPLOYER
CONTACT EMPLOYER
CHECK BENEFIT CARD
EVANSVILLE OPC VA
Attn: FEE BASIS
500 E WALNUT ST
EVANSVILLE IN 47713
EVANSVILLE OPC VA
CHECK BENEFIT CARD
DBA: Hope Presbyterian Church
EVANSVILLE OPC VA 3309
SERVICES
Network.
Info as of 12/24/2007
Page PIRMI-171
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
EVERCOM SYSTEMS
GROUP & PENSION
Affiliated With: GROUP AND PENSION ADMINISTRATORS INC
ADMINISTRATORS INC
PO Box 749075
COMPENSABILITY
GROUP & PENSION
ADMINISTRATORS INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 827-7223
(800) 827-7223
Everest ACCA San Francisco
Affiliated With: Everest ACCA
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
Everest National
Affiliated With: Everest SRS
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
EVEREST NATIONAL INSURANCE CO.
Affiliated With: EVEREST NATIONAL
INSURANCE CO.
EVEREST NATIONAL INSURANCE
CO.
EVEREST NATIONAL INSURANCE
CO.
65 Enterprise Suite 235
Aliso Viejo CA 92656
(949) 330-6892
EVEREST NATIONAL
INSURANCE CO.
(949) 330-6892
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
(949) 330-6892
* EVOLUTION BUSINESS SOLUTIONS
AADMINISTRATORS
EXCEL CORPORATION
GROUP
EXPERIENCE WORKS, INC.
Affiliated With: PERFORMAX BCI
(800) 533-5044
PO Box 61505
(888) 554-7629
PERFORMAX / AMERICAN
HEALTH HOLDING
(614) 818-3222
(888) 554-7629
Network.
Info as of 12/24/2007
Page PIRMI-172
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PAYOR NAME
EZCORP, INC.
Affiliated With: BOON CHAPMAN
BENEFIT ADMINISTRATORS
F RODGERS SPECIALTY
CONTRACTORS INC
F. A. Richard & Associates, Inc.
Affiliated With: F. A. Richard &
Associates, Inc.
CLAIMS SUBMISSION
BOON CHAPMAN
PO Box 9201
AUSTIN TX 78766
COMPENSABILITY
BOON CHAPMAN
(800) 252-9653
(800) 252-9653
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
FARA - F. A. Richard & Associates, Inc.
1625 W. Causeway Approach
Mandeville LA 70471
FARA - F. A. Richard & Associates, Inc. FARA - F. A. Richard &
Associates, Inc.
(985) 624-6740
(985) 624-6740
(985) 624-6740
F.A. RICHARD & ASSOCIATES, INC.
Affiliated With: FARA BENEFIT
SERVICES
FARA BENEFIT SERVICES C/O CCN
FABRICUT, INC.
ADMINISTRATION
St Louis MO 63101
(800) 394-6888
Fair Isaac Corporation
UTILIZATION REVIEW
PRIME DX
(800) 477-4625
FARA BENEFIT SERVICES C/O CCN CHECK BENEFIT CARD
PO Box 5190
TAMPA FL 33675-5190
CHECK BENEFIT CARD
(314) 982-5616
CONTACT EMPLOYER
CONTACT EMPLOYER
Network.
CONTACT EMPLOYER
Info as of 12/24/2007
Page PIRMI-173
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
Fairfield
University
International
Students
*
123 INTERSTATE DR
MANAGEMENT SYSTEMS
(413) 534-8658
FAIRMONT HOTELS RESORTS
GROUP
* Falvey Linen
SERVICE CENTER
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(413) 534-8658
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
GISC, INC
GISC, INC
20 WINTER ST
PEMBROKE MA 02359
(800) 242-4472
GISC TOTALCARE
(800) 999-1077
GLOBALCARE, INC.
GLOBALCARE, INC.
AVIDYN HEALTH
(214) 647-6194
(800) 242-4472
FAMILY HEALTH PLAN
GLOBALCARE, INC.
FAMILY HOME HEALTH AGENCY
FISERV HEALTH INC
FISERV HEALTH INC
PO Box 520
(800) 235-7160
FANCOR INC
SERVICES INC
PO Box 25946
(800) 990-9058
6875 Shiloh Rd E
ALPHARETTA GA 30005
HCM
(800) 990-9058
Network.
Info as of 12/24/2007
Page PIRMI-174
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PAYOR NAME
CLAIMS SUBMISSION
FANNING/HOWEY ASSOCIATES, INC. BAC
ADMINISTRATORS & CONSULTANTS REYNOLDSBURG OH 43068
(614) 863-8780 Ext 3102
COMPENSABILITY
BAC
UTILIZATION REVIEW
(614) 863-8780 Ext 3102
BAC
(614) 863-8780
FANSTEEL
Affiliated With: CBCA Administrators, Inc. PO Box 902
Beattyville KY 41311
FARA Avondale
Associates, Inc.
Associates, Inc.
(985) 624-6740
(985) 624-6740
FARA Ingalls
Associates, Inc.
FARGO VAMC 3707
SERVICES
FARLEY AND SON
LLC
Mandeville LA 70471
(985) 624-6740
Mandeville LA 70471
Associates, Inc.
(985) 624-6740
(985) 624-6740
(985) 624-6740
2025 AEROJET RD
(916) 985-1259
CHECK BENEFIT CARD
(916) 985-1259
PO Box 1959
Gray ME 04039
Network.
Info as of 12/24/2007
Page PIRMI-175
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PAYOR NAME
FARMER NATIONAL BANK
Affiliated With: THE CHANDLER
GROUP #13352
FAULTLESS LINEN
SERVICES, INC.
CLAIMS SUBMISSION
DIRECT CARE AMERICA
PO Box 2090 C
STOW OH 44224
COMPENSABILITY
DIRECT CARE AMERICA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 266-5896
(800) 266-5896
FMH / HCM
FMH / HCM
(800) 990-9058
FMH / HCM
(800) 990-9058
(800) 990-9058
FAYETTE R III SCHOOLS
SERVICES, INC.
HEALTHLINK
INC.
FAYETTEVILLE ARKANSAS VAMC
3103
SERVICES
Attn: FEE BASIS 04FB
1100 NORTH COLLEGE
FAYETTEVILLE AR 72703
CHECK BENEFIT CARD
FAYETTEVILLE NC VAMC 3136
SERVICES
FAYETTEVILLE NC VAMC
Attn: FEE BASIS BUSINESS OFFICE
(04)
2300 RAMSEY ST
FAYETTEVILLE NC VAMC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 2408
(888) 722-1668
PO Box 419104
SAINT LOUIS MO 63141-9104
FAYETTEVILLE STATE UNIVERSITY
CORP #14005
(888) 722-1668
Network.
Info as of 12/24/2007
Page PIRMI-176
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PAYOR NAME
FCCI Insurance Group
Affiliated With: FCCI Insurance Group
CLAIMS SUBMISSION
6300 University Pkwy
Sarasota FL 34240
COMPENSABILITY
(800) 226-3224
UTILIZATION REVIEW
(800) 226-3224
(800) 226-3224
FEATHER RIVER HOSPITAL
SYSTEM/WEST
ADVENTIST HEALTH SYSTEM WEST
FEATHERLITE COACHES, INC
SERVICES
Auxiant
Auxiant
PO Box 75008
Cedar Rapids IA 52401
(800) 475-2232
* FEDERAL ASSIST
NETWORK INC
Federal Government
Affiliated With: GLOBALHEALTH AND
GENERATION HEALTHCARE
FEDERATED INNSURANCE
12717
PO Box 619031
CHECK BENEFIT CARD
(800) 475-2232
New York NY 10019
(212) 581-8228
UM NOT APPLICABLE
(212) 581-8228
GLOBALHEALTH
GLOBALHEALTH
7001 NE 10th St
(405) 280-5600
GLOBALHEALTH
(405) 230-8781
NHBC
NHBC
CHECK BENEFIT CARD
Scottsdale AZ 85260
(888) 621-7900
(405) 280-5600
(888) 621-7900
Network.
Info as of 12/24/2007
Page PIRMI-177
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PAYOR NAME
FEDERATED MUTUAL INSURANCE
COMPANY
Affiliated With: FEDERATED MUTUAL
INSURANCE COMPANY
FEHR GRAHAM & ASSOCIATES
SERVICE COMPANY SISCO
Feintool US Operations Inc
Claims Inc.
FELICIAN COLLEGE
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SISCO
SISCO
CHECK BENEFIT CARD
PO Box 389
(800) 457-4726
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
(800) 457-4726
First Health
Underwriters Safety & Claims Inc.
PO Box 8399
(800) 678-1536
Underwriters Safety & Claims Inc
(800) 678-1536
(800) 678-1536
OF UICI
OF UICI
PO Box 809026
DALLAS TX 75038
(800) 767-0700
CHECK BENEFIT CARD
(800) 767-0700
CONTACT EMPLOYER
Ferrellgas
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
FH-Savings-Corporate Benefit Services
of America
Affiliated With: FH-Savings-Corporate
Benefit Services of America
Corporate Beneifit Services of America
Corporate Beneifit Services of America Corporate Beneifit Services of
America
(800) 925-2272
(800) 925-2272
400 Highway 169 South, Ste 800
Minneapolis MN 55426-1141
(800) 925-2272
Network.
Info as of 12/24/2007
Page PIRMI-178
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PAYOR NAME
FI PPO
Affiliated With: OSF HEALTHPLANS,
INC.
Fidelity Mortgage
Affiliated With: Carolina Benefit
Administrators
CLAIMS SUBMISSION
PO Box 1229
Peoria IL 61601-5128
COMPENSABILITY
(800) 673-5222
UTILIZATION REVIEW
(800) 284-2273
(800) 673-5222
CAROLINA BENEFIT
ADMINISTRATORS
CAROLINA BENEFIT
ADMINISTRATORS
333 SOUTH PINE ST
(800) 476-2295
CHECK BENEFIT CARD
(800) 476-2295
Fidelty Security Life
Corporation #962500302
FIMCO SERVICES LLC
FINDLAY MANAGEMENT GOUP INC. TRAVEL
FINDLAY MANAGEMENT GROUP INC
CHECK BENEFIT CARD
(800) 843-3106
(800) 843-3106
PO Box 520
(800) 235-7160
CO.
(800) 725-6566
(800) 235-7160
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 742-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-179
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
Firemans Fund Insurance Company
CONTACT EMPLOYER
Affiliated With: Firemans Fund Insurance Attn:
Company
FIRST AMERICAN BANK
ADMINISTRATORS
COMPENSABILITY
CONTACT EMPLOYER
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
UTILIZATION REVIEW
CONTACT EMPLOYER
CHECK BENEFIT CARD
(800) 825-3540
FIRST COMMUNITY BANK
PO Box 8046
CHECK BENEFIT CARD
(715) 841-7802
(715) 841-7802
First Health Group Corp.
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
America's TPA
America's TPA
CHECK BENEFIT CARD
PO Box 398220
(952) 896-4888
FIRST NATIONAL BANK HOLDINGS
COMPANY - PEPM
Affiliated With: AMERICA'S TPA
FIRST NATIONAL BANK HOLDINGS
COMPANY - TRAVEL
(952) 896-4888
America's TPA
America's TPA
PO Box 398220
(952) 896-4888
CHECK BENEFIT CARD
(952) 896-4888
Network.
Info as of 12/24/2007
Page PIRMI-180
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
FIRST NATIONAL BANK OF ARDMORE CHECK BENEFIT CARD
Affiliated With: FISERVE HEALTH
KANSAS
* FIRST SUPPORT SERVICES INC
FIRST UNITED BANK & TRUST
SERVICES
FISERV
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 899-9355
(800) 899-9355
PO Box 720460
(405) 755-2929
CHECK BENEFIT CARD
(405) 755-2929
Benefit Planners
Benefit Planners
PO Box 690450
(800) 292-5386
CHECK BENEFIT CARD
(800) 292-5386
FITZ VOGT AND ASSOCIATES LTD
PLAN ADMINISTRATORS
EBPA
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
EBPA
CHECK BENEFIT CARD
(800) 578-3272
(800) 578-3272
FLEETWOOD ENTERPRISES
GROUP
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
Network.
Info as of 12/24/2007
Page PIRMI-181
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
3125 Myers Street
Riverside CA 92513
COMPENSABILITY
(909) 351-3664
UTILIZATION REVIEW
(909) 351-3664
(909) 351-3664
FLETCHER JONES MANAGEMENT
INC - TRAVEL
FLETCHER JONES MANAGEMENT,
INC. - TRAVEL
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
FLEXIBLE TECHNOLOGIES INC
SOLUTIONS
CHECK BENEFIT CARD
FLINT GROUP
NGS AMERICAN
NGS AMERICAN
PO Box 7676
DETROIT MI 48080
8005211555
NGS AMERICAN
8005211555
CADENT ADMINSTRATORS, INC.
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8005514049
8005211555
FLORIDA COMPREHENSIVE HEALTH
ASSOCIATION
Affiliated With: CADENT
ADMINISTRATORS INC
CADENT ADMINSTRATORS, INC.
1004 118th Ave N
St Petersburg FL 33716
Network.
Info as of 12/24/2007
Page PIRMI-182
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
FLORIDA KEYS COMMUNITY
COLLEGE
Attn: WHIT WALTERS
CORP
FLORENCE SC 29501
(843) 622-6001
Florida League of Cities
Affiliated With: Florida League of Cities
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(843) 622-6001
PO Box 538140
Orlando FL 32853-8140
(800) 756-3042
(877) 676-3890
(800) 756-3042
FLORISTS TRANSWORLD DELIVERY
(FTD)
ADMINISTRATORS INC
GALLAGHER BENEFIT
ADMINISTRATORS INC
GALLAGHER BENEFIT
ADMINISTRATORS INC
750 WARRENVILLE RD STE 200
LISLE IL 60532
(866) 471-6037
(866) 471-6037
FOOD EMPLOYERS & BAKERY &
CONFECTIONERY BENEFIT FUND
CONFECTIONERY BEN. FUND
Affiliated With: FOOD EMPLOYERS &
BAKERY & CONFECTIONERY BEN.
FUND
2221 Rosecrans Ave. #203
EL SEGUNDO CA 90245-4911
FOOD GIANT SUPERMARKETS INC
BENEFITS INC #11491
FOOTHILL DEANZA COMMUNITY
COLLEGE DISTRICT - FACULTY
CHECK BENEFIT CARD
CONFECTIONERY BEN. FUND
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 619055
DALLAS TX 75261
(877) 240-0142
(877) 240-0142
CHECK BENEFIT CARD
PO Box 39710
COLORADO SPRINGS CO 80949
Network.
Info as of 12/24/2007
Page PIRMI-183
www.firsthealth.com
PAYOR NAME
Foreign Mission Division - 1G97000012
Group, Inc.
FOREST OIL CORP
CLAIMS SUBMISSION
407 N Fulton St
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(317) 655-4500 Outside US
(800) 628-4664 Inside US
(317) 655-4500 Outside US
(800) 628-4664 Inside US
ASSURECARE
ASSURECARE
340 Quadrangle Dr
Bolingbrook IL 60440
(800) 759-1311
Careline UR
(763) 383-4800
NORTH AMERICA
NORTH AMERICA
(800) 759-1311
FOREST RIVER, INC.
ADMINISTRATORS, L.P.-TENNESSEE
NORTH AMERICA
FORMOST PACKAGING
INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
FORT CALLEY UNIVERSITY
UNDERGRAD MANDATORY
CORP
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
UM NOT APPLICABLE
PO Box 1984
NASHVILLE TN 37202
(800) 222-6491
(800) 222-6491
FORT VALLEY STATE UNIV
AIH0058107
PO Box 2271
CORP #14005
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-184
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
FORT VALLEY STATE UNIV
AIH0058117
PO Box 2271
CORP #14005
(843) 622-6001
Forte
Affiliated With: Forte
FORTIS REMOTE REPRICING
Affiliated With: ASSURANT HEALTH
Forte
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
(800) 580-1642
Forte
(800) 580-2273
ASSURANT HEALTH
CHECK BENEFIT CARD
Forte
(800) 580-1642
ASSURANT HEALTH
(800) 743-8469
(800) 743-8469
FOSTER ASSOCIATES INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
FOUNTAINBLEAU RESORTS TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
FOX BROTHERS
ASSURECARE
ASSURECARE
LANSING MI 38823
(800) 968-6616
CARELINE
(763) 383-4800
NHBC
NHBC
CHECK BENEFIT CARD
Scottsdale AZ 85260
(888) 621-7900
(800) 968-6616
FOX EVERETT INSURANCE PEPM
(888) 621-7900
Network.
Info as of 12/24/2007
Page PIRMI-185
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PAYOR NAME
FRANCIS DRILLING FLUIDS LTD
Affiliated With: GILSBAR, INC.
CLAIMS SUBMISSION
GILSBAR
PO Box 998
COVINGTON LA 70434
COMPENSABILITY
GILSBAR
UTILIZATION REVIEW
CHECK BENEFIT CARD
(985) 898-1673
(985) 898-1673
FRANCIS MARION UNIVERSITY
AMH9029757
PO Box 2437
Affiliated With: MAKSIN MANAGEMENT Florence SC 29503-2437
CORP #14005
(843) 622-6001
FRANCIS TUTTLE TECHNOLOGY
CENTER
SERVICES
PO Box 720460
(405) 755-2929
FRANCISCAN FRIARS-HCH ADMIN.
NM
CHECK BENEFIT CARD
(843) 622-6001
CHECK BENEFIT CARD
(405) 755-2929
HCH ADMINISTRATORS
HCH ADMINISTRATORS
FRANCISCAN FRIARS-SERVANTS OF CBCA Administrators Inc
THE PARACLETE
PO Box 902
Affiliated With: CBCA Administrators, Inc. Beattyville KY 41311
Frank Gates Service Company
Affiliated With: Frank Gates Service
Company
CONTACT EMPLOYER
CONTACT EMPLOYER
Affiliated With: HCH ADMINISTRATION
HCH ADMINISTRATORS
PO Box 1986
PEORIA IL 61656
CONTACT EMPLOYER
Attn:
Network.
Info as of 12/24/2007
Page PIRMI-186
www.firsthealth.com
PAYOR NAME
FRANK R HOWARD MEMORIAL
HOSPITAL
SYSTEM/WEST
FRANKLIN & MARSHALL COLLEGE
CONCEPTS, INC.
CLAIMS SUBMISSION
UTILIZATION REVIEW
COMPENSABILITY
CHECK
BENEFIT CARD
PO Box 619031
WAYNE PA 19087-1706
UM NOT APPLICABLE
(888) 293-9229
(888) 293-9229
FRASER PAPERS
ADMINISTRATORS - NY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
FRASIER TIMBER UNLIMITED
ADMINISTRATORS-NY
NORTH AMERICAN
ADMINISTRATORS-NY
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 9501
AMHERST NY 14226
(800) 828-6922
NORTH AMERICAN
ADMINISTRATORS-NY
(800) 828-6922
(800) 828-6922
FRC ELECTRICAL INDUSTRIES
10469
FREDS PLUMBING AND HEATING
WRAP JMS
(EBPA)
THE EPOCH GROUP, LC
THE EPOCH GROUP, LC
PO Box 12170
(800) 255-6065
SHORMAN SOLUTIONS
(800) 255-6065
(800) 255-6065
ADMINISTRATOR INC
ADMINISTRATOR INC
PO Box 2365
(800) 525-8788
CHECK BENEFIT CARD
(802) 846-8060
Network.
Info as of 12/24/2007
Page PIRMI-187
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PAYOR NAME
CLAIMS SUBMISSION
FREEDOM GRAPHICS SYSTEMS, INC CBSA
Affiliated With: CORPORATE BENEFIT 400 Highway 169 South, Ste 800
SERVICE OF AMERICA
(952) 593-6438
FREEDOM LIFE INSURANCE CO. OF
AMERICA
Affiliated With: FREEDOM LIFE
INSURANCE CO. OF AMERICA
FREEDOM LIFE INSURANCE CO. OF
AMERICA
FREEDOM PLASTICS
ADMINISTRATORS INC
MIDWEST SECURITY
FREMONT COUNTY SCHOOL
DISTRICT 14
110 W 7TH ST STE 300
FORT WORTH TX 76120
COMPENSABILITY
CBSA
(952) 593-6438
UTILIZATION REVIEW
GUIDED2HEALTH
(952) 593-6447
FREEDOM LIFE INSURANCE CO. OF FREEDOM LIFE INSURANCE
CO. OF AMERICA
AMERICA
(800) 387-9027
MIDWEST SECURITY
MIDWEST SECURITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
PO Box 574
ONALASKA WI 54650
CONSU
FREMONT MILLWORK CO.
INC.
FREMONT MOTOR COMPANIES
ASSOCIATES
(541) 312-8512
MBA OF WYOMING
MBA OF WYOMING
PO Box 94
WORLAND WY 82401
Network.
Info as of 12/24/2007
Page PIRMI-188
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PAYOR NAME
FRESNO VA MEDICAL CENTER 3188
SERVICES
Fringe MIni-Med Hospital - Hospital &
Professional
HEALTH PLANS
Fringe Mini-Med Professional Only
HEALTH PLANS
FRISBIE MEMORIAL HOSPITAL
CLAIMS SUBMISSION
2025 AEROJET RD
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(916) 985-1259
(916) 985-1259
195 STAFFORD ST
(800) 633-7867
UM NOT APPLICABLE
(800) 633-7867
195 STAFFORD ST
(800) 633-7867
UM NOT APPLICABLE
(800) 633-7867
HEALTH PLAN INC
HEALTH PLAN INC
(508) 752-2480
CARE MANAGEMENT
SERVICES
(866) 325-1550
(508) 752-2480
FROST INDUSTRIES
ADMINISTRATORS
FRY STEEL
(800) 899-9355
CHECK BENEFIT CARD
(800) 899-9355
EMPLOYEE BENEFIT
PO Box 3000
Network.
Info as of 12/24/2007
Page PIRMI-189
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COMPENSABILITY
FT WAYNE VA MEDICAL CENTER
CHECK BENEFIT CARD
BAS
BAS
CHECK BENEFIT CARD
17475 JOVANNA DR
HOMEWOOD IL 60430
(709) 799-7400
PAYOR NAME
CLAIMS SUBMISSION
FT WAYNE VA MEDICAL CENTER 3159 FT WAYNE VA MEDICAL CENTER
Affiliated With: HEALTH NET FEDERAL Attn: FEE BASIS 136A
SERVICES
2121 LAKE AVE
FT WAYNE IN 46805
Full -O-Pep Appliances
ADMINISTRATIVE SYSTEMS
FULLER THEOLOGICAL SEMINARY
UTILIZATION REVIEW
(709) 799-7400
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
FULLERTON COLLEGE/NORTH
AMERIBEN SOLUTIONS
ORANGE COUNTY COMMUNITY
PO Box 7186
COLLEGE DISTRICT
BOISE ID 83707
(800)
786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
FUNDIS TRUCKING COMPANY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
FURST- MCNESS COMPANY
America's TPA
America's TPA
PO Box 398220
(952) 896-1255
7753526901
CHECK BENEFIT CARD
(952) 896-1255
Network.
Info as of 12/24/2007
Page PIRMI-190
www.firsthealth.com
PAYOR NAME
FUSION
GROUP #13352
CLAIMS SUBMISSION
DIRECT CARE AMERICA
PO Box 2090 C
STOW OH 44224
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 266-5896
(800) 266-5896
FUTURE CARE MEDCHECK
DIVERSIFIED HEALTHCARE SVCS
201 SANDPOINTE
SANTA ANA CA 92707
G & C INDUSTRIES
COMPENSABILITY
DIRECT CARE AMERICA
DIVERSIFIED HEALTHCARE SVCS
SVCS
ASSURECARE
ASSURECARE
LANSING MI 38823
(800) 968-6616
CARELINE
(763) 383-4800
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 968-6616
G E JOHNSON CONSTRUCTION CO
INC
SOLUTIONS
CHECK BENEFIT CARD
GAB Robbins
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
GADSDEN ELEMENTARY SCHOOL
DISTRICT
SRT ADMINISTRATORS
SRT ADMINISTRATORS
CHECK BENEFIT CARD
8014742555
PO Box 25160
Network.
Info as of 12/24/2007
Page PIRMI-191
www.firsthealth.com
PAYOR NAME
GAFTEK, LLC
SERVICE CENTER
CLAIMS SUBMISSION
CENTER
20 WINTER ST
PEMBROKE MA 02359
COMPENSABILITY
CENTER
UTILIZATION REVIEW
GISC TOTALCARE
(800) 242-4472
(800) 242-4472
(800) 242-4472
GAINESVILLE COLLEGE AIH 0058127
CORP #14005
GAINESVILLE COLLEGE AIH0058137
CORP #14005
GAINESVILLE COLLEGE
UNDERGRAD MANDATORY
CORP
PO Box 2271
Florence SC 29503
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
PO Box 2271
Florence SC 29503
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
GALAXY SCIENTIFIC CORPORATION
ADMINISTRATORS
Gallagher Bassett Managed Care
Services
Affiliated With: Gallagher Bassett
Managed Care Services
720 BLAIR MILL RD
HORSHAM PA 19044
(800) 480-5032
AMERIHEALTH
ADMINISTRATORS
(800) 952-3404
(800) 480-5032
First Health
First Health
PO Box 23812
Tucson AZ 85734
(800) 370-0594
CONTACT EMPLOYER
(800) 370-0594
Network.
Info as of 12/24/2007
Page PIRMI-192
www.firsthealth.com
PAYOR NAME
Gallagher Bassett Services, Inc.
Affiliated With: Gallagher Bassett
Services, Inc.
GALLIKER DAILY COMPANY
Affiliated With: MCA
GAMING PARTNERS INTERNATIONAL
COMPENSABILITY
CONTACT EMPLOYER
CONTACT EMPLOYER
MCA ADMINISTRATORS INC
CHECK BENEFIT CARD
820 PARISH ST
PITTSBURGH PA 15220
(800) 922-4966
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
UTILIZATION REVIEW
(800) 922-4966
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
GAMING PARTNERS
INTERNATIONAL - TRAVEL
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
GARDNER DENVER - TSHCC
COMPANY (SISCO) C/O CCN
GARGIULIO INC
LLC
COMPANY (SISCO)
CHECK BENEFIT CARD
MedWatch
(800) 432-8421
PO Box 3000
NAPLES FL 34103
Network.
Info as of 12/24/2007
Page PIRMI-193
www.firsthealth.com
PAYOR NAME
Garland Company The
Affiliated With: SUPERIEN HEALTH
NETWORK
CLAIMS SUBMISSION
SUPERIEN HEALTH NETWORK
COMPENSABILITY
EBC
EBC Review
CHECK BENEFIT CARD
UTILIZATION REVIEW
PO Box 2388
STOW OH 44224
(800) 634-8816
Refer to Intercorp
GARY WILLIAMS ENERGY
CORPORATION
CHECK BENEFIT CARD
CHECK BENEFIT CARD
GASDEN LAWN & LANDSCAPE
Affiliated With: PACIFIC LIFE &
ANNUITY
PACIFIC LIFE & ANNUITY COMPANY
PACIFIC LIFE & ANNUITY COMPANY CHECK BENEFIT CARD
PO Box 295
Onalaska WI 54650
(800) 542-6642
Gases Plus
GBS CORP
ADMINISTRATORS & CONSULTANTS
(800) 542-6642
Western Health
Western Health
Rapid City SD 57701
(605) 719-4600 or (888) 3411766
Western Health
(605) 719-4640 or (800) 2290892
(605) 719-4600 or (888) 3411766
CONSULTANTS INC
CONSULTANTS INC
(614) 863-8780
BUSINESS ADMINISTRATORS
& CONSULTANTS INC
(614) 863-8780
CONTACT EMPLOYER
CONTACT EMPLOYER
(614) 863-8780
GE Young and Co
CONTACT EMPLOYER
Attn:
Network.
Info as of 12/24/2007
Page PIRMI-194
www.firsthealth.com
PAYOR NAME
GE/ERC
GELCO CONSTRUCTION
CLAIMS SUBMISSION
First Health
COMPENSABILITY
CONTACT EMPLOYER
PO Box 23812
Tucson AZ 85734
UTILIZATION REVIEW
First Health
(800) 370-0594
EBMS
EBMS
PO Box 21367
(800) 777-3575
EBMS
(800) 777-3575
MBA OF WYOMING
MBA OF WYOMING
CHECK BENEFIT CARD
(800) 777-3575
GEM CITY BONE AND JOINT
ASSOCIATES
GEMINI INDUSTRIES INC
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
PO Box 94
WORLAND WY 82401
(800) 825-3540
MENNONITE MUTUAL AID & ASSOC MENNONITE MUTUAL AID &
ASSOC & MMA INSURANCE
& MMA INSURANCE
GEMINUS CORPORATION
Affiliated With: MENNONITE MUTUAL
AID ASSOC. AND MMA INS. CO./MMA
MENNONITE MUTUAL AID & ASSOC
& MMA INSURANCE
GEMPERLE ENTERPRISES
Affiliated With: COMBINED BENEFITS
ADMINISTRATORS
COMBINED BENEFIT
ADMINISTRATORS
COMBINED BENEFIT
ADMINISTRATORS
4704 W. Jennifer Ave. #104
FRESNO CA 93722
(559) 275-3984
PO Box 483
GOSHEN IN 46527
CHECK BENEFIT CARD
(559) 275-3984
Network.
Info as of 12/24/2007
Page PIRMI-195
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
CBCA ADMINISTRATORS, INC.
GEN PROBE INC
MINNEAPOLIS MN 55440-9498
COMPENSABILITY
BENEFIT PLAN ADMINISTRATORS,
INC.
BENEFIT PLAN
CHECK BENEFIT CARD
GENDEX DEL MEDICAL IMAGING
BENEFIT PLAN ADMINISTRATORS,
INC.
GENERAL ELECTRIC
Affiliated With: COVENTRY HEALTH
CARE
120 E Kensinger Dr
Cranberry Township PA 16066
(724) 778-5362
UTILIZATION REVIEW
One Huntington Quadrangle #4N
MELVILLE NY 11747
(724) 778-5362
GENERAL GROWTH PROPERTIES
INC
SYSTEMS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
GENERAL MONITORS
CDN
CDN
UM NOT APPLICABLE
GENERAL PLASTICS MFG
SERVICE CORPORATION
TRUSTEED PLANS SERVICE
CORPORATION
CORPORATION
(888) 877-7994
PO Box 1894
(800) 426-9786
PO Box 10999
SCOTTSDALE AZ 85271
(800) 426-9786
Network.
Info as of 12/24/2007
Page PIRMI-196
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
GENERAL RUBBER AND PLASTIC OF PRINCIPAL FINANCIAL GROUP
LOUISVILLE INC
PO Box 5319
TAMPA FL 33675-5319
GROUP
(800) 533-5044
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 533-5044
Genesis Managed Care
PO Box 17076
Charlotte NC 28227
(704) 321-3909
(704) 321-3909
(704) 321-3909
GENEX Services Exclusive - CCN
Transition
Affiliated With: GENEX Services, Inc.
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Genex Services, Inc.
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
GENEX Services, Inc. EPP
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
GENLYTE THOMAS GROUP, LLC
Affiliated With: EASTERN BENEFIT
SYSTEMS, INC
CHECK BENEFIT CARD
200 Freeway Dr, East
East Orange 07018
(800) 524-0227
(800) 524-0227
Network.
Info as of 12/24/2007
Page PIRMI-197
www.firsthealth.com
PAYOR NAME
GEORGE FOX UNIVERSITY
CLAIMS SUBMISSION
PERSONAL INSURANCE
ADMINISTRATORS
COMPENSABILITY
PERSONAL INSURANCE
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 468-4343
(800) 468-4343
GEORGE J FOSTER CO INC. CITIZEN
PUBLISHING
GEORGE SCHMITT & CO.
HEALTH PLAN INC
HEALTH PLAN INC
PO Box 5199
(508) 752-2480
CARE MANAGEMENT
SERVICES
(886) 325-1550
(508) 752-2480
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
GEORGIA COLLEGE & STATE
CORP
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
GEORGIA COLLEGE AND STATE
PO Box 2271
CORP #14005
(843) 622-6001
GEORGIA COLLEGE AND STATE
PO Box 2271
CORP #14005
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-198
www.firsthealth.com
COMPENSABILITY
CONSOLIDATED BENEFITS
CHECK BENEFIT CARD
GEORGIA HIGHLANDS COLLEGE
AIH0058197
PO Box 2271
CORP #14005
(843) 622-6001
CHECK BENEFIT CARD
IAH0058187
PO Box 2271
CORP #14005
(843) 622-6001
Attn: WHIT WALTERS
PAYOR NAME
CLAIMS SUBMISSION
GEORGIA CROWN DISTRIBUTING CO. CONSOLIDATED BENEFITS
Affiliated With: GEORGIA CROWN
820 PARISH ST
DISTRIBUTING CO.
PITTSBURGH PA 15220
UNDERGRAD MANDATORY
CORP
UTILIZATION REVIEW
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
UM NOT APPLICABLE
(800) 222-6491
419 S. COIT ST
FLORENCE SC 29501
(800) 222-6491
GEORGIA INSTITUTE OF
TECHNOLOGY AIH0000286
CORPORATION
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
CHECK BENEFIT CARD
(888) 722-1668
(800) 722-1668
CORP #14005
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
CHECK BENEFIT CARD
(843) 622-6001
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-199
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
PO Box 2271
CORP #14005
(843) 622-6001
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
TECHNOLOGY UNDERGRAD
Attn: WHIT WALTERS
MANDATORY
419 S. COIT ST
FLORENCE SC 29501
CORP
(800) 222-6491
Georgia Pacific
CONTACT EMPLOYER
CONTACT EMPLOYER
GEORGIA PERIMETER COLLEGE
AIH0058237
PO Box 2271
CORP #14005
(843) 622-6001
CHECK BENEFIT CARD
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
GEORGIA PERIMETER COLLEGE
UNDERGRAD MANDATORY
CORP
CONTACT EMPLOYER
Attn:
UM NOT APPLICABLE
(800) 222-6491
(843) 622-6001
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
GEORGIA SOUTHERN UNIV
AIH0058247
PO Box 2271
CORP #14005
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-200
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
GEORGIA SOUTHERN UNIV
AIH0058257
PO Box 2271
CORP #14005
(843) 622-6001
GEORGIA SOUTHERN UNIVERSITY
UNDERGRAD MANDATORY
CORP
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
GEORGIA SOUTHWESTERN STATE
PO Box 2271
Florence SC 29503
(843) 622-6001
CORP #14005
(843) 622-6001
PO Box 2271
CORP #14005
(843) 622-6001
Attn: WHIT WALTERS
MANDATORY
419 S. COIT ST
FLORENCE SC 29501
CORP
(800)
222-6491
GEORGIA STATE UNIVERSITY PEARCE ADMINISTRATION
AIH0058287
PO Box 2271
CORP #14005
(843) 622-6001
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(843) 622-6001
UM NOT APPLICABLE
(800) 222-6491
CHECK BENEFIT CARD
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-201
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
GEORGIA STATE UNIVERSITY PEARCE ADMINISTRATION
AIH0058297
Attn: WHIT WALTERS
CORP #14005
FLORENCE SC 29501
(843) 622-6001
GEORGIA STATE UNIVERSITY
UNDERGRAD MANDATORY
CORP
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
GERALD A. MARTIN, LTD.
SERVICES, INC. (HDS)
HCH ADMINISTRATORS
GETTYSBURG COLLEGE
CONCEPTS, INC.
HCH ADMINISTRATORS
HCH ADMINISTRATORS
UM NOT APPLICABLE
PO Box 1986
PEORIA IL 61656
(888) 293-9229
WAYNE PA 19087-1706
(888) 293-9229
GETTYSBURG HEALTH
ADMINISTRATORS
Affiliated With: PREFERRED CARE INC
GIANGRECO MEDICAL GROUP INC
AMUINITY COMPANY
1300 VIRGINIA DR STE 315
FT. WASHINGTON PA 19034
(215) 639-6208
CHECK BENEFIT CARD
(215) 639-6208
PO Box 295
Onalaska WI 54650
Network.
Info as of 12/24/2007
Page PIRMI-202
www.firsthealth.com
PAYOR NAME
GILBERT HOSPITAL
SOLUTIONS LLC
CLAIMS SUBMISSION
LLC
COMPENSABILITY
LLC
UTILIZATION REVIEW
(888) 419-1094
MEDICAL CARE
(800) 852-8001
MIDWEST SECURITY
MIDWEST SECURITY
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
CHECK BENEFIT CARD
DALLAS TX 75251
(800) 827-7223
PO Box 71490
PHOENIX AZ 85050
(888) 419-1094
GILMAN ENGINEERING
ADMINISTRATORS INC
* Ginny's Copying Services inc (TRAVEL)
ADMINISTRATORS
MIDWEST SECURITY
PO Box 574
ONALASKA WI 54650
(800) 827-7223
GIUMARRA VINEYARDS
MANAGEMENT INC
INC
INC
PO Box 2220
NEWPORT BEACH CA 92658
(800) 777-7898
UM NOT APPLICABLE
(800) 777-7898
GLACIER FISH COMPANY
SERVICE CORPORATION
CORPORATION
CORPORATION
PO Box 1894
(800) 426-9786
(888) 877-7994
(800) 426-9786
GLEN OAK VEBA TRUST
Professional Benefit Administrators, Inc. Professional Benefit Administrators, Inc. CHECK BENEFIT CARD
(630) 655-3755
BENEFIT ADMINISTRATORS INC (PBA) Oakbrook IL 60523
(630) 655-3755
Network.
Info as of 12/24/2007
Page PIRMI-203
www.firsthealth.com
PAYOR NAME
GLENDALE ADVENTIST MEDICAL
CENTER-EPO PLAN
SYSTEM/WEST
Global
Group, Inc.
CLAIMS SUBMISSION
PO Box 619031
407 N Fulton St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
GLOBALCARE
GLOBAL EXCEL MANAGEMENT
Affiliated With: GLOBAL EXCEL
MANAGEMENT
Global Missions Associated
Group, Inc.
CHECK BENEFIT CARD
(317) 655-4500 Outside US
(800) 628-4664 Inside US
GLOBAL EMERGENCY MEDICAL
SERVICES, INC. (GEMS)
* GLOBAL EXCHANGE INC
NETWORK INC
UTILIZATION REVIEW
COMPENSABILITY
CHECK
BENEFIT CARD
GLOBALCARE
GLOBALCARE
73 QUEEN ST
LENNOXVILLE QC J1M 1J3
(819) 566-2901
(819) 566-2901
UM NOT APPLICABLE
New York NY 10019
(212) 581-8228
6875 SHILOH RD E
ALPHARETTA GA 30005
(819) 566-2901
(212) 581-8228
407 N Fulton St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
CHECK BENEFIT CARD
(317) 655-4500 Outside US
(800) 628-4664 Inside US
Network.
Info as of 12/24/2007
Page PIRMI-204
www.firsthealth.com
PAYOR NAME
Global Select Worldwide
Group Inc
Globalcare Individuals
Group, Inc.
Globalcare Scholars
Group, Inc.
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
(800) 628-4664
(800) 628-4664
CHECK BENEFIT CARD
407 N Fulton St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
2960 N Meridian St
Indianapolis IN 46208
(800) 628-4664
(317) 655-4500 Outside US
(800) 628-4664 Inside US
407 N Fulton St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
CHECK BENEFIT CARD
(317) 655-4500 Outside US
(800) 628-4664 Inside US
SERVICES, INC.
GLOBAL EMERGENCY
MEDICAL SERVICES, INC.
(800) 533-4755
(800) 258-2873
G M WHITE CONSTRUCTION, INC
G M WHITE CONSTRUCTION, INC
CHECK BENEFIT CARD
867 MIDDLE RD
ACUSHNET MA 02743
(508) 763-8868
GLOBALCARE/WEYCO
SERVICES, INC.
GM
CHECK BENEFIT CARD
GM WHITE CONSTRUCTION INC
Affiliated With: ULTRABENEFITS
2001 Westside Pkwy #120
ALPHARETTA GA 30004
(508) 763-8868
GMP INTERNATIONAL
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
(800) 422-2026
Network.
Info as of 12/24/2007
Page PIRMI-205
www.firsthealth.com
PAYOR NAME
GMP RETIRED
CLAIMS SUBMISSION
ASSURECARE
HUDSON OH 44224
COMPENSABILITY
ASSURECARE
(800) 422-2026
UTILIZATION REVIEW
Careline UR
(763) 383-4800
(800) 422-2026
GODWIN PUMPS OF AMERICA INC
Affiliated With: INSURANCE ADMIN OF
AMERICA INC
Gold Coast Joint Benefit Trust
Affiliated With: Gold Coast Joint Benefit
Trust
Exclude all freestanding psych/cd
facilities.
GOLDEN GATE UNIVERSITY
IAA
IAA
PO Box 5082
MT LAUREL NJ 08054
(800) 283-2524
INC
(800) 582-1535
(800) 283-2524
Gold Coast Joint Benefits Trust
PO Box 10956
(800) 382-6278
(800) 382-6278
For claim/bill questions, contact:
301 Mission Street Ste 600
(800) 388-0508
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
(800) 786-7930
GOLDEN RULE INSURANCE
COMPANY
Affiliated With: GOLDEN RULE
INSURANCE COMPANY
GOLDEN STATE BULB GROWERS, INC
INSURANCE
COMPANY
COMPANY
712 11TH ST.
LAWRENCEVILLE IL 62439
(317) 297-4189
CHECK BENEFIT CARD
(317) 297-4189
955 N Street
Fresno CA 93721
(559) 499-2000
CHECK BENEFIT CARD
(559) 499-2000
Network.
Info as of 12/24/2007
Page PIRMI-206
www.firsthealth.com
PAYOR NAME
Goldkist
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
COMPENSABILITY
CONTACT EMPLOYER
CONTACT EMPLOYER
HINES & ASSOCIATES
(800) 528-2498
UTILIZATION REVIEW
GOLTEN MARINE CO.
GOOD VOCATIONS HEALTH &
BENEFIT SYSTEMS
BENEFIT SYSTEMS
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
UM NOT APPLICABLE
PO Box 1959
Gray ME 04039
(800) 290-8559
* Good Will Hinckley
LLC
GOODFELLOW CORP - TRAVEL
PO Box 3000
(800) 283-4927
(800) 290-8559
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
GOODWILL CENTRAL FLORIDA
(800) 899-9355
(800) 899-9355
Network.
Info as of 12/24/2007
Page PIRMI-207
www.firsthealth.com
PAYOR NAME
GOODWILL EASTER SEALS OF THE
MIAMI INC.
BENEFIT SYSTEMS
GOODWILL FORT WORTH
ADMINISTRATOR
GOODWILL INDUSTRIAL SERVICES
CORPORATION
BENEFIT SYSTEMS
GOODWILL INDUSTRIES OF
CENTRAL INDIANA
Affiliated With: HEALTH AND
WELFARE BENEFIT SYSTEMS INC
Goodwill Industries of Lower South
Carolina
GOODWILL INDUSTRIES OF NORTH
GEORGIA
BENEFIT SYSTEMS
CLAIMS SUBMISSION
SYSTEMS INC
COMPENSABILITY
SYSTEMS INC
UTILIZATION REVIEW
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
CHECK BENEFIT CARD
(800) 899-9355
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
(800) 899-9355
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
SYSTEMS INC
SYSTEMS INC
HEALTH & WELFARE BENEFIT
(800) 283-4927
3241 ELECTRIC RD BLDG D STE 2-B
ROANOKE VA 24018
(800) 283-4927
(800) 283-4927
(800) 283-4927
CORESOURCE
CORESOURCE
PO Box 2920
(866) 280-4120
UM NOT APPLICABLE
(866) 280-4120
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
Network.
Info as of 12/24/2007
Page PIRMI-208
www.firsthealth.com
PAYOR NAME
GOODWILL INDUSTRIES OF NORTH
LOUISIANA
* GOODWILL LOWER SOUTH
CAROLINA
GOODWILL OF NORTH FLORIDA DBA
GINFL SERVICES
GOODWILL SERVICES INC.
BENEFIT SYSTEMS
CLAIMS SUBMISSION
UTILIZATION REVIEW
COMPENSABILITY
UM
NOT APPLICABLE
(800) 899-9355
(800) 899-9355
(800) 899-9355
(800) 899-9355
(800) 899-9355
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
HEALTH WATCH
(972) 238-7900
DALLAS TX 75251
(800) 827-7223
(800) 283-4927
Goose Creek Travel
ADMINISTRATORS
(800) 827-7223
GORDON COLLEGE
HEALTH PLANS INC
195 STAFFORD ST
(800) 633-7867
(800) 633-7867
Network.
Info as of 12/24/2007
Page PIRMI-209
www.firsthealth.com
PAYOR NAME
GORDON COLLEGE AIH0058307
CORP #14005
GORDON COLLEGE UNDERGRAD
MANDATORY
CORP
CLAIMS SUBMISSION
PO Box 2271
Florence SC 29503
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
(843) 622-6001
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
GORDON CONWELL THEOLOGICAL
SEMINARY
MANAGEMENT SYSTEMS
GOWAN COMPANY
123 INTERSTATE DR
(877) 868-9060
CHECK BENEFIT CARD
(877) 868-9060
HEALTHCOMP
HEALTHCOMP
PO Box 45018
Fresno CA 93718
(800) 442-7247
HEALTHCOMP
(800) 755-7247
(800) 442-7247
GOWAN MILLING COMPANY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
GRADY MEMORIAL HOSPITAL
WATERSTONE BENEFIT
WATERSTONE BENEFIT
CHECK BENEFIT CARD
(888) 440-0971
(888) 440-0971
Network.
Info as of 12/24/2007
Page PIRMI-210
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
PLAN OF NEVADA
GRAEAGLE CONSTRUCTION &
DEVELOPMENT LLC
LAS VEGAS NV 89114
(702) 242-7700
GRAFOXATION
PLANS, INC.
GRAHAM ENTERPRISES - PEPM
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
GLOBALCARE
GLOBALCARE
UM NOT APPLICABLE
6875 SHILOH RD E
ALPHARETTA GA 30005
(678) 341-1811
(800) 832-8212
(678) 341-1811
GRAHAM ENTERPRSES - % OF
SAVINGS
GLOBALCARE
GLOBALCARE
6875 SHILOH RD E
ALPHARETTA GA 30005
(678) 341-1811
UM NOT APPLICABLE
(678) 341-1811
GRAND JUNCTION VAMC 3533
SERVICES
GRAND JUNCTION VAMC
Attn: FEE BASIS
WILLIAM ST off HWY 12 WEST
GRAND JUNCTION VAMC
CHECK BENEFIT CARD
GRAND SIERRA CONSULTING
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-211
www.firsthealth.com
PAYOR NAME
GRANGER MEDICAL CLINIC
ADMINISTRATORS
GRANITE STATE GLASS
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
HEALTH PLAN INC
HEALTH PLAN INC
CHECK BENEFIT CARD
(508) 752-2480
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
(508) 752-2480
* GRANT PRIDECO
Benefit Planners
Benefit Planners
PO Box 690450
(800) 292-5386
CHECK BENEFIT CARD
(800) 292-5386
Gray Insurance Company The
The Gray Insurance Company
Affiliated With: Gray Insurance Company 1717 East Loop Ste 333
The
Houston TX 77029
(800) 293-3131
(713) 671-2534
(713) 671-2534
GRAY TELEVISION INC
GROUP
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
GRAYLIFT INC
Affiliated With: COMBINED BENEFIT
ADMINIS./VALUE ADDED BENEFITS
(800) 533-5044
COMBINED BENEFITS
COMBINED BENEFITS
4704 W. Jennifer Ave. #104
FRESNO CA 93722
Network.
COMBINED BENEFITS
ADMINIS./VALUE ADDED
BENEFITS
Info as of 12/24/2007
Page PIRMI-212
www.firsthealth.com
PAYOR NAME
GREASEWOOD SPRINGS
COMMUNITY SCHOOL
CLAIMS SUBMISSION
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
PO Box 25160
Great American Insurance
Affiliated With: Fair Isaac
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Great American Insurance Company
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
GREAT BASIN GOLD
SERVICE CORP
CORPORATION
CORPORATION
(888) 877-7994
PO Box 1894
(253) 564-5850
(253) 564-5850
Great Lakes Dredge and Dock Company
Group
PO Box 5227
LISLE IL 60532
ECS Payor ID 37283
(877) 782-6828
Inc.
(800) 538-5222
(877) 782-6828
GREAT PLAINS
(800) 899-9355
(800) 899-9355
Network.
Info as of 12/24/2007
Page PIRMI-213
www.firsthealth.com
PAYOR NAME
GREAT PLAINS REGIONAL MEDICAL
CTR
GREAT WESTERN MALTING
CLAIMS SUBMISSION
WATERSTONE BENEFIT
COMPENSABILITY
WATERSTONE BENEFIT
UTILIZATION REVIEW
CHECK BENEFIT CARD
(888) 440-0971
(888) 440-0971
HEALTHCOMP
HEALTHCOMP
PO Box 45018
Fresno CA 93718
(800) 442-7247
HEALTHCOMP
(800) 755-7247
(800) 442-7247
* GREAT WHITE ENERGY SERVICES,
LLC
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
(800) 825-3540
MUTUAL ASSURANCE
ADVANTAGE
(800) 825-3540
(800) 825-3540
GREATER LA HCS (SEPULVEDA
VAMC) 3189
VAMC)
VAMC)
CHECK BENEFIT CARD
SERVICES
Attn: BLDG 1, ROOM A165
16111 PLUMMER ST
SEPULVEDA CA 91343
Greater NY New Jersey
Affiliated With: Greater New York
Company
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
GREEN MOUNTAIN
COMMUNICATIONS INC
SERVICE CENTER INC
CENTER, INC
CENTER, INC
CHECK BENEFIT CARD
20 WINTER ST
PEMBROKE MA 02359
(781) 829-8595 Ext 136
(781) 829-8595 Ext 136
Network.
Info as of 12/24/2007
Page PIRMI-214
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
GREENWOOD CONSTRUCTION
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
GREER AND SONS
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
GREY WOLF DRILLING
ADMINISTRATORS AND
CONSULTANTS
CONSULTANTS INC
CONSULTANTS INC
CHECK BENEFIT CARD
PO Box 107
(800) 521-2654
PAYOR NAME
GREENE CONCRETE CUTTING
ADMINISTRATORS
GRIFFIN TELEVISION OKC, LLC
ADMINISTRATORS
UTILIZATION REVIEW
8002615511
(800) 521-2654
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
GRIFFITH ENERGY SERVICES
SERVICE OF AMERICA
MERITAIN HEALTH
MERITAIN HEALTH
PO Box 1065
AMHERST NY 14226
(877) 777-6076
GUIDED2HEALTH
(952) 593-6447
(877) 777-6076
Network.
Info as of 12/24/2007
Page PIRMI-215
www.firsthealth.com
PAYOR NAME
Grinnell Mutual Reinsurance Company
Southeast Region
GRISWOLD INDUSTRIES, INC.
ADMIN. & MANAGEMENT (EBA&M)
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
COMPENSABILITY
CONTACT EMPLOYER
UTILIZATION REVIEW
CONTACT EMPLOYER
EMPLOYEE BENEFITS
HINES & ASSOCIATES
EMPLOYEE BENEFITS
ADMINISTRATION & MGMT. (EBA&M) (800) 528-2498
PO Box 5079
(805) 497-4581
(805) 497-4581
GRIZZARD BENEFITS TRUST
Affiliated With: MARKETING SERVICES
GROUP, INC. BENEFITS TRUST
PIAG HEALTH GUARD TRUST
GROB SYSTEMS INC
SERVICE INC
1 WALL ST STE 2A
RAVENSWOOD WV 26164
(888) 225-0522
AMERICAN HEALTH
HOLDINGS INC
(800) 592-9858
5020 Highlands Pkwy.
SMYRNA GA 30082
(888) 225-0522
GROSSMONT CUYAMACA
COMMUNITY COLLEGE DISTRICT
MANAGEMENT SERVICES
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
HEALTH WATCH
(972) 238-7900
ADMINISTRATORS
DALLAS TX 75251
(800) 827-7223
(972) 238-7900
Network.
Info as of 12/24/2007
Page PIRMI-216
www.firsthealth.com
PAYOR NAME
GROUP ADMINISTRATORS LTD
ADMINISTRATORS LTD
GROUP HEALTH MANAGERS
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
GLOBALCARE
GLOBALCARE
6875 SHILOH RD E
ALPHARETTA GA 30005
(678) 341-1811
GROUP HEALTH MANAGERS
(866) 807-6193
(678) 341-1811
CENTER
SERVICE CENTER
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
GROUP MANAGEMENT SERVICES DLORAH, INC. GMS-402
GLOBALCARE
GLOBALCARE
6875 Shiloh Rd E
ALPHARETTA GA 30005
(910) 485-0510
HINES & ASSOCIATES
(800) 670-7718
GROUP MANAGEMENT SERVICES EL DORADO CLAIMS SERVICES GMS-452
GROUP MANAGEMENT SERVICES MARSHALL ENGINES INC. GMS-435
(678) 341-1811
GLOBALCARE
GLOBALCARE
6875 Shiloh Rd E
ALPHARETTA GA 30005
(678) 341-1811
HINES & ASSOCIATES
(800) 670-7718
(678) 341-1811
GLOBALCARE
GLOBALCARE
6875 Shiloh Rd E
ALPHARETTA GA 30005
(678) 341-1811
HINES & ASSOCIATES
(800) 670-7718
(678) 341-1811
Network.
Info as of 12/24/2007
Page PIRMI-217
www.firsthealth.com
PAYOR NAME
GROUP MANAGEMENT SERVICES TASLER
GROUP MANAGEMENT SERVICES TASLER PALLET AND EPS INC. GMS418
GROUP360 INC.
#10469
CLAIMS SUBMISSION
GLOBALCARE
6875 Shiloh Rd E
ALPHARETTA GA 30005
COMPENSABILITY
GLOBALCARE
UTILIZATION REVIEW
UM NOT APPLICABLE
(678) 341-1922
(678) 341-1922
GLOBALCARE
GLOBALCARE
6875 Shiloh Rd E
ALPHARETTA GA 30005
(678) 341-1811
HINES & ASSOCIATES
(800) 670-7718
(678) 341-1811
THE EPOCH GROUP
THE EPOCH GROUP
10795 Watson Rd
St. Louis MO 63129
(800) 365-9036
INTRACORP
(800) 716-8506
(800) 365-9036
GROUPE SEB USA DBA ROWENTA
Affiliated With: EASTERN BENEFITS
SYSTEMS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
GSL ELECTRIC
IntraCorp
IntraCorp
Guarantee Life Insurance Company
PO Box 828
(800) 843-3106
CHECK BENEFIT CARD
(800) 522-2161
PO Box 19002
PROVO UT 84605-9002
(800) 843-3106
Network.
Info as of 12/24/2007
Page PIRMI-218
www.firsthealth.com
PAYOR NAME
GUARANTEE LIFE INSURANCE
COMPANY
#11337
GUARDIAN INDUSTRIES
CLAIMS SUBMISSION
(IAC)
PO Box 828
COMPENSABILITY
(IAC)
UTILIZATION REVIEW
Med-Valu
(800) 522-2161
(800) 843-3106
(800) 843-3106
NGS AMERICAN
NGS AMERICAN
PO Box 7676
DETROIT MI 48080
8005211555
NGS AMERICAN
8005211555
8005211555
GUERNSEY COUNTY
BENEFITS INC
GULF COAST ENTERPRISES
CENTRAL BENEFITS
CENTRAL BENEFITS
PO Box 619053
(800) 223-2900
QUANTUM HEALTH
(800) 257-2038
(800) 223-2900
(800) 899-9355
(800) 899-9355
GULF INDUSTRIES, INC. / SIGNAL
COMMUNICATION CORP.
Affiliated With: FARA BENEFIT
SERVICES, INC.
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
GULFPORT VAMC 3104
SERVICES
400 VETERANS AVE
BILOXI MS 39531
CHECK BENEFIT CARD
(214) 387-3232
(214) 387-3232
Network.
Info as of 12/24/2007
Page PIRMI-219
www.firsthealth.com
PAYOR NAME
GULLEY ENTERPRISES INC
ASSOCIATES
GURLEY-LEEP EMPLOYEE BENEFIT
FUND
ADMINISTRATORS
GYPSUM MANAGEMENT AND
SUPPLY COMPANY
COMPENSABILITY
MBA OF WYOMING
MBA OF WYOMING
NORTH AMERICAN
ADMINISTRATORS
NORTH AMERICAN
ADMINISTRATORS
MED-CERT
(800) 356-7126
PO Box 1984
NASHVILLE TN 37202
(800) 411-3650
CLAIMS SUBMISSION
UTILIZATION REVIEW
PO Box 94
WORLAND WY 82401
(800) 411-3650
ASSURECARE
ASSURECARE
340 Quadrangle Dr
(800) 759-7422
Careline UR
(763) 383-4800
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 759-7422
H S DEVELOPERS
CHECK BENEFIT CARD
H C DUKE AND SON INC
SERVICES INC (HDS) 12791
PO Box 1986
PEORIA IL 61656
(800) 447-3227
(877) 876-5969
CHECK BENEFIT CARD
CHECK BENEFIT CARD
H K CONTRACTORS INC
ADMINISTRATORS
8002218942
(800) 447-3227
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-220
www.firsthealth.com
PAYOR NAME
HAA PREFERRED PARTNERS LLC
Affiliated With: HAA PREFERRED
PARTNERS LLC
HAAS CABINET CO INC
PLAN INC 962550088
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
(502) 992-4535
HALL MANAGEMENT GROUP
ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
HALLMARK AVIATION GROUP
SYSTEMS
PO Box 2128
STOCKTON CA 95201
(209) 939-3426
DELTA TEAM CARE
(800) 336-0123
HAMILTON STORAGE TECH INC..
SERVICE CENTER
HAMMEL, GREEN & ABRAHAMSON,
INC.
(209) 939-3426
GISC, INC
GISC, INC
20 WINTER ST
PEMBROKE MA 02359
(800) 242-4472
GISC TOTALCARE
(800) 999-1077
(800) 242-4472
SERVICES
PO Box 59212
SERVICES
(800) 997-1750
(800) 997-1750
(800) 997-1750
Network.
Info as of 12/24/2007
Page PIRMI-221
www.firsthealth.com
PAYOR NAME
HAMMOND LUMBER COMPANY
LLC
HAMPSHIRE COLLEGE
MANAGEMENT SYSTEMS
COMPENSABILITY
CHECK BENEFIT CARD
123 INTERSTATE DR
(877) 868-9060
CLAIMS SUBMISSION
UTILIZATION REVIEW
PO Box 1959
Gray ME 04039
(877) 868-9060
HAMPTON VAMC 3548
SERVICES
HAMPTON VAMC
HAMPTON VAMC
CHECK BENEFIT CARD
HANCOCK PARK ASSOCIATES CORP
ADMINISTRATORS LTD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
HANFORD COMMUNITY MEDICAL
CENTER
SYSTEM/WEST
HANFORD JOINT UNION HIGH
SCHOOL DISTRICT
SYSTEMS
PO Box 1147
STOCKTON CA 95201
(800) 556-7265
100 EMANCIPATION DR
HAMPTON VA 23667
PO Box 619031
DELTA TEAMCARE
(877) 464-1441
(800) 556-5918
Network.
Info as of 12/24/2007
Page PIRMI-222
www.firsthealth.com
PAYOR NAME
HANNIBAL CARBIDE TOOL INC
CLAIMS SUBMISSION
1016 COLLIER CENTER WAY STE 200
NAPLES FL 34110
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(239) 403-7884
(239) 403-7884
Harbor Furniture MFG
Affiliated With: Carolina Benefit
Administrators
CAROLINA BENEFIT
ADMINISTRATORS
CAROLINA BENEFIT
ADMINISTRATORS
333 SOUTH PINE ST
(800) 476-2295
CHECK BENEFIT CARD
(800) 476-2295
HARBOR VIEW HOTEL
ADMINISTRATORS - NY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
HARD ROCK
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
HARD ROCK - TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
HARDWOOD PRODUCTS COMPANY
LLC
CHECK BENEFIT CARD
PO Box 1959
Gray ME 04039
Network.
Info as of 12/24/2007
Page PIRMI-223
www.firsthealth.com
PAYOR NAME
HARDWOODS SPECIALTY
PRODUCTS US LP
Affiliated With: EBMS (EMPLOYEE
BENEFIT MANAGEMENT SERVICES)
HARLAN SPRAGUE DAWLEY
CLAIMS SUBMISSION
EBMS
PO Box 21367
COMPENSABILITY
EBMS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 777-3575
(800) 777-3575
NORTH AMERICAN
ADMINISTRATORS
NORTH AMERICAN
ADMINISTRATORS
PO Box 730
AMHERST NY 14226
(800) 397-2122
CHECK BENEFIT CARD
(800) 397-2122
HARLEY MARINE SERVICES
SERVICE CORPORATION
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
HARLFINGER COMPANIES
SERVICE CENTER
GISC, INC
GISC, INC
20 WINTER ST
PEMBROKE MA 02359
(800) 242-4472
GISC TOTALCARE
(800) 999-1077
HARLFINGER COMPANIES / HARPAK,
LD PLASTICS, FBM
SERVICE CENTER
HAROLD'S STORES INC
#10469
(800) 242-4472
GISC, INC
GISC, INC
20 WINTER ST
PEMBROKE MA 02359
(800) 242-4472
GISC TOTALCARE
(800) 999-1077
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 242-4472
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-224
www.firsthealth.com
PAYOR NAME
HARPER COMPANIES
ADMINISTRATORS
HARPER CORPORATE SERVICES
ADMINISTRATORS
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
(801) 274-8100
CORVEL
(801) 269-8723
GROUP & PENSION
ADMINISTRATORS INC
GROUP & PENSION
ADMINISTRATORS INC
HEALTH WATCH
(972) 238-7900
DALLAS TX 75251
(972) 238-7900
(801) 274-8100
(972) 238-7900
HARRINGTON
HELLER ASSOCIATES
GLOBALCARE
2755 Bristol St STE 250
COSTA MESA CA 92626
8008601111 Ext 1722
GLOBALCARE
8008601111 Ext 1722
HARRIS FARMS
HEALTHCOMP TPA
HEALTHCOMP TPA
PO Box 45018
Fresno CA 93718
(800) 442-7247
CHECK BENEFIT CARD
(800) 442-7247
HARRIS MORAN SEED
ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
HARRY GRODSKY CO INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-225
www.firsthealth.com
PAYOR NAME
HARTT TRANSPORTATION
CLAIMS SUBMISSION
CORPORATION
PO Box 299
COMPENSABILITY
CORPORATION
(888) 322-2524
UTILIZATION REVIEW
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
HARTUNG INDUSTRIES INC
#11608
ADMINISTRATORS
ADMINISTRATORS
Bellevue WA 98005
(425) 462-1000
ADMINISTRATORS
(425) 462-1000
EMPLOYEE BENEFIT
CARE
(541) 883-2947
(425) 462-1000
HARVARD-WESTLAKE SCHOOL
HARVEST FORD
INC.
BEND OR 97702
(541) 312-8512
HAWK CORPORATION
PO Box 3000
(541) 312-8512
NGS AMERICAN
NGS AMERICAN
PO Box 7676
DETROIT MI 48080
8005211555
NGS AMERICAN
8005211555
8005211555
HCA THE HEALTHCARE COMPANY
HEALTH RISK MANAGEMENT, INC.
Affiliated With: HCA THE HEALTHCARE PO Box 1479
COMPANY
HEALTH RISK MANAGEMENT, INC.
Network.
HEALTH RISK MANAGEMENT,
INC.
Info as of 12/24/2007
Page PIRMI-226
www.firsthealth.com
PAYOR NAME
HCA The Healthcare Company
Affiliated With: HCA
HCJB Radio
Group, Inc.
HCP PACKAGING USA INC
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
COMPENSABILITY
CONTACT EMPLOYER
2960 N Meridian St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
UTILIZATION REVIEW
CONTACT EMPLOYER
(317) 655-4500 Outside US
(800) 628-4664 Inside US
(317) 655-4500 Outside US
(800) 628-4664 Inside US
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
Health and Welfare Luggage Industry
Insurance Co.
Health & Welfare - Luggage Industry
(800) 356-0850
ACS/Health Net Inc
Health Net Inc
PO Box 14225
Lexington KY 40512
(800) 289-2818
First Health
(800) 932-6690
PO Box 2045
ECS Payor ID 13550
(212) 539-5681
Health Net Arizona
Affiliated With: Health Net Inc
(800) 289-2818
Exclude all psych/cd services
Health Net California
Health Net Commercial Claims
Health Net Inc
PO Box 14702
Lexington KY 40512
(800) 641-7761
First Health
(800) 932-6690
(800) 641-7761
Health Net California Travel Benefit
Health Net Commercial Claims
Health Net Inc
PO Box 14702
Lexington KY 40512
(800) 641-7761
Health Net Inc
(800) 977-7282
(800) 641-7761
Network.
Info as of 12/24/2007
Page PIRMI-227
www.firsthealth.com
PAYOR NAME
Health Net New York Out of Area Plans
CLAIMS SUBMISSION
Health Net Inc
COMPENSABILITY
Health Net Inc
UTILIZATION REVIEW
(888) 747-7823
First Health
(800) 932-6690
Health Net Inc
Health Net Inc
UM NOT APPLICABLE
1 Far Mill Crossing
Shelton CT 06484
(203) 402-4899
PO Box 14700
Lexington KY 40512
(888) 747-7823
HEALTH NET NORTHEAST - IPI
BRICKLAYERS TRAVEL
Affiliated With: HEALTH NET INC
(203) 402-4899
Include Access to all PSYCH Hospitals
Health Net Northeast Travel Member
Benefit
Health Net Inc
Health Net Inc
PO Box 14700
Lexington KY 40512
(888) 747-7823
Health Net Inc
(888) 747-7823
Health Net Inc
Health Net Inc
UM NOT APPLICABLE
1 Far Mill Crossing
Shelton CT 06484
(203) 402-4899
(888) 747-7823
HEALTH NET NORTHEASTIPI/BRICKLAYERS TRAVEL
Affiliated With: HEALTH NET INC.
(203) 402-4899
Include Access to all PSYCH Hospitals
Health Net Oregon
Health Net Inc
Health Net Inc
PO Box 14130
Lexington KY 40512
(888) 802-7001
First Health
(800) 932-6690
(888) 802-7001
Health Net Oregon Travel Benefit
Health Net Inc
Health Net Inc
PO Box 14130
Lexington KY 40512
(888) 802-7001
Health Net Inc
(888) 802-7001
GLOBALCARE, INC.
GLOBALCARE, INC.
(888) 802-7001
HEALTH PLAN OF NEVADA
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
Network.
Info as of 12/24/2007
Page PIRMI-228
www.firsthealth.com
PAYOR NAME
HEALTH PLAN OF UPPER OHIO
VALLEY
CLAIMS SUBMISSION
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
COMPENSABILITY
GLOBALCARE, INC.
8008601111
UTILIZATION REVIEW
Health Plan of Upper Ohio Valley
(740) 695-3585
6783411722
SERVICES (GEMS) C/O CCN
GLOBALCARE
HEALTH PLAN INC
HEALTH PLAN INC
CHECK BENEFIT CARD
(800) 343-7674
HEALTH PLAN SOUTHEAST
HEALTH PLANS INC % OF SAVI NGS
Affiliated With: HEALTHPLANS INC
PO Box 5190
TAMPA FL 33675-5190
(800) 343-7674
HEALTH PLANS INC. - PEPM
HEALTH PLAN INC
HEALTH PLAN INC
(508) 752-2480
CMS
(866) 325-1550
(508) 752-2480
HEALTH SYSTEMS OF KENTUCKY
Healthco
Affiliated With: MERITAIN HEALTH
PO Box 520
(800) 235-7160
AVIDYN HEALTH
(866) 802-1328
(800) 235-7160
MERITAIN HEALTH
MERITAIN HEALTH
PO Box 1090
EVANSVILLE IN 47706
(800) 455-1938
EMPLOYERS RISK SERVICES
(800) 705-3765
(800) 455-1938
HEARTWOOD CREATIONS
ASSURECARE
ASSURECARE
340 Quadrangle Dr
(800) 759-1311
Careline UR
(763) 383-4800
(800) 759-1311
Network.
Info as of 12/24/2007
Page PIRMI-229
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
HEAT AND FROST INSULATORS AND ASSOCIATED THIRD PARTY
ASBESTOS WRKS H W FUND
ADMINISTRATORS
Affiliated With: ASSOCIATED THIRD
PO Box 2590
PASADENA CA 91102-2590
Heath Net Arizona Travel Member
Benefit
COMPENSABILITY
ASSOCIATED THIRD PARTY
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
ACS/Health Net Inc
Health Net Inc
PO Box 14225
Lexington KY 40512
(800) 289-2818
Health Net Inc
(800) 289-2818
(800) 289-2818
HEIDELBERG USA
ADMINISTRATORS - NY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
HEIDELBERG USA
CORESOURCE
CORESOURCE
CORESOURCE
HEIL, HEIL, SMART & GOLEE
ADMINISTRATIVE SYSTEMS, LTD.
SYSTEMS LTD
SYSTEMS LTD
SYSTEMS LTD
HELICAL PRODUCTS
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 2920
17475 JOVANNA DR
HOMEWOOD IL 60430
2092753984
Network.
Info as of 12/24/2007
Page PIRMI-230
www.firsthealth.com
PAYOR NAME
HELLENIC COLLEGE / HOLY GREEK
ORTHODOX SCHOOL
CLAIMS SUBMISSION
OF UICI
PO Box 809026
DALLAS TX 75038
COMPENSABILITY
OF UICI
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 767-0700
(800) 767-0700
HELPING HANDS SACTUARY OF
IDAHO INC.
ASSOCIATES
CRITIQUE
CRITIQUE
CHECK BENEFIT CARD
HENKE SASS WOLF OF AMERICA INC
ULTRABENEFITS INC
ULTRABENEFITS INC
CHECK BENEFIT CARD
PO Box 763
WESTBORO MA 01581
(866) 858-7223
PO Box 651109
S SALT LAKE UT 84165-1109
(866) 858-7223
HENKE SASS WOLF OF AMERICA INC
ULTRABENEFITS INC
ULTRABENEFITS INC
PO Box 763
WESTBORO MA 01581
(866) 858-7223
CHECK BENEFIT CARD
(866) 858-7223
HENRY MAYO NEWHALL MEMORIAL
HOSPITAL
ADMINISTRATORS
HERBST LAZAR BELL INC
SYSTEMS INC
EMPLOYEE BENEFIT
ADMINISTRATORS
EMPLOYEE BENEFIT
ADMINISTRATORS
424 N FIRST AVE
ARCADIA CA 91006
(626) 294-2800
EMPLOYEE BENEFIT
ADMINISTRATORS
(626) 294-2800
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(626) 294-2800
CHECK BENEFIT CARD
3129068000
Network.
Info as of 12/24/2007
Page PIRMI-231
www.firsthealth.com
PAYOR NAME
Hercules Incorporated
HERCULES INDUSTRIES
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
COMPENSABILITY
CONTACT EMPLOYER
HEALTHCOMP THIRD PARTY
ADMINISTRATORS INC
ADMINISTRATORS INC
PO Box 45018
FRESNO CA 93721
(800) 442-7247
UTILIZATION REVIEW
CONTACT EMPLOYER
CHECK BENEFIT CARD
(800) 442-7247
HEWITT CONTRACTING COMPANY,
INC.
Affiliated With: HEALTHDATAINSIGHTS
DBA MCPPO
Hewitt, Coleman and Associates, Inc.
HEALTHDATAINSIGHTS DBA MVPPO
7083 Grand National Dr. #104
ORLANDO FL 32819
HEALTHDATAINSIGHTS DBA MVPPO PPHA
(407) 246-1848
(800) 952-5277
(800) 952-5277
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
WATERSTONE BENEFIT
WATERSTONE BENEFIT
UM NOT APPLICABLE
(800) 816-6049
HIAWATHA COMMUNITY HOSPTIAL
(800) 816-6049
* HICKORY SPRINGS
MANUFACTURING CO
PARTY ADMINISTRATOR
ACORDIA NATIONAL
ACORDIA NATIONAL
CHECK BENEFIT CARD
(888) 685-7774
(888) 685-7774
Network.
Info as of 12/24/2007
Page PIRMI-232
www.firsthealth.com
PAYOR NAME
HILL BROTHERS CHEMICAL CO.
HILL VIEW RETIREMENT CENTER
CONSULTANTS
HILLCREST FAMILY SERVICE
Butler
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
EMPLOYEE BENEFIT
PO Box 3000
EMPLOYEE BENEFIT CONSULTANTS EMPLOYEE BENEFIT CONSULTANTS MEDICAL COST MANAGEMENT
(800) 367-9938
PO Box 928
(800) 472-6630
FINDLAY OH 45839
(800) 472-6630
SISCO
SISCO
PO Box 389
(800) 547-4726
CHECK BENEFIT CARD
(800) 547-4726
Hinz Claim Management Inc
Hinz Claim Management, Inc.
2815 Old Jacksonville Rd Ste 204
Springfield IL 62704
CONTACT EMPLOYER
CONTACT EMPLOYER
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
HMA Administrators, LLC
HMA Administrators, LLC
CHECK BENEFIT CARD
7 Wells Avenue, Suite 24
Newton MA 02459
(617) 581-6655 Ext 228
(217) 698-1280
HM ELECTRONICS, INC.
(800) 786-7930
HMA ADMINISTRATORS, LLC
Affiliated With: HMA
ADMINISTRATORS, LLC
(617) 581-6655 Ext 228
Network.
Info as of 12/24/2007
Page PIRMI-233
www.firsthealth.com
PAYOR NAME
HMA DIRECT
CONCEPTS INC/BENEFIT CONCEPTS
INC
HMO
INC.
HOBBY LOBBY
SERVICES
HOFFINGER INDUSTRIES
CLAIMS SUBMISSION
PO Box 60608
King of Prussia PA 19406
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(610) 337-2600
(610) 337-2600
PO Box 1229
(800) 673-5222
(800) 284-2273
FISERV HEALTH INC
FISERV HEALTH INC
CHECK BENEFIT CARD
PO Box 690450
(210) 558-2100
(800) 673-5222
(210) 558-2100
EBA&M
EBA&M
PO Box 5079
(800) 776-1545
HINES & ASSOCIATES
(800) 528-2498
EBA&M
EBA&M
CHECK BENEFIT CARD
PO Box 5079
(714) 668-8920
(800) 776-1545
HOFFINGER INDUSTRIES, INC.
HOGAN AND HARTSON LLP
Affiliated With: CORESOURCE, INC.
(714) 668-8920
CORESOURCE INC
CORESOURCE INC
PO Box 2920
(800) 354-5233
CHECK BENEFIT CARD
(800) 354-5233
Network.
Info as of 12/24/2007
Page PIRMI-234
www.firsthealth.com
PAYOR NAME
HOLDEN BUSINESS FORMS
CLAIMS SUBMISSION
ASSURECARE
HUDSON OH 44224
COMPENSABILITY
ASSURECARE
(800) 422-2026
UTILIZATION REVIEW
Careline UR
(763) 383-4800
(800) 422-2026
AMERICAN EMPLOYERS GROUP
C/O CCN
CHECK BENEFIT CARD
NORTH AMERICA
NORTH AMERICA
EBPA
EBPA
CHECK BENEFIT CARD
PO Box 2365
(802) 846-8060
HOLIDAY INN/BEST INN
EMPLOYERS GROUP
AMERICAN EMPLOYERS GROUP
C/O CCN
HOLLADAY PROPERTY SERVICES
MIDWEST, INC.
NORTH AMERICA
HOLYOKE HOSPITAL WRAP JMS
(EBPA)
* HOME STREET BANK
ADMINISTRATORS INC
HOMETOWN HEALTH NETWORK
PO Box 3000
PO Box 1984
NASHVILLE TN 37202
(802) 846-8060
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8004427247
GLOBALCARE, INC.
GLOBALCARE, INC.
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
Network.
Info as of 12/24/2007
Page PIRMI-235
www.firsthealth.com
COMPENSABILITY
HONOLULU VAMC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 2490
ALPHARETTA GA 30023
(678) 339-0211
PAYOR NAME
CLAIMS SUBMISSION
HONOLULU VAMC 3183
HONOLULU VAMC
Affiliated With: HEALTH NET FEDERAL Attn: FEE 043MD
SERVICES
459 PATTERSON RD
HONOLULU HI 96819
HOOVER MATERIALS HANDLING
GROUP
SOLUTIONS, INC.
UTILIZATION REVIEW
(678) 339-0211
HOOVER PRECISION PRODUCTS
Affiliated With: GROUP RESOURCES,
INC.
GROUP RESOURCES, INC.
HOPE UNIVERSITY
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
5161 Brook Hollow Pkwy. #200
NORCROSS GA 30071
(800) 786-7930
HORIZON GOODWILL INDUSTRIES
BENEFIT SYSTEMS
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
Horizon Managed Care
2868 Prospect Park Dr
Rancho Cordova CA 95670
(916) 631-1220
(916) 631-1220
(800) 293-3131
Network.
Info as of 12/24/2007
Page PIRMI-236
www.firsthealth.com
PAYOR NAME
HORIZON MOVING SYSTEM
CLAIMS SUBMISSION
Services
TUCSON AZ 85710
COMPENSABILITY
Services
UTILIZATION REVIEW
(847) 214-2780
(520) 722-7133
(520) 722-7133
* Horizon Transport Inc
AID
HORNE'S LODGING PROPERTIES
MMA
MMA
PO Box 483
GOSHEN IN 46527
(800) 348-7468
CHECK BENEFIT CARD
(800) 348-7468
SRT ADMINISTRATORS
SRT ADMINISTRATORS
PO Box 25160
(888) 690-2020
HINES & ASSOCIATES
(800) 944-9401
CONTACT EMPLOYER
CONTACT EMPLOYER
Hospitality Partners Health & Welfare
THE LOOMIS COMPANY
Trust
850 N PARK RD
Affiliated With: THE LOOMIS COMPANY WYOMISSING PA 19610
(866) 473-6615
THE LOOMIS COMPANY
CHECK BENEFIT CARD
HOT SPRINGS COUNTY
ASSOCIATES
MBA OF WYOMING
(888) 690-2020
Hortica Insurance Company
CONTACT EMPLOYER
Attn:
(866) 473-6615
MBA OF WYOMING
PO Box 94
WORLAND WY 82401
Network.
Info as of 12/24/2007
Page PIRMI-237
www.firsthealth.com
PAYOR NAME
HOUSING AUTHORITY OF THE
COUNTY OF MONTEREY
HOUSING AUTHORITY-COUNTY OF
MONTEREY WRAP
Affiliated With: COASTAL TPA, INC.
HOUSING BENEFITS PLAN
AMERICA 10442
HOUSTON VA MEDICAL CENTER 3101
SERVICES
CLAIMS SUBMISSION
COASTAL HEALTHCARE
ADMINISTRATORS
COMPENSABILITY
COASTAL HEALTHCARE
ADMINISTRATORS
UTILIZATION REVIEW
COASTAL HEALTHCARE
ADMINISTRATORS
PO Box 80308
SALINAS CA 93912
COASTAL TPA, INC.
COASTAL TPA, INC.
PO Box 80308
SALINAS CA 93912
(800) 564-7475
HINES & ASSOCIATES
(800) 592-8097
CHECK BENEFIT CARD
PO Box 4542
IOWA CITY IA 52244
(800) 290-7303
(800) 564-7475
(800) 290-7303
Attn: 04FRM (FEE BASIS)
2002 HOLCOMB BLVD
HOUSTON TX 77030
CHECK BENEFIT CARD
(214) 387-3232
(214) 387-3232
HOWARD BAER
KANSAS
HRH Insurance
FISERV HEALTH INC
FISERV HEALTH INC
300 W DOUGLAS STE 800
WICHITA KS 67202
(800) 235-7160
AVIDYN HEALTH
(214) 647-4417
HRH Insurance
HRH Insurance
(800) 235-7160
HRH Insurance
Network.
Info as of 12/24/2007
Page PIRMI-238
www.firsthealth.com
PAYOR NAME
HUB FOLDING BOX
Affiliated With: ACCORDIA NATIONAL
CLAIMS SUBMISSION
WELLS FARGO TPA, INC.
602 VIRGINIA ST EAST
CHARLESTON WV 25301
COMPENSABILITY
WELLS FARGO TPA, INC.
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 624-8605
(304) 353-8661
HUDSON VALLEY VA HEALTHCARE
SYSTEM 3198
SERVICES
SYSTEM
Attn: FEE BASIS 136M
CAMPUS RT 9D
CASTLE POINT NY 12511
SYSTEM
CHECK BENEFIT CARD
HUFCOR, INC.
ADMINISTRATORS INC
MIDWEST SECURITY
MIDWEST SECURITY
MIDWEST SECURITY
HUISH DETERGENTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
HUMBOLDT STATE UNIVERSITY
ADMINISTRATORS
AMERICAN INSURANCE
ADMINISTRATORS/ROSA
MONOSTORI
HUNTINGTON MEMORIAL HOSPITAL
SYSTEMS
PO Box 574
ONALASKA WI 54650
8007159414
AMERICAN INSURANCE
ADMINISTRATORS/ROSA
MONOSTORI
CHECK BENEFIT CARD
3415 S. Sepulveda Blvd #200
LOS ANGELES CA 90034-6035
PO Box 1168
STOCKTON CA 95201
Network.
Info as of 12/24/2007
Page PIRMI-239
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
HUNTINGTON VAMC 3149
HUNTINGTON VAMC
Affiliated With: HEALTH NET FEDERAL Attn: FEE BASIS (136F)
SERVICES
1540 SPRING VALLEY DR
HUNTINGTON WV 25704
HUTCHISON & STEFFEN
COMPENSABILITY
HUNTINGTON VAMC
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
UTILIZATION REVIEW
CHECK BENEFIT CARD
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
HYDRAULIC CONTROLS
ADMINISTRATORS INC
CHECK BENEFIT CARD
HYDRITE CHEMICAL COMPANY
ADMINISTRATORS
MIDWEST SECURITY
ADMINISTRATORS INC
MIDWEST SECURITY
ADMINISTRATORS INC
2700 Midwest Dr.
ONALASKA WI 54650
(800) 236-8672
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8004427247
UM NOT APPLICABLE
(800) 236-8672
HYDRO-GEAR, INC.
Hygeia Corporation
Affiliated With: Hygeia Corporation
CHECK BENEFIT CARD
Hygeia Corporation
Hygeia Corporation
121 Richmond St W Penthouse
Toronto, Ontario Canada M5H 2K1
(416) 595-1094 Ext 243
Hygeia Corporation
(416) 595-1094 Ext 243
PO Box 3000
(416) 595-1094 Ext 243
Network.
Info as of 12/24/2007
Page PIRMI-240
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
I.U.P.A.T. DISTRICT COUNCIL 78
HEALTH AND WELFARE FUND
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
IAC INTERNATIONAL
INSURERS ADMINISTRATIVE CORP.
C/O CCN
INSURERS ADMINISTRATIVE CORP. CHECK BENEFIT CARD
C/O CCN
PO Box 5190
TAMPA FL 33675-5190
(800) 843-3106
PAYOR NAME
I LOGIX
ADMINISTRATORS - NY
UTILIZATION REVIEW
(800) 843-3106
IBC GROUP, INC.
Affiliated With: FLORIDA HEALTH
ADMINISTRATORS DBA FHA-TPA
DIVISION
FLORIDA HEALTH ADMINISTRATORS FLORIDA HEALTH ADMINISTRATORS CORVEL CORPORATION
(517) 784-0821
PO Box 327810
(954) 366-0111
Fort Lauderdale FL 33332
(954) 366-0111
IBEW WESTERN UTILITIES HEALTH & COMPUSYS
WELFARE TRUST FUND / ID MT OR
2156 W 2200 S
WA WY
Affiliated With: IBEW WESTERN
(800) 628-6562
UTILITIES HEALTH & WELFARE
TRUST FUND
IBEW WESTERN UTILITIES HEALTH
AND WELFARE FUND/ ID MT OR WA
WY
Affiliated With: IBEW WESTERN
UTILITIES HEALTH & WELFARE FUND
COMPUSYS
UM NOT APPLICABLE
(800) 628-6562
COMPUSYS
COMPUSYS
2156 W 2200 S
(800) 628-6562
UM NOT APPLICABLE
(800) 628-6562
Network.
Info as of 12/24/2007
Page PIRMI-241
www.firsthealth.com
PAYOR NAME
IBEW-NECA Southwestern Health &
Benefit Fund
Affiliated With: IBEW-NECA
Southwestern Health & Benefit Fund
IBS INDUSTRIES INC
BENEFIT SYSTEMS
CLAIMS SUBMISSION
IBEW-NECA Southwestern Health and
Benefit Fund
4040 McEwen Ste 100
Dallas TX 75244-5092
UTILIZATION REVIEW
COMPENSABILITY
First
Health
IBEW-NECA Southwestern Health and
Benefit Fund
(800) 932-3869
(800) 527-0320
(800) 527-0320
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
IDAHO ASPHALT
ADMINISTRATORS
IDAHO OPAL & GEM
ADMINISTRATORS
IDAHO STATE UNIVERSITYSTUDENTS
MANAGEMENT
IEC GROUP BENEFIT TRUST FUND
Affiliated With: MEDICAL BENEFITS
ADMINISTRATORS OF MD, INC.
3761 S. 700 E.
(801) 261-5511
SERVICE ASSOCIATES
(801) 261-5511
(801) 261-5511
3761 S. 700 E.
(800) 261-5511
SERVICE ASSOCIATES
(800) 261-5511
TRUE CHOICE
CI
CHECK BENEFIT CARD
PO Box 700307
DALLAS TX 75370
(817) 479-2115
(800) 261-5511
(800) 785-2446
STRATEGIC HEALTH
DEVELOPMENT CORP
STRATEGIC HEALTH
DEVELOPMENT CORP
9501 N. E. 2ND AVENUE
MIAMI SHORES FL 33138
(888) 532-3467
STRATEGIC HEALTH
DEVELOPMENT CORP
(888) 532-3467
(888) 532-3467
Network.
Info as of 12/24/2007
Page PIRMI-242
www.firsthealth.com
PAYOR NAME
IGA GROUP EMPLOYEE BENEFIT
TRUST
Illinois Industrial Commission (IIC)
Affiliated With: STATE OF ILLINOIS
CLAIMS SUBMISSION
CONTACT EMPLOYER
COMPENSABILITY
CONTACT EMPLOYER
STATE OF ILLINOIS
STATE OF ILLINOIS
604 William G. Stratton Office Building
Springfield IL 62706
(217) 785-1954
UTILIZATION REVIEW
CHECK BENEFIT CARD
STATE OF ILLINOIS
(217) 785-1954
(217) 785-1954
IMCS PUERTO RICO
SERVICES
SERVICES
7205 Corporate Center Dr. #405
MIAMI FL 33126
(305) 463-9696
CHECK BENEFIT CARD
(305) 463-9696
* IMI FABI (USA), INC.
BENEFIT SYSTEMS & SERVICES,
INC.
INC.
760 Pasquinelli Dr. STE 320
WESTMONT IL 60559
(630) 789-2093
CHECK BENEFIT CARD
(630) 789-2093
IMMUNOGEN, INC
HEALTH PLAN INC
HEALTH PLAN INC
(508) 752-2480
CMS
(866) 325-1550
(508) 752-2480
IMPRESSIONS PRINTING
ADMINISTRATORS
SYSTEMS
SYSTEMS
17475 JOVANNA DR
HOMEWOOD IL 60430
(708) 647-3434
CHECK BENEFIT CARD
(708) 647-3434
Network.
Info as of 12/24/2007
Page PIRMI-243
www.firsthealth.com
PAYOR NAME
Indemni-Med Management
Affiliated With: Indemni-Med
Management
* Independent Bank Group Inc. (TRAVEL)
ADMINISTRATORS
CLAIMS SUBMISSION
2080 N Highway 360 Ste 345
Grand Prairie TX 75050
COMPENSABILITY
(972) 606-9100 Ext 1308
UTILIZATION REVIEW
(Clinical Operations)
(972) 606-9108
(972) 606-9100 Ext 1308
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
DALLAS TX 75251
(800) 827-7223
CHECK BENEFIT CARD
(800) 827-7223
INDEPENDENT MEAT COMPANY
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
INDEPENDENT MEDICAL SYSTEMS
NETWORK INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
INDEPENDENT STAVE COMPANY INC FMH BENEFIT SERVICES, INC. A
SERVICES INC A DIVISION OF
PO Box 25946
CORESOURCE
(800) 990-9058
CHECK BENEFIT CARD
INDIAN ELECTRIC COOPERATIVE INC
Affiliated With: BMI HEALTHPLANS,
INC.
BMI HEALTHPLANS
BMI HEALTHPLANS
PO Box 14379
SPRINGFIELD MO 65814
(918) 335-0450
(800) 990-9058
HEALTH REVIEW, LLC
(918) 335-0450
Network.
Info as of 12/24/2007
Page PIRMI-244
www.firsthealth.com
PAYOR NAME
INDIAN SUMMER CARPET MILLS
HEALTHCARE ALLIANCE
INDIANA FURNITURE INDUSTRIES,
INC
PLANS INC
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
8165237779
8165237779
PO Box 437017
Louisville KY 40253
(800) 832-8212
CHECK BENEFIT CARD
(800) 832-8212
Indiana Lumbermens
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
INDIANA STATE UNIVERSITY
MANAGEMENT
TRUE CHOICE USA
TRUE CHOICE USA
CHECK BENEFIT CARD
PO Box 700307
DALLAS TX 75370
(800) 785-2446
INDIANA WESLEYAN UNIVERSITY
INDIANAPOLIS VA MEDICAL CENTER
3156
SERVICES
(800) 785-2446
Professional Benefit Administrators, Inc. Professional Benefit Administrators, Inc. ICM
(800) 728-0327
(800) 435-5694
Oakbrook IL 60523
(800) 435-5694
INDIANAPOLIS VA MEDICAL CENTER
Attn: FEE BASIS 136C3
INDIANAPOLIS VA MEDICAL CENTER CHECK BENEFIT CARD
1700 E 38TH ST
MARION IN 46953
Network.
Info as of 12/24/2007
Page PIRMI-245
www.firsthealth.com
PAYOR NAME
INDUSTRIAL METAL SUPPLIES
ADMINISTRATORS
INDUSTRIAL METAL SUPPLY
ADMINISTARTORS INC.
INDUSTRIAL METAL SUPPLY
Affiliated With: THE PLAN HANDLERS
INC
INDUSTRIAL MOTOR AND CONTROL
Affiliated With: THIRD PARTY
CLAIMS SUBMISSION
HEALTHCOMP
PO Box 45018
Fresno CA 93718
COMPENSABILITY
HEALTHCOMP
UTILIZATION REVIEW
CHECK BENEFIT CARD
(559) 499-2450
(559) 499-2450
HEALTHCOMP
HEALTHCOMP
PO Box 45018
Fresno CA 93718
(559) 499-2450
CHECK BENEFIT CARD
(559) 499-2450
THE PLAN HANDLERS INC
930 Canterbury Pl.
ESCONDIDO CA 92025
(800) 538-5512
(800) 538-5512
SERVICES
SERVICES
7493 N Oracle Rd Ste 200
Tucson AZ 85704
(520) 670-0227
THIRD PARTY
(520) 670-0227
(520) 670-0227
INDUSTRIAL SAFETY SUPPLY
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
INDUSTRY BUYING GROUP
GLOBALCARE, INC.
GLOBALCARE, INC.
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
Network.
Info as of 12/24/2007
Page PIRMI-246
www.firsthealth.com
PAYOR NAME
Indy Plus
Group, Inc.
INETICO - PEPM
Affiliated With: INETICO, INC.
CLAIMS SUBMISSION
407 N Fulton St
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(317) 655-4500 Outside US
(800) 628-4664 Inside US
(317) 655-4500 Outside US
(800) 628-4664 Inside US
INETICO, INC.
INETICO, INC.
PO Box 10972
TAMPA FL 33679
(813) 258-2200
UM NOT APPLICABLE
(813) 258-2200
INETICO - TRAVEL WRAP
Affiliated With: INETICO, INC.
INETICO, INC.
INETICO, INC.
3902 Henderson Blvd
Tampa FL 33679
(813) 258-2200
UM NOT APPLICABLE
(813) 258-2200
C/O CCN
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
INFINIA HEALTH CARE
C/O CCN
INFINIA INC
GROUP
INFINITY HEALTHCARE, INC.
ADMINISTRATORS INC
PO Box 3000
(800) 533-5044
MIDWEST SECURITY
MIDWEST SECURITY
MIDWEST SECURITY
2700 Midwest Dr.
ONALASKA WI 54650
Network.
Info as of 12/24/2007
Page PIRMI-247
www.firsthealth.com
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
PAYOR NAME
CLAIMS SUBMISSION
INFORMATION SYSTEMS SOLUTIONS CHECK BENEFIT CARD
INTERNATIONAL
INFRA-METALS CO
GROUP
INGLEWOOD UNIFIED SCHOOL
DISTRICT
INLAND SEAFOOD
Affiliated With: KHS, A KMG AMERICA
COMPANY
UTILIZATION REVIEW
(800) 533-5044
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
KMG AMERICA
KMG AMERICA
PO Box 1000
LANCASTER SC 29721
(800) 822-1274
CHECK BENEFIT CARD
(800) 822-1274
INNERPAC INC - PERFORMAX
ADMINISTRATORS - NY
AMERICAN HEALTH HOLDINGS INC
AMERICAN HEALTH HOLDINGS INC
AMERICAN HEALTH
HOLDINGS INC
INNOVATIVE ADMINISTRATIVE
SERVICES (WRAP)
Affiliated With: INNOVATIVE
SERVICES
SERVICES
CHECK BENEFIT CARD
540 WALD AVE
IRVINE CA 92618
(949) 442-6600
921 EASWIND
WESTERVILLE OH 43081
(949) 442-6600
Network.
Info as of 12/24/2007
Page PIRMI-248
www.firsthealth.com
PAYOR NAME
INNOVIA FILMS INC
MANAGEMENT INC #962501916
CLAIMS SUBMISSION
PO Box 1090
GREAT BEND KS 67530
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 290-1368
(800) 290-1368
INSERVICES, INC.
INSERVICES, INC.
INSERVICES, INC.
(704) 945-2892
INSERVICES, INC.
(704) 945-2892
4401 Barclay Downs Dr.
Charlotte NC 28209
EBPA
EBPA
CHECK BENEFIT CARD
PO Box 2365
(802) 846-8060
(704) 945-2892
INSTITUTE OF PROFESSIONAL
PRACTICE JMS
(EBPA)
(802) 846-8060
INSURANCE PROGRAMMERS INC
CHECK BENEFIT CARD
PROGRAMMERS NE ELEC WORKERS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
INSURCORP
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
INSURERS ADMINISTRATIVE
CORPORATION
INSURERS ADMINISTRATIVE CORP.
C/O CCN
INSURERS ADMINISTRATIVE CORP. CHECK BENEFIT CARD
C/O CCN
PO Box 5190
TAMPA FL 33675-5190
(800) 843-3106
(800) 843-3106
Network.
Info as of 12/24/2007
Page PIRMI-249
www.firsthealth.com
PAYOR NAME
INTEGRAL YOUTH SERVICES
INC.
Integrated Care Systems
CLAIMS SUBMISSION
BEND OR 97702
COMPENSABILITY
(541) 312-8512
UTILIZATION REVIEW
CARE
(541) 883-2947
(541) 312-8512
CompIQ Corporation
CompIQ Corporation
35 Tesla Way #100
Irvine CA 92618
(949) 923-4021
CHECK BENEFIT CARD
(949) 923-4021
INTEGRATED HEALTHCARE
SOLUTIONS LLC DBA MVPPO
SOLUTIONS LLC PERCENT
Affiliated With: INTEGRATED
HEALTHCARE SOLUTIONS LLC DBA
MVPPO
INTEGRATED TECHNOLOGY CORP.
Affiliated With: DAN R. WAGNON &
ASSOCIATES, INC.
INC.
DAN R WAGNON AND ASSOCIATES DAN R WAGNON AND
ASSOCIATES INC
INC
3825 N. 24th St.
PHOENIX AZ 85016
(800) 362-5894 Ext 230
7083 Grand National Dr. #104
ORLANDO FL 32819
6022402404 Ext 230
(800) 362-5894 Ext 230
6022402404 Ext 230
INTEGRITY CHRYSLER JEEP DODGE
MEGASTORE
INTERCONNECT DEVICES INC
Affiliated With: AMERICAN STERLING
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
AMERICAN STERLING INSURANCE
SERVICES
AMERICAN STERLING INSURANCE
SERVICES
10975 Grandview Dr, Ste 100 Bldg 27
Overland Park KS 66210
(913) 498-9096
CHECK BENEFIT CARD
(913) 498-9096
Network.
Info as of 12/24/2007
Page PIRMI-250
www.firsthealth.com
PAYOR NAME
Intermed
INTERMOUNTAIN CENTERS FOR
HUMAN DEVELOPMENT
Affiliated With: GILSAR INC
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
GILSBAR
GILSBAR
PO Box 2947
COVINGTON LA 70434
(888) 472-4352
UTILIZATION REVIEW
CONTACT EMPLOYER
MedCom Services, Inc.
(800) 643-4416
(888) 472-4352
IRONWORKERS INTERMOUNTAIN
HEALTH & WELFARE TRUST
CHECK BENEFIT CARD
MBA OF WYOMING
MBA OF WYOMING
International Brotherhood of
Boilermakers
Boilermakers
PO Box 23825
Tucson AZ 85734
(913) 342-2882
Boilermakers
(888) 560-8932
HEALTHCOMP TPA
HEALTHCOMP TPA
CHECK BENEFIT CARD
PO Box 45018
Fresno CA 93718
(559) 499-2450
INTERMOUNTAIN IRONWORKERS
Affiliated With: INTERMOUNTAIN
IRONWORKERS HEALTH & WELFARE
TRUST
IRONWORKERS INTERMOUNTAIN
INTERMOUNTAIN LABORATORIES
ASSOCIATES
MBA OF WYOMING
Boilermakers
Affiliated With: Boilermakers National
Health & Welfare Fund
INTERNATIONAL COFFEE AND TEA,
LLC
COMPENSABILITY
CONTACT EMPLOYER
PO Box 30124
PO Box 98
WORLAND WY 82401
(913) 342-2882
(559) 499-2450
Network.
Info as of 12/24/2007
Page PIRMI-251
www.firsthealth.com
PAYOR NAME
INTERNATIONAL COMMUNITY
SERVICES MA
INTERNATIONAL HEALTHCARE
HEALTHCARE
CLAIMS SUBMISSION
STUDENT RESOURCES
PLANO TX 75075
COMPENSABILITY
STUDENT RESOURCES
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
(800) 237-0903 Ext 6352
SERVICES
INTERNATIONAL MANAGED
CARE SERVICES
UM NOT APPLICABLE
New York NY 10019
(212) 581-8228
303 H
DBA: SIMNSA HealthCare
SERVICES
* INTERNATIONAL MED CARE
NETWORK INC
International Mission Board - IMB
Group, Inc.
International Service Corp.
Group, Inc.
SERVICES
7205 Corporate Center Dr. #405
MIAMI FL 33126
(212) 581-8228
407 N Fulton St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
CHECK BENEFIT CARD
(317) 655-4500 Outside US
(800) 628-4664 Inside US
407 N Fulton St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
CHECK BENEFIT CARD
(317) 655-4500 Outside US
(800) 628-4664 Inside US
Network.
Info as of 12/24/2007
Page PIRMI-252
www.firsthealth.com
PAYOR NAME
INTERNATIONAL UNION OF
INDUSTRIAL AND INDEPENDENT
WORKERS
Affiliated With: GREENTREE
ADMINISTRATORS
Intracorp
Affiliated With: Intracorp
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CONTACT EMPLOYER
CONTACT EMPLOYER
PO Box 23507
(800) 678-1536
(800) 264-7502
CLAIMS SUBMISSION
CHECK BENEFIT CARD
First Health
UTILIZATION REVIEW
PO Box 11158
Includes Specialized Physical Therapy
Intratech Dental Products
Claims Inc.
INUNISON
ADMINISTRATORS
(800) 678-1536
(801) 261-5511
SERVICE ADVOCATES
(801) 261-5511
(801) 261-5511
INVACARE
INVACARE
INVACARE
One Invacare Way
Elyria OH 44036
(440) 329-6149
INVACARE
(440) 329-6149
(440) 329-6149
Investco Insurance Trust
Affiliated With: Trusteed Plans Service
Corporation
PO Box 1894
TRUSTEED PLANS SERVICE GROUP QUALIS
8007838606
(800) 426-9786
(800) 426-9786
Network.
Info as of 12/24/2007
Page PIRMI-253
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
IOWA CITY VAMC 3709
IOWA CITY VA MEDICAL CENTER
Affiliated With: HEALTH NET FEDERAL Attn: FEE 136B
SERVICES
HIGHWAY 6 WEST
IOWA CITY IA 52246
IPRO
COMPENSABILITY
IOWA CITY VA MEDICAL CENTER
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 831-7783
Capp Care
(800) 937-2277
CHECK BENEFIT CARD
(800) 831-7783
IRON MOUNTAIN VAMC 3163
SERVICES
IRON MOUNTAIN VAMC
Attn: FEE BASIS 585/170
325 E H ST
IRON MOUNTAIN MI 49801
IRON MOUNTAIN VAMC
IRON WORKERS DISTRICT COUNCIL
IRON WORKERS DISTRICT COUNCIL
C/O CCN
IRON WORKERS DISTRICT COUNCIL CHECK BENEFIT CARD
C/O CCN
IRON WORKERS LOCAL 395 TRUST
FUND
Affiliated With: IRON WORKERS
LOCAL 395 TRUST FUND
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
IRVINE VALLEY COLLEGE INTL
STUDENT SRVCS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 5190
TAMPA FL 33675-5190
Network.
Info as of 12/24/2007
Page PIRMI-254
www.firsthealth.com
PAYOR NAME
IRVING VALLEY COLLEGE
CLAIMS SUBMISSION
PERSONAL INSURANCE
ADMINISTRATORS
COMPENSABILITY
PERSONAL INSURANCE
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 468-4343
(800) 468-4343
ISCAR METALS
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
PO Box 749075
(800) 827-7223
CHECK BENEFIT CARD
(210) 691-0500
ISEC INC
MANAGEMENT SERVICES (EBMS)
EBMS
EBMS
PO Box 21367
(800) 777-3575
EBMS CARELINK
(406) 245-3575
SYSTEMS LTD
SYSTEMS LTD
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(800) 777-3575
ISW EMPLOYEE LEASING COMPANY,
INC.
SYSTEMS, LTD.
IT Strategies OOA
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
HOMEWOOD IL 60430
(702) 242-7700
I-TECH USA, INC
ADMINISTRATIVE SYSTEMS, LLC
SYSTEMS
SYSTEMS
7 JOVANNA DR STE 1B
HOMEWOOD IL 60430
(800) 523-0582
CHECK BENEFIT CARD
(800) 523-0582
Network.
Info as of 12/24/2007
Page PIRMI-255
www.firsthealth.com
PAYOR NAME
ITRON INC
AMERICA
J D STREETT & COMPANY, INC
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
UTILIZATION REVIEW
CHECK BENEFIT CARD
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
J KNIPPER & COMPANY
ADMINISTRATORS OF AMERICA (IAA)
J SQUARE
ADMINISTRATORS SYSTEMS
IAA
IAA
(856) 470-1200
INC
8885991515
(856) 470-1200
SYSTEMS
SYSTEMS
17475 JOVANNA DR
HOMEWOOD IL 60430
(708) 799-7400
CHECK BENEFIT CARD
(708) 799-7400
J.M. SMUCKERS COMPANY
PARTY ADMINISTRATOR
JACK JONES TRUCKING, INC.
ACORDIA NATIONAL
ACORDIA NATIONAL
CHECK BENEFIT CARD
(888) 685-7774
(888) 685-7774
PO Box 5079
(800) 776-1545
EMPLOYEE BENEFIT
(800) 776-1545
Network.
Info as of 12/24/2007
Page PIRMI-256
www.firsthealth.com
PAYOR NAME
Jackson Tube Service Inc
Claims Inc.
CLAIMS SUBMISSION
First Health
PO Box 3017
Scottsdale AZ 85271
COMPENSABILITY
Underwriters Safety & Claims Inc.
UTILIZATION REVIEW
(800) 678-1536
Underwriters Safety & Claims Inc
(800) 678-1536
(800) 678-1536
JACKSON VA MEDICAL CENTER 3110
SERVICES
JACKSON VA MEDICAL CENTER
1500 E WOODROW WILSON DR
JACKSON MS 39216
JACKSON VA MEDICAL CENTER
CHECK BENEFIT CARD
JACOB STERN & SONS, INC.
EMPLOYEE BENEFIT
JAGER DI PAOLA KEMP DESIGN JMS
(EBPA)
EBPA
EBPA
CHECK BENEFIT CARD
PO Box 2365
(802) 846-8060
PO Box 3000
(802) 846-8060
JAMES HARDIE BUILDING PRODUCTS DELTA HEALTH SYSTEMS
PO Box 80
INC
Stockton CA 95201
(559) 448-4148
JAMES HODGE AUTO GROUP
SERVICES
PO Box 720460
(405) 755-2929
DELTA TEAM CARE
(559) 448-4148
CHECK BENEFIT CARD
(405) 755-2929
Network.
Info as of 12/24/2007
Page PIRMI-257
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
JARVIS GROUP
ADMINISTRATORS - NY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
JASON ASSOCIATES
EMPLOYEE BENEFIT
EMPLOYEE BENEFIT
EMPLOYEE BENEFIT
JASPER SEATING COMPANY INC
PLANS, INC.
CHECK BENEFIT CARD
PO Box 437017
Louisville KY 40253
(800) 832-8212
PAYOR NAME
JARVIS COMPANY
ADMINISTRATORS INC
JBA CONSULTING % OF SAVINGS
UTILIZATION REVIEW
PO Box 5079
(800) 832-8212
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
JBA CONSULTING ENGINEERS TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-258
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
JCB INC
Affiliated With: CBCA Administrators, Inc. 4150 INTERNATIONAL PLAZA STE
900
FORT WORTH TX 76109
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 631-3441
(912) 691-3782
JCM
PLAN OF NEVADA
PLAN OF NEVADA
2720 N. Tenaya Way, Room 507
Las Vegas NV 89128
(702) 240-8931
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 240-8931
JDC LOGISTICS
ASSURECARE
ASSURECARE
340 Quadrangle Dr
(800) 759-1311
Careline UR
(763) 383-4800
SRT ADMINISTRATORS
CHECK BENEFIT CARD
CO.
(801) 261-5511
(800) 759-1311
JEEHDEEZ 'A ACADEMY, INC.
SRT ADMINISTRATORS
JEFFERSON COUNTY
ADMINISTRATORS
SMITH ADMINISTRATORS, INC.
3761 S 700 E SUITE 202
(801) 261-5511
JEFFERSON COUNTY BOARD OF
EDUCATION
PO Box 25160
(801) 261-5511
TREVOSE PA 19053
(215) 639-6208
(215) 639-6208
Network.
Info as of 12/24/2007
Page PIRMI-259
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
JEFFERSON ENERGY COOPERATIVE COOPERATIVE BENEFIT
ADMINISTRATOR
Affiliated With: NATIONAL RURAL
ELECTRIC COOPERATIVE
PO Box 6249
ASSOCIATION
(402) 483-9200
* Jefferson Rehabilitation Center Inc
BENEFIT SYSTEMS
COMPENSABILITY
COOPERATIVE BENEFIT
ADMINISTRATOR
UTILIZATION REVIEW
CHECK BENEFIT CARD
(402) 483-9200
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
JEFFERSON STATE ROCK
PRODUCTIONS, INC.
INC.
JERRY'S NUGGET - TRAVEL
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
JESUIT HEALTH TRUST/HMSRCHRISTIAN BROTHERS SERVICES
GROUP
* Jetta Operating Company Inc. (TRAVEL)
ADMINISTRATORS
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
DALLAS TX 75251
(800) 827-7223
CHECK BENEFIT CARD
(800) 827-7223
Network.
Info as of 12/24/2007
Page PIRMI-260
www.firsthealth.com
PAYOR NAME
JFP BENEFIT MANAGEMENT PEPM
CLAIMS SUBMISSION
GLOBALCARE
6875 Shiloh Rd E
ALPHARETTA GA 30005
COMPENSABILITY
GLOBALCARE
UTILIZATION REVIEW
CHECK BENEFIT CARD
(888) 285-4864
(888) 285-4864
* JK GUARDIAN SECURITY SERVICES
JMA ARCHITECTURE STUDIO - PEPM
(800) 899-9355
(800) 899-9355
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
JMA ARCHITECTURE STUDIO TRAVEL
JOB OPTIONS
ADMINISTRATORS
JOB SQUAD INC
BENEFIT SYSTEMS
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
(800) 899-9355
(800) 899-9355
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
Network.
Info as of 12/24/2007
Page PIRMI-261
www.firsthealth.com
PAYOR NAME
JOE BROWN COMPANY INC
CLAIMS SUBMISSION
WATERSTONE BENEFIT
COMPENSABILITY
WATERSTONE BENEFIT
UTILIZATION REVIEW
CHECK BENEFIT CARD
(405) 440-8888
(405) 440-8888
JOHN A MARTIN
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
JOHN A MARTIN TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
JOHN ALDEN LIFE INSURANCE
COMPANY
COMPANY
COMPANY
PO Box 981602
EL PASO TX 79998
(800) 328-4316
Fortis
(800) 500-0036
(800) 328-4316
COMPANY - REMOTE REPRICING
COMPANY
COMPANY
PO Box 1599
BOISE ID 83701-1599
(800) 328-4316
CHECK BENEFIT CARD
(800) 328-4316
COMPANY/HSP ONLY
INSURANCE COMPANY
COMPANY
COMPANY
CHECK BENEFIT CARD
PO Box 1599
BOISE ID 83701-1599
Network.
Info as of 12/24/2007
Page PIRMI-262
www.firsthealth.com
PAYOR NAME
JOHN ALDEN REWARDS
INSURANCE COMPANY
JOHN BOYLE AND COMPANY INC
PHYSICIANCARE INC
CLAIMS SUBMISSION
8330 ALLISON POINT TRAIL
INDIANAPOLIS IL 46250
COMPENSABILITY
(866) 387-0489
UTILIZATION REVIEW
FORTIS BENEFITS
INSURANCE COMPANY
(866) 387-3407
(317) 284-7649
PO Box 11088
CHARLOTTE NC 28220
(800) 446-5439
(800) 582-7774
(800) 446-5439
JOHN BUNNING TRANSFER
COMPANY
Affiliated With: REGIONAL CARE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
John Davis Trucking Co Inc - Travel
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
JOHN HAMMONS HOTELS INC
GROUP
JOHNSON & WALES UNIVERSITY
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
KLAIS & COMPANY INC
KLAIS & COMPANY INC
1867 W MARKET ST
AKRON OH 44313
(800) 331-1096
CHECK BENEFIT CARD
(800) 331-1096
Network.
Info as of 12/24/2007
Page PIRMI-263
www.firsthealth.com
PAYOR NAME
JOHNSON & WALES UNIVERSITY
PSPM
JOHNSON BIBLE COLLEGE
SERVICES
JOHNSON BROTHERS CORP
CLAIMS SUBMISSION
KLAIS & COMPANY INC
1867 W MARKET ST
AKRON OH 44313
COMPENSABILITY
KLAIS & COMPANY INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 331-1096
(800) 331-1096
333 N. MAIN STREET
STILLWATER MN 55082
6514397098
CHECK BENEFIT CARD
6514397098
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
MBA OF WYOMING
MBA OF WYOMING
MBA OF WYOMING
MBA OF WYOMING
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 422-2026
JOHNSON COUNTY
ASSOCIATES
JOHNSON COUNTY HOSPITAL
DISTRICT
ASSOCIATES
JOHNSTON EMPLOYEE BENEFIT
ASSOCIATION
KANSAS
CHECK BENEFIT CARD
PO Box 94
WORLAND WY 82401
PO Box 94
WORLAND WY 82401
Network.
Info as of 12/24/2007
Page PIRMI-264
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
JONES VARGAS
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
JON-LIN FOODS
ADMINISTRATION & MANAGEMENT
MGMT. (EBA&M)
MGMT. (EBA&M)
PO Box 5079
(714) 668-8920
HINES & ASSOCIATES
(800) 528-2498
(714) 668-8920
JORDAN OUTDOOR IMMERSION
GRAPHICS
INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
JOSEPH CARRARA & SONS WRAP
JMS
ADMINISTRATOR INC
ADMINISTRATOR INC
CHECK BENEFIT CARD
(EBPA)
PO Box 2365
(800) 525-8788
JOSEPH GALLO FARMS
(802) 846-8060
ADMINISTRATORS INC
ADMINISTRATORS INC
PO Box 45018
FRESNO CA 93721
(800) 442-7247
CHECK BENEFIT CARD
(800) 442-7247
JOSEPH MERRITT
SERVICE CENTER
GISC, INC
GISC, INC
20 INDUSTRIAL PARK DR
PEMBROKE MA 02359
(800) 242-4472
CHECK BENEFIT CARD
7818298595 Ext 136
Network.
Info as of 12/24/2007
Page PIRMI-265
www.firsthealth.com
PAYOR NAME
JOY GLOBAL INC
GROUP
JP FARLEY
CLAIMS SUBMISSION
PO Box 5319
TAMPA FL 33675-5319
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 533-5044
(800) 533-5044
GLOBALCARE, INC.
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
8008601111
JP Farley
(800) 634-0173
6783411722
JR SIMPLOT
GROUP
PRUDENTIAL OVERALL SUPPLY
JR SIMPLOT/UT MEMBERS
GROUP
JSA HEALTHCARE NEVADA LLC
TRAVEL
JSI STORE FIXTURES INC
PRUDENTIAL OVERALL SUPPLY
PRUDENTIAL OVERALL
SUPPLY
PO Box 39710
COLORADO SPRINGS CO 80949
(888) 421-2926
(800) 553-5044
PO Box 11210
SANTA ANA CA 92711
(888) 421-2926
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
HEALTH PLAN INC
HEALTH PLAN INC
(508) 752-2480
CARE MANAGEMENT
SERVICES
(866) 325-1550
(508) 752-2480
Network.
Info as of 12/24/2007
Page PIRMI-266
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
JULIET - TRAVEL
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
JUPITER MEDIA CORPORATION
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
JUPITERMEDIA
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
JVS
BENEFIT SYSTEMS
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
K & D CONSTRUCTION - TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
K 12 BUSINESS
STUDENT INSURANCE DIVISION
STUDENT INSURANCE DIVISION
PO Box 809025
(800) 767-0700
CHECK BENEFIT CARD
(800) 767-0700
Network.
Info as of 12/24/2007
Page PIRMI-267
www.firsthealth.com
PAYOR NAME
KAESER COMPRESSORS
Affiliated With: ACS BENEFIT
SERVICES, INC.
CLAIMS SUBMISSION
ACS BENEFIT SERVICES INC
PO Box 2000
Winston-Salem SC 27102
COMPENSABILITY
ACS BENEFIT SERVICES INC
(800) 849-5370
(800) 849-5370
KAISER PERM ROCKY MOUNTAIN
Affiliated With: KAISER PERMANENTE
INSURANCE COMPANY ROCKY
MOUNTAIN
CHECK BENEFIT CARD
KAISER PERMANENTE NORTH WEST
Affiliated With: KAISER FOUNDATION
HEALTH PLAN OF THE NORTHWEST
CHECK BENEFIT CARD
Kaisers Contracting Cleaning
Specialities Inc
MET Team
MET Team
2700 Midwest Dr.
ONALASKA WI 54650
(800) 783-9281
Affiliated With: Midwest Security
Administrators
KALB CONSTRUCTION - TRAVEL
UTILIZATION REVIEW
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8003824661
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8008132000
CHECK BENEFIT CARD
(800) 783-9281
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
KANSAS CITY VAMC 3526
SERVICES
KANSAS CITY VAMC
4801 LINWOOD BLVD
KANSAS CITY MO 64128
KANSAS CITY VAMC
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-268
www.firsthealth.com
PAYOR NAME
KATAHDIN PAPER COMPANY LLC
ADMINISTRATORS - NY
KAYCAN LTD
GROUP
KAYSUN CORPORATIOM
CONSULTANT
KBS BUILDING SYSTEMS
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
(800) 533-5044
PO Box 928
(800) 558-7798
FINDLAY OH 45839
(800) 558-7798
HEALTH PLAN INC
HEALTH PLAN INC
5087522480
CMS INC
(866) 325-1550
THE EPOCH GROUP
THE EPOCH GROUP
CHECK BENEFIT CARD
10793 WATSON RD
ST. LOUIS MO 63127-1036
(314) 821-3957
5087522480
KCG INC
#10469
KEENE TECHNOLOGY, INC
CONSULTANTS
(314) 821-3957
PO Box 928
(800) 558-7798
FINDLAY OH 45839
(800) 558-7798
Network.
Info as of 12/24/2007
Page PIRMI-269
www.firsthealth.com
PAYOR NAME
KELLER SUPPLY COMPANY
CLAIMS SUBMISSION
EBMS
PO Box 21367
COMPENSABILITY
EBMS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 777-3575
(800) 777-3575
KEMA CONSULTING
THE LOOMIS COMPANY
WYOMISSING PA 19610
THE LOOMIS COMPANY
CHECK BENEFIT CARD
(877) 634-9814
(877) 634-9814
KENNESAW STATE UNIV AIH0058327
CORP #14005
KENNESAW STATE UNIV AIH0058337
CORP #14005
KENNESAW STATE UNIVERSITY
UNDERGRAD MANDATORY
CORP
PO Box 2271
Florence SC 29503
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
PO Box 2271
Florence SC 29503
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
KENT BEVERAGE
GROUP
(800) 266-5896
PRIORITY HEALTH
(800) 446-5674
PO Box 2388 C
STOW OH 44224
(800) 266-5896
Network.
Info as of 12/24/2007
Page PIRMI-270
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
KENTUCKY CHRISTIAN UNIVERSITY
Affiliated With: MAKSIN MANAGEMENT Attn: WHIT WALTERS
CORP
419 S. COIT ST
FLORENCE SC 29501
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(843) 622-6001
(843) 622-6001
NORTH AMERICA
NORTH AMERICA
OF UICI
OF UICI
CHECK BENEFIT CARD
PLANO TX 75075
(800) 767-0700
KENTUCKY MACHINE AND
ENGINEERING
NORTH AMERICA
KERN HIGH SCHOOL DISTRICT
PO Box 1984
NASHVILLE TN 37202
(800) 237-0903 Ext 6352
KERN VALLEY HEALTHCARE
DISTRICT
Affiliated With: MANAGED CARE
SYSTEMS
MANAGED CARE SYSTEMS
5080 CALIFORNIA AVE STE 120
BAKERSFIELD CA 93309
6617167100
(661) 716-7140
ASSOCIATED ADMINISTRATORS,
INC.
ASSOCIATED
CHECK BENEFIT CARD
6617167100
KETTLE FOODS
Affiliated With: ASSOCIATED
INC.
KETTLE FOODS
SOLUTIONS
2455 E. Parleys Way #300
(800) 348-6898
2929 NW 31st St
PORTLAND OR 97210
(800) 348-6898
Network.
Info as of 12/24/2007
Page PIRMI-271
www.firsthealth.com
PAYOR NAME
KEY MANAGEMENT CO OF
MISSOURI, LLC
ADMINISTRATIVE SYSTEMS
Key Risk Management Services, Inc.
Affiliated With: Key Risk Insurance
Company
CLAIMS SUBMISSION
SYSTEMS
HOMEWOOD IL 60430
COMPENSABILITY
SYSTEMS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(618) 628-0289
(618) 628-0289
Key Risk Insurance Company
PO Box 49129
Greensboro NC 27419
(800) 366-1511
(800) 366-1511
PENN WESTERN BENEFITS, INC.
CHECK BENEFIT CARD
UM NOT APPLICABLE
(800) 366-1511
KEY RISK MANAGEMENT SERVICES,
INC.
Affiliated With: PENN WESTERN
BENEFITS, INC.
C/O CCN
KEYS INSURANCE SERVICES INC
SELF INSURED BENEFIT
101 STARCREST DR
CLEARWATER FL 33758
(800) 683-7422
PO Box 5190
TAMPA FL 33675-5190
(800) 683-7422
KEYSPAN ENERGY DELIVERY
PLAN ADMINISTRATORS
EBPA
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
EBPA
CHECK BENEFIT CARD
(800) 578-3272
(800) 578-3272
KEYWELL LLC
GROUP
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
Network.
Info as of 12/24/2007
Page PIRMI-272
www.firsthealth.com
PAYOR NAME
KIFI TV8
ADMINISTRATORS
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
BAC
(614) 863-8780
KIN DAH LICHI 'I OLTA
KINETICS NOISE CONTROL
ADMINISTRATORS AND
CONSULTANTS
BAC
BAC
(614) 863-8780
KING, CHAPMAN & BROUSSARD, INC
UTILIZATION REVIEW
PO Box 25160
(614) 863-8780
CONSULTANTS INC
CONSULTANTS INC
PO Box 107
(800) 521-2684
UM NOT APPLICABLE
(614) 863-8780
KINGFISHER REGIONAL HOSPITAL
COMPANY
KINRO INC
PO Box 26967
(405) 290-5696
CHECK BENEFIT CARD
(405) 290-5696
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-273
www.firsthealth.com
PAYOR NAME
KINROSS GOLD USA INC
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
8007773575
KINROSS GOLD USA INC TRAVEL
MANAGEMENT SERVICES
EBMS
KINSETH HOTEL COORPORATION
Butler
KIPP & CO PACTRUST
COMPENSABILITY
CHECK BENEFIT CARD
EBMS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
215 N MAIN ST STE 800
DAVENPORT IA 52801
(563) 327-2240
PO Box 21367
(563) 327-2240
GLOBALCARE
GLOBALCARE
6875 Shiloh Rd E
ALPHARETTA GA 30005
(678) 341-1922
UM NOT APPLICABLE
(678) 341-1922
KIPP AND COMPANY - WRG DESIGN
GLOBALCARE
GLOBALCARE
6875 Shiloh Rd E
ALPHARETTA GA 30005
(678) 341-1922
UM NOT APPLICABLE
(678) 341-1922
KITTRELL GARLOCK & ASSOCIATES
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
KLAIS & COMPANY - PEPM
KLAIS & COMPANY INC
KLAIS & COMPANY INC
1867 W MARKET ST
AKRON OH 44313
(800) 331-1096
CHECK BENEFIT CARD
(800) 331-1096
Network.
Info as of 12/24/2007
Page PIRMI-274
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
KLAMATH ALCOHOL & DRUG ABUSE, QVI RISK SOLUTIONS INC
INC.
BEND OR 97702
INC.
(541) 312-8512
KLAMATH CHILD AND FAMILY
TREATMENT CENTER
INC.
KLAMATH COUNTY EMPLOYESS
INC.
KLAMATH COUNTY SCHOOLS
INC.
KLAMATH FALLS CITY SCHOOLS
INC.
KLAMATH FAMILY HEAD START
INC.
COMPENSABILITY
(541) 312-8512
BEND OR 97702
(541) 312-8512
UTILIZATION REVIEW
CARE
(541) 883-2947
CARE
(541) 883-2947
(541) 312-8512
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
1011 SW EMKAY DR
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
Network.
Info as of 12/24/2007
Page PIRMI-275
www.firsthealth.com
PAYOR NAME
KLAMATH FAMILY PRACTICE
INC.
KLAMATH HEALTH PARTNERSHIP
INC.
KLAMATH HOSPICE
INC.
KLAMATH MEDICAL CLINIC
INC.
KLAMATH ORTHOPEDIC & SPORTS
MEDICINE CLINIC
INC.
KLAMATH RADIOLOGY ASSOCIATES,
PC
INC.
CLAIMS SUBMISSION
BEND OR 97702
COMPENSABILITY
(541) 312-8512
UTILIZATION REVIEW
CARE
(541) 883-2947
(541) 312-8512
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
Network.
Info as of 12/24/2007
Page PIRMI-276
www.firsthealth.com
PAYOR NAME
KLAUSSNER FURNITURE
INDUSTRIES, INC
PHYSICIANCARE
KNOWLEDGE HEALTHCARE, INC
CLAIMS SUBMISSION
PPC
PO Box 11088
CHARLOTTE NC 28220
COMPENSABILITY
PPC
(800) 446-5439
UTILIZATION REVIEW
PPC
(704) 523-2758
(800) 446-5439
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
KOHNER PROPERTIES
THE EPOCH GROUP
THE EPOCH GROUP
10795 Watson Rd
St. Louis MO 63129
(314) 821-3957
HEALTHLINK
(314) 821-3957
(314) 821-3957
KONOCTI UNIFIED SCHOOLS
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
KORTE ELECTRIC
ASSURECARE
ASSURECARE
LANSING MI 38823
(800) 968-6616
CARELINE
(763) 383-4800
(800) 968-6616
KOYO CORPORATION
BENEFITS, INC
(866) 885-4944
(501) 218-7691
(800) 560-4664
Network.
Info as of 12/24/2007
Page PIRMI-277
www.firsthealth.com
PAYOR NAME
KRAFT FOODS
BENEFITS INC
KRALIS BROTHERS FOODS
ADMINISTRATORS
KUMHO TIRE USA INC
CLAIMS SUBMISSION
COMPENSABILITY
(866) 885-4944
UTILIZATION REVIEW
(501) 218-7691
(800) 560-4664
(801) 274-8100
CORVEL
(810) 269-8723
(801) 274-8100
AFFORDABLE BENEFIT
ADMINISTRATORS INC
AFFORDABLE BENEFIT
ADMINISTRATORS INC
PO Box 10787
BURBANK CA 91510-0787
(818) 842-0147
AFFORDABLE BENEFIT
ADMINISTRATORS INC
(818) 842-0147
(818) 842-0147
KYOCERA
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CORESOURCE, MN
(866) 280-4120
KYOCERA AMERICA, INC.
Affiliated With: KYOCERA
INTERNATIONAL, INC.
HELLER ASSOCIATES
HELLER ASSOCIATES
HELLER ASSOCIATES
KYOCERA SOLAR, INC.
INTERNATIONAL, INC.
HELLER ASSOCIATES
HELLER ASSOCIATES
HELLER ASSOCIATES
COSTA MESA CA 92626
COSTA MESA CA 92626
Network.
Info as of 12/24/2007
Page PIRMI-278
www.firsthealth.com
PAYOR NAME
KYOCERA TYCOM
INTERNATIONAL, INC.
CLAIMS SUBMISSION
HELLER ASSOCIATES
COMPENSABILITY
HELLER ASSOCIATES
HELLER ASSOCIATES
HELLER ASSOCIATES
HELLER ASSOCIATES
HEALTHCORP
(800) 457-4726
UTILIZATION REVIEW
COSTA MESA CA 92626
KYOCERA WIRELESS CORPORATION
INTERNATIONAL, INC.
HELLER ASSOCIATES
K-Z, Inc.
Butler
COMPANY (SISCO)
COMPANY (SISCO)
PO Box 389
(800) 457-4726
COSTA MESA CA 92626
(800) 457-4726
L ROBERT KIMBALL AND
THE LOOMIS COMPANY
ASSOCIATES
PO Box 7011
Affiliated With: THE LOOMIS COMPANY WYOMISSING PA 19610-6011
(800) 346-1223
THE LOOMIS COMPANY
(800) 346-1223
HINES & ASSOCIATES
(888) 826-5769
LAB SAFETY SUPPLY
ADMINISTRATORS INC
MIDWEST SECURITY
MIDWEST SECURITY
MIDWEST SECURITY
LABEL TECH INC JMS
(EBPA)
EBPA
EBPA
CHECK BENEFIT CARD
PO Box 2365
(802) 846-8060
PO Box 574
ONALASKA WI 54650
(802) 846-8060
Network.
Info as of 12/24/2007
Page PIRMI-279
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
THE LOOMIS COMPANY
LABOR READY
WYOMISSING PA 19610
COMPENSABILITY
THE LOOMIS COMPANY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(866) 473-6615
(866) 473-6615
LACK STORES INC
ADMINISTRATORS CONSULTANTS
CONSULTANTS INC
CONSULTANTS INC
PO Box 107
(800) 521-2654
CHECK BENEFIT CARD
(800) 521-2654
LACONIA SAVINGS BANK
(EBPA)
EBPA
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
EBPA
CHECK BENEFIT CARD
(800) 578-3272
(800) 578-3272
LAFRANCE BROTHERS, INC. ET AL
SERVICE CENTER
LAKE COUNTY
INC.
LAKE COUNTY CLERK OF COURTS
Affiliated With: WEB TPA
BENEFIRST LLC
BENEFIRST LLC
1020 PLAIN ST
MARSHFIELD MA 02050
7818374402
(800) 641-3224
7818374402
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
WEB TPA
WEB TPA
1000 Riverside Ave. #500
JACKSONVILLE FL 32204
(800) 697-2235
CHECK BENEFIT CARD
(800) 697-2235
Network.
Info as of 12/24/2007
Page PIRMI-280
www.firsthealth.com
PAYOR NAME
LAKE COUNTY GOVERNMENT
Affiliated With: PROFESIONAL CLAIMS
MANAGEMENT
CLAIMS SUBMISSION
16455 Frontage Rd
Burr Ridge IL 60527
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 590-6500
(800) 590-6500
LAKE COUNTY PLASTERS AND
CEMENT MASONS WELFARE
LAKE COUNTY PLASTERS
AND CEMENT MASONS
WELFARE
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
CEMENT MASONS WELFARE FUND
Affiliated With: LAKE COUNTY
PLASTERS & CEMENT MASONS
WELFARE FUND
CEMENT MASONS WELFARE
LAKE DISTRICT HOSPITAL
INC.
LAKE ELSINORE UNIFIED SCHOOLS
COMPENSABILITY
28 N. First St
GENEVA IL 60134
(541) 312-8512
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
LAKE FOREST COLLEGE
MANAGEMENT SERVICES
LAKE LAS VEGAS RESORT
PO Box 9040
(413) 539-9900
CHECK BENEFIT CARD
(413) 539-9900
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-281
www.firsthealth.com
PAYOR NAME
LAKELAND VILLAGE
SOLUTIONS
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
LAKESHORE FOODS CORPORATION
BENEFIT ADMINISTRATORS, INC. /
ILLINO
LAKESIDE INDUSTRIES, INC
MANAGAMENT SERVICES #15318
EBMS
EBMS
PO Box 21367
(800) 777-3575
LAKESIDE TRAVEL
LAMAR COUNTY
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
Professional Benefit Administrators, Inc. CHECK BENEFIT CARD
Oakbrook IL 60523
EBMS CARELINK
4062453575
(800) 777-3575
PO Box 520
(800) 235-7160
CO.
(800) 725-6566
(800) 235-7160
GROUP & PENSION
ADMINISTRATORS INC
GROUP & PENSION
ADMINISTRATORS INC
DALLAS TX 75251
(972) 238-7900
HEALTH WATCH
(972) 238-7900
(972) 238-7900
LAMAR UNIVERSITY
MANAGEMENT
TRUE CHOICE USA
TRUE CHOICE USA
PO Box 700307
DALLAS TX 75370
(800) 785-2446
CHECK BENEFIT CARD
(800) 785-2446
Network.
Info as of 12/24/2007
Page PIRMI-282
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PAYOR NAME
LAND AIR EXPRESS INC
CLAIMS SUBMISSION
MERITAIN HEALTH
PO Box 1090
EVANSVILLE IN 47706
COMPENSABILITY
MERITAIN HEALTH
UTILIZATION REVIEW
UM NOT APPLICABLE
(800) 455-1938
(800) 455-1938
LAND AIR EXPRESS OF N E
(EBPA)
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
LANDAMRK COMMUNITIES
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
LANDER MEDICAL CLINIC
ADMINISTRATORS & INS
CONSULTANTS
MANAGED BENEFITS
CONSULTANTS
MANAGED BENEFITS
CONSULTANTS
PO Box 98
WORLAND WY 82401
(307) 347-6151
(307) 347-7979
(307) 347-6151
LANDMARK COLLEGE WRAP JMS
(EBPA)
LANDMARK SERVICES, INC
ADMINISTRATORS
EBPA
EBPA
PO Box 2365
(800) 525-8788
CHECK BENEFIT CARD
(802) 846-8060
(800) 899-9355
(800) 899-9355
Network.
Info as of 12/24/2007
Page PIRMI-283
www.firsthealth.com
PAYOR NAME
LANDSCAPE DEVELOPMENT INC
Affiliated With: PHYSICIANS
DEVELOPMENT INC
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MIDWEST SECURITY
MIDWEST SECURITY
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 742-7345
LANG GRAPHICS, LTD.
ADMINISTRATORS INC
MIDWEST SECURITY
LAS VEGAS ATHLETIC CLUB
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
UTILIZATION REVIEW
2700 Midwest Dr.
ONALASKA WI 54650
(702) 242-7700
LAS VEGAS POLICE PROTECTIVE
ASSOCIATION CIVILIAN EMPLOYEES
Laundry, Dry Cleaning Workers & Allied
Industries Health Fund
Insurance Co
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
730 Broadway
New York NY 10003
ECS Payor ID 13550
(212) 539-5104
ALICARE, Inc
(800) 332-5426
(212) 539-5104
LAUREL HEALTH CARE COMPANY
ADMINISTRATORS
ADMINISTRATORS
PO Box 4687
OAKBROOK IL 60522-4687
(800) 435-5694
CHECK BENEFIT CARD
(800) 435-5694
Network.
Info as of 12/24/2007
Page PIRMI-284
www.firsthealth.com
PAYOR NAME
LB WHITE COMPANY
Affiliated With: MMSI
CLAIMS SUBMISSION
MMSI
4001 41ST STREET NW
ROCHESTER MN 55901
COMPENSABILITY
MMSI
(800) 965-6674
UTILIZATION REVIEW
MMSI
(800) 965-6674
(800) 965-6674
LEADER DISTRIBUTION SYSTEMS INC GISC, INC
20 WINTER ST
SERVICE CENTER
PEMBROKE MA 02359
(800) 242-4472
GISC, INC
LEAR CORPORATION
Affiliated With: ASSURECARE OF
ILLINOIS
ASSURECARE
ASSURECARE
4050 HUNSACKER DR STE 110
EAST LANSING MI 48823
(800) 968-6616
LEARFIELD COMMUNICATIONS, INC
ADMINISTRATORS
(800) 242-4472
GISC TOTALCARE
(800) 242-4472
ASSURECARE
(800) 968-6616
(800) 968-6616
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
(800) 825-3540
MUTUAL ASSURANCE
ADVANTAGE
(800) 825-3540
(800) 825-3540
LEASE CRUTCHER LEWIS
INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
LEAVITT GROUP
SOLUTIONS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-285
www.firsthealth.com
PAYOR NAME
LEAVITT GROUP AGENCY
ASSOCIATION
Affiliated With: P5 HEALTH SOLUTIONS
LEBANON VAMC 3126
SERVICES
LEDCOR HOLDINGS INC
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
5504 HILL HEAVEN CT
FRISCO TX 75035
(214) 387-3232
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
(214) 387-3232
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
LEDCOR HOLDINGS INC - TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
LEE AND RUSSELL LAW FIRM TRAVEL
LEGACY BANK
ADMINISTRATORS
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
Network.
Info as of 12/24/2007
Page PIRMI-286
www.firsthealth.com
PAYOR NAME
LEGACY INVESTMENTS
Affiliated With: PRODUCERS
EXCHANGE BENEFIT SERVICES INC
CLAIMS SUBMISSION
PRODUCERS EXCHANGE BENEFIT
SERVICES INC.
4004 BELT LINE RD STE 160
ADDISON TX 75001
COMPENSABILITY
PRODUCERS EXCHANGE BENEFIT
SERVICES INC.
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 443-2595
(800) 443-2595
LEICA GEOSYSTEMS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
LENNYS FURNITURE, INC
BENEFIT ADMINISTRATORS, LLC
UM NOT APPLICABLE
101 STARCREST DR
CLEARWATER FL 33758
(727) 532-0400
(727) 532-0400
LESCO RESTORATIONS INC
CHECK BENEFIT CARD
Letica Corporation
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
LEW A CUMMINGS PRINTING INC
PLAN ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8002779476
Network.
Info as of 12/24/2007
Page PIRMI-287
www.firsthealth.com
PAYOR NAME
LEWIS AND CLARK UNIVERSITY
CLAIMS SUBMISSION
PERSONAL INSURANCE
ADMINISTRATORS
COMPENSABILITY
PERSONAL INSURANCE
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 468-4343
(800) 468-4343
LEWIS M CARTER MANUFACTURING
COMPANY
COMPANY
LEWIS M CARTER MANUFACTURING
COMPANY PEPM
COMPANY
LEWIS SEEDS
ADMNISTRATORS
PO Box 1000
LANCASTER SC 29721
(803) 283-5378
KHS, A KMG AMERICA
COMPANY
(803) 283-2737
(803) 283-5378
PO Box 1000
LANCASTER SC 29721
(803) 283-5378
KHS, A KMG AMERICA
COMPANY
(803) 283-2737
(803) 283-5378
NORTH AMERICA
NORTH AMERICA
PO Box 1984
NASHVILLE TN 37202
(615) 255-6654
MED-CERT
(800) 356-7126
(615) 255-6654
LEXINGTON PRECISION
CORPORATION
GROUP #13352
LEXINGTON VA MEDICAL CENTER
3147
SERVICES
DIRECT CARE AMERICA
DIRECT CARE AMERICA
PO Box 2090 C
STOW OH 44224
(800) 266-5896
CHECK BENEFIT CARD
(800) 266-5896
Attn: 4-FEE
1101 VETERANS DR
LEXINGTON KY 40502
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-288
www.firsthealth.com
PAYOR NAME
LIBERTY GOLD
ADMINISTRATORS
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
8772615511
Liberty Mutual Insurance Company
Affiliated With: Liberty Mutual Insurance
Company
Plan Type: Auto
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
LICKING KNOX GOODWILL
BENEFIT SYSTEMS
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
LIDSEEN OF NORTH CAROLINA
LIFEGUARD TRANSPORTATION
SERVICES INC
Affiliated With: HILLCREST BENEFIT
ADMINISTRATORS
LIFETIME FITNESS
PO Box 520
(800) 235-7160
CO.
(800) 725-6566
(800) 235-7160
HILLCREST BENEFIT
ADMINISTRATORS INC
HILLCREST BENEFIT
ADMINISTRATORS INC
PO Box 1516
MOUNT DORA FL 32756
(800) 743-9264
STRATEGIC HEALTH
DEVELOPMENT
(800) 874-2378
America's TPA
America's TPA
CHECK BENEFIT CARD
PO Box 398220
(952) 896-4888
(800) 743-9264
(952) 896-4888
Network.
Info as of 12/24/2007
Page PIRMI-289
www.firsthealth.com
PAYOR NAME
LIFETIME FITNESS TRAVEL
CLAIMS SUBMISSION
America's TPA
PO Box 398220
COMPENSABILITY
America's TPA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(952) 896-4888
(952) 896-4888
LIFEWISE HEALTH PLAN OF OREGON
Affiliated With: LIFEWISE HEALTH
PLAN OF OREGON
OREGON
OREGON
815 S W BOND
BEND OR 97702
(800) 722-3372
OREGON
(800) 722-3372
(800) 722-3372
LIFT-ALL COMPANY
THE LOOMIS COMPANY
READING PA 19612-4086
(800) 875-2364
CHN SOLUTIONS
(800) 293-9795
EBA&M
EBA&M
UM NOT APPLICABLE
PO Box 5079
(800) 776-1545
THE LOOMIS COMPANY
(800) 875-2364
LIMONEIRA COMPANY
(800) 776-1545
LINCOLN UNIVERSITY
CHECK BENEFIT CARD
Lincolnway Affiliate Schools
Affiliated With: Lincolnway Affiliate
Schools
Professional Benefit Administrators, Inc. Professional Benefit Administrators, Inc. First Health
(800) 522-8812
(630) 655-3755
Oakbrook IL 60523
CHECK BENEFIT CARD
CHECK BENEFIT CARD
For written inquiries regarding claims &
payment, contact:
ASCO
800 Roosevelt Rd Bldg E #200
Glen Ellyn IL 60137
(630) 655-3755
(800) 323-8092 Outside IL
Network.
Info as of 12/24/2007
Page PIRMI-290
www.firsthealth.com
PAYOR NAME
LINDEN A SHOWALTER CPA
AID
LINDENMEYER MUNROE
SERVICE CENTER INC
CLAIMS SUBMISSION
MMA
PO Box 483
GOSHEN IN 46527
COMPENSABILITY
MMA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 348-7468
(800) 348-7468
CENTER INC
CENTER INC
PO Box 9120
MARSHFIELD MA 02050
(800) 242-4472
CHECK BENEFIT CARD
(800) 242-4472
LINFIELD COLLEGE - DOMESTIC
PERSONAL INSURANCE
ADMINISTRATORS
PERSONAL INSURANCE
ADMINISTRATORS
(800) 468-4343
CHECK BENEFIT CARD
(800) 468-4343
LINFIELD COLLEGE INTERNATIONAL
PERSONAL INSURANCE
ADMINISTRATORS
PERSONAL INSURANCE
ADMINISTRATORS
(800) 468-4343
CHECK BENEFIT CARD
(800) 468-4343
LINK SNACKS INC
SERVICES
PO Box 59212
SERVICES
(800)
997-1750
(800) 997-1750
(800) 997-1750
LINTON-STOCKTON SCHOOL CORP
PLANS, INC.
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
(800) 832-8212
Network.
Info as of 12/24/2007
Page PIRMI-291
www.firsthealth.com
PAYOR NAME
LIPE ROLLWAY CORPORATION PRE
65 RETIREES
C
LIQUIDHUB INC
INC
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 61553
(610) 337-2600
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
(610) 337-2600
LITTLE SINGER COMMUNITY SCHOOL SRT ADMINISTRATORS, INC.
PO Box 25160
CHECK BENEFIT CARD
LIUNA
Affiliated With: ULLICO
LIUNA Staf Health and Welfare Plan
LIUNA Staf Health and Welfare Plan
905 16th St NW
Washington DC 20006
(800) 548-6242
Ullicare
(800) 848-9200
HEALTHCOMP TPA
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 548-6242
LIVERMORE UNIFIED
LOCAL 348 PLAN D RD JETRO (RDC)
NETWORK #18373
HEALTHCOMP TPA
PO Box 45018
Fresno CA 93718
(800) 442-7247
(800) 266-5896
PO Box 2388 C
STOW OH 44224
(800) 266-5896
Network.
Info as of 12/24/2007
Page PIRMI-292
www.firsthealth.com
PAYOR NAME
LOCAL 348 PLAN J JETRO INNETWORK (JETINILA)
NETWORK #18373
CLAIMS SUBMISSION
PO Box 2388 C
STOW OH 44224
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 266-5896
(800) 266-5896
LOCAL 348 STAFF PLAN
NETWORK #18373
PO Box 2388 C
STOW OH 44224
CHECK BENEFIT CARD
(800) 266-5896
(800) 266-5896
Local 75 California
Insurance Co.
LODGING HOST HOTEL
CORPORATION
SERVICE OF AMERICA
LOGAN MEDICAL CENTER
COMPANY
Logans Roadhouse
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CBSA
CBSA
400 Highway 169 South, Ste 800
(952) 593-6438
GUIDED2HEALTH
(952) 593-6447
CHECK BENEFIT CARD
PO Box 26967
(405) 290-5696
PO Box 10728
Scottsdale AZ 85271
(800) 356-0850
(952) 593-6438
(405) 290-5696
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
Network.
CONTACT EMPLOYER
Info as of 12/24/2007
Page PIRMI-293
www.firsthealth.com
PAYOR NAME
LOGISTICS HEALTH INC
Affiliated With: MMSI
CLAIMS SUBMISSION
MMSI
4001 41ST STREET NW
ROCHESTER MN 55901
COMPENSABILITY
MMSI
UTILIZATION REVIEW
(800) 965-6674
MMSI
(800) 965-6674
(800) 965-6674
LOMA LINDA VA MEDICAL CENTER
3190
SERVICES
Attn: FEE BASIS - 11C
11201 BENTON ST
LOMA LINDA CA 92359
CHECK BENEFIT CARD
LONE PINE UNIFIED SCHOOLS
OF UICI
OF UICI
CHECK BENEFIT CARD
PLANO TX 75075
(800) 767-0700
(800) 237-0903 Ext 6352
LONG BEACH CITY COLLEGE
PERSONAL INSURANCE
ADMINISTRATORS
PERSONAL INSURANCE
ADMINISTRATORS
(800) 468-4343
CHECK BENEFIT CARD
(800) 468-4343
LONG BEACH VAMC 3191
SERVICES
LONG BEACH VAMC
Attn: FEE BASIS 04F
5901 E 7TH ST
LONG BEACH CA 90822
LONG BEACH VAMC
CHECK BENEFIT CARD
LONG TERM CARE WORKERS
HEALTH TRUST FUND
Affiliated With: PHYSICIANS CARE
INSURANCE SERVICES
PHYSICIANS CARE INSURANCE
SERVICES, INC.
SERVICES, INC.
PO Box 15165
SANTA ANA CA 92735
(714) 540-5882
PHYSICIAN CARE OF
CALIFORNIA
(714) 540-5882
(714) 540-5882
Network.
Info as of 12/24/2007
Page PIRMI-294
www.firsthealth.com
PAYOR NAME
LONGVIEW FIBRE
CLAIMS SUBMISSION
NHBC
Scottsdale AZ 85260
COMPENSABILITY
NHBC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(888) 621-7900
(888) 621-7900
LOOMIS COMPANY
THE LOOMIS COMPANY
Wyomissing PA 19610
THE LOOMIS COMPANY
CHECK BENEFIT CARD
(877) 634-9814
(877) 634-9814
LOPEZ FOODS, INC.
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
LOS ALAMITOS UNIFIED SCHOOL
DISTRICT
Affiliated With: LOS ALAMITOS
UNIFIED SCHOOL DISTRICT
RIVERSIDE COUNTY FOUNDATION
FOR MEDICAL CARE
LOS ANGELES CARDIOLOGY
ASSOCIATES
LOS ANGELES COUNTY
FIREFIGHTERS LOCAL 1014
Affiliated With: LOS ANGELES
COUNTY FIREFIGHTERS LOCAL 1014
CHECK BENEFIT CARD
FOR MEDICAL CARE
RIVERSIDE COUNTY
FOUNDATION FOR MEDICAL
CARE
EMPLOYEE BENEFIT
CHECK BENEFIT CARD
CHECK BENEFIT CARD
3993 Jurupa
RIVERSIDE CA 92506
PO Box 3000
8006601014
Network.
Info as of 12/24/2007
Page PIRMI-295
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
LOS ANGELES HOTEL-RESTAURANT LOS ANGELES HOTEL
RESTAURANT EMPLOYER UNION
EMPLOYER UNION WLF FUND
Affiliated With: LOS ANGELES HOTEL- WELFARE FUND
PO Box 57924
WELF
LOS ANGELES CA 90057
COMPENSABILITY
LOS ANGELES HOTEL
WELFARE FUND
LOS ANGELES HOTEL
RESTAURANT EMPLOYER
UNION WELFARE FUND
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UTILIZATION REVIEW
LOS RIOS COMMUNITY COLLEGE
DISTRICT
Affiliated With: A G ADMINISTRATORS
CHECK BENEFIT CARD
LOUISIANA STATE UNIVERSITY PENNINGTON
MACORI ADMINISTRATION
19609 WIED
SPRING TX 77388
(800) 285-8133
LOUISIANA STATE UNIVERSITY
HEALTH SCIENCES CENTER
SERVICES INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
LOUISVILLE VAMC 3150
SERVICES
LOUISVILLE VAMC
800 ZORN AVE
LOUISVILLE KY 40206
LOUISVILLE VAMC
CHECK BENEFIT CARD
LOVARC
BENEFIT SYSTEMS
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
6109330300
CORP
(800) 285-8133
UM NOT APPLICABLE
(800) 283-4927
Network.
Info as of 12/24/2007
Page PIRMI-296
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PAYOR NAME
LOVEJOY TOOL COMPANY WRAP
JMS
(EBPA)
LOVES TRAVEL INC
SERVICES INC
LOVITT & TOUCHE
ADMINISTRATIVE SERVICES INC
CLAIMS SUBMISSION
ADMINISTRATOR INC
PO Box 2365
COMPENSABILITY
ADMINISTRATOR INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 525-8788
(802) 846-8060
PO Box 25946
(800) 990-9058
CHECK BENEFIT CARD
(800) 990-9058
Services
Services
TUCSON AZ 85710
(520) 722-7133
(847) 214-2780
(520) 722-7133
LOWELL BROTHERS AND BAILEY
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
LSA ASSOCIATES, INC.
MANAGEMENT SERVICES
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
LSB INDUSTRIES
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
CHECK BENEFIT CARD
PO Box 42096
(800) 825-3540
(800) 825-3540
Network.
Info as of 12/24/2007
Page PIRMI-297
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PAYOR NAME
LUCAS TREE EXPERTS PEPM
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UTILIZATION REVIEW
LUKACHUKAI COMMUNITY SCHOOL
LUMBER PRODUCTS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Lumbermans Underwriting Alliance
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Lutheran Church Synod
Group, Inc.
CHECK BENEFIT CARD
407 N Fulton St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
LYLE HUGHART WELFARE PLAN
SOLUTIONS GROUP INC
PO Box 25160
(317) 655-4500 Outside US
(800) 628-4664 Inside US
INC.
INC.
PO Box 1309
MUSKOGEE OK 74402
(800) 749-1422
CHECK BENEFIT CARD
(800) 749-1422
Network.
Info as of 12/24/2007
Page PIRMI-298
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PAYOR NAME
M & J WILKOW, LTD.
CLAIMS SUBMISSION
SYSTEMS, LTD.
HOMEWOOD IL 60430
COMPENSABILITY
SYSTEMS LTD
UTILIZATION REVIEW
SYSTEMS LTD
7087997400
7087997400
M D PPRODUCTS INC
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
* M7 Aerospace TRAVEL
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
DALLAS TX 75251
(800) 827-7223
CHECK BENEFIT CARD
(800) 827-7223
MAC Risk Managament, Inc.
Affiliated With: MAC Risk Managament
CONTACT EMPLOYER
Mac Risk MANAGEMENT, INC.
MAC Risk Management, Inc.
(800) 288-8415
(800) 288-8415
45 Dan Road
Canton MA 02021
CHECK BENEFIT CARD
PO Box 2271
Florence SC 29503
(843) 622-6001
(800) 288-8415
(800) 288-8415
(800) 288-8415
MACON STATE COLLEGE AIH0058347
CORP #14005
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-299
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
MACON STATE COLLEGE OF GA
UNDERGRAD MANDATORY
Attn: WHIT WALTERS
CORP
FLORENCE SC 29501
(800) 222-6491
MACRO PLASTICS INC
CONCEPTS INC/BENEFIT CONCEPTS
INC.
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(800) 222-6491
PERFORMAX / BROKERAGE
CONCEPTS, INC.
PERFORMAX / BROKERAGE
CONCEPTS, INC.
PO Box 61505
(888) 554-7629
PERFORMAX / AMERICAN
HEALTH HOLDING
(800) 337-0506
(888) 554-7629
MACSTEEL SERVICE CENTERS USA
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Madison National Life Insurance
Company Inc
Corporation
PO Box 828
(800) 843-3106
CHECK BENEFIT CARD
(800) 522-2161
(IAC)
(IAC)
Med-Valu
(800) 522-2161
PO Box 828
(800) 843-3106
MADISON NATIONAL LIFE
INSURANCE COMPANY INC
#11337
(800) 843-3106
(800) 843-3106
MADISON PRECISION PRODUCTS INC PREFERRED HEALTH PLANS INC.
PLANS, INC.
LOUISVILLE KY 40223
(800) 832-8212
CHECK BENEFIT CARD
(800) 832-8212
Network.
Info as of 12/24/2007
Page PIRMI-300
www.firsthealth.com
COMPENSABILITY
MADISON VAMC
CHECK BENEFIT CARD
PREFERRED BENEFIT
ADMINISTRATORS INC
PREFERRED BENEFIT
ADMINISTRATORS INC
MedWatch
(800) 432-8421
PO Box 916188
(407) 786-2777
PAYOR NAME
CLAIMS SUBMISSION
MADISON VAMC 3164
MADISON VAMC
Affiliated With: HEALTH NET FEDERAL Attn: FEE 136
SERVICES
2500 OVERLOOK TERRACE
MADISON WI 53705
MADSEN KNEPPERS & ASSOCIATES,
INC.
ADMINISTRATORS INC.
MAGSTAR TECHNOLOGIES
Affiliated With: BENEFITS
INCORPORATED
MAINE DISTRIBUTORS - %
UTILIZATION REVIEW
(407) 786-2777
BENEFITS INCORPORATED
2277 W. Hwy 36 #316
ROSEVILLE MN 55113-3887
(651) 636-8288
(651) 636-8288
(651) 636-8288
HEALTH PLAN INC
HEALTH PLAN INC
(508) 752-2480
CARE MANAGEMENT
SERVICES
(866) 325-1550
(508) 752-2480
MACHIGONNE BENEFIT
ADMINISTRATORS
CHECK BENEFIT CARD
HEALTH PLAN INC
HEALTH PLAN INC
100 FRONT ST STE 600
WORCESTER MA 01608
(800) 532-7575
CARE MANAGEMENT
SERVICES
(866) 325-1550
MAINE MUNICIPAL EMPLOYEES
HEALTH TRUST
Affiliated With: MACHIGONNE BENEFIT
ADMINISTRATORS
MACHIGONNE BENEFIT
ADMINISTRATORS
MAINE RUBBER INTERNATIONAL
PO BOX 3859
PORTLAND ME 04104-3859
(508) 752-2480
Network.
Info as of 12/24/2007
Page PIRMI-301
www.firsthealth.com
PAYOR NAME
MAKSIN - WRAP
CORPORATION
MAMMOTH HOSPITAL
Affiliated With: SUPERIOR
MAMMOTH MOUNTAIN SKI AREA
Affiliated With: CLAIMS AND BENEFIT
MANAGEMENT INC
CLAIMS SUBMISSION
19609 WIED
SPRING TX 77388
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(281) 651-8787
(281) 651-8787
SUPERIOR ADMINISTRATORS, INC.
3720 SOUTH SUSAN ST STE 200
SANTA ANA CA 92704
(714) 429-1700
CHECK BENEFIT CARD
(702) 733-3145
CLAIMS AND BENEFIT
MANAGEMENT INC
CLAIMS AND BENEFIT
MANAGEMENT INC
CHINCORP
(702) 433-3145
6251 SCHAEFER AVE STE M
CHINO CA 91710
(909) 902-1890
(714) 429-1700
(909) 902-1890
MAMMOTH MOUNTAIN SKI RESORT
SYSTEMS
MAMMOTH UNIFIED SCHOOLS
PO Box 80
Stockton CA 95201
(559) 228-4198
DELTA TEAM CARE
(800) 356-2395
(559) 228-4198
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
Manageability, Inc
Affiliated With: FDI Group DBA
Manageability, Inc
ManageAbility Inc
ManageAbility Inc
ManageAbility Inc
39500 High Pointe Blvd
Novi MI 48375
Network.
Info as of 12/24/2007
Page PIRMI-302
www.firsthealth.com
PAYOR NAME
MANAGED CARE SYSTEMS LP
Affiliated With: MANAGED CARE
SYSTEMS LP
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
4550 California Ave Ste 500
Bakersfield CA 93309
6617167100
MANAGED HEALTH FUNDING
Affiliated With: MHF INSURANCE
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MANAGEMENT INFORMATION
DISCIPLINES
ADMINISTRATORS AND
CONSULTANTS
BAC
BAC
(614) 863-8780
BAC
(614) 863-8780
(614) 863-8780
MANCHESTER VA MEDICAL CENTER
3117
SERVICES
MANCHESTER VA MEDICAL CENTER
MANCHESTER VA MEDICAL CENTER CHECK BENEFIT CARD
MANOR VAIL LODGE
SOLUTIONS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MANPOWER
MANPOWER
MANPOWER
600 North Pearl Street, 17th Floor
Dallas TX 75201
(214) 220-1500
MANPOWER
(214) 220-1500
718 SMYTH RD
MANCHESTER NH 03104
(214) 220-1500
Network.
Info as of 12/24/2007
Page PIRMI-303
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
MANSFIELD PAPER COMPANY WRAP COMPREHENSIVE BENEFITS
ADMINISTRATOR INC
JMS
PO Box 2365
(EBPA)
(802)
846-8060
MANUFACTURING TECHNOLOGY,
INC.
DIVISION
BROWN & BROWN, INC.
MARAVILLA
COMPENSABILITY
ADMINISTRATOR INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 525-8788
BROWN & BROWN, INC.
CHECK BENEFIT CARD
SERVICES
SERVICES
HEALTH ASSIST
(866) 214-1106
540 WALD AVE
IRVINE CA 92618
8002723433
PO Box 2480
8002723433
MARC-JAC POULTRY
SOLUTIONS INC
Marcone Appliance Parts
PO Box 2490
ALPHARETTA GA 30023
(678) 339-0211
INNOVATIVE CARE
MANAGEMENT
(800) 398-7353
(678) 339-0211
MERITAIN HEALTH
Attn: Claims Dept
PO Box 853921
(800) 828-6922
HEALTHLINK
(800) 624-2356
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MERITAIN HEALTH
(800) 828-6922
MARIAN MANOR
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-304
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MARICOPA INT
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MARICOPA VOL
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MARIE CALLENDER PIE SHOPS INC
INSURANCE SERVICES INC
SERVICES, INC.
SERVICES, INC.
1570 BROOKHOLLOW STE 208
SANTA ANA CA 92705
(714) 540-5882
PHYSICIANS CARE
INSURANCE SERVICES, INC.
(714) 540-5882
MARION IL VAMC
CHECK BENEFIT CARD
MARION IN VA MEDICAL CENTER
CHECK BENEFIT CARD
PAYOR NAME
MARICOPA COUNTY COMMUNITY
COLLEGE AKA MCCCD
ADMINISTRATORS INC
UTILIZATION REVIEW
(714) 540-5882
MARION IL VAMC 3523
SERVICES
MARION IL VAMC
Attn: FISCAL SERVICE 04C
MARION IN VA MEDICAL CENTER 3157
SERVICES
MARION IN VA MEDICAL CENTER
Attn: FEE BASIS 136C3
1700 E 38TH ST
MARION IN 46953
2401 WEST MAIN
MARION IL 62959
Network.
Info as of 12/24/2007
Page PIRMI-305
www.firsthealth.com
PAYOR NAME
MARKET LOGISTICS INC
MARKET TRANSPORT LTD
SERVICE CORPORATION
MARQUETTE TRANSPORTATION
COMPANY, INC.
ADMINISTRATORS
MARQUIS COMPANIES
INC.
MARSHALL RETAIL GROUP LLC
CLAIMS SUBMISSION
PO Box 520
COMPENSABILITY
(800) 235-7160
UTILIZATION REVIEW
CO.
(800) 725-6566
(800) 235-7160
PO Box 1894
(888) 877-7994
(800) 426-9786
(800) 426-9786
NORTH AMERICA
NORTH AMERICA
PO Box 1984
NASHVILLE TN 37202
(615) 255-6654
MED-CERT
(800) 356-7126
(615) 255-6654
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
MARSHALL RETAIL GROUP LLC TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-306
www.firsthealth.com
PAYOR NAME
MARTIN & ASSOCIATES, INC.
Martin Boyer
Affiliated With: Cambridge
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
EMPLOYEE BENEFIT
PO Box 3000
Cambridge
Cambridge
175 W Jackson Ste 1000
Chicago IL 60604
(312) 821-8800
Cambridge
(312) 821-8800
(312) 821-8800
MARTIN BOYER
MARTIN BOYER
MARTIN BOYER
175 W Jackson Ste 1000
Chicago IL 60604
(312) 381-8800
MARTIN BOYER
(312) 381-8800
(312) 381-8800
MARTIN HARRIS CONSTRUCTION
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
MARTINS POINT HEALTHCARE JMS
ADMINISTRATORS INC (EBPA)
ADMINISTRATION
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
ADMINISTRATION
MARTINSBURG VA MEDICAL CENTER
3133
SERVICES
MARTINSBURG VA MEDICAL
CENTER
Attn: FEE SVCS GB113
510 BUTLER AVE
MARTINSBURG WV 25401
MARTINSBURG VA MEDICAL
CENTER
CHECK BENEFIT CARD
(800) 525-8788
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-307
www.firsthealth.com
PAYOR NAME
MARVIN ENGINEERING
MARYMOUNT COLLEGE
MANAGEMENT SERVICES
MARYMOUNT UNIVERSITY
MANAGEMENT
MARYVILLE UNIVERSITY
SERVICES INC
COMPENSABILITY
EMPLOYEE BENEFIT
CHECK BENEFIT CARD
PO Box 9040
(413) 539-9900
CLAIMS SUBMISSION
UTILIZATION REVIEW
PO Box 3000
(413) 539-9900
TRUE CHOICE
CI
PO Box 700307
DALLAS TX 75370
(817) 479-2115
CI
(817) 479-2115
(800) 785-2446
INC
INC
333 N. MAIN STREET
STILLWATER MN 55082
(800) 328-2739
CHECK BENEFIT CARD
(800) 328-2739
MASAMI FOODS, INC.
INC.
MASCO CONTRACTOR SERVICES
CENTRAL, INC.
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
FISERV HEALTH INC
FISERV HEALTH INC
FISERV HEALTH INC
PO Box 360
PUEBLO CO 81002
Network.
Info as of 12/24/2007
Page PIRMI-308
www.firsthealth.com
PAYOR NAME
MASONRY INDUSTRY TRUST
Affiliated With: UNITED CLAIMS
SOLUTIONS
MASSACHUSETTS COMMUNITY
COLLEGES
HEALTH PLANS, INC.
MASTER CRAFT FABRICS
CLAIMS SUBMISSION
UNITED CLAIM SOLUTIONS
10835 N 25TH AVE STE 105
PHOENIX AZ 85029
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(602) 393-4553
(602) 393-4553
195 STAFFORD ST
(800) 633-7867
(800) 633-7867
BENESIGHT INC
BENESIGHT INC
PO Box 370
PUEBLO CO 81002
(877) 718-6920
BENESIGHT MEDICAL
MANAGEMENT
(877) 718-6920
(877) 718-6920
MASTERGRAPHICS, INC
CONSULTANTS
Masters, Mates & Pilots
Affiliated With: Master Mates & Pilots
Health and Benefit Plan
EMPLOYEE BENEFIT CONSULTANTS EMPLOYEE BENEFIT CONSULTANTS AMERICAN HEALTH HOLDING
(614) 818-3222
215 STANFORD PARKWAY
(800) 558-7798
FINDLAY OH 45840
(800) 558-7798
Masters, Mates and Pilots Health &
Benefit Plan
Masters, Mates and Pilots Health &
Benefit Plan
5700 Hammonds Ferry Rd
Linthicum Heights MD 21090-1996
(410) 850-8500
First Health
(800) 213-1185
(410) 850-8500
MATERIAL SERVICES
ASSURECARE
ASSURECARE
340 Quadrangle Dr
(800) 759-1311
Careline UR
(763) 383-4800
(800) 759-1311
Network.
Info as of 12/24/2007
Page PIRMI-309
www.firsthealth.com
PAYOR NAME
MATHES MANAGEMENT
ENTERPRISES, INC.
CLAIMS SUBMISSION
PREFERRED BENEFIT
ADMINISTRATORS INC
COMPENSABILITY
PREFERRED BENEFIT
ADMINISTRATORS INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
PO Box 916188
MATHEWS BROTHERS
LLC
CHECK BENEFIT CARD
MATHIS BROTHERS FURNITURE
GROUP
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
PO Box 1959
Gray ME 04039
(800) 533-5044
Matrix Absence Management Inc
Affiliated With: Matrix Absence
Management Inc
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
First Health
(800) 931-3439
MATRIX BANCORP, INC.
AFFORDABLE BENEFIT
AFFORDABLE BENEFIT
AFFORDABLE BENEFIT
Matson Navigation Company
Affiliated With: Matson Navigation
Company
PO Box 10787
BURBANK CA 91510
555 12th St
Oakland CA 94607
Network.
Info as of 12/24/2007
Page PIRMI-310
www.firsthealth.com
PAYOR NAME
May Department Stores Co - Central
Affiliated With: May Department Stores
Co.
May Department Stores Co - Eastern
Co.
May Department Stores Co - Western
Co.
MAYO FOUNDATION
SERVICES INC
CLAIMS SUBMISSION
May Department Stores
7004 Security Blvd, Ste 304
Baltimore MD 21244
COMPENSABILITY
(410) 298-1866
UTILIZATION REVIEW
(410) 298-1866
(410) 298-1866
Baltimore MD 21244
(410) 298-1866
(410) 298-1866
(410) 298-1866
Baltimore MD 21244
(410) 298-1866
(410) 298-1866
(410) 298-1866
MMSI
MMSI
MMSI
(866) 222-3914
4001 41ST STREET NW
ROCHESTER MN 55901
(866) 222-3914
MAYO FOUNDATION SCOTTSDALE
SERVICES INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MAYS HOUSECALL HOME HEALTH
Affiliated With: MARSH
ADVANTAGE/MERCER
ADMINISTRATION #10442
CHECK BENEFIT CARD
ONE W. THIRD ST #900
TULSA OK 74103
(918) 732-4935
(918) 732-4935
Network.
Info as of 12/24/2007
Page PIRMI-311
www.firsthealth.com
PAYOR NAME
MCALESTER REGIONAL HEALTH
CENTER
#962501227
MCARE HMO
GROUP 1352
MCBRIDE CLINIC INC
INC
CLAIMS SUBMISSION
WATERSTONE BENEFIT
UTILIZATION REVIEW
(888) 440-0971
WATERSTONE BENEFIT
(800) 460-0238
DIRECT CARE AMERICA
DIRECT CARE AMERICA
CHECK BENEFIT CARD
PO Box 2090 C
STOW OH 44224
(800) 266-5896
(888) 440-0971
(800) 266-5896
THE KEMPTON GROUP
THE KEMPTON GROUP
PO Box 54889
(405) 521-1711
CHECK BENEFIT CARD
(405) 521-1711
MCBRIDE ELECTRIC
Affiliated With: WILLIS OF KANSAS,
INC.
WILLIS OF KANSAS, INC.
MCCALL PATTERN COMPANY
KANSAS
* MCCORMICK TRUCKING
ADMINISTRATORS #10388
COMPENSABILITY
WATERSTONE BENEFIT
FISERV HEALTH INC
FISERV HEALTH INC
PO Box 520
(800) 235-7160
TRUSTMARK INSURANCE CO
(800) 725-6566
PO Box 2697
WICHITA KS 67201
(800) 235-7160
(800) 899-9355
(800) 899-9355
Network.
Info as of 12/24/2007
Page PIRMI-312
www.firsthealth.com
PAYOR NAME
* MCCOY'S CORPORATION
CLAIMS SUBMISSION
Benefit Planners
PO Box 690450
COMPENSABILITY
Benefit Planners
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 292-5386
(800) 292-5386
MCCRACKEN COUNTY JAIL INMATES
CONSULTANTS
EBC
EBC
PO Box 1639
APPLETON WI 54912
(800) 342-1407
CHECK BENEFIT CARD
(800) 342-1407
Professional Benefit Administrators, Inc. CHECK BENEFIT CARD
MCDANIEL FIRE SYSTEMS
BENEFIT ADMINISTRATORS, ILLINOIS
McGean
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
THE LOOMIS COMPANY
THE LOOMIS COMPANY
CHECK BENEFIT CARD
PO Box 13906
READING PA 19612
(800) 367-3721
Oakbrook IL 60523
MCGUIRE BEARINGS, INC.
Affiliated With: LOOMIS BENEFITS
WEST
MCLAREN HEALTH PLANS
(800) 367-3721
GLOBALCARE, INC.
GLOBALCARE, INC.
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
Network.
Info as of 12/24/2007
Page PIRMI-313
www.firsthealth.com
PAYOR NAME
MCO Advantage - EDI
Affiliated With: MCO Advantage / PBM
Corporation
MCO Advantage - Paper
Corporation
* MD ABROAD
NETWORK INC
MD BUILDING PRODUCTS
Affiliated With: MD BUILDING
PRODUCTS
MEBP - EASTERN MENNONITE
UNIVERSITY
AID ASSOC AND MMA INSURANCE CO
* MEDAIRE
NETWORK INC
COMPENSABILITY
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
CHECK BENEFIT CARD
New York NY 10019
(212) 581-8228
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
UTILIZATION REVIEW
(212) 581-8228
WINTERBROOK/CCN
WINTERBROOK/CCN
PO Box 568800
(405) 843-9551 Ext 106
CHECK BENEFIT CARD
(405) 843-9551 Ext 106
& MMA INSURANCE
PO Box 483
GOSHEN IN 46527
MENNONITE MUTUAL AID & ASSOC MENNONITE MUTUAL AID C/O
CCN
& MMA INSURANCE
(800)
348-7468
(574) 533-9515
(574) 533-9515
New York NY 10019
(212) 581-8228
CHECK BENEFIT CARD
(212) 581-8228
Network.
Info as of 12/24/2007
Page PIRMI-314
www.firsthealth.com
PAYOR NAME
MEDBEN
CLAIMS SUBMISSION
GLOBALCARE, INC.
COMPENSABILITY
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
MEDCARE INTERNATIONAL, INC.
Affiliated With: MEDCARE
INTERNATIONAL, INC.
MEDCATH INC
BENEFITS INC
CHECK BENEFIT CARD
MEDCOST BENEFIT SERVICES
NHBC
NHBC
Scottsdale AZ 85260
(888) 621-7900
MEDICAL CARE DEVELOPMENT
PLAN ADMINISTRATORS
UTILIZATION REVIEW
GLOBALCARE, INC.
MEDCARE INTERNATIONAL,
INC.
CHECK BENEFIT CARD
CHECK BENEFIT CARD
7301 N.W. 4th St. #109
DAVIE FL 33317
8009723025
CHECK BENEFIT CARD
(888) 621-7900
EBPA
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
EBPA
CHECK BENEFIT CARD
(800) 578-3272
(800) 578-3272
MEDICAL CARE DEVELOPMENT JMS
PLAN ADMINISTRATORS
EBPA
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
EBPA
CHECK BENEFIT CARD
(800) 578-3272
(800) 578-3272
Network.
Info as of 12/24/2007
Page PIRMI-315
www.firsthealth.com
PAYOR NAME
MEDICAL CARE DEVELOPMENT
WRAP % JMS
PLAN ADMINISTRATORS
CLAIMS SUBMISSION
EBPA
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
COMPENSABILITY
EBPA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 578-3272
(800) 578-3272
MEDICAL CLAIMS MANAGEMENT
MEDICAL COLLEGE OF GA
UNDERGRAD MANDATORY
CORP
NHBC
NHBC
Scottsdale AZ 85260
(888) 621-7900
CHECK BENEFIT CARD
(888) 621-7900
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
MEDICAL COLLEGE OF GEORGIA
AIH0058367
PO Box 2271
CORP #14005
(843) 622-6001
Medical Consultants Network
3 Huntington Quad
Melville NY 11747
(631) 454-8399
CHECK BENEFIT CARD
(843) 622-6001
(631) 454-8399
(631) 454-8399
MEDICAL DATA SYSTEMS INC
BENESIGHT INC
BENESIGHT INC
PO Box 360
(800) 476-5832
BENESIGHT MEDICAL
MANAGEMENT
(800) 476-5832
(800) 476-5832
Network.
Info as of 12/24/2007
Page PIRMI-316
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MEDICAL MUTUAL OF OHIO - CCN
TRAVEL
Affiliated With: MEDICAL MUTUAL OF
OHIO
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MEDICAL RESOURCES
MANAGEMENT, INC.
MEDICAL UNIVERSITY OF SOUTH
CAROLINA
PO Box 2437
CORP #14005
(843) 622-6001
CHECK BENEFIT CARD
MEDICOR AUTO
Affiliated With: MEDICOR
Plan Type: Auto
MEDICOR
MEDICOR
UM NOT APPLICABLE
Medicor Managed Care
Affiliated With: Medicor
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
PAYOR NAME
MEDICAL MUTUAL OF OHIO - CCN
RESIDENT
Affiliated With: MEDICAL MUTUAL OF
OHIO
UTILIZATION REVIEW
PO Box 9000
Affiliated With: CBCA Administrators, Inc. LONDON KY 40742
(843) 622-6001
1745 N Brown Rd Ste 400
Lawrenceville GA 30043
Network.
Info as of 12/24/2007
Page PIRMI-317
www.firsthealth.com
PAYOR NAME
MediCor-DOAS_Medata
Affiliated With: Medicor Managed Care
LLC
CLAIMS SUBMISSION
MEDICOR
COMPENSABILITY
MEDICOR
UM NOT APPLICABLE
UTILIZATION REVIEW
1745 N Brown Rd Ste 400
Lawrenceville GA 30043
MEDIPAC INTERNATIONAL INC
Affiliated With: MEDIPAC
INTERNATIONAL
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MEDSAVE, INC
Affiliated With: MEDSAVE, INC
MEDSAVE
MEDSAVE
CHECK BENEFIT CARD
390 Rabro Rd
Hauppauge NY 11788
(516) 622-1700
(516) 622-1700
* MEGA ASSISTANCE
NETWORK INC
New York NY 10019
(212) 581-8228
(212) 581-8228
MEGA CORPORATION
HCH ADMINISTRATORS
PO Box 1986
PEORIA IL 61656
MEGA LIFE & HEALTH INSURANCE
COMPANY
Affiliated With: MEGA LIFE & HEALTH
INSURANCE COMPANY
CHECK BENEFIT CARD
COMPANY
HCH ADMINISTRATORS
HCH ADMINISTRATORS
COMPANY
MEGA LIFE & HEALTH
INSURANCE COMPANY
PO Box 982009
NORTH RICHLAND HILLS TX 76182
Network.
Info as of 12/24/2007
Page PIRMI-318
www.firsthealth.com
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MEGA LIFE AND HEALTH INSURANCE HEALTHMARKETS
COMPANY - CDHP
PO Box 982009
Affiliated With: MEGA LIFE & HEALTH NORTH RICHLAND HILLS TX 76182
INSURANCE COMPANY - CDHP
(866) 855-5542
HEALTHMARKETS
CHECK BENEFIT CARD
MELALEUCA INC
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MELITTA NORTH AMERICA
BENEFIT ADMINISTRATORS, INC.
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MELO INTERNATIONAL
CHECK BENEFIT CARD
Affiliated With: BENEFIT SERVICES INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Memco Barge Line Inc
CONTACT EMPLOYER
CONTACT EMPLOYER
PAYOR NAME
MEGA LIFE AND HEALTH INC CO
CDHP INDIVIDUAL
Affiliated With: MEGA LIFE &
INSURANCE COMPANY
CLAIMS SUBMISSION
CHECK BENEFIT CARD
CONTACT EMPLOYER
Attn:
UTILIZATION REVIEW
(866) 855-5542
Network.
Info as of 12/24/2007
Page PIRMI-319
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PAYOR NAME
MEMORIAL HOSPITAL THE JMS
(EBPA)
CLAIMS SUBMISSION
ADMINISTRATOR INC
PO Box 2365
COMPENSABILITY
ADMINISTRATOR INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(802) 846-8060
(802) 846-8060
MEMORIAL HOSPITALS ASSOCIATION HEALTHCOMP TPA
PO Box 45018
Fresno CA 93718
(800) 442-7247
HEALTHCOMP TPA
MEMPHIS VA MEDICAL CENTER 3148
SERVICES
MEMPHIS VA MEDICAL CENTER
Attn: FEE BASIS (136G)
1030 JEFFERSON AVE
MEMPHIS TN 38104
MEMPHIS VA MEDICAL CENTER
CHECK BENEFIT CARD
MENNONITE CHURCH USA
AID ASSOC AND MMA INS CO MMA
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MENNONITE MUTUAL AID ASSOC
AND MMA INS
MENNONITE MUTUAL AID C/O CCN
& MMA INSURANCE
MENTOR GRAPHICS CORP
GROUP
PO Box 5190
TAMPA FL 33675-5190
CHECK BENEFIT CARD
(800) 442-7247
(574) 533-9515 Ext 389
(574) 533-9515 Ext 389
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
Network.
Info as of 12/24/2007
Page PIRMI-320
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PAYOR NAME
MERCEDES HOMES, INC.
CLAIMS SUBMISSION
PREFERRED BENEFIT
ADMINISTRATORS INC
COMPENSABILITY
PREFERRED BENEFIT
ADMINISTRATORS INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
PO Box 916188
MERCEDES-BENZ CREDIT
CORPORATION
PROGRAMMERS, INC.
INSURANCE PROGRAMMERS INC.
MERCER TRANSPORTATION
ADMINISTRATION
INSURANCE PROGRAMMERS INC.
INSURANCE PROGRAMMERS
INC.
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
CHECK BENEFIT CARD
PO Box 2439
Florence SC 29503
(888) 722-1668
Mercury Insurance Company
Affiliated With: Mercury Insurance
Plan Type: Auto
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MERIAL LIMITED
INC
PO Box 8046
CHECK BENEFIT CARD
MERCER UNIVERSITY - DOMESTIC
AMH9033306
60 MAIN
WALLINGFORD CT 06492
(502) 992-4535
CORP #14005
(800) 722-1668
(715) 841-7802
(715) 841-7802
Network.
Info as of 12/24/2007
Page PIRMI-321
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PAYOR NAME
MERIT AUTO
Plan Type: Auto
CLAIMS SUBMISSION
MCMC LLC
COMPENSABILITY
MCMC LLC
UTILIZATION REVIEW
Canonsburg PA 15317
(888) 350-1150 Ext 228
MCMC LLC
(888) 350-1150 Ext 228
MERRIMACK BUILDING SUPPLY
Affiliated With: ATLANTIC
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MERRIMACK COLLEGE
MANAGEMENT SYSTEMS
INC
INC
PIONEER MANAGEMENT
SYSTEMS INC
330 WHITNEY AVE
HOLYOKE MA 01041
8004234586
8004234586
MIDWEST SECURITY
MIDWEST SECURITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MERITAIN HEALTH
MERITAIN HEALTH
300 CORPORATE PKWY
AMHERST NY 14226
(800) 828-6922
MERITAIN HEALTH
(800) 828-6922
MESABA AVIATION, INC.
MIDWEST SECURITY
MESILLA VALLEY TRANSPORTATION
Met America Mortgage Bankers Inc.
2700 Midwest Dr.
ONALASKA WI 54650
(800) 828-6922
Network.
Info as of 12/24/2007
Page PIRMI-322
www.firsthealth.com
PAYOR NAME
MetLife
Affiliated With: Mitchell Medical
Plan Type: Auto
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
New York State Insurance Fund
CONTACT EMPLOYER
CONTACT EMPLOYER
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
CHECK BENEFIT CARD
PO Box 42096
(800) 825-3540
UTILIZATION REVIEW
Metlife: Administered by Mitchell Medical
Exclude Physical Therapists,
Chiropractors & Behavioral Health
providers (OCN ONLY)
MetLife Insurance (Auto)
Plan Type: Auto
Metlife: Administered by Mitchell Medical
* Metro Group 90
Insurance Fund
METROPOLITAN LIBRARY SYSTEM
ADMINISTRATORS
199 Church St
New York NY 10007
(212) 312-7306
(800) 825-3540
Metropolitan Life
Affiliated With: Mitchell Medical div. of
Thompson Publishing Corp
Plan Type: Auto
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
METROPOLITAN STATE COLLEGE OF
DENVER
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-323
www.firsthealth.com
PAYOR NAME
Metropolitan Transit Authority
Affiliated With: Metropolitan Transit
Authority
METSCH HOURLY
CLAIMS SUBMISSION
Metro
COMPENSABILITY
Metro
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
UTILIZATION REVIEW
Metro
Careline UR
(763) 383-4800
(800) 422-2026
METSCH SALARY
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
(800) 422-2026
MEYER TRUCKING INC.
Affiliated With: MEYER TRUCKING INC. LLC
PO Box 71490
PHOENIX AZ 85050
LLC
(888) 419-1094
MEDICAL CARE
(800) 852-8001
(888) 419-1094
MFIA
ADMINISTRATORS INC
GALLAGHER BENEFIT
ADMINISTRATORS INC
GALLAGHER BENEFIT
ADMINISTRATORS INC
LISLE IL 60532
(630) 493-3511
GALLAGHER BENEFIT
ADMINISTRATORS INC
(630) 493-3845
(630) 493-3511
MIAMI VAMC 3140
SERVICES
MIAMI VAMC
Attn: FEE BASIS - 136B
1201 NW 16TH ST
MIAMI FL 33125
MIAMI VAMC
CHECK BENEFIT CARD
MICA
ADMINISTRATORS, LTD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-324
www.firsthealth.com
PAYOR NAME
MICROCHIP
CLAIMS SUBMISSION
Services
TUCSON AZ 85710
COMPENSABILITY
Services
UTILIZATION REVIEW
(847) 214-2780
(520) 722-7133
(520) 722-7133
MICROGROUP INC
HEALTH PLAN INC
HEALTH PLAN INC
(508) 752-2480
CMS
(866) 325-1550
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
(508) 752-2480
MID AMERICAN ENERGY HOLDINGS
COMPANY
GROUP
MID CONTINENT UNIVERSITY
CORP #14005
(800) 533-5044
2500 McClellan Ave
Pennsauken NJ 08109
(800) 220-1123
(800) 220-1123
MIDDLE GEORGIA COLLEGE
AIH0058377
PO Box 2271
CORP #14005
(843) 622-6001
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
MIDDLE GEORGIA COLLEGE
UNDERGRAD MANDATORY
CORP
UM NOT APPLICABLE
CHECK BENEFIT CARD
(843) 622-6001
UM NOT APPLICABLE
(800) 222-6491
(800) 222-6491
Network.
Info as of 12/24/2007
Page PIRMI-325
www.firsthealth.com
PAYOR NAME
MIDDLEBURY COLLEGE
Affiliated With: KLAIS AND COMPANY
MIDDLEBURY COLLEGE
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
KLAIS & COMPANY INC
KLAIS & COMPANY INC
CHECK BENEFIT CARD
1867 W MARKET ST
AKRON OH 44313
(330) 867-8443
UTILIZATION REVIEW
(330) 867-8443
MIDDLEBURY COLLEGE - JMS
PLAN ADMINISTRATION
EBPA
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
EBPA
CHECK BENEFIT CARD
(800) 578-3272
(800) 578-3272
Midlands Injury Management
Affiliated With: Midlands Injury
Management
MIDWEST PRODUCTS CO. INC
ADMINISTRATORS SYSTEMS
Deborah Storey
Deborah Storey
PO Box 238804
(405) 767-1760
Deborah Storey
(405) 767-1760
(405) 767-1760
SYSTEMS
SYSTEMS
7 JOVANNA DR STE 1B
HOMEWOOD IL 60430
(800) 523-0582
CHECK BENEFIT CARD
(800) 523-0582
MIDWEST SECURITY INSURANCE
COMPANIES PPO
LIFE INSURANCE COMPANY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-326
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
MIDWEST TROPHY MANUFACTURING MUTUAL ASSURANCE
CO, INC.
ADMINISTRATORS
PO Box 42096
ADMINISTRATORS
(800) 825-3540
MIDWESTERN TEAMSTERS HEALTH
& WELFARE FUND
Affiliated With: MIDWESTERN
TEAMSTERS HEALTH & WELFARE
FUND
TEDRO & ASSOCIATES C/O CCN
MIECO, INC.
AFFORDABLE BENEFIT
MIKE BROOKS, INC
Butler
MILES KIMBALL COMPANY
COMPENSABILITY
MUTUAL ASSURANCE
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 825-3540
TEDRO & ASSOCIATES C/O CCN
CHECK BENEFIT CARD
AFFORDABLE BENEFIT
AFFORDABLE BENEFIT
SISCO
SISCO
CHECK BENEFIT CARD
PO Box 389
(800) 547-4726
PO Box 5190
TAMPA FL 33675-5190
PO Box 10787
BURBANK CA 91510
(800) 547-4726
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
MILES MCCLELLAN CONSTRUCTION
CO
BAC
BAC
PO Box 107
(800) 521-2654
BAC
(614) 863-8780
(614) 863-8780
Network.
Info as of 12/24/2007
Page PIRMI-327
www.firsthealth.com
PAYOR NAME
MILITARY DELI AND BAKERY
Affiliated With: HEALTH AND
WELFARE BENEFIT SYSTEMS INC
CLAIMS SUBMISSION
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
COMPENSABILITY
SYSTEMS INC
UTILIZATION REVIEW
(800) 283-4927
(800) 283-4927
(800) 283-4927
Millennium Risk Managers
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
MILLER AND COMPANY
Affiliated With: BENEFIT SYSTEMS &
SERVICES
INC.
INC.
CHECK BENEFIT CARD
WESTMONT IL 60559
(630) 203-5124
(630) 203-5124
MILLS PENINSULA HEALTH SYSTEMS
Affiliated With: BENEFIT & RISK
MANAGEMENT SERVICES
BRMS
BRMS
PO Box 2650
(888) 326-2555
BRMS
(800) 368-0767
(888) 326-2555
MILWAUKEE VAMC (CLEMENT J
ZABLOCKI VAMC)
SERVICES
MILWAUKEE VA MEDICAL CENTER
Attn: FEE BASIS MIS-136E
5000 W NATIONAL AVE
MILWAUKEE WI 53295
MILWAUKEE VA MEDICAL CENTER
CHECK BENEFIT CARD
MINERAL TECHNOLOGIES INC
GROUP
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
(800) 533-5044
Network.
Info as of 12/24/2007
Page PIRMI-328
www.firsthealth.com
PAYOR NAME
MINI SYSTEMS INC
HEALTHPLANS, LLC
CLAIMS SUBMISSION
LLC
Houston TX 77040
UTILIZATION REVIEW
COMPENSABILITY
AMERICAN
HEALTH
HOLDINGS INC
LLC
(888) 578-1812
(877) 224-3627
(877) 224-3627
MINI-SYSTEMS, INC
SERVICE CENTER
GISC TOTALCARE
GISC TOTALCARE
20 WINTER ST
PEMBROKE MA 02359
(800) 242-4472
GISC TOTALCARE
(800) 242-4472
(800) 242-4472
MINNEAPOLIS VA MEDICAL CENTER
3703
SERVICES
MINNEAPOLIS VA MEDICAL CENTER
Attn: FEE BASIS 17A2
ONE VETERANS DR
MINNEAPOLIS VA MEDICAL CENTER CHECK BENEFIT CARD
MIRAMAR BOBCAT, INC ET.AL.
#10469
THE EPOCH GROUP
THE EPOCH GROUP
PO Box 12170
(800) 255-6065
SHPS
(888) 645-1380
(800) 255-6065
MISSION AVIATION FELLOWSHIP
CORESOURCE
MISSION AVIATION FELLOWSHIP
CORESOURCE
CORESOURCE
(800) 480-6658
EMPLOYEE BENEFIT
PO Box 2920
PO Box 3000
Network.
Info as of 12/24/2007
Page PIRMI-329
www.firsthealth.com
PAYOR NAME
MISSION LINEN SUPPLY
INC
CLAIMS SUBMISSION
PO Box 8046
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(715) 841-7802
(715) 841-7802
Mission Plus
Group, Inc.
MISSION TO THE WORLD (PCA) INC
Affiliated With: ALTERNATIVE
INSURANCE RESOURCES, INC.
MISSOURI CONSORTIUM NORTHWEST STATE UNIVERSITY
SERVICES
407 N Fulton St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
CHECK BENEFIT CARD
(317) 655-4500 Outside US
(800) 628-4664 Inside US
INSURANCE CLAIMS SERVICES INC
INSURANCE CLAIMS SERVICES INC CHECK BENEFIT CARD
PO Box 660787
BIRMINGHAM AL 35266
(800) 931-3439
(800) 931-3439
333 N. MAIN STREET
STILLWATER MN 55082
6514397098
CHECK BENEFIT CARD
6514397098
MISSOURI CONSORTIUM SOUTHEAST STATE UNIVERSITY
SERVICES INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MISSOURI CONSORTIUM SOUTHERN STATE UNIVERSITY
SERVICES
CHECK BENEFIT CARD
333 N. MAIN STREET
STILLWATER MN 55082
6514397098
6514397098
Network.
Info as of 12/24/2007
Page PIRMI-330
www.firsthealth.com
PAYOR NAME
MISSOURI CONSORTIUM - TRUMAN
STATE UNIVERSITY
SERVICES
MISYS INTERNATIONAL BANKING
SYSTEMS MKI FRUSTUM
Affiliated With: PERFORMAX NAA
CLAIMS SUBMISSION
333 N. MAIN STREET
STILLWATER MN 55082
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
6514397098
6514397098
NORTH AMERICAN
ADMINISTRATORS-PERFORMAX
NORTH AMERICAN
ADMINISTRATORS-PERFORMAX
PO Box 1065
AMHERST NY 14226
(877) 777-6076
CHECK BENEFIT CARD
(877) 777-6076
EMPLOYEE BENEFIT
(800) 249-8440
MITSUBISHI CEMENT CORPORATION
PO Box 5079
(800) 249-8440
MMI PLANS
SERVICE CORPORATION
TRUSTEED PLANS SERVICE GROUP CHECK BENEFIT CARD
MMO Indemnity Travel
Attn: Barb Hufgard
PO Box 1894
CHECK BENEFIT CARD
(216) 736-2522
2060 E 9th St
Cleveland OH 44115
(216) 736-2522
MODERN FACILITIES
(800) 899-9355
(800) 899-9355
Network.
Info as of 12/24/2007
Page PIRMI-331
www.firsthealth.com
PAYOR NAME
MODERN LUXURY
SOLUTIONS
MODERN WOODMEN OF AMERICA
CLAIMS SUBMISSION
PO Box 3559
COMPENSABILITY
UTILIZATION REVIEW
(800) 426-7453
(800) 426-7453
CORESOURCE MN
CORESOURCE MN
THE LOOMIS COMPANY
(800) 875-2364
HINES & ASSOCIATES
(888) 826-5769
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 426-7453
CORESOURCE MN
7830 BROADWAY
TUCSON AZ 85710
MODSPACE
THE LOOMIS COMPANY
WYOMISSING PA 19610
(800) 875-2364
MOHON INTERNATIONAL INC
Affiliated With: CAPITOL
ADMINISTRATORS INC
CHECK BENEFIT CARD
MONROE COUNTY SCHOOL BOARD
ADMINISTRATORS DBA FHA - TPA
FLORIDA HEALTH ADMINISTRATORS FLORIDA HEALTH ADMINISTRATORS CORVEL CORPORATION
(954) 340-8990
PO Box 327810
(954) 366-0111
MONROE PLUMBERS & PIPEFITTERS
GROUP #13352
(954) 366-0111
DIRECT CARE AMERICA
DIRECT CARE AMERICA
PO Box 2090 C
STOW OH 44224
(800) 266-5896
CHECK BENEFIT CARD
(800) 266-5896
Network.
Info as of 12/24/2007
Page PIRMI-332
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
MONTANA HEALTH CARE SYSTEM
3534
Attn: FEE BASIS
Affiliated With: HEALTH NET FEDERAL WILLIAM ST off HWY 12 WEST
SERVICES
MONTEBELLO PACAKAGING INC
PLAN INC 962550088
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
PACIFIC HEALTH ALLIANCE
(502) 992-4535
MONTEREY BAY PUBLIC
EMPLOYEES TRUST
Affiliated With: PACIFIC HEALTH
ALLIANCE
MONTEX DRILLING
ADMINISTRATORS INC
FT. WORTH TX 76134
(817) 335-2582
SERVICE ADVOCATES
(801) 261-5511
PO Box 9248
FRESNO CA 93791
(817) 335-2582
MONTGOMERY ESCALATOR
ELEVATOR INC
Affiliated With: INTEGRITY HEALTH
SERVICES
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MONTGOMERY VAMC 3543
SERVICES
MONTGOMERY VAMC
Attn: FEE BASIS SECTION
215 PERRY HILL RD
MONTGOMERY AL 36109
MONTGOMERY VAMC
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-333
www.firsthealth.com
PAYOR NAME
MOOSEHEAD MANUFACTURING
COMPANY
LLC
MORIDGE MANUFACTURING, INC
MANAGEMENT INC
MORRIS COLLEGE
CORP #14005
CLAIMS SUBMISSION
PO Box 1959
Gray ME 04039
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(207) 657-7733
(207) 657-7733
PO Box 1090
GREAT BEND KS 67530
(800) 290-1368
CHECK BENEFIT CARD
(800) 290-1368
PO Box 2437
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
MORRIS INDUSTRIAL
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MORRIS TRANSFER, INC.
INC.
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
MORTON WELDING COMPANY INC
Affiliated With: OSF HEALTHPLANS INC PO Box 5128
(800) 673-5222
(800) 673-5222
(309) 677-8356
Network.
Info as of 12/24/2007
Page PIRMI-334
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
BENEFIT SUPPORT
MOSLEY HOLDINGS
Affiliated With: HEALTHDATAINSIGHTS 305 GREEN ST
DBA MVPPO
GAINSVILLE GA 30501
(800) 777-4782
COMPENSABILITY
BENEFIT SUPPORT
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 777-4782
MOSSBERG SANITATION
MANAGEMENT INC
MedWatch
(800) 432-8421
Motel Hotel Associates, Inc
CORESOURCE
CORESOURCE
PO Box 2920
(800) 624-7143
CORESOURCE
(800) 480-6658
CHECK BENEFIT CARD
123 INTERSTATE DR
(877) 868-9060
(800) 624-7143
MOUNT HOLYOKE COLLEGE
MANAGEMENT SYSTEMS
MOUNT IDA COLLEGE
(877) 868-9060
KLAIS & COMPANY INC
KLAIS & COMPANY INC
1867 W MARKET ST
AKRON OH 44313
(330) 867-8443
CHECK BENEFIT CARD
(330) 867-8443
MOUNTAIN HOME VA MEDICAL
CENTER 3146
SERVICES
CENTER
Attn: 04F
MOUNTAIN HOME VAMC
MOUNTAIN HOME TN 37684
CENTER
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-335
www.firsthealth.com
PAYOR NAME
MOUNTAIN VIEW HOSPITAL
ADMINISTRATORS
MOUNTVILLE MILLS INC
INC
* MPD INC
PARTY ADMINISTRATOR
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
(801) 274-8100
CORVEL
(801) 269-8723
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(801) 274-8100
CHECK BENEFIT CARD
8882954864
ACORDIA NATIONAL
ACORDIA NATIONAL
CHECK BENEFIT CARD
(888) 685-7774
(888) 685-7774
MPR ASSOCIATES INC
THE LOOMIS COMPANY
THE LOOMIS COMPANY
UM NOT APPLICABLE
(800) 346-1223
(800) 346-1223
MRCC EMPLOYEE BENEFITS
FUND/RETIREES
Affiliated With: MRCC EMPLOYEE
BENEFITS FUND
MT. VERNON COMMUNITY SCHOOL
CORPORATION
Affiliated With: WEYCO, INC.
BENESYS INC
BENESYS INC
700 TOWER DR
TROY MI 48098
(248) 813-9800
HINES & ASSOCIATES
(847) 214-2780
WEYCO INC
WEYCO INC
(248) 813-9800
WEYCO INC
PO Box 30132
LANSING MI 48909
Network.
Info as of 12/24/2007
Page PIRMI-336
www.firsthealth.com
PAYOR NAME
MTS - INTRANSIT, INC
SERVICE GROUP
CLAIMS SUBMISSION
CORPORATION
PO Box 1894
COMPENSABILITY
CORPORATION
UTILIZATION REVIEW
(888) 877-7994
(253) 564-5850
(253) 564-5850
MUELLER INDUSTRIES INC
GROUP
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
MULLER MARTINI CORPORATION
CHECK BENEFIT CARD
Affiliated With: HEALTHDATAINSIGHTS
/ DBA MVPPO
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MULVANNY G2 ARCHITECTURE
Affiliated With: TRUSTEED PALNS
SERVICE CORPORATION
CORPORATION
CORPORATION
(888) 877-7994
PO Box 1984
NASHVILLE TN 37202
(253) 564-5850
(253) 564-5850
MURFREESBORO VA MEDICAL
CENTER 3151
SERVICES
CENTER
3400 LEBANON PIKE
MURFREESBORO TN 37129
CENTER
CHECK BENEFIT CARD
MURRAY BROS CADDY SHACK
PO Box 520
(800) 235-7160
AVIDYN HEALTH
(866) 802-1328
(800) 235-7160
Network.
Info as of 12/24/2007
Page PIRMI-337
www.firsthealth.com
COMPENSABILITY
MUSKOGEE VAMC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 720460
(800) 749-2631
PAYOR NAME
CLAIMS SUBMISSION
MUSKOGEE VAMC 3105
MUSKOGEE VAMC
Affiliated With: HEALTH NET FEDERAL Attn: 161A
SERVICES
1011 HONOR HEIGHTS DR
MUSKOGEE OK 74401
MUSTANG MACHINERY COMPANY
LTD
SERVICES
UTILIZATION REVIEW
(800) 749-2631
MUTUAL FIRE ASSOC THE
PROVIDENCE MUTUAL FIRE
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MUTUAL FIRE INSURANCE OF NEW
ENGLAND
ADMINISTRATORS INC
GALLAGHER BENEFIT
ADMINISTRATORS INC
GALLAGHER BENEFIT
ADMINISTRATORS INC
LISLE IL 60532
(630) 493-3516
GALLAGHER BENEFIT
ADMINISTRATORS INC
(630) 493-3845
CHECK BENEFIT CARD
1300 VIRGINIA DR STE 315
FT. WASHINGTON PA 19034
(215) 639-6208
MUTUAL OF OMAHA - SPECIAL RISK
STUDENT ATHLETIC PROGRAM
Affiliated With: PREFERRED CARE INC
(630) 493-3516
(215) 639-6208
MVM INC.
THE LOOMIS COMPANY
THE LOOMIS COMPANY
(800) 498-6250
HINES & ASSOCIATES
(888) 826-5769
(800) 498-6250
Network.
Info as of 12/24/2007
Page PIRMI-338
www.firsthealth.com
PAYOR NAME
MYERS LUMBER
N LITTLE ROCK VA MEDICAL CENTER
3109
SERVICES
CLAIMS SUBMISSION
NORTH AMERICA
COMPENSABILITY
NORTH AMERICA
UTILIZATION REVIEW
CHECK BENEFIT CARD
PO Box 1984
NASHVILLE TN 37202
Attn: FEE BASIS (136G)
2200 FORT ROOTS DR
N LITTLE ROCK AR 72114
CHECK BENEFIT CARD
(214) 387-3232
(214) 387-3232
N. KOHL GROCER
Affiliated With: ROBERT C. BOUCK,
INC.
ROBERT C. BOUCK, INC.
NACHI ROBOTIC
ASSURECARE
ASSURECARE
CHECK BENEFIT CARD
(800) 968-6616
126 N. 30th #205
QUINCY IL 62301
(800) 968-6616
NA'NEELZHIIN JI OLTA TORREON
DAY SCHOOL
Affiliated With: SUMMIT
* Nassau
Insurance Fund
SUMMIT
SUMMIT
PO Box 25160
(888) 690-2020
UM NOT APPLICABLE
(888) 690-2020
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
Network.
CONTACT EMPLOYER
Info as of 12/24/2007
Page PIRMI-339
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
NATIONAL BUSINESS FURNITURE INC CLAIM MANAGEMENT SERVICES
Affiliated With: NATIONAL BUSINESS
PO Box 2790
FURNITURE INC
WEST BEND WI 53095-7970
NATIONAL COLLEGE OF
NATUROPATHIC MEDICINE
NATIONAL DISTRIBUTORS
LLC
COMPENSABILITY
CLAIM MANAGEMENT SERVICES
PERSONAL INSURANCE
PERSONAL INSURANCE
(800) 468-4343
UTILIZATION REVIEW
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 468-4343
PO Box 1959
Gray ME 04039
(207) 657-7733
(207) 657-7733
(207) 657-7733
NATIONAL FOUNDATION LIFE
INSURANCE CO.
INSURANCE CO C/O CCN
INSURANCE CO C/O CCN
CHECK BENEFIT CARD
Affiliated With: NATIONAL
FOUNDATION LIFE INSURANCE CO.
PO Box 5190
TAMPA FL 33675-5190
National Grange Mutual Insurance
Company
Plan Type: Auto
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
National Grange Mutual Insurance
Company
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Network.
Info as of 12/24/2007
Page PIRMI-340
www.firsthealth.com
PAYOR NAME
NATIONAL HEALTH BENEFIT
CORPORATION PEMP (NHBC)
BENEFIT CORPORATION (NHBC)
CLAIMS SUBMISSION
NHBC
Scottsdale AZ 85260
COMPENSABILITY
NHBC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(888) 321-7900
(888) 321-7900
DBA: SPENCER AND ASSOCIATES
NATIONAL HEALTH BENEFITS
CORPORATION % SAVINGS (NHBC)
NHBC
CORPORATION (NHBC)
CORPORATION (NHBC)
NATIONAL HEALTH INSURANCE
Affiliated With: PREMIER ACCESS
PREMIER ACCESS
PREMIER ACCESS
CHECK BENEFIT CARD
PO Box 150375
Arlington TX 76015
(888) 463-4137
Scottsdale AZ 85260
(888) 463-4137
NATIONAL HEALTHCARE
RESOURCES
NATIONAL HEALTHCARE
RESOURCES
NATIONAL HEALTHCARE
RESOURCES
720 Cool Springs Blvd., #300
Franklin TN 37067
(800) 243-2336
NATIONAL HEALTHCARE
RESOURCES
(800) 243-2336
(800) 243-2336
NATIONAL INSURANCE BOARD
Affiliated With: SANUS HEALTH
SANUS HEALTH CORPORATION
12501 KENDALL DR STE 2
MIAMI FL 33186
(305) 572-9756
SANUS HEALTH
CORPORATION
(305) 572-9756
(305) 572-9756
NATIONAL OUTDOOR LEADERSHIP
SCHOOLS
CONSU
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-341
www.firsthealth.com
PAYOR NAME
NATIONAL PEN CORPORATION
CLAIMS SUBMISSION
CENBEN USA
4079 Executive Pkwy
COMPENSABILITY
CENBEN USA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(614) 797-5204
(614) 797-5204
NATIONAL SPORTS SERVICES
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
HEALTH PLAN
(702) 242-7345
CHECK BENEFIT CARD
(702) 242-7700
NATIONAL TELECOMMUNICATION
COOPERATIVE ASSOCIATION
INC
Attn: ACCOUNTING
DALLAS TX 75206
(800) 342-0719
(800) 342-0719
National Title Travel
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
NATIONAL WOOD PRODUCTS
ADMINISTRATORS
CHECK BENEFIT CARD
NATIONWIDE HEALTH PLAN
CHECK BENEFIT CARD
First Health
8774534201
GLOBALCARE
PO Box 5190
TAMPA FL 33675-5190
Network.
Info as of 12/24/2007
Page PIRMI-342
www.firsthealth.com
PAYOR NAME
NATIONWIDE HEALTH PLANS CALIFORNIA FARM BUREAU
Affiliated With: NATIONWIDE HEALTH
PLANS
NATIONWIDE HEALTH PLANS CALIFORNIA SMALL GROUP
PRODUCT
Affiliated With: NATIONWIDE
NATIONWIDE HEALTH PLANS - OHIO
FARM BUREAU PRIM
PLANS
FARM BUREAU WRAP
PLANS
WRAP
PLANS - OHIO WRAP
NATIONWIDE HEALTH PLANS OHIO
PRIMES LIVES
PLANS OHIO PRIMES LIVES
CLAIMS SUBMISSION
NATIONWIDE HEALTH CLAIMS
PO Box 182690
COLUMBUS OH 43218
COMPENSABILITY
(800) 299-6080
UTILIZATION REVIEW
NATIONWIDE BETTER HEALTH
(866) 835-5328
(800) 299-6080
NATIONWIDE HEALTH PLANS
PO Box 8026
DUBLIN OH 43017
(800) 331-4222
(800) 331-4222
(800) 331-4222
PO Box 182690
COLUMBUS OH 43218
(800) 299-6080
HEALTH & MEDICAL
SOLUTIONS
(866) 835-5328
(800) 299-6080
PO Box 182690
COLUMBUS OH 43218
(800) 299-6080
NATIONWIDE BETTER HEALTH
(866) 835-5328
(800) 299-6080
PO Box 182690
COLUMBUS OH 43218
(800) 331-4222
(800) 331-4222
(800) 331-4222
PO Box 182690
COLUMBUS OH 43218
(800) 331-4222
(800) 331-4222
(800) 331-4222
Network.
Info as of 12/24/2007
Page PIRMI-343
www.firsthealth.com
PAYOR NAME
NATURAL GAS PROCESSING
CONSU
NATURES REALM
ANNUITY
NAVAGENTE GROUP INC
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
PO Box 295
Onalaska WI 54650
(800) 542-6642
(800) 542-6642
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
NAVAJO MOUNTAIN COMMUNITY
SCHOOL
CHECK BENEFIT CARD
CHECK BENEFIT CARD
14646 N. Kierland Blvd. #200
SCOTTSDALE AZ 85254
NAVAJO PREPARATORY SCHOOL
NAZLINI COMMUNITY SCHOOL
PO Box 25160
PO Box 25160
Network.
Info as of 12/24/2007
Page PIRMI-344
www.firsthealth.com
PAYOR NAME
NBM CORPORATION DBA THE BANK
NA
BENEFITS ADMINISTRATORS
NE CONSERVATORY MUSIC
MANAGEMENT SERVICES
CLAIMS SUBMISSION
WATERSTONE BENEFIT
COMPENSABILITY
WATERSTONE BENEFIT
UTILIZATION REVIEW
(888) 440-0971
WATERSTONE BENEFIT
(800) 460-0238
CHECK BENEFIT CARD
PO Box 9040
(413) 539-9900
(888) 440-0971
(413) 539-9900
Nebraska Western Iowa HCS - Grand
Island 4006
SERVICES
CLAIMS MANAGER
Attn: Fee Basis 136F
2201 N Broadwell Ave
Grand Island NE 68803
Nebraska Western Iowa HCS - Lincoln
SERVICES
NEBRASKA WESTERN IOWA HCS LINCOLN
Attn: FEE BASIS BLDG 1
600 S 70TH ST
NEBRASKA WESTERN IOWA HCS LINCOLN
UM NOT APPLICABLE
(916) 985-1259
CHECK BENEFIT CARD
LINCOLN NE 68510
NEI WPCC
HEALTHPLANS LLC
LLC
Houston TX 77040
HOLDINGS INC
LLC
(888) 578-1812
(877) 224-3627
(877) 224-3627
NEIL HUFFMAN INC
SOLUTIONS
10835 N 25TH AVE STE 105
PHOENIX AZ 85029
(602) 393-4553
UM NOT APPLICABLE
(602) 393-4553
Network.
Info as of 12/24/2007
Page PIRMI-345
www.firsthealth.com
PAYOR NAME
NELSON AND SONS INC
ADMINISTRATORS
NELSON NUTRACEUTICAL
ADMINISTRATORS
NESTLE, USA
Affiliated With: WAUSAU BENEFITS,
INC.
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
(801) 274-8100
CORVEL
(801) 269-8723
CHECK BENEFIT CARD
(801) 274-8100
PO Box 8046
(715) 841-7802
(715) 841-7802
EMPLOYEE BENEFIT
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MBA OF WYOMING
MBA OF WYOMING
MBA OF WYOMING
NETAFIM IRRIGATION, INC.
NETCARE LIFE & HEALTH
PO Box 3000
NEUMAN ENTERPRISES
ASSOCIATES
PO Box 98
WORLAND WY 82401
Network.
Info as of 12/24/2007
Page PIRMI-346
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
NEVADA CANCER CENTER TRAVEL
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
NEVADA TITLE INSURANCE
COMPANY
NEW COM INC PEPM
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
NEW COM INC.
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
NEW ENGLAND COLLEGE SPORTS
CONCEPTS INC
CHECK BENEFIT CARD
NEW ENGLAND CULINARY INSTITUTE CONSOLIDATED HEALTH PLANS INC
195 STAFFORD ST
HEALTH PLANS, INC.
(800) 633-7867
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 633-7867
Network.
Info as of 12/24/2007
Page PIRMI-347
www.firsthealth.com
PAYOR NAME
NEW ENGLAND HOMES
LLC
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
(800) 290-8559
(800) 290-8559
EBPA
EBPA
CHECK BENEFIT CARD
PO Box 2365
(800) 525-8788
PO Box 1959
Gray ME 04039
(800) 290-8559
NEW ENGLAND PRECISION JMS
(EBPA)
(802) 846-8060
NEW ERA LIFE INSURANCE
INC
Attn: ACCOUNTING
DALLAS TX 75206
CHECK BENEFIT CARD
(800) 552-7879
(800) 552-7879
New Freedom Care
Group, Inc.
NEW HAMPSHIRE HEALTH PLAN
PLAN ADMINISTRATION
2960 N Meridian St
(800) 628-4664 or (317) 6554500
(800) 628-4664 or (317) 6554500
ADMINISTRATION
ADMINISTRATION
APS HEALTHCARE
(262) 787-2200
37 INDUSTRIAL DR
EXETER NH 03833
(888) 877-6447
(800) 628-4664 or (317) 6554500
(888) 877-6447
NEW MEXICO INSTITUTE OF MINING
AND TECHNOLOGY
HCH ADMINISTRATORS
HCH ADMINISTRATORS
HCH ADMINISTRATORS
PO Box 1986
PEORIA IL 61656
Network.
Info as of 12/24/2007
Page PIRMI-348
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PAYOR NAME
CLAIMS SUBMISSION
NEW ORLEANS VA MEDICAL CENTER NEW ORLEANS VA MEDICAL
3106
CENTER
Affiliated With: HEALTH NET FEDERAL Attn: FEE BASIS 136F
SERVICES
400 VETERANS AVE
BILOXI MS 39531
NEW PARK RESOURCES INC
COMPENSABILITY
NEW ORLEANS VA MEDICAL
CENTER
GILSBAR, INC.
GILSBAR, INC.
PO Box 2947
COVINGTON LA 70434-2947
(800) 445-7227
UTILIZATION REVIEW
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 445-7227
NEW TRIBES MISSION
Affiliated With: NEW TRIBES MISSION
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
NEW TRIBES MISSION FLORIDA
Affiliated With: NEW TRIBES MISSION
NAPLES FL 34103
(239) 403-7884
MedWatch
(800) 432-8421
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
(239) 403-7884
* New York City Division
Insurance Fund
New York Special Funds Conservation
Affiliated With: New York Special Funds
Conservation
199 Church St
New York NY 10007
(212) 312-7306
CONTACT EMPLOYER
Attn:
Network.
Info as of 12/24/2007
Page PIRMI-349
www.firsthealth.com
PAYOR NAME
NEW YORK VA MEDICAL CENTER
3522
SERVICES
CLAIMS SUBMISSION
5504 HILL HEAVEN CT
FRISCO TX 75035
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(214) 387-3232
(214) 387-3232
NEWBURY COLLEGE SPORTS
CONCEPTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
NEWBURY COMICS INC
HEALTHPLANS LLC
LLC
HOLDINGS INC
LLC
(888) 578-1812
(877) 224-3627
Houston TX 77040
CHECK BENEFIT CARD
(877) 224-3627
Newkirk's Ace Hardware
NEWMAN MEMORIAL HOSPITAL
COMPANY
NEWSPAPER FIRST INC
Affiliated With: PERFORMAX CBSA
Western Health
Western Health
Rapid City SD 57701
(605) 719-4600 or (888) 3411766
Western Health
(605) 719-4640 or (800) 2290892
CHECK BENEFIT CARD
PO Box 26967
(405) 290-5696
(605) 719-4600 or (888) 3411766
(405) 290-5696
CBSA
CBSA
PO Box 27725
(800) 925-2272
PERFORMAX /
GUIDED2HEALTH
(866) 405-2021
(304) 353-8743
Network.
Info as of 12/24/2007
Page PIRMI-350
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
NF SG VA MEDICAL CENTER 3143
NF SG VA MEDICAL CENTER
Affiliated With: HEALTH NET FEDERAL Attn: BUSINESS OFFICE 04
SERVICES
619 S MARION
LAKE CITY FL 32025
Nippon Life Insurance Company of
America
NOAHS COLLECTORS GALLERY
COMPENSABILITY
NF SG VA MEDICAL CENTER
PO Box 828
(800) 843-3106
UTILIZATION REVIEW
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 522-2161
(800) 843-3106
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
NOBLE HEALTH SYSTEMS INC WRAP
JMS
(EBPA)
NOBLE HEALTH SYSTEMS INC WRAP
VST
(EBPA)
NOOKSACK RIVER CASINO
EBPA
EBPA
PO Box 2365
(802) 846-8060
CHECK BENEFIT CARD
(802) 846-8060
ADMINISTRATORS INC
ADMINISTRATORS INC
PO Box 2365
SOUTH BURLINGTON VT 05407-2365
(800) 587-3272
ADMINISTRATORS INC
(800) 587-3272
(800) 587-3272
SRT ADMINISTRATORS, INC. C/O
CCN
SRT ADMINISTRATORS, INC. C/O
CCN
CHECK BENEFIT CARD
PO Box 3000
Network.
Info as of 12/24/2007
Page PIRMI-351
www.firsthealth.com
PAYOR NAME
NOR-CAL BEVERAGE COMPANY
NORDENIA USA, INC
BENEFITS, INC.
NORDSTROM
Affiliated With: NORDSTROM
COMPENSABILITY
COMBINED BENEFIT
ADMINISTRATORS
COMBINED BENEFIT
ADMINISTRATORS
CHECK BENEFIT CARD
PO Box 619055
DALLAS TX 75261
(877) 266-2054
CLAIMS SUBMISSION
COMBINED BENEFIT
ADMINISTRATORS
UTILIZATION REVIEW
4704 W. Jennifer #104
FRESNO CA 93722
(877) 266-2054
NORDSTROM
NORDSTROM
3501 West Sunflower Avenue
Santa Ana CA 92704-6944
(714) 513-4879
NORDSTROM
(714) 513-4879
(714) 513-4879
NORRIS SUCKER RODS
WATERSTONE BENEFIT
WATERSTONE BENEFIT
(405) 440-8888
CHECK BENEFIT CARD
(405) 440-8888
NORTEL GOVERNMENT SOLUTIONS
THE LOOMIS COMPANY
(866) 239-7191
HINES & ASSOCIATES
(888) 826-5769
NORTH AMERICAN ADMINISTRATORS CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
NORTH AMERICAN PREFERRED
ADMINISTRATORS - NY
NORTH AMERICAN
ADMINISTRATORS-NY
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 9501
AMHERST NY 14226
(800) 828-6922
NORTH AMERICAN
ADMINISTRATORS-NY
(800) 828-6922
THE LOOMIS COMPANY
(866) 239-7191
(800) 828-6922
Network.
Info as of 12/24/2007
Page PIRMI-352
www.firsthealth.com
PAYOR NAME
NORTH AMERICAN RISK SERVICES
(NARS)
CLAIMS SUBMISSION
CompIQ Corporation
COMPENSABILITY
CompIQ Corporation
UTILIZATION REVIEW
UM NOT APPLICABLE
35 Tesla Way #100
Irvine CA 92618
(800) 293-3131
NORTH AMERICAN RISK SERVICES
(NARS) AUTO
Plan Type: Auto
CompIQ Corporation
CompIQ Corporation
35 Tesla Way #100
Irvine CA 92618
(800) 293-3131
NORTH CARE CENTER
ADMINISTRATORS 20183
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
MUTUAL ASSURANCE
ADMINISTRATORS
(800) 825-3540
NORTH CAROLINA AT&T STATE
UNIVERSITY
PO Box 2408
CORP #14005
(888) 722-1668
CHECK BENEFIT CARD
Attn: WHIT WALTERS
UM NOT APPLICABLE
(405) 607-2587
NORTH CAROLINA SCHOOL OF THE
ARTS
CORPORATION
(888) 722-1668
CHECK BENEFIT CARD
(888) 722-1668
419 S. COIT ST
FLORENCE SC 29501
(800) 722-1668
NORTH CAROLINA STATE
UNIVERSITY
CORPORATION
Attn: WHIT WALTERS
419 S. COIT ST
FLORENCE SC 29501
CHECK BENEFIT CARD
(888) 722-1668
(800) 722-1668
Network.
Info as of 12/24/2007
Page PIRMI-353
www.firsthealth.com
PAYOR NAME
NORTH CAROLINA WESLEYAN
COLLEGE
MANAGEMENT
CLAIMS SUBMISSION
TRUE CHOICE
PO Box 700307
DALLAS TX 75370
COMPENSABILITY
PLAN OF NEVADA
UTILIZATION REVIEW
UM NOT APPLICABLE
(800) 251-9665
(800) 251-9665
NORTH CHICAGO VA MEDICAL
CENTER 3165
SERVICES
CENTER
Attn: FEE 136B
3001 GREE BAY RD
NORTH CHICAGO IL 60064
CENTER
CHECK BENEFIT CARD
NORTH COUNTY HEALTH SYSTEMS
BENEFIT ADMINISTRATORS, INC.
EBPA
EBPA
CHECK BENEFIT CARD
PO Box 2365
SOUTH BURLINGTON VT 05407-2365
(802) 846-8060
NORTH COUNTY HEALTH SYSTEMS
BENEFIT ADMINISTRATOR, INC.
(802) 846-8060
EBPA
EBPA
PO Box 2365
(802) 846-8060
CHECK BENEFIT CARD
(802) 846-8060
NORTH GEORGIA COLLEGE & STATE PEARCE ADMINISTRATION
UNIV AIH0058397
PO Box 2271
CORP #14005
(843) 622-6001
NORTH GEORGIA COLLEGE & STATE PEARCE ADMINISTRATION
Attn: WHIT WALTERS
MANDATORY
419 S. COIT ST
FLORENCE SC 29501
CORP
(800) 222-6491
CHECK BENEFIT CARD
(843) 622-6001
UM NOT APPLICABLE
(800) 222-6491
Network.
Info as of 12/24/2007
Page PIRMI-354
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
NORTH GREENVILLE UNIVERSITY PEARCE ADMINISTRATION
DOMESTIC
Attn: WHIT WALTERS
CORP
FLORENCE SC 29501
(843) 622-6001
NORTH HARRIS MONTGOMERY CCD
MANAGEMENT
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(843) 622-6001
TRUE CHOICE
TRUE CHOICE
PO Box 700307
DALLAS TX 75370
(800) 251-9665
UM NOT APPLICABLE
(800) 251-9665
NORTH ORANGE COMMUNITY
COLLEGE DISTRICT CYPRESS
COLLEGE DISTRICT/CYPRESS
COLLEGE
AMERIBEN SOLUTIONS
NORTHAMPTON VA MEDICAL
CENTER 3112
SERVICES
NORTHAMPTON VAMC
Attn: FEE BASIS 001 FEE
421 N MAIN ST
LEEDS MA 01053
AMERIBEN SOLUTIONS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 6977
BOISE ID 83707
(214) 387-3232
(214) 387-3232
NORTHEAST KINGDOM HUMAN
SERVICES
BENEFITS ADMINISTRATOR
NORTHEASTERN VERMONT
REGIONAL HOSPITAL WRAP JMS
(EBPA)
ADMINISTRATOR INC
ADMINISTRATOR INC
PO Box 2365
(800) 525-8788
CHECK BENEFIT CARD
(800) 525-8788
ADMINISTRATOR INC
ADMINISTRATOR INC
PO Box 2365
(800) 525-8788
CHECK BENEFIT CARD
(802) 846-8060
Network.
Info as of 12/24/2007
Page PIRMI-355
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
BENESYS
NORTHERN CA SHEET METAL
WORKERS DBA "LOCAL 162" HEALTH PO Box 1138
CARE PLAN
SAN RAMON CA 94583
Affiliated With: SHEET METAL
WORKERS LOCAL 104 HEALTH CARE (248) 822-4200
PLAN
NORTHERN CALIFORNIA HCS 3184
SERVICES
NORTHERN CALIFORNIA HCS
Attn: FEE SERVICE (04F)
201 WALNUT AVE
VALLEJO CA 94592
NORTHERN MAINE MEDICAL CENTER CHECK BENEFIT CARD
COMPENSABILITY
BENESYS
UTILIZATION REVIEW
(248) 822-4200
(209) 951-6711
NORTHERN CALIFORNIA HCS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
NORTHPORT VA MEDICAL CENTER
3120
SERVICES
NORTHPORT VA MEDICAL CENTER
Attn: FEE BASIS 136A
NORTHPORT VA MEDICAL CENTER CHECK BENEFIT CARD
Northstar Providers LLC
Plan Type: Auto
NORTHSTAR PROVIDERS, LLC
8080 NW 155TH ST
MIAMI LAKES FL 33016
(786) 507-1600
Northstar Providers LLC
8080 NW 155TH ST
MIAMI LAKES FL 33016
(786) 507-1600
79 MIDDLEVILLE RD
NORTHPORT NY 11768
Network.
UM NOT APPLICABLE
UM NOT APPLICABLE
Info as of 12/24/2007
Page PIRMI-356
www.firsthealth.com
PAYOR NAME
NORTHWEST BEC CORPORATION
ASSOCIATES
CLAIMS SUBMISSION
CRITIQUE
COMPENSABILITY
CRITIQUE
CHECK BENEFIT CARD
UTILIZATION REVIEW
PO Box 651109
S SALT LAKE UT 84165-1109
NORTHWEST INDIANA PAINTERS
Affiliated With: PAINTERS LOCAL 460
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
NORTHWEST LIQUID FERTILIZER INC
PO Box 520
(800) 235-7160
AVIDYN HEALTH
(866) 802-1328
(800) 235-7160
NORTHWEST METAL PRODUCTS CO
INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
NORTHWEST TEXTBOOK
Affiliated With: LOOMIS BENEFITS
WEST
THE LOOMIS COMPANY
THE LOOMIS COMPANY
CHECK BENEFIT CARD
PO Box 7045
WYOMISSING PA 19610
(877) 634-9814
NORTHWESTERN MUTUAL LIFE
GROUP
(877) 634-9814
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
Network.
Info as of 12/24/2007
Page PIRMI-357
www.firsthealth.com
PAYOR NAME
* Norwich University
MANAGEMENT SYSTEMS
NOTRE DAME DE NAMUR
#15255
NOVA HEALTHCARE
ADMINISTRATORS
Affiliated With: NOVA HEALTHCARE
ADMINISTRATORS
CLAIMS SUBMISSION
123 INTERSTATE DR
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(413) 534-8658
(413) 534-8658
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN
(800) 388-3193
(800) 786-7930
NOVA HEALTHCARE
ADMINISTRATORS INC
NOVA HEALTHCARE
ADMINISTRATORS INC
250 ESSJAY RD
BUFFALO NY 14221
(800) 999-5703
CHECK BENEFIT CARD
(716) 250-7302
NOXIOUS VEGETATION CONTROL,
INC.
ENTERPRISE GROUP PLANNING,
INC.
ENTERPRISE GROUP PLANNING,
INC.
CHECK BENEFIT CARD
Affiliated With: ENTERPRISE GROUP
PLANNING, INC.
5910 Harper Rd.
CLEVELAND OH 44139-1835
NRECA - HOPPO
Affiliated With: NRECA NATIONAL
RURAL ELECTRIC COOPERATIVE
COOPERATIVE BENEFIT
ADMINISTRATOR
COOPERATIVE BENEFIT
ADMINISTRATOR
CHECK BENEFIT CARD
NRECA - OUT OF AREA NATIONAL
NETWORK (TRAVEL @ %)
Affiliated With: NRECA - National Rural
Electric Cooperative
CBA - COOPERATIVE BENEFITS
CORPORATION
CBA - COOPERATIVE BENEFITS
CORPORATION
CHECK BENEFIT CARD
PO Box 6249
(402) 483-9265
PO Box 6249
(402) 483-9265
Network.
Info as of 12/24/2007
Page PIRMI-358
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PAYOR NAME
NSB RETAIL SYSTEM
GROUP #13352
NUNN MILLING
CLAIMS SUBMISSION
DIRECT CARE AMERICA
PO Box 2090 C
STOW OH 44224
COMPENSABILITY
DIRECT CARE AMERICA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 266-5896
(800) 266-5896
MERITAIN HEALTH
MERITAIN HEALTH
PO Box 1090
GREAT BEND KS 67530
(812) 429-2747
CHECK BENEFIT CARD
(812) 429-2747
NW DOOR
CHECK BENEFIT CARD
MANAGEMENT ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
NYK LOGISTICS (AMERICAS) NUWDC
DIVISION
Affiliated With: MID SOUTH
MSAG
MSAG
1180 Vickery Lane
Cordova TN 38016
(800) 486-4068
MSAG
(800) 486-4068
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 486-4068
O C TANNER
CHECK BENEFIT CARD
OAK HOTELS GROUP
ENTRUST INC
ENTRUST INC
HOUSTON TX 77079
(281) 368-7878
8007159414
UM NOT APPLICABLE
(281) 368-7878
Network.
Info as of 12/24/2007
Page PIRMI-359
www.firsthealth.com
PAYOR NAME
OAKTREE CAPITAL MANAGEMENT
GROUP
O'BRIEN STEEL
INC.
CLAIMS SUBMISSION
PO Box 5319
TAMPA FL 33675-5319
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 533-5044
(800) 533-5044
PO Box 5128
(309) 677-8356
CHECK BENEFIT CARD
(309) 677-8356
OCEAN PROPERTIES LTD
LLC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
OCEANSIDE AUTO COUNTRY
HealthComp
HealthComp
PO Box 45018
Fresno CA 93718
(800) 442-7247
HealthComp
(800) 755-7247
UM NOT APPLICABLE
Octagon Risk Services, Inc - Rancho
Cordova
Octagon Risk Services, Inc Rancho Cordova
(866) 672-9296
(800) 442-7247
* OCS-EAJ RICHMOND
NETWORK 19313
Octagon Risk Services, Inc
Affiliated With: CompManagement, Inc.
(CMI)
New York NY 10019
CONTACT EMPLOYER
Attn:
(866) 672-9296
(866) 672-9296
Network.
Info as of 12/24/2007
Page PIRMI-360
www.firsthealth.com
PAYOR NAME
ODLE MCGUIRE AND SHOOK
CLAIMS SUBMISSION
ADMINISTRATORS
Oakbrook IL 60523
COMPENSABILITY
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 435-5694
(800) 435-5694
Ohio Casualty
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Ohio Casualty Group AUTO
Plan Type: Auto
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
OHIO STATE UNIVERSITY BENEFITS
SERVICES (GEMS)
SERVICES (GEMS)
GLOBAL EMERGENCY
MEDICAL SERVICES (GEMS)
OKLAHOMA BANKERS ASSOCIATION
KANSAS - 11297
PO Box 520
(800) 235-7160
AVIDYN HEALTH
(866) 802-1328
TRUE CHOICE
TRUE CHOICE
UM NOT APPLICABLE
PO Box 700307
DALLAS TX 75370
(800) 251-9665
OKLAHOMA BAPTIST UNIVERSITY
MANAGEMENT
ALPHARETTA GA 30004
(800) 235-7160
(800) 251-9665
Network.
Info as of 12/24/2007
Page PIRMI-361
www.firsthealth.com
PAYOR NAME
OKLAHOMA BLOOD INSTITUTE
ADMINISTRATORS
CLAIMS SUBMISSION
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
COMPENSABILITY
MUTUAL ASSURANCE
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 825-3540
(800) 825-3540
OKLAHOMA CARDIOVASCULAR
ASSOCIATES
ADMINISTRATORS
OKLAHOMA CHRISTIAN UNIVERSITY
MANAGEMENT
OKLAHOMA CITY UNIVERSITY
DOMESTIC
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
TRUE CHOICE USA
TRUE CHOICE USA
PO Box 700307
DALLAS TX 75370
(800) 785-2446
CHECK BENEFIT CARD
(800) 785-2446
TRUE CHOICE
CI
PO Box 700307
DALLAS TX 75370
(817) 479-2115
CI
(817) 479-2115
MANAGEMENT
(800) 785-2446
OKLAHOMA CITY VAMC 3107
SERVICES
OKLAHOMA CITY VAMC
Attn: FEE SERVICES (136A-2)
921 NE 13TH
OKLAHOMA CITY VAMC
CHECK BENEFIT CARD
OKLAHOMA CITY ZOO
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
CHECK BENEFIT CARD
PO Box 42096
(800) 825-3540
(800) 825-3540
Network.
Info as of 12/24/2007
Page PIRMI-362
www.firsthealth.com
PAYOR NAME
OKLAHOMA CONFERENCE OF
UNITED METHODIST CHURCHES
INC
OKLAHOMA COUNTY
COMMISSIONERS RETIREES
ADMINISTRATORS
CLAIMS SUBMISSION
THE KEMPTON GROUP
PO Box 54889
UTILIZATION REVIEW
CHECK BENEFIT CARD
(405) 521-1711
(405) 521-1711
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
OKLAHOMA ELECTRIC COOPERATIVE THE KEMPTON GROUP
Affiliated With: THE KEMPTON GROUP PO Box 54889
INC
(405) 521-1711
OKLAHOMA FOUNDATION FOR
CARDIOVASCULAR RESEARCH
ADMINISTRATORS
COMPENSABILITY
THE KEMPTON GROUP
THE KEMPTON GROUP
CHECK BENEFIT CARD
(405) 521-1711
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
OKLAHOMA HEALTH INSURANCE
HIGH RISK
#10469
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
OKLAHOMA HEART HOSPITAL LLC
ADMINISTRATORS #20183
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
MUTUAL ASSURANCE
ADVANTAGE
(800) 825-3540
(405) 607-2624
Network.
Info as of 12/24/2007
Page PIRMI-363
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
OKLAHOMA LEATHER PRODUCTS INC AMERICA'S CHOICE HEALTHPLANS,
LLC
HEALTH PLAN
PO Box 922043
HOUSTON TX 77292
OKLAHOMA LUMBERMANS
ASSOCIATION
COMPANY
OKLAHOMA MED RESEARCH
FOUNDATION
ADMINISTRATORS
OKLAHOMA MUNICIPAL ASSURANCE
GROUP
ADMINISTRATORS
OKLAHOMA PRESS
ASSOCIATION/MEMBERS
EMPLOYEES BENEFIT TRUST
ADMINISTRATORS
OKLAHOMA STATE UNIVERSITY
MANAGEMENT
UTILIZATION REVIEW
COMPENSABILITY
MANAGED
CARE CONCEPTS
LLC
(409) 886-2723
PO Box 26967
(405) 290-5696
CHECK BENEFIT CARD
(405) 290-5696
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
(800) 825-3540
UM NOT APPLICABLE
(800) 825-3540
TRUE CHOICE USA
TRUE CHOICE USA
PO Box 700307
DALLAS TX 75370
(800) 785-2446
CHECK BENEFIT CARD
(800) 785-2446
Network.
Info as of 12/24/2007
Page PIRMI-364
www.firsthealth.com
PAYOR NAME
OKLAHOMA UNIVERSITY
INTERNATIONAL STUDENTS
MANAGEMENT
OLYMPIA TILE (USA), INC.
Affiliated With: FLORIDA BENEFIT
ADMINISTRATORS
* ON CALL INTERNATIONAL
NETWORK INC
ON CALL INTERNATIONAL
Affiliated With: ON CALL
INTERNATIONAL
CLAIMS SUBMISSION
TRUE CHOICE
PO Box 700307
DALLAS TX 75370
COMPENSABILITY
CI
(817) 479-2115
UTILIZATION REVIEW
CI
(817) 479-2115
(800) 785-2446
FLORIDA BENEFIT
CHECK BENEFIT CARD
CHECK BENEFIT CARD
New York NY 10019
(212) 581-8228
FLORIDA BENEFIT
13080 Belcher Rd. S. #A
LARGO FL 33773-1642
(212) 581-8228
THE LOOMIS COMPANY
(800) 875-2364
HINES & ASSOCIATES
(888) 826-5769
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8c Industrial Way
SALEM NH 03079
ON SITE E-DISCOVERY
THE LOOMIS COMPANY
READING PA 19612-4086
(800) 875-2364
One Beacon
Plan Type: Auto
CHECK BENEFIT CARD
One Beacon: Administered by Mitchell
Medical
Exclude Physical Therapists,
Chiropractors & Behavioral Health
providers (OCN ONLY)
Network.
Info as of 12/24/2007
Page PIRMI-365
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PAYOR NAME
OPERATING ENGINEERS LOCAL 139
HEALTH BENEFIT FUND
Affiliated With: OPERATING
ENGINEERS LOCAL 139 HEALTH
BENEFIT FUND
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
AMERICA INC
INC
8885991515
SELECT BENEFIT
SELECT BENEFIT
PROFESSIONAL BUSINESS
SERVICES
SERVICES
CHECK BENEFIT CARD
2959 LUCERNE DR
GRAND RAPIDS MI 48546
(800) 732-3412
OPEX CORPORATION
ADMINISTRATORS OF AMERICA (IAA)
AMERICA INC
OPHTHALMIC MANAGEMENT
COMPANY
SELECT BENEFIT
PO Box 3000
OPPORTUNITIES ENTERPRISES
SOLUTIONS
(800) 732-3412
OPPORTUNITY RESOURCES
BENEFIT SYSTEMS
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(619) 574-1685
(800) 283-4927
* OPTIMUS CORPORATION
Affiliated With: FISERV BENEFIT
PLANNERS
Benefit Planners
Benefit Planners
PO Box 690450
(866) 868-8230
FISERV HEALTH INC
(866) 868-8230
(866) 868-8230
Network.
Info as of 12/24/2007
Page PIRMI-366
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PAYOR NAME
ORAL ROBERTS UNIVERSITY
CLAIMS SUBMISSION
STUDENT RESOURCES
PLANO TX 75075
COMPENSABILITY
STUDENT RESOURCES
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
(800) 237-0903 Ext 6352
GUARANTEE TRUST LIFE
INSURANCE CO
INSURANCE CO
CORPORATION
CORPORATION
(888) 877-7994
PO Box 1894
(800) 426-9786
ORAL ROBERTS UNIVERSITY
INSURANCE CO. C/O CCN
PO Box 3000
SCOTTSDALE AZ 85271
ORCHARD RITE LTD
SERVICE CORPORATION
(800) 426-9786
OREGON COLLEGE OF ARTS AND
CRAFTS
OREGON GLASS COMPANY
INC
OREGON GRADUATE INSTITUTE
SCHOOL OF SCIENCE AND ENG
Affiliated With: FIRST UNDERWRITERS
INC
PERSONAL INSURANCE
ADMINISTRATORS
PERSONAL INSURANCE
ADMINISTRATORS
(800) 468-4343
CHECK BENEFIT CARD
(800) 468-4343
Bellevue WA 98005
(800) 700-7153
(800) 869-7093
CHECK BENEFIT CARD
(800) 700-7153
WAYNE PA 19087-1706
Network.
Info as of 12/24/2007
Page PIRMI-367
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
USI ADMINISTRATORS
OREGON INSTITUTE OF
TECHNOLOGY
PO Box 3357
Affiliated With: FIRST UNDERWRITERS FORT WORTH TX 76113
INC
COMPENSABILITY
USI ADMINISTRATORS
UTILIZATION REVIEW
USI ADMINISTRATORS
OREGON INSTITUTE OF
AMERIBEN SOLUTIONS
TECHNOLOGY INTERNATIONAL &
PO Box 7186
DOMESTIC
BOISE ID 83707
(800)
786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
ORION MARIN GROUP
ADMINISTRATORS AND
CONSULTANTS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ORLAND SCHOOL #135
ASSURECARE
ASSURECARE
340 Quadrangle Dr
(800) 759-1311
Careline UR
(763) 383-4800
(800) 759-1311
ORTHOPAEDIC CENTER OF THE
ROCKIES
AFFORDABLE BENEFIT
ADMINISTRATORS INC
AFFORDABLE BENEFIT
ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 10787
BURBANK CA 91510-0787
OSF-H S I PARTNERSHIP
Affiliated With: OSF HEALTHPLANS INC PO Box 5128
(877) 677-8222
(877) 677-8222
Network.
Info as of 12/24/2007
Page PIRMI-368
www.firsthealth.com
PAYOR NAME
OSFHP
INC.
OSLER INSTITUTE
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
(800) 673-5222
(800) 284-2273
MERITAIN HEALTH
MERITAIN HEALTH
UM NOT APPLICABLE
9245 N Meridian St Ste 100
(800) 842-3216
PO Box 1229
(800) 673-5222
(800) 842-3216
OSMA HEALTH NETWORK
COMPANY
OTAY WATER DISTRICT
PO Box 26967
(405) 290-5696
CHECK BENEFIT CARD
(405) 290-5696
CENBEN USA
4079 Executive Pkwy
CENBEN USA
CHECK BENEFIT CARD
(614) 797-5204
(614) 797-5204
OTT SCHWEITZER DISTRIBUTORS
INC
ADMINISTRATORS INC
MIDWEST SECURITY
ADMINISTRATORS INC
MIDWEST SECURITY
ADMINISTRATORS INC
MIDWEST SECURITY
ADMINISTRATORS INC
TRUE CHOICE
UM NOT APPLICABLE
PO Box 574
ONALASKA WI 54650
OUR LADY OF THE LAKE UNIVERSITY TRUE CHOICE
PO Box 700307
MANAGEMENT
DALLAS TX 75370
(800) 251-9665
(800) 251-9665
Network.
Info as of 12/24/2007
Page PIRMI-369
www.firsthealth.com
PAYOR NAME
OVERLAND WEST INC
SOLUTIONS
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
8014742555
Owens Illinois
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
OWENSBORO MEDICAL HEALTH
SYSTEM
MERITAIN HEALTH
MERITAIN HEALTH
CHECK BENEFIT CARD
111 SE THIRD ST STE 404
EVANSVILLE IN 47708
(800) 455-1938
(800) 455-1938
SELECT BENEFIT
SELECT BENEFIT
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
CHECK BENEFIT CARD
CHECK BENEFIT CARD
OXLEY PETROLEUM
SELECT BENEFIT
PACE - TEC, INC.
BENEFIT SYSTEMS
PO Box 3000
(800) 283-4927
PACIFIC CATARACT AND LASER
INSTITUTE
SERVICE CORPORATION
CHECK BENEFIT CARD
8004269786
Network.
Info as of 12/24/2007
Page PIRMI-370
www.firsthealth.com
PAYOR NAME
PACIFIC COAST FEATHER
NORTHWEST FRAMING
ADMINISTRATORS INC
PACIFIC COAST STEEL TRAVEL
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
8004427247
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
EMPLOYEE BENEFIT
Pacific Gas & Electric Company
77 Beale St., 28th Floor
(415) 973-3350
(415) 973-3350
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PACIFIC ECHO, INC.
Pacific Gas and Electric
Affiliated With: Pacific Gas and Electric
PO Box 3000
(415) 973-3350
PACIFIC LUTHERAN UNIVERSITY
CONCEPTS INC
CHECK BENEFIT CARD
PACIFIC MARITIME ASSOCIATION
Affiliated With: PACIFIC MARITIME
ASSOCIATION
CHECK BENEFIT CARD
6102939229
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8009922322
Network.
Info as of 12/24/2007
Page PIRMI-371
www.firsthealth.com
PAYOR NAME
PACIFIC NORTHWEST COLLEGE OF
ART
CLAIMS SUBMISSION
PERSONAL INSURANCE
ADMINISTRATORS
COMPENSABILITY
PERSONAL INSURANCE
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 468-4343
(800) 468-4343
PACIFIC SOUTHWEST INSTRUMENTS HELLER ASSOCIATES
Affiliated With: HELLER ASSOCIATES
2755 BRISTOL
COSTA MESA CA 92626
HELLER ASSOCIATES
HELLER ASSOCIATES
PACIFIC UNIVERSITY
MANAGEMENT
TRUE CHOICE USA
TRUE CHOICE USA
CHECK BENEFIT CARD
PO Box 700307
DALLAS TX 75370
(800) 785-2446
PacificSource Health Plans
Affiliated With: PacificSource Health
Plans
PacificSource Travel Benefit
Affiliated With: PacificSource Health
Plans
PACKAGING UNLIMITED
PLANS, INC.
(800) 785-2446
PacificSource Customer Service
PO Box 7068
Eugene OR 97401-0068
(800) 624-6052
First Health
(800) 449-9905
(800) 624-6052
PacificSource
250 Country Club Rd
Eugene OR 97401
(800) 624-6052
PacificSource Medical Affairs
(800) 624-6052
(800) 624-6052
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
(800) 832-8212
Network.
Info as of 12/24/2007
Page PIRMI-372
www.firsthealth.com
PAYOR NAME
PACKERS HOLDING, LLC
Butler
PACKING TECHNOLOGIES
Butler
CLAIMS SUBMISSION
SISCO
PO Box 389
COMPENSABILITY
SISCO
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 547-4726
(800) 547-4726
PO Box 3310
Davenport IA 52808-3310
(563) 327-2240
CHECK BENEFIT CARD
(563) 327-2240
PADLOCK RANCH
ASSOCIATES
MBA OF WYOMING
MBA OF WYOMING
MBA OF WYOMING
PAINTERS ASSOCIATED TRADES
Affiliated With: PAINTERS
ASSOCIATED TRADES
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PAINTERS AND ALLIED TRADES
BENEFIT TRUST
Affiliated With: PAINTERS AND ALLIED
TRADES BENEFIT TRUST
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PAK 2000 INC
HEALTH PLAN INC
HEALTH PLAN INC
(800) 532-7575
PO Box 98
WORLAND WY 82401
8007596944
CARE MANAGEMENT
SERVICES
(866) 325-1550
(508) 752-2480
Network.
Info as of 12/24/2007
Page PIRMI-373
www.firsthealth.com
PAYOR NAME
PALA BAND OF MISSION INDIANS
CLAIMS SUBMISSION
CENBEN USA
4079 Executive Pkwy
COMPENSABILITY
CENBEN USA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(614) 797-5204
(614) 797-5204
* Palm Beach Atlantic College
MANAGEMENT SYSTEMS
PALM BEACH COMMUNITY COLLEGE
PALM BEACH COUNTY
FIREFIGHTERS
Affiliated With: APA PARTNERS INC
123 INTERSTATE DR
(413) 534-8658
UM NOT APPLICABLE
(413) 534-8658
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
APA Partners Inc
APA Partners Inc
PO Box 1506
Latham NY 12110
(800) 833-3650
APA Partners Inc
(800) 833-3650
(800) 833-3650
PALO ALTO HCS 3185
SERVICES
PALO ALTO HCS
Attn: FEE DEPT 640/136C
3801 MIRANDA AVE
PALO ALTO CA 94304
PALO ALTO HCS
CHECK BENEFIT CARD
PALOMAR COLLEGE
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
PAM TRANSPORT
(800) 786-7930
ASSURECARE
ASSURECARE
LANSING MI 38823
(800) 968-6616
CARELINE
(763) 383-4800
(800) 968-6616
Network.
Info as of 12/24/2007
Page PIRMI-374
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
PAN WESTERN TRAVEL
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
PANDOL & SONS
EBA&M
EBA&M
PO Box 5079
(714) 668-8920
HINES & ASSOCIATES
(800) 528-2498
CHECK BENEFIT CARD
(714) 668-8920
PAPER PRODUCTS
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PAPPAS TELECASTING
Affiliated With: PAPPAS TELECASTING
FOR MEDICAL CARE
RIVERSIDE CNTY FOUNDATION FOR RIVERSIDE COUNTY
FOUNDATION FOR MEDICAL
MEDICAL CARE C/O CCN
CARE
(800) 825-3540
PARADIGM
SERVICES (GEMS)
PARADIGM HEALTH CORPORATION
Affiliated With: PARADIGM HEALTH
CORPORATION (GROUP HLTH)
PARADIGM HEALTH CORPORATION
3993 Jurupa Ave.
RIVERSIDE CA 92506
SERVICES (GEMS)
GLOBAL EMERGENCY
MEDICAL SERVICES (GEMS)
ALPHARETTA GA 30004
1001 Galaxy Way #300
CONCORD CA 94520
PARADIGM HEALTH CORPORATION PARADIGM HEALTH
CORPORATION
Network.
Info as of 12/24/2007
Page PIRMI-375
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
Paradigm Health Systems Auto
CONTACT EMPLOYER
Affiliated With: Paradigm Health Systems Attn:
Plan Type: Auto
Paradigm Management Services, LLC
Affiliated With: Paradigm Management
Services, LLC
COMPENSABILITY
CONTACT EMPLOYER
Paradigm Health Claims Department
Paradigm Health (David Vargas)
1001 Galaxy Way Ste 300
Concord CA 94520
(925) 677-4719
UTILIZATION REVIEW
CONTACT EMPLOYER
Paradigm Health (David Vargas)
(925) 677-4719
(925) 677-4719
PARADISE VALLEY HOSPITAL - PPO
SYSTEM/WEST
PARAMETRIX
INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PARKVIEW HOSPITAL
WATERSTONE BENEFIT
WATERSTONE BENEFIT
CHECK BENEFIT CARD
(405) 440-8888
PO Box 619031
(405) 440-8888
Parsons Company
Affiliated With: OSF Healthplans Inc
PO Box 5128
(800) 673-5222
(800) 673-5222
(309) 677-8356
Network.
Info as of 12/24/2007
Page PIRMI-376
www.firsthealth.com
PAYOR NAME
PASO ROBLES JOINT UNIFIED
SCHOOL DISTRICT
PASSION PARTIES
CLAIMS SUBMISSION
OF UICI
PLANO TX 75075
COMPENSABILITY
OF UICI
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 767-0700
(800) 237-0903 Ext 6352
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
PAT CLARK ENTERPRISES TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
PATE CONSRUCTION CO. INC.
AMERICA
PATRICK INDUSTRIES, INC.
GROUP
PATRIOT HEALTHCARE - JMS
PLAN ADMINISTRATOR
501 N BROADWAY STE 500
ST. LOUIS MO 63102
(800) 394-6888
CHECK BENEFIT CARD
(800) 394-6888
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
EBPA
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
EBPA
CHECK BENEFIT CARD
(800) 578-3272
(800) 578-3272
Network.
Info as of 12/24/2007
Page PIRMI-377
www.firsthealth.com
PAYOR NAME
PATRIOT HOMES, INC
ADMINISTRATIVE SYSTEM
CLAIMS SUBMISSION
SYSTEMS
17475 JOVANNA DR
HOMEWOOD IL 60430
COMPENSABILITY
SYSTEMS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(708) 799-7400
(708) 799-7400
Patriot Risk Services
Affiliated With: TIMCO/Guarantee
Insurance Co
PAUL FISHER OIL COMPANY
KANSAS - 11297
PAUL G WHITE TILE COMPANY-PEPM
CHECK BENEFIT CARD
PO Box 520
(800) 235-7160
1061 521 Corporate Center Dr Ste 140
Fort Mill SC 29715
(800) 235-7160
HEALTH PLAN INC
HEALTH PLAN INC
PO Box 5199
(508) 752-2480
CARE MANAGEMENT
SERVICES
(866) 325-1550
(508) 752-2480
PAWN SHOP MANAGEMENT
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Payless ShoeSouce Inc
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
Network.
CONTACT EMPLOYER
Info as of 12/24/2007
Page PIRMI-378
www.firsthealth.com
PAYOR NAME
PAYROLL SOLUTIONS
CLAIMS SUBMISSION
C/O CCN
COMPENSABILITY
C/O CCN
UTILIZATION REVIEW
CHECK BENEFIT CARD
PO Box 3000
PBM Corp - EDI
Corporation
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
PBM Corp - Paper
Corporation
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Peace Corps Volunteers
Group, Inc.
CHECK BENEFIT CARD
407 N Fulton St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
PEACE RIVER CENTER FOR
PERSONAL DEVELOPMENT INC
CONSULTANTS INC
* PEARCE INDUSTRIES
(317) 655-4500 Outside US
(800) 628-4664 Inside US
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8002822460
Benefit Planners
Benefit Planners
PO Box 690450
(800) 292-5386
CHECK BENEFIT CARD
(800) 292-5386
Network.
Info as of 12/24/2007
Page PIRMI-379
www.firsthealth.com
PAYOR NAME
PEDDINGHAUS CORPORATION
CLAIMS SUBMISSION
GLOBALCARE
6875 SHILOH RD E
ALPHARETTA GA 30005
COMPENSABILITY
GLOBALCARE
UTILIZATION REVIEW
UM NOT APPLICABLE
(678) 341-1922
(678) 341-1922
PEGGY LAWTON KITCHENS, INC.
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
PELTRAM PLUMBING INC
Affiliated With: TRUSTED PLANS
SERVICE CORPORATION
CORPORATION
CORPORATION
PO Box 1984
TACOMA WA 98406
(253) 564-5850
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 877-7994
(253) 564-5850
Pemaquid Underwriting Brokerage
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
PENDER MEMORIAL HOSPITAL
Affiliated With: J SMITH LANIER &
COMPANY
J SMITH LANIER & CO
J SMITH LANIER & CO
(910) 480-3100
DOCTORS DIRECT
HEALTHCARE
(910) 480-3100
(910) 480-3100
PENMORE LITHOGRAPHERS - PEPM
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PENN WESTERN - NEW POSEIDON
ENTERPRISES
Affiliated With: GLOBALCARE INC
GLOBALCARE, INC.
GLOBALCARE, INC.
UM NOT APPLICABLE
6875 Shiloh Rd E
ALPHARETTA GA 30005
(678) 341-1922
(678) 341-1922
Network.
Info as of 12/24/2007
Page PIRMI-380
www.firsthealth.com
PAYOR NAME
PENN WESTERN -AMSOL
CLAIMS SUBMISSION
GLOBALCARE
COMPENSABILITY
GLOBALCARE
UTILIZATION REVIEW
(678) 341-1922
MEDCOST
(800) 722-2157
GLOBALCARE
GLOBALCARE
UM NOT APPLICABLE
6875 Shiloh Rd E
ALPHARETTA GA 30005
(678) 341-1922
6875 SHILOH RD E
ALPHARETTA GA 30005
(678) 341-1922
PENN WESTERN -AMSOL TRAVEL
NETWORK GEORGIA
(678) 341-1922
PENSACOLA CHRISTIAN COLLEGE
HEALTHCARE ALLIANCE
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PEPPERMILL HOTEL AND CASINO
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PEPPERMILL HOTEL CASINO
Affiliated With: PEPPERMILL HOTEL
CASINO
HOMETOWN HEALTH PROVIDERS
INSURANCE
HOMETOWN HEALTH PROVIDERS
INSURANCE
830 HARVARD WAY
RENO NV 89502
(775) 982-3039
HOMETOWN HEALTH
PROVIDERS INSURANCE
(775) 982-3039
CHECK BENEFIT CARD
PO Box 5227
Lisle IL 60532-5227
ECS Payor ID 37283
(800) 323-1726
7753526901
(775) 982-3039
Performance Bankers
Group
(800) 323-1726
Network.
Info as of 12/24/2007
Page PIRMI-381
www.firsthealth.com
PAYOR NAME
PERFORMANCE CONTRACTORS
PERFORMANCE HEALTH (PHA)
* PERMIAN MUD SERVICES INC
CLAIMS SUBMISSION
PREFERRED BENEFIT
ADMINISTRATORS INC
COMPENSABILITY
PREFERRED BENEFIT
ADMINISTRATORS INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
PO Box 916188
NHBC
NHBC
Scottsdale AZ 85260
(888) 621-7900
CHECK BENEFIT CARD
(888) 621-7900
Benefit Planners
Benefit Planners
PO Box 690450
(800) 292-5386
CHECK BENEFIT CARD
(800) 292-5386
PERRY POINT/BALTIMORE VA
MEDICAL CENTER 3131
SERVICES
PERRY POINT / BALTIMORE VA
MEDICAL CENTER
Attn: MAS/FEE SERVICES - 136
BLDG G 4H, RM 120
PERRY POINT MD 21902
PERRY POINT / BALTIMORE VA
MEDICAL CENTER
CHECK BENEFIT CARD
PERRYSBURG SCHOOL
MANAGEMENT CORP
(EBMC)
(EBMC)
CHECK BENEFIT CARD
4789 Rings Rd
(614) 766-5800
(614) 766-5800
PersonalCare Freedom PPO
Affiliated With: Coventry Health Care
PERSONALCARE
PERSONALCARE
PO Box 7141
LONDON KY 40742-7141
(800) 562-5792
PERSONALCARE
(800) 562-5792
(800) 562-5792
Network.
Info as of 12/24/2007
Page PIRMI-382
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
PERSONNEL MANAGEMENT, INC.
Affiliated With: SEABURY & SMITH, INC. (SEABURY & SMITH) C/O CCN
COMPENSABILITY
HEALTH CARE SAVINGS
UTILIZATION REVIEW
HEALTH CARE SAVINGS
PO Box 5190
TAMPA FL 33675-5190
Peter Chang Enterprises
Affiliated With: Peter Chang Enterprises
28530 Orchard Lake Rd Ste 101
Farmington Hills MI 48334
(248) 455-8972
(248) 455-8972
(248) 455-8972
PETERSON TRACTOR COMPANY
ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PHC OF NEVADA
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
HEALTH PLAN
(702) 242-7345
(702) 242-7700
PHILADELPHIA VAMC 3127
SERVICES
PHILADELPHIA VAMC
Attn: FEE BASIS 04F
UNIVERSITY & WOODLANDS AVE
PHILADELPHIA PA 19104
PHILADELPHIA VAMC
CHECK BENEFIT CARD
PHILCOR TV & ELECTRONIC TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
PHOENIX CEMENT COMPANY
CORESOURCE
CORESOURCE
PO Box 2920
(866) 280-4120
CORESOURCE
(866) 794-0770
(866) 280-4120
Network.
Info as of 12/24/2007
Page PIRMI-383
www.firsthealth.com
PAYOR NAME
PHOENIX COLOR CORPORATION
CONCEPTS BENEFIT CONCEPTS
* PHOENIX VAMC 3173
SERVICES
CLAIMS SUBMISSION
1021 W. 8TH AVE STE 200
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(610) 337-2600
(610) 337-2600
PHOENIX VAMC
Attn: FEE BASIS 136E5
620 E INDIAN SCHOOL RD
PHOENIX AZ 85012
PHOENIX VAMC
CHECK BENEFIT CARD
PHP HEALTH PLAN
Affiliated With: SHASTA
SHASTA ADMINISTRATIVE
SERVICES
SERVICES
SERVICES
PHP INDIVIDUAL PLANS
INC.
1011 SW EMKAY DR
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
PHP OF NORTHERN INDIANA ASO
2751 S.W. Airport Way
REDMOND OR 97756
(541) 312-8512
GLOBALCARE, INC.
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
8008601111
PHP Management
(800) 982-6257
6783411722
PHP SMALL GROUP
INC.
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
Network.
Info as of 12/24/2007
Page PIRMI-384
www.firsthealth.com
PAYOR NAME
PHYSICIANS HEALTH PLAN OF
NORTHERN INDIANA
PHYSICIANS MUTUAL INSURANCE
COMPANY-CARRIER
PHYSICIANS MUTUAL INSURANCE
COMPANY-MEICARE SELECT
Piccadilly Cafeterias, Inc.
Affiliated With: Benesight
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
6783411722
GILSBAR
GILSBAR
COVINGTON LA 70433
(985) 871-1863
CHECK BENEFIT CARD
(985) 871-1863
GILSBAR
GILSBAR
COVINGTON LA 70433
(985) 871-1863
CHECK BENEFIT CARD
(985) 871-1863
Piccadilly Cafeterias, Inc.
Benesight
PO Box 2467
Baton Rouge LA 70821
(800) 752-3473
CHECK BENEFIT CARD
(800) 752-3473
Pictorial Offset Corporation
(800) 831-7783
Capp Care
(800) 937-2277
CHECK BENEFIT CARD
450 E Remington Rd
Schaumburg IL 60173
(847) 519-1880
(800) 831-7783
PIERCE, COUCN, HENDRICKSON,
BAYSINGER & GREEN, LLP
ADMINISTRATORS, LTD.
(847) 519-1880
Network.
Info as of 12/24/2007
Page PIRMI-385
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
Piercy Bowler Taylor & Kern Travel
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
PINE STATE TRADING COMPANY JMS
PLAN ADMINISTRATORS
EBPA
Attn: Denise Oberg
PO Box 2000
Exeter NH 03833
EBPA
CHECK BENEFIT CARD
(800) 578-3272
(800) 578-3272
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Western Health
Western Health
Rapid City SD 57701
(605) 719-4600 or (888) 3411766
Western Health
(605) 719-4640 or (800) 2290892
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PINNACLE RESTAURANT GROUP, LLC
Affiliated With: PENN WESTERN
BENEFITS, INC.
C/O CCN
PINON COMMUNITY SCHOOL
Pioneer Manor
PIONEER TELEPHONE
Affiliated With: PIONEER TELEPHONE
PO Box 5190
TAMPA FL 33675-5190
PO Box 25160
(605) 719-4600 or (888) 3411766
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-386
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
Pipe
Maintenance
Travel
*
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
PITTSBURGH VA MEDICAL CENTER
3130
SERVICES
PITTSBURGH VA MEDICAL CENTER
Attn: FEE BASIS 04D4-H
7180 HIGHLAND DR
PITTSBURGH PA 15206
PITTSBURGH VA MEDICAL CENTER CHECK BENEFIT CARD
PIZZA HUT OF IDAHO
NORTH AMERICAN
ADMINISTRATORS-NY
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 9501
AMHERST NY 14226
(800) 397-2122
NORTH AMERICAN
ADMINISTRATORS-NY
(800) 397-2122
(800) 397-2122
PLAN HANDLERS INC
BENEFITS INC #11491
CENBEN USA
CENBEN USA
PO Box 612900
(888) 633-7879
CENTRAL BENEFITS
(800) 882-9889
SEABURY & SMITH/MARSH
ADVANTAGE AMERICA
ADVANTAGE AMERICA
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(888) 633-7879
PLAYBOY ENTERPRISES, INC.
Affiliated With: PLAYBOY
ENTERPRISES, INC.
ADVANTAGE AMERICA
PLAYLV GAMING OPERATION, LLC
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
PO Box 1520
IOWA CITY IA 52240
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-387
www.firsthealth.com
PAYOR NAME
PLEASANT VALLEY JT UNION
ELEMENTARY
PLUMB HOUSE INC.
CLAIMS SUBMISSION
OF UICI
PLANO TX 75075
COMPENSABILITY
OF UICI
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 767-0700
(800) 237-0903 Ext 6352
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
PLUMBERS PIPEFITTERS LOCAL
421 HEALTH WELFARE FUND
Affiliated With: CORE MANAGEMENT
RESOURCES GROUP INC
CHECK BENEFIT CARD
PLUMBERS AND PIPEFITTERS H AND
S FUND
Affiliated With: PLUMBERS AND
PIPEFITTERS H AND S FUND
LEO A. RILEY
LEO A. RILEY
141 S CENTER STE 200
CASPER WY 82601
(307) 266-2877
PMA Insurance Group The
Affiliated With: PMA Insurance Group
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8887412673
HEALTH SERVICES ADVISORY
GROUP
(602) 264-6382
(307) 266-2877
CONTACT EMPLOYER
(888) 476-2669
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
CHECK BENEFIT CARD
DALLAS TX 75251
(800) 827-7223
PO Box 25249
Lehigh Valley PA 18002-5249
(888) 476-2669
* PointBank (TRAVEL)
ADMINISTRATORS
(800) 827-7223
Network.
Info as of 12/24/2007
Page PIRMI-388
www.firsthealth.com
PAYOR NAME
POMPANOOSUC MILLS
CORPORATION
CLAIMS SUBMISSION
CORPORATION
PO Box 299
COMPENSABILITY
CORPORATION
(888) 322-2524
UTILIZATION REVIEW
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
POPLAR BLUFF VA MEDICAL
CENTER 3527
SERVICES
POPLAR BLUFF VA MEDICAL CNTER
Attn: FEE BASIS 04
1500 N WESTWOOD BLVD
POPLAR BLUFF MO 63901
POPLAR BLUFF VA MEDICAL CNTER CHECK BENEFIT CARD
POPULATION REFERENCE BUREAU
(PRB)
ASSURECARE
ASSURECARE
340 Quadrangle Dr
(800) 759-1311
PORT TOWNSEND PAPER
Careline UR
(763) 383-4800
(800) 759-1311
220 120th Ave Ste D200
Bellevue WA 98005
(425) 482-1000
(425) 482-1000
(425) 482-1000
PORTAGE ENVIRONMENTAL INC
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PORTAGE SCHOOLS TEACHERS AND
ADMINISTRATORS
SOLUTIONS
SERVICES
SERVICES
CHECK BENEFIT CARD
2959 LUCERNE DR
GRAND RAPIDS MI 48546
(800) 732-3412
(800) 732-3412
Network.
Info as of 12/24/2007
Page PIRMI-389
www.firsthealth.com
PAYOR NAME
PORTER COUNTY GOVERNMENT
Affiliated With: PORTER COUNTY
GOVERNMENT
PORTLAND STATE UNIVERSITY
CLAIMS SUBMISSION
STEWART C. MILLER
COMPENSABILITY
STEWART C. MILLER
UTILIZATION REVIEW
STEWART C. MILLER
PO Box 5769
LA FAYETTE IN 47903
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
(800) 786-7930
PORTLAND STATE UNIVERSITY
INTERNATIONAL
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
(800) 786-7930
PORTLAND VAMC 3178
SERVICES
PORTLAND VAMC
3710 SW US VETERANS HOSPITAL
RD
PORTLAND OR 97239
PORTLAND VAMC
CHECK BENEFIT CARD
PORTOLA PLAZA HOTEL AT
MONTEREY BAY
FISERV HEALTH INC
FISERV HEALTH INC
FISERV HEALTH INC
POS
INC.
PO Box 1229
(800) 673-5222
(800) 284-2273
PO Box 375
PUEBLO CO 81002
(800) 673-5222
Network.
Info as of 12/24/2007
Page PIRMI-390
www.firsthealth.com
PAYOR NAME
POST REGISTER
ADMINISTRATORS
POTANDON PRODUCE
ADMINISTRATION
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
St Louis MO 63101
(800) 394-6888
CLAIMS SUBMISSION
CHECK BENEFIT CARD
(314) 982-5616
POTOMAC ELECTRIC POWER
COMPANY (PEPCO)
Affiliated With: POTOMAC ELECTRIC
POWER COMPANY (PEPCO)
NATIONAL CLAIMS
ADMINISTRATIVE SERVICES, INC.
POUDRE VALLEY RURAL ELECTRIC
ASSOCIATION INC.
ZENITH ADMINISTRATORS C/O CCN
Affiliated With: MOUNTAIN MEDICAL
AFFILIATES (MMA)
POWER HOUSE GYM
ADMINISTRATORS
UTILIZATION REVIEW
NATIONAL CLAIMS
ADMINISTRATIVE SERVICES, INC.
PO Box 10104
FAIRFAX VA 22030
NATIONAL CLAIMS
ADMINISTRATIVE SERVICES,
INC.
ZENITH ADMINISTRATORS C/O CCN CHECK BENEFIT CARD
PO Box 3000
CAROLINA BENEFIT
ADMINISTRATORS
CAROLINA BENEFIT
ADMINISTRATORS
333 SOUTH PINE ST
(800) 476-2295
CHECK BENEFIT CARD
(800) 476-2295
POWER SHOT UTILITY
CONSTRUCTION SERVICES, LLC
SERVICE CENTER INC
GISC, INC
GISC, INC
20 WINTER ST
PEMBROKE MA 02359
(800) 242-4472
CHECK BENEFIT CARD
(800) 242-4472
Network.
Info as of 12/24/2007
Page PIRMI-391
www.firsthealth.com
PAYOR NAME
POWERWORKS INDUSTRIES, INC
BENEFIT SYSTEMS
CLAIMS SUBMISSION
SYSTEMS INC
COMPENSABILITY
SYSTEMS INC
UTILIZATION REVIEW
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
UNITED BENEFITS
UNITED BENEFITS
CHECK BENEFIT CARD
PO Box 2480
(386) 239-4350
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
PPI MOTORSPORTS LLC
DIVISION
(386) 239-4350
PRATT FEEDERS/BUFFALO FEEDERS THE EPOCH GROUP, LC
PO Box 12170
EPOCH GROUP LC THE
UM NOT APPLICABLE
(800) 255-6065
(800) 255-6065
WATERSTONE BENEFIT
WATERSTONE BENEFIT
(800) 816-6049
WATERSTONE UTILIZATION
MANAGEMENT
(800) 460-0238
PRECEPT MEDICAL PRODUCTS, INC. CBCA Administrators Inc
LONDON KY 40742
PREFERRED BENEFIT
ADMINISTRATORS
Affiliated With: PREFERRED PLUS OF
KANSAS INC
Preferred Plus of Kansas, Inc
8535 E 21st St North
Wichita KS 67206
(316) 609-2308
PREFERRED HEALTH
SYSTEMS
(800) 289-0345
PRATT REGIONAL MEDICAL CENTER
#962501227
(800) 816-6049
(316) 609-2308
Network.
Info as of 12/24/2007
Page PIRMI-392
www.firsthealth.com
PAYOR NAME
PREFERRED CARE
CLAIMS SUBMISSION
PREFERRED CARE
UTILIZATION REVIEW
PREFERRED CARE
TREVOSE PA 19053
PREFERRED HEALTH ALLIANCE
ALLIANCE
PREFERRED PLUS OF KANSAS INC
Affiliated With: PREFERRED PLUS OF
KANSAS INC / AHA
PREFERRED SOURCING
COMPENSABILITY
PREFERRED CARE
PREFERRED HEALTH
ALLIANCE
8535 E 21st St North
Wichita KS 67206
(316) 609-2308
PREFERRED HEALTH
SYSTEMS
(800) 424-0345
300 Corporate Pkwy, #3
BIRMINGHAM AL 35242
(316) 609-2308
MERITAIN HEALTH
MERITAIN HEALTH
PO Box 80884
(800) 824-8316
CHECK BENEFIT CARD
(800) 824-8316
PREMIER ACCESS (OUT OF AREA)
Affiliated With: PREMIER ACCESS
PREMIER ACCESS
PREMIER ACCESS
PO Box 150275
ARLINGTON TX 76015
(888) 463-4137
CHECK BENEFIT CARD
(888) 463-4137
PREMIER CLUB BENEFITS DBA BALD
CREEK COLONY CLUB
MBA OF MARYLAND
MBA OF MARYLAND
3103 EMMORTON RD
ABINGDON MD 21009
(410) 505-0507
STRATEGIC HEALTH
DEVELOPMENT
(410) 505-0507
PREMIER CLUB BENEFITS DBA BOCA MBA OF MARYLAND
LAGO COUNTRY CLUB, INC.
3103 EMMORTON RD
ABINGDON MD 21009
(410) 505-0507
MBA OF MARYLAND
(410) 505-0507
Network.
STRATEGIC HEALTH
DEVELOPMENT
Info as of 12/24/2007
Page PIRMI-393
www.firsthealth.com
PAYOR NAME
Premier Control Services
PREMIER LABORATORY LLC
CLAIMS SUBMISSION
CONTACT EMPLOYER
Attn:
COMPENSABILITY
CONTACT EMPLOYER
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
UTILIZATION REVIEW
CONTACT EMPLOYER
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
NETWORK, INC.
NETWORK, INC.
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
CHECK BENEFIT CARD
PO Box 42096
(800) 825-3540
PREMIER MANUFACTURING
CORPORATIONS
BENEFITS NETWORK, INC.
NETWORK, INC.
PREMIER RESORTS INTERNATIONAL
INC
SOLUTIONS
PREMIUM BEERS OF OKLAHOMA
ADMINISTRATORS
19800 Detroit Rd.
ROCKY RIVER OH 44116
(800) 825-3540
PREMIUM STANDARD FARMS
SERVICES, INC. A DIVISION OF
CORESOURC
PO Box 25946
(800) 990-9058
HCM
(800) 990-9058
(800) 990-9058
Network.
Info as of 12/24/2007
Page PIRMI-394
www.firsthealth.com
PAYOR NAME
PRENT CORPORATION
ADMINISTRATORS INC
PRESBYTERIAN INTERCOMMUNITY
HOSPITAL
INSURANCE SERVICES
CLAIMS SUBMISSION
MIDWEST SECURITY
COMPENSABILITY
MIDWEST SECURITY
UTILIZATION REVIEW
MIDWEST SECURITY
PO Box 574
ONALASKA WI 54650
SERVICES, INC.
SERVICES, INC.
PO Box 15165
SANTA ANA CA 92735
(714) 540-5882
PHYSICIAN CARE OF
CALIFORNIA
(714) 540-5882
(714) 540-5882
PRESCOTT VAMC (N ARIZONA) 3175
SERVICES
PRESCOTT VAMC
Attn: FEE - 144BF
500 HWY 89 NORTH
PRESCOTT AZ 86313
PRESCOTT VAMC
CHECK BENEFIT CARD
PRESS SEAL GASKET
ASSURECARE
ASSURECARE
LANSING MI 38823
(800) 968-6616
CARELINE
(763) 383-4800
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 968-6616
PRETIUM PACKAGING LLC
C
CHECK BENEFIT CARD
PRICE EDWARDS, HENDERSON & CO EQUITABLE PLAN SERVICES
PO Box 720460
SERVICES
(405) 755-2929
(405) 755-2929
Network.
Info as of 12/24/2007
Page PIRMI-395
www.firsthealth.com
PAYOR NAME
PRIDE
CLAIMS SUBMISSION
America's TPA
PO Box 398220
COMPENSABILITY
America's TPA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(952) 896-1255
(952) 896-1255
PRIDE FEEDERS I LTD COMPANY
INC
KEMPTON GROUP
ADMINISTRATORS INC
KEMPTON GROUP
ADMINISTRATORS INC
PO Box 54889
(405) 521-1711
CHECK BENEFIT CARD
(405) 521-1711
PRIMARY PROVIDER MANAGEMENT
COMPANY, INC.
Affiliated With: PRIMARY PROVIDER
MANAGEMENT COMPANY, INC.
PRIMERA HEALTHCARE SERVICES,
INC
PRIMARY PROVIDER MANAGEMENT
COMPANY, INC.
2525 Camino del Rio South Ste 300
San Diego CA 92108
PRIMARY PROVIDER MANAGEMENT PRIMARY PROVIDER
MANAGEMENT COMPANY, INC
COMPANY, INC.
(909)
778-6118
(619) 742-3223
(619) 742-3223
MSO, INC. OF SOUTHERN
CALIFORNIA
MSO, INC. OF SOUTHERN
CALIFORNIA
2360 HUNTINGTON DR
SAN MARINO CA 91108
(626) 656-2370
CHECK BENEFIT CARD
(626) 656-2370
GROUP
PRINTING SPEC. & PAPER PRODS.
JOINT EMP/UNION HLTH & WEL
Affiliated With: PRINTING SPEC. &
PAPER PRODS. JOINT EMP/UNION
HLTH
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
NORTHWEST ADMINISTRATORS,
INC
NORTHWEST ADMINISTRATORS,
INC
2323 Eastlake Avenue East
Seattle WA 98102
(206) 726-3259
UNICARE
(800) 762-3029
(206) 726-3259
Network.
Info as of 12/24/2007
Page PIRMI-396
www.firsthealth.com
PAYOR NAME
Procura
CLAIMS SUBMISSION
Procura
COMPENSABILITY
CONTACT EMPLOYER
UTILIZATION REVIEW
CONTACT EMPLOYER
2435 Blvd of the Generals Ste 201
Norristown PA 19403
(610) 290-7202
PRODUCTION METAL FORMING, INC.
INC.
PROFESIONAL ELECTRICAL
CONTRACTORS OF CT, INC.
PROFESSIONAL OFFICE SERVICES,
INC.
ADMINISTRATOR
* Professional Performance Development
Corporation
ADMINISTRATORS
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
(541) 312-8512
HEALTH PLAN INC
HEALTH PLAN INC
(508) 752-2480
CMS
(866) 325-1550
CHECK BENEFIT CARD
St Louis MO 63101
(800) 394-6888
(508) 752-2480
(800) 394-6888
Attn: Mary Shepherd
PO Box 489
(800) 967-2077
MEDCAREONE CORP
(800) 816-1206
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(918) 967-2077
Progressive Insurance (Auto)
Plan Type: Auto
CHECK BENEFIT CARD
Progressive: Administered by Mitchell
Medical
Network.
Info as of 12/24/2007
Page PIRMI-397
www.firsthealth.com
PAYOR NAME
Progressive Insurance Company
Affiliated With: Progressive Insurance
Company
CLAIMS SUBMISSION
Accordia National
PO Box 3262
CHARLESTON WV 25332
COMPENSABILITY
Accordia National
(800) 428-1291
UTILIZATION REVIEW
Accordia National
(800) 428-1291
(800) 428-1291
PROGRESSIVE MEDICAL INC
BENEFITS INC
CONSULTANTS INC
CONSULTANTS INC
(800) 521-2654
PROJECT ADVENTURES
HEALTH PLAN INC
HEALTH PLAN INC
(508) 752-2480
CHECK BENEFIT CARD
CARE MANAGEMENT
SERVICES
(866) 325-1550
(508) 752-2480
PROLOG SERVICES
ASSURECARE
ASSURECARE
340 Quadrangle Dr
(800) 759-1311
Careline UR
(763) 383-4800
(800) 759-1311
PROVIDENCE AND WORCESTER
RAILROAD
PROVIDENCE COLLEGE
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
OF UICI
OF UICI
2301 PLANO
PLANO TX 75075
(800) 767-0700
STUDENT INSURANCE A
DIVISION OF UICI
(800) 767-0700
Network.
Info as of 12/24/2007
Page PIRMI-398
www.firsthealth.com
PAYOR NAME
PROVIDENCE VA MEDICAL CENTER
3114
SERVICES
CLAIMS SUBMISSION
UTILIZATION REVIEW
COMPENSABILITY
CHECK
BENEFIT CARD
5504 HILL HEAVEN CT
FRISCO TX 75035
Providence Washington
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
PROVIDER NETWORKS OF
AMERICA - PEPM
Affiliated With: PROVIDER NETWORKS
OF AMERICA
AMERICA, INC
AMERICA, INC
CHECK BENEFIT CARD
PO Box 850778
RICHARDSON TX 75085
(817) 417-2839
PUGET SOUND FREIGHT LINES
INC.
(817) 417-2839
PO Box 85008
BELLEVUE WA 98015
(800) 869-7093 Ext 117
(425) 462-1000 Ext 400
(800) 869-7093 Ext 117
PUGET SOUND VA HCS AMERICAN
LAKE DIVISION 3179
SERVICES
PUGET SOUND VA HCS - AMIRICAN
LAKE DIVISION
Attn: A-136-FEE
9600 VETERANS DR
TACOMA WA 98493
PUGET SOUND VA HCS - AMIRICAN CHECK BENEFIT CARD
LAKE DIVISION
PULLEN AND ASSOCIATES
TENNESSEE
PO Box 530
(800) 255-8109
INTRACORP
(800) 866-8899
(800) 255-8109
Network.
Info as of 12/24/2007
Page PIRMI-399
www.firsthealth.com
PAYOR NAME
PULMONARY ASSOCIATES
SOLUTIONS LLC
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
8884191094
UTILIZATION REVIEW
ADVANCED BENEFITS
SOLUTIONS
PYROMATION, INC.
ADMINISTRATOR - NY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
QUAIL MOUNTAIN PEPSI COLA
INC.
BEND OR 97702
(541) 312-8512
CARE
(541) 883-2947
QUALITY PROJECT MANAGEMENT
SYSTEMS
QUALITY WOOD PRODUCTS
(541) 312-8512
PO Box 495
Stockton CA 95201
(209) 939-3992
MEDICAL CARE
(602) 417-2337
(209) 939-3992
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Quanta Services Group
Affiliated With: Gallagher Benefit
Administrators, Inc.
Quanta Services Group
Gallagher Benefit Administrators Inc
PO Box 8429
(800) 323-1726
IntraCorp
(800) 535-5222
(800) 323-1726
Network.
Info as of 12/24/2007
Page PIRMI-400
www.firsthealth.com
PAYOR NAME
QUANTUM SERVICES
ADMINISTRATORS AND
CONSULTANTS
QUECHAN TRIBE - PARADISE
CASINOS
CLAIMS SUBMISSION
BAC
COMPENSABILITY
BAC
(614) 863-8780
UTILIZATION REVIEW
BAC
(614) 863-8780
(614) 863-8780
SRT ADMINISTRATORS
SRT ADMINISTRATORS
PO Box 25160
(888) 690-2020
Action HealthCare
(800) 433-6915
NORTH AMERICA
NORTH AMERICA
HEALTH WATCH
(972) 238-7900
(888) 690-2020
QUEST PHARMACEUTICALS, INC.
NORTH AMERICA
QUICKSILVER RESOURCES, INC
Affiliated With: GROUP & PENSIONS
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
DALLAS TX 75251
(800) 827-7223
PO Box 1984
NASHVILLE TN 37202
(800) 827-7223 Ext 2325
QUIK PRINT/DOCUMART
SERVICES
QUINCY COMPRESSOR DIVISION
SALES UNIT
C
PO Box 720460
(405) 755-2929
CHECK BENEFIT CARD
(405) 755-2929
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8002556065
Network.
Info as of 12/24/2007
Page PIRMI-401
www.firsthealth.com
PAYOR NAME
QUINNIPIAC COLLEGE SPORTS
CONCEPTS INC
Quixote Corporation
Group
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
PO Box 5227
LISLE IL 60532
ECS Payor ID 37283
(800) 323-1726
UTILIZATION REVIEW
CHECK BENEFIT CARD
Inc.
(800) 538-5222
(800) 323-1726
R & B EXPRESS
* R & R JANITORIAL PAINTING &
BUILDING SERVICES INC
PO Box 520
(800) 235-7160
AVIDYN HEALTH
(866) 802-1328
(800) 235-7160
(800) 899-9355
(800) 899-9355
R AND O CONSTRUCTION
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
R G RAY CORPORATION
SYSTEMS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
3129068080
Network.
Info as of 12/24/2007
Page PIRMI-402
www.firsthealth.com
PAYOR NAME
RADIO FREQUENCY COMPANY
CLAIMS SUBMISSION
CORPORATION
PO Box 299
COMPENSABILITY
CORPORATION
(888) 322-2524
UTILIZATION REVIEW
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
RAIN FOR RENT
LTD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
RAM
Affiliated With: Liberty
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
RAMAHA NAVAJO CHAPTER
CONSULTANTS INC
CHECK BENEFIT CARD
PO Box 285
PEORIA IL 61650
(800) 447-3227
RAMPART RESORT MANAGEMENT
(309) 673-7330
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
RAMSEY INDUSTRIES, INC
THE EPOCH GROUP
THE EPOCH GROUP
6717 SHAWNEE MISSION PARKWAY
(800) 255-6065
THE EPOCH GROUP
(800) 255-6065
(800) 255-6065
Network.
Info as of 12/24/2007
Page PIRMI-403
www.firsthealth.com
PAYOR NAME
RANCHO SAN MARCOS
SOLUTIONS
Rapid Chevrolet
RATH MANUFACTURING
ADMINISTRATORS INC
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
Western Health
Western Health
Rapid City SD 57701
(605) 719-4600 or (888) 3411766
Western Health
(605) 719-4640 or (800) 2290892
MIDWEST SECURITY
MIDWEST SECURITY
(800) 831-7783
Capp Care
(800) 937-2277
EMPLOYEE BENEFIT
CHECK BENEFIT CARD
(605) 719-4600 or (888) 3411766
MIDWEST SECURITY
PO Box 574
ONALASKA WI 54650
Rayonier Inc.
(800) 831-7783
RAYPAK, INC.
RCI
NHBC
NHBC
Scottsdale AZ 85260
(888) 621-7900
PO Box 3000
(888) 621-7900
Network.
Info as of 12/24/2007
Page PIRMI-404
www.firsthealth.com
PAYOR NAME
RDT EMPLOYEE BENEFIT TRUST
CLAIMS SUBMISSION
Services
TUCSON AZ 85710
COMPENSABILITY
Services
UTILIZATION REVIEW
(847) 214-2780
(520) 722-7133
(520) 722-7133
REAL SERVICES
ADMINISTRATORS
NORTH AMERICA
NORTH AMERICA
PO Box 1984
NASHVILLE TN 37202
(800) 411-3650
MED-CERT
(800) 356-7126
(800) 411-3650
RED INC
ADMINISTRATORS
RED MESA UNIFIED SCHOOL
DISTRICT - PEPM
ADMINISTRATORS, INC
(801) 261-5511
SERVICE ADVOCATES
(877) 261-5511
(801) 261-5511
14646 N. Kierland Blvd
(480) 505-0424
(800) 528-2498
(480) 505-0424
REDBUD COMMUNITY HOSPITAL
SYSTEM/WEST
C/O CCN
ADVENTIST HEALTH SYSTEM/WEST CHECK BENEFIT CARD
C/O CCN
REDGINTON-FAIRVIEW GENERAL
HOSPITAL
BENEFIT ADMINISTRATORS INC.
ADMINISTRATOR
ADMINISTRATOR
PO Box 2365
(800) 525-8788
PO Box 3000
CHECK BENEFIT CARD
(800) 525-8788
Network.
Info as of 12/24/2007
Page PIRMI-405
www.firsthealth.com
PAYOR NAME
REED COLLEGE
CLAIMS SUBMISSION
PERSONAL INSURANCE
ADMINISTRATORS
COMPENSABILITY
PERSONAL INSURANCE
ADMINISTRATORS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 468-4343
(800) 468-4343
Regional Health
Affiliated With: Western Health
Western Health
Western Health
Rapid City SD 57701
(605) 719-4600 or (888) 3411766
Western Health
(605) 719-4640 or (800) 2290892
(605) 719-4600 or (888) 3411766
REGIONAL MEDICAL
ADMINISTRATORS
REGIS COLLEGE
* RELIEF ENTERPRISE, INC.
RELIGIOUS COMP TRUST/HMSRCHRISTIAN BROTHER SERVICES
GROUP
GLOBALCARE, INC.
GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
8008601111
GLOBALCARE
8008601111
STUDENT RESOURCES
STUDENT RESOURCES
CHECK BENEFIT CARD
PLANO TX 75075
(800) 237-0903 Ext 6352
6783411722
(800) 237-0903 Ext 6352
(800) 899-9355
(800) 899-9355
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
Network.
Info as of 12/24/2007
Page PIRMI-406
www.firsthealth.com
PAYOR NAME
REMEC
CLAIMS SUBMISSION
EBA&M
PO Box 5079
COMPENSABILITY
EBA&M
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 776-1545
(800) 776-1545
* REMINGTON ARMS COMPANY INC
PARTY ADMINISTRATOR
Accordia National
Accordia National
PO Box 3262
CHARLESTON WV 25332
(888) 685-7774
CHECK BENEFIT CARD
(888) 685-7774
RENO VAMC 3186
SERVICES
RENO VAMC
Attn: FEE BASIS 04FB
1000 LOCUST ST
RENO NV 89502
RENO VAMC
CHECK BENEFIT CARD
RENY Company
CompIQ Corporation
CompIQ Corporation
CONTACT EMPLOYER
2 South Pointe
(800) 293-3131
(800) 293-3131
RENY Company The
Affiliated With: RENY Company The
RENY Company The
RENY Company The
16610 Dallas Parkway Ste 2400
Dallas TX 75248
(972) 250-0189
RENY Company The
(972) 250-0189
(972) 250-0189
REPUBLIC MORTGAGE TRAVEL PLAN
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
REPUBLIC MORTGAGE, LLC
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-407
www.firsthealth.com
PAYOR NAME
REPUBLIC PARKING SYSTEMS, INC.
SERVICES, INC.
RESOURCE MANAGEMENT INC
CLAIMS SUBMISSION
ACS BENEFIT SERVICES, INC.
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UTILIZATION REVIEW
PO Box 2000
CHECK BENEFIT CARD
8007773575
RESTAURANT CONCEPTS INC
APPALACHIAN BENEFITS
Affiliated With: PPALACHAIN BENEFITS PO Box 780
STOCKTON CA 94565
APPALACHIAN BENEFITS
CHECK BENEFIT CARD
(828) 926-4040
(828) 926-4040
RETALIX USA
Affiliated With: CENBEN USA INC /
HEALTHSCOPE
CENBEN USA
4079 Executive Pkwy
CENBEN USA
CHECK BENEFIT CARD
(614) 797-5204
(614) 797-5204
REVIEW MED L.P.
Review Med
Review Med
10300 N Central Expressway Ste 450
Dallas TX 75231
(214) 696-3855
Review Works AUTO
Affiliated With: Review Works
Plan Type: Auto
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
RGIS INVENTORY SPECIAL
GROUP
CHECK BENEFIT CARD
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
Network.
Info as of 12/24/2007
Page PIRMI-408
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
THE LOOMIS COMPANY
RHODE & SCHWARZ, INC
COMPENSABILITY
THE LOOMIS COMPANY
UTILIZATION REVIEW
(800) 346-1223
HINES & ASSOCIATES
(888) 826-5769
(800) 346-1223
RHODE ISLAND COLLEGE SPORTS
CONCEPTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
RHODE ISLAND SCHOOL OF DESIGN
KLAIS & COMPANY INC
KLAIS & COMPANY INC
CHECK BENEFIT CARD
1867 W MARKET ST
AKRON OH 44313
(330) 867-8443
(330) 867-8443
RHODES INTERNATIONAL INC
ADMINISTRATORS INC
PO Box 19002
PROVO UT 84605-9002
(800) 286-4160
CHECK BENEFIT CARD
(800) 286-4160
RHYTHM & HUES, INC.
RICHMOND (H HOLMES MCGUIRE)
VA 3137
SERVICES
VA
Attn: FEE 04A
1201 BROAD ROCK BLVD
RICHMOND VA 23249
HINES & ASSOCIATES
(800) 528-2498
VA
CHECK BENEFIT CARD
PO Box 3000
Network.
Info as of 12/24/2007
Page PIRMI-409
www.firsthealth.com
PAYOR NAME
RIDLEYS SUPERMARKETS INC
ADMINISTRATORS INC
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
(801) 261-5511
SERVICE ADVOCATES
(801) 261-5511
CONTACT EMPLOYER
CONTACT EMPLOYER
RINGLING SCHOOL OF ART AND
DESIGN - AMH9076276
PO Box 2438
CORP #14005
(800) 722-1668
CHECK BENEFIT CARD
RIO ALGOM MINING CORPORATION
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
RIMCO
3761 S 700 E SUITE 202
(801) 261-5511
CONTACT EMPLOYER
(888) 722-1668
CHECK BENEFIT CARD
(800) 825-3540
RIO GRANDE ACTIVE EMPLOYEES
HOSPITAL ASSOCIATION
Affiliated With: RIO GRANDE
EMPLOYEES HOSPITAL
ASSOCIATION
RIO GRANDE EMPLOYEES
Risk Administration Services Inc
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
1675 Carr St. #200-S
LAKEWOOD CO 80215
Network.
Info as of 12/24/2007
Page PIRMI-410
www.firsthealth.com
PAYOR NAME
Risk Administration Services, Inc.
CLAIMS SUBMISSION
3900 W 53rd St
Sioux Falls SD 57109-1008
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(605) 361-5701
(605) 361-5701
Risk Enterprise Management
Affiliated With: Risk Enterprise
Management
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
RISK REDUCTION
NHBC
NHBC
CHECK BENEFIT CARD
Scottsdale AZ 85260
(888) 621-7900
RITE HITE HOLDING CORPORATION
CONSULTANTS
RITEMADE PAPER CONVERTERS
(888) 621-7900
EMPLOYEE BENEFIT CONSULTANTS EMPLOYEE BENEFIT CONSULTANTS AHH/EBC REVIEW
PO Box 928
(800) 558-7798
FINDLAY OH 45839
(800) 558-7798
THE EPOCH GROUP, LC
THE EPOCH GROUP, LC
PO Box 12170
(800) 255-6065
UM NOT APPLICABLE
(800) 255-6065
RITTAL CORP.
Affiliated With: UNDERWRITERS
SAFETY & CLAIMS, INC.
UNDERWRITERS SAFETY & CLAIMS
PO Box 23507
LOUISVILLE KY 40223
UNDERWRITERS SAFETY & CLAIMS UNDERWRITERS SAFETY &
CLAIMS
Network.
Info as of 12/24/2007
Page PIRMI-411
www.firsthealth.com
PAYOR NAME
RIVERSIDE COMMUNITY COLLEGE
Affiliated With: RIVERSIDE
COMMUNITY COLLEGE
RIVERSIDE GENERAL HOSPITAL
Affiliated With: PHYSICIAN CHOICE
NETWORK LLC
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
SELECT BENEFIT ADMINISTRATORS
OF AMERICA
SELECT BENEFIT ADMINISTRATORS CHECK BENEFIT CARD
OF AMERICA
Laguna Springs Dr Ste 320
Elk Grove CA 95758
(916) 226-2020
(916) 226-2020
RIVERSIDE SAN BERNARDINO CNTY
INDIAN HEALTH INC
Affiliated With: RIVERSIDE SAN
BERNARDINO CNTY INDIAN HEALTH
CLINIC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
RIVERSIDE-SAN BERNARDINO
COUNTY INDIAN HEALTH, INC.
Affiliated With: PRIMARY PROVIDER
MANAGEMENT COMPANY
ACCESS HEALTH DIRECT
9275 SKY PARK CT STE 400
SAN DIEGO CA 92123
(858) 467-7630
(951) 778-6118
RMSCO
Affiliated With: RMSCO INC
(858) 467-7630
RMSCO INC
RMSCO INC
115 CONTINUUM DR
LIVEPOOL NY 13088
(315) 448-9000
RMSCO INC
(315) 448-9000
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(315) 448-9000
RO MAC LUMBER SUPPLY INC
CONSULTANTS INC
CHECK BENEFIT CARD
8639674139
Network.
Info as of 12/24/2007
Page PIRMI-412
www.firsthealth.com
PAYOR NAME
ROBERT C BOUK-MERCANTILE
BANCORP, INC
CLAIMS SUBMISSION
GLOBALCARE
6875 SHILOH RD E
ALPHARETTA GA 30005
COMPENSABILITY
GLOBALCARE
UTILIZATION REVIEW
CHECK BENEFIT CARD
(678) 341-1811
(678) 341-1811
ROBERT F KENNEDY MEDICAL PLAN
Affiliated With: ROBERT F KENNEDY
MEDICAL PLAN
CHECK BENEFIT CARD
ROBERT MANN PACKAGING
COASTAL HEALTHCARE
ADMINISTRATORS
ROBERTS BROTHERS REALTORS
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8003216607
COASTAL HEALTHCARE
ADMINISTRATORS
COASTAL HEALTHCARE
ADMINISTRATORS
CAROLINA BENEFIT
ADMINISTRATORS
CAROLINA BENEFIT
ADMINISTRATORS
CHECK BENEFIT CARD
333 SOUTH PINE ST
(800) 476-2295
PO Box 80308
SALINAS CA 93912
(800) 476-2295
* Rochester
Insurance Fund
ROCK COUNTY
ADMINISTRATORS INC
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
MIDWEST SECURITY
MIDWEST SECURITY
MIDWEST SECURITY
PO Box 574
ONALASKA WI 54650
Network.
Info as of 12/24/2007
Page PIRMI-413
www.firsthealth.com
PAYOR NAME
ROCKHURST UNIVERSITY
CLAIMS SUBMISSION
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
COMPENSABILITY
AMERIBEN SOLUTIONS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 953-1801
(800) 953-1801
ROCKWAY INC
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
ROCKY MOUNTAIN CARE
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ROCKY MOUNTAIN CHOCOLATE
FACTORY, INC.
PO Box 8046
CHECK BENEFIT CARD
(715) 841-7802
(715) 841-7802
ROCKY MOUNTAIN THERAPY
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Rocor International
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
Network.
Info as of 12/24/2007
Page PIRMI-414
www.firsthealth.com
PAYOR NAME
RODMAN COMPANIES
ADMINISTRATORS
CLAIMS SUBMISSION
GROUP & PENSION
ADMINISTRATORS INC
DALLAS TX 75251
COMPENSABILITY
GROUP & PENSION
ADMINISTRATORS INC
UTILIZATION REVIEW
HEALTH WATCH
(972) 238-7900
(800) 827-7223
(972) 238-7900
ROGER WILLIAMS UNIVERSITY
HEALTH PLANS
195 STAFFORD ST
(800) 633-7867
CHECK BENEFIT CARD
(800) 633-7867
ROHRER CORPORATION
BENEFIT SERVICES, INC.
Affiliated With: BENEFIT SERVICES INC 3636 COPLEY RD
AKRON OH 44216
RONNOCO SPECIALTY COFFEE
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
8003673762
Med-Valu
(800) 349-8587
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
ROSE HULMAN - DOMESTIC
Affiliated With: COMMERCIAL
TRAVELERS MUTUAL INSURANCE
COMPANY
ROSE HULMAN - INTERNATIONAL
COMPANY
COMMERCIAL TRAVELERS
70 GENESEE ST
UTICA NY 13502
(800) 756-3702
CHECK BENEFIT CARD
(800) 756-3702
70 GENESEE ST
UTICA NY 13502
(800) 756-3702
CHECK BENEFIT CARD
(800) 756-3702
Network.
Info as of 12/24/2007
Page PIRMI-415
www.firsthealth.com
PAYOR NAME
ROSE HULMAN - SPORTS
COMPANY
ROSEBURG VA HCS 3180
SERVICES
ROSENS DIVERSIFIED, INC
ROSENSTEIN FIST AND RINGOLD
ADMINISTRATORS
CLAIMS SUBMISSION
70 GENESEE ST
UTICA NY 13502
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 756-3702
(800) 756-3702
2025 AEROJET RD
(916) 985-1259
CHECK BENEFIT CARD
(916) 985-1259
SISCO
SISCO
PO Box 389
(800) 457-4726
CHECK BENEFIT CARD
(800) 457-4726
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
ROTATION DYNAMICS CORP.
COMPANY (SISCO)
COMPANY (SISCO)
PO Box 389
(319) 583-7301 Ext 285
CHECK BENEFIT CARD
(319) 583-7301 Ext 285
ROTATIONAL MOLDING
TECHNOLOGIES
Affiliated With: BENEFITS SERVICES,
INC.
3636 Copley Rd
Akron OH 44321
(800) 367-3762
CHECK BENEFIT CARD
(800) 367-3762
Network.
Info as of 12/24/2007
Page PIRMI-416
www.firsthealth.com
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 536
ROCKLAND MA 02370
(781) 753-7559
PAYOR NAME
CLAIMS SUBMISSION
ROUGH ROCK COMMUNITY SCHOOL SRT ADMINISTRATORS, INC.
PO Box 25160
ROYAL INSTITUTIONAL SERVICES
PAWTUCKET ANGELICA
MANAGEMENT
ROYAL OAKS
ADMINISTRATORS
UTILIZATION REVIEW
(781) 753-7559
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
DALLAS TX 75251
(800) 827-7223
HEALTH WATCH
(972) 238-7900
(972) 238-7900
RPM MANAGEMENT, INC
ADMINISTRATORS AND
CONSULTANTS
* RS STAFFING
RS STAFFING
ADMINISTRATORS
BAC
BAC
(614) 863-8780
BAC
(614) 863-8780
(614) 863-8780
(800) 899-9355
(800) 899-9355
(800) 899-9355
(800) 899-9355
Network.
Info as of 12/24/2007
Page PIRMI-417
www.firsthealth.com
COMPENSABILITY
EMPLOYEE BENEFIT
RSKCO Cunningham and Lindsey
CONTACT EMPLOYER
Channeling
Attn:
Affiliated With: RSKCO Cunningham and
Lindsey
CONTACT EMPLOYER
CONTACT EMPLOYER
RSVP TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
PAYOR NAME
RSA-USA, INC.
CLAIMS SUBMISSION
EMPLOYEE BENEFITS
UTILIZATION REVIEW
30501 Agoura Rd. #101
(702) 242-7700
RUIZ FOOD PRODUCTS
SYSTEMS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
RUSH UNIVERSITY
Affiliated With: JOHN RILEY
INSURANCE
JOHN RILEY INSURANCE
Attn: SUSAN RINDFLEISCH
JOHN RILEY INSURANCE
(800) 541-1101
(800) 246-4127
CHECK BENEFIT CARD
PO Box 720460
(405) 755-2929
PO Box 356
WEST BOYLSTON MA 01453
(800) 541-1101
RUSTIN CONCRETE
SERVICES
(405) 755-2929
Network.
Info as of 12/24/2007
Page PIRMI-418
www.firsthealth.com
PAYOR NAME
RYAN BUILDING GROUP
SYSTEMS, INC.
CLAIMS SUBMISSION
CHICAGO IL 60604
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(312) 906-8080 Ext 259
(312) 906-8080 Ext 259
INC.
BENEFIT SYSTEMS &
SERVICES, INC.
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
SABROSO COMPANY
ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SAC FINANCE
ASSURECARE
ASSURECARE
LANSING MI 38823
(800) 968-6616
CARELINE
(763) 383-4800
S E T ENVIRONMENTAL, INC.
Affiliated With: BENEFIT SYSTEMS &
SERVICES, INC.
INC.
S U A Insurance Company
Affiliated With: S U A Insurance
Company
WESTMONT IL 60559
(800) 968-6616
SADDLEBACK COLLEGE
PERSONAL INSURANCE
ADMINISTRATORS
PERSONAL INSURANCE
ADMINISTRATORS
(800) 468-4343
CHECK BENEFIT CARD
(800) 468-4343
Network.
Info as of 12/24/2007
Page PIRMI-419
www.firsthealth.com
PAYOR NAME
SADDLEBACK VALLEY COMMUNITY
CHURCH
ADMINISTRATORS INC
* Safety Group Office 1
Insurance Fund
* Safety Group Office 2
Insurance Fund
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
8004427247
8005287936
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
199 Church St
New York NY 10007
(212) 312-7306
199 Church St
New York NY 10007
(212) 312-7306
SAFEWAY
SAFEWAY
SAFEWAY
(925) 467-3828
SAFEWAY
(925) 467-3828
5918 Stoneridge Mall Rd.
Pleasanton CA 94588-3229
MERITAIN HEALTH
MERITAIN HEALTH
CHECK BENEFIT CARD
19800 Detroit Rd.
(877) 801-1500
(925) 467-3828
SAFY
(877) 801-1500
Sagamore Insurance Company
Affiliated With: GENEX Services, Inc
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
Network.
CONTACT EMPLOYER
Info as of 12/24/2007
Page PIRMI-420
www.firsthealth.com
PAYOR NAME
SAGE PUBLICATIONS
PARTY ADMOINISTRATORS
SAGEBRUSH - RHODES HOMES
CLAIMS SUBMISSION
HEALTHCOMP TPA
PO Box 45018
Fresno CA 93718
COMPENSABILITY
HEALTHCOMP TPA
(800) 442-7247
UTILIZATION REVIEW
HEALTHCOMP TPA
(800) 755-7247
(800) 442-7247
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
SAGEBRUSH-TRAVEL
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
SAGINAW VA MEDICAL CENTER 3158
SERVICES
* SAIA BURGES AUTOMOTIVE
CURATORS
PARTY ADMINISTRATOR
SAINT FRANCIS UNIVERSITY
CONCEPTS INC
SAGINAW VA MEDICAL CENTER
1500 WEISS ST
SAGINAW MI 48602
SAGINAW VA MEDICAL CENTER
CHECK BENEFIT CARD
ACORDIA NATIONAL
ACORDIA NATIONAL
CHECK BENEFIT CARD
(888) 685-7774
(888) 685-7774
WAYNE PA 19087-1706
UM NOT APPLICABLE
(888) 293-9229
(888) 293-9229
Network.
Info as of 12/24/2007
Page PIRMI-421
www.firsthealth.com
PAYOR NAME
SAINT MARTIN'S COLLEGE
ATHLETICS
INSURANCE SERVICES
CLAIMS SUBMISSION
SERVICES
UTILIZATION REVIEW
SERVICES
5001 College Blvd., #216
LEAWOOD KS 66211
EMPLOYEE BENEFIT
ADMINISTRATORS
CHECK BENEFIT CARD
SALEM VAMC
Attn: FEE BASIS 04H
1970 ROANOKE BLVD
SALEM VA 24153
SALEM VAMC
CHECK BENEFIT CARD
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
CHECK BENEFIT CARD
DALLAS TX 75251
(800) 827-7223
SAKURA FINETEK
ADMINISTRATORS
EMPLOYEE BENEFIT
ADMINISTRATORS
SALEM VAMC 3138
SERVICES
* Sales Partners Southwest (TRAVEL)
ADMINISTRATORS
COMPENSABILITY
SERVICES
424 N. First Ave.
(800) 827-7223
SALINAS FIREFIGHTERS
COASTAL HEALTHCARE
ADMINISTRATORS
COASTAL HEALTHCARE
ADMINISTRATORS
PO Box 80308
SALINAS CA 93912
8006547475 Ext 322
COASTAL HEALTHCARE
ADMINISTRATORS
8006547475 Ext 322
SALINAS GOLF & COUNTRY CLUB
Affiliated With: KEY BENEFIT
ADMINISTRATORS
PO Box 1239
FORT MILL SC 29716
(866) 387-0489
Health Care Management
(317) 284-7650
(866) 387-0489
Network.
Info as of 12/24/2007
Page PIRMI-422
www.firsthealth.com
PAYOR NAME
SALINAS VALLEY MEMORIAL HOSP
(NON-WRAP)
SALINAS VALLEY MEMORIAL
HOSPITAL
CLAIMS SUBMISSION
COASTAL TPA, INC.
PO Box 80308
SALINAS CA 93912
COMPENSABILITY
COASTAL TPA, INC.
(800) 564-7475
UTILIZATION REVIEW
SVMH
(831) 757-4333
(800) 564-7475
COASTAL TPA, INC.
COASTAL TPA, INC.
PO Box 80308
SALINAS CA 93912
(831) 455-1833
SALINAS VALLEY MEMORIAL
HOSPITAL
(831) 757-4333
(831) 455-1833
SALISBURY VAMC 3139
SERVICES
SALISBURY VAMC
Attn: FEE BASIS (04J)
1601 BRENNER RD
SALISBURY NC 28144
SALISBURY VAMC
CHECK BENEFIT CARD
SALT LAKE CITY VAMC 3535
SERVICES
SALT LAKE CITY VAMC
SALT LAKE CITY VAMC
CHECK BENEFIT CARD
SALT LAKE ORTHOPAEDIC CLINIC
ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SALT RIVER PIMA MARICOPA INDIAN
COMMUNITY
Affiliated With: SALT RIVER PIMA
MARICOPA INDIAN COMMUNITY
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930 Ext 9234
500 FOOTHILL DR
(800) 786-7930 Ext 9234
Network.
Info as of 12/24/2007
Page PIRMI-423
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PAYOR NAME
SALT RIVER SAND & ROCK
CLAIMS SUBMISSION
CORESOURCE
COMPENSABILITY
CORESOURCE
UTILIZATION REVIEW
(866) 280-4120
CORESOURCE
(866) 794-0770
CHECK BENEFIT CARD
WAYNE PA 19087-1706
(888) 293-9229
PO Box 2920
(866) 280-4120
SALVE REGINA UNIVERSITY
CONCEPTS INC
SAM HOUSTON STATE UNIVERSITY
MANAGEMENT
SAMARITAN HEALTH PLANS
SAMC
INC.
SAMMON TRUCKING, INC.
SERVICE GROUP
(888) 293-9229
TRUE CHOICE USA
TRUE CHOICE USA
PO Box 700307
DALLAS TX 75370
(800) 785-2446
CHECK BENEFIT CARD
(800) 785-2446
NHBC
NHBC
Scottsdale AZ 85260
(888) 621-7900
CHECK BENEFIT CARD
(888) 621-7900
PO Box 1229
(800) 673-5222
(800) 284-2273
CORPORATION
CORPORATION
(888) 877-7994
PO Box 1894
(253) 564-5850
(800) 673-5222
(253) 564-5850
Network.
Info as of 12/24/2007
Page PIRMI-424
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
SAN ANTONIO AEROSPACE - TRAVEL GROUP & PENSION
ADMINISTRATORS INC
ADMINISTRATORS
DALLAS TX 75251
COMPENSABILITY
GROUP & PENSION
ADMINISTRATORS INC
UTILIZATION REVIEW
HEALTH WATCH
(972) 238-7900
(800) 827-7223
(972) 238-7900
SAN BENITO HEALTH CARE DISTRICT
ADMINISTRATORS INC
ADMINISTRATORS INC
PO Box 45018
Fresno CA 93718
(800) 442-7247
CHECK BENEFIT CARD
(800) 442-7247
SAN DIEGO CO. TEAMSTERS EMPLOYERS INSURANCE TRUST
Affiliated With: SAN DIEGO CO.
TEAMSTERS-EMPLOYERS
INSURANCE TRUST
ADMINISTRATORS
SAN DIEGO CO. TEAMSTERS
Affiliated With: SAN DIEGO CO.
TEAMSTERS HEALTH & WELFARE
TRUST
ALLIED ADMINISTRATORS
SAN DIEGO FIREMAN RELIEF
ASSOCIATION
INC
THE PLAN HANDLERS, INC. C/O CCN
SAN DIEGO HCS 3192
SERVICES
SAN DIEGO HCS
Attn: FEE BASIS 136B-SV
3350 LA JOLLA VILLAGE DR
SAN DIEGO CA 92161
ADMINIATRATORS
ADMINIATRATORS
SAN DIEGO HCS
CHECK BENEFIT CARD
2831 Camino del Rio S STE 207
SAN DIEGO CA 92108
SAN DIEGO CA 92108
PO Box 3000
Network.
Info as of 12/24/2007
Page PIRMI-425
www.firsthealth.com
PAYOR NAME
SAN DIEGO HOTEL & REST.
EMPLOYEE HLTH & PENSION FUND
Affiliated With: SAN DIEGO HOTEL &
REST. EMPLOYEE HLTH & PENS.
FUND
CLAIMS SUBMISSION
EMPLOYEE BENEFIT
ADMINISTRATORS
SAN FRANCISCO ELECTRICAL
WORKERS H&W TRUST
EISB C/O HEALTH ASPEX, INC.
SAN FRANCISCO VAMC 3187
SERVICES
EMPLOYEE BENEFIT
ADMINISTRATORS
CHECK BENEFIT CARD
SAN FRANSISCO VAMC
CHECK BENEFIT CARD
424 N. First Ave.
5301 Buckeystown Pike #455
FREDERICK MD 21704
SAN FRANSISCO VAMC
Attn: FEE BASIS 04F
4150 CLEMENT ST BLDG 6
SAN FRANSISCO CA 94121
SAN JOAQUIN COMMUNITY HOSPITAL ADVENTIST HEALTH SYSTEM WEST
PO Box 619031
SYSTEM/WEST
SAN JOAQUIN COMMUNITY
HOSPITAL EXCLUSIVE
SYSTEM/WEST
UTILIZATION REVIEW
SAN DIEGO CA 92108
SAN DIEGO TRANSIT CORPORATION
ADMINISTRATORS
Affiliated With: SAN FRANCISCO
ELECTRICAL WORKERS H&W TRUST
COMPENSABILITY
ADVENTIST HEALTH
SYSTEMS/WEST
ADVENTIST HEALTH
SYSTEMS/WEST
CHECK BENEFIT CARD
PO Box 619031
Network.
Info as of 12/24/2007
Page PIRMI-426
www.firsthealth.com
PAYOR NAME
SAN JUAN IPA
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UTILIZATION REVIEW
SAN JUAN VA MEDICAL CENTER 3145
SERVICES
SAN JUAN VA MEDICAL CENTER
Attn: 672-B01D
10 CASIA ST
SAN JUAN PR 00921
SAN JUAN VA MEDICAL CENTER
CHECK BENEFIT CARD
SANDVIK
SYSTEMS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SANTA BARBARA COUNTY MAIN JAIL
SERVICES, INC.
INC.
SANTA CLARA UNIVERSITY
INC.
INC.
CHECK BENEFIT CARD
PO Box 5096
PORTLAND OR 97208
(800) 770-6672
BRENTWOOD TN 37027
(800) 770-6672
SANTA CRUZ MEDICAL CLINIC
ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-427
www.firsthealth.com
PAYOR NAME
SANTA MONICA COLLEGE
* SANUS HEALTH
NETWORK INC
SANUS HEALTH
Affiliated With: SANUS HEALTH
CORPORATION
SAPAUGH MOTORS, INC
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
New York NY 10019
(212) 581-8228
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
(212) 581-8228
12501 KENDALL DR STE 2
MIAMI FL 33186
(469) 417-1755
SANUS HEALTH
CORPORATION
(469) 417-1755
(469) 417-1755
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
SARGENT CORP JMS
(EBPA)
SAVANNAH STATE UNIV AIH0058417
CORP #14005
EBPA
EBPA
PO Box 2365
(802) 846-8060
CHECK BENEFIT CARD
(802) 846-8060
PO Box 2271
Florence SC 29503
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-428
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
SAVANNAH STATE UNIVERSITY
UNDERGRAD MANDATORY
Attn: WHIT WALTERS
CORP
FLORENCE SC 29501
(800) 222-6491
SAYRE MEMORIAL HOSPITAL
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(800) 222-6491
WATERSTONE BENEFIT
WATERSTONE BENEFIT
(405) 440-8888
CHECK BENEFIT CARD
(405) 440-8888
SCC INDUSTRIES
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SCHAFFER COMPANIES GH
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
SCHAFFER COMPANIES WC
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
SCHALLER ANDERSON BEHAVIORAL
HEALTH OF CALIFORNIA
ADMINISTRATORS
HEALTHCARE
SCHALER ANDERSON HEALTHCARE
SCHALER ANDERSON HEALTHCARE CHECK BENEFIT CARD
BLDG 1 #200
PHOENIX AZ 85040
(602) 659-1403
(602) 659-1403
Network.
Info as of 12/24/2007
Page PIRMI-429
www.firsthealth.com
PAYOR NAME
SCHEPEL BUICK-GMC TRUCK, INC.
Affiliated With: THE CALENDS GROUP
SCHMIEDESKAMP, ROBERTSON,
NEW & MITCHELL
ADMINISTRATORS
SCHMITT, SUSSMAN, ENTERPRISES
dba PFP
CONCEPTS INC
SCHOOL CITY OF EAST CHICAGO
Affiliated With: PROFESIONAL CLAIMS
MANAGEMENT
COMPENSABILITY
THE CALENDS GROUP
THE CALENDS GROUP
NORTH AMERICA
NORTH AMERICA
MED-CERT
(800) 356-7126
PO Box 1984
NASHVILLE TN 37202
(615) 255-6654
CLAIMS SUBMISSION
THE CALENDS GROUP
UTILIZATION REVIEW
5972 Stellhorn Rd.
FORT WAYNE IN 46815
(615) 255-6654
CLAIMS MANAGER
(800) 220-2600
CHECK BENEFIT CARD
CHECK BENEFIT CARD
BURR RIDGE IL 60527
(800) 590-6500
PO Box 61553
(610) 337-2600
(800) 590-6500
SCHOOL DISTRICT OF JANESVILLE
ADMINISTRATORS INC
MIDWEST SECURITY
MIDWEST SECURITY
MIDWEST SECURITY
SCHWARZ PARTNERS-PACKAGING
NGS AMERICAN, INC.
NGS AMERICAN, INC.
UM NOT APPLICABLE
PO Box 7676
DETROIT MI 48080
8005211555
PO Box 574
ONALASKA WI 54650
8005211555
Network.
Info as of 12/24/2007
Page PIRMI-430
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SCOLARI S FOOD DRUG
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SCOTIABANK
Affiliated With: COLONIAL GROUP
INTERNATIONAL LTD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SCOTLAND YARD SECURITY
SERVICES LTD
BENEFIT SYSTEMS
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
SCHALLER ANDERSON
HEALTHCARE LLC
SCHALLER ANDERSON
HEALTHCARE LLC
SCHALLER ANDERSON
HEALTHCARE LLC
SCHALLER ANDERSON
HEALTHCARE LLC
PAYOR NAME
SCICOM INC
SERVICES INC
UTILIZATION REVIEW
7753526959
(800) 283-4927
SCRIPPS HEALTH INC EPO
HEALTHCARE LLC
SCHALLER ANDERSON
HEALTHCARE LLC
SCRIPPS HEALTH INC PPO AND OUT
OF AREA
HEALTHCARE LLC
SCHALLER ANDERSON
HEALTHCARE LLC
PO Box 63065
PO Box 63065
Network.
Info as of 12/24/2007
Page PIRMI-431
www.firsthealth.com
PAYOR NAME
SD CEMENT MASONS TRUST
Affiliated With: SD CEMENT MASONS
TRUST
SD COUNTY TEAMSTER TRUST
Affiliated With: SD COUNTY
TEAMSTER TRUST
SD IRELAND CONCRETE
SEABOARD INTERNATIONAL
CLAIMS SUBMISSION
SAN DIEGO CA 92108
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(619) 297-8235
(619) 297-8235
SAN DIEGO CA 92108
(619) 297-8235
CHECK BENEFIT CARD
(619) 297-8235
CBA
CBA
PO Box 2365
(800) 525-8788
UM NOT APPLICABLE
(800) 525-8788
ENTRUST INC
ENTRUST INC
HOUSTON TX 77079
(281) 368-7878
MEDICAL HELPLINE
(877) 463-3435
(281) 368-7878
SEALMASTER EPT HOURLY
Affiliated With: SEALMASTER EPT
HOURLY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SEASONAL CONCEPTS INC
America's TPA
America's TPA
CHECK BENEFIT CARD
PO Box 398220
(952) 896-1255
(952) 896-1255
Seaton Corporation
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
Network.
CONTACT EMPLOYER
Info as of 12/24/2007
Page PIRMI-432
www.firsthealth.com
PAYOR NAME
SEATTLE FINANCIAL GROUP
CLAIMS SUBMISSION
EBMS
PO Box 21367
COMPENSABILITY
EBMS
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 777-3575
(800) 777-3575
SEATTLE PACIFIC INDUSTRIES
INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SEATTLE TACOMA BOX CO
SERVICE CORPORATION
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 899-9355
* SECURIGUARD
SECURITIES AMERICA FINANCIAL
CORPORATION
HEALTHCARE ALLIANCE
* Security Forces
Affiliated With: KANAWHA
HEALTHCARE
(800) 899-9355
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
KHS
KHS
UM NOT APPLICABLE
PO Box 1000
LANCASTER SC 29720
(800) 822-1274
(800) 822-1274
Network.
Info as of 12/24/2007
Page PIRMI-433
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
Sedgwick Claims Management Services CONTACT EMPLOYER
Attn:
SENECA CENTER
COMPENSABILITY
CONTACT EMPLOYER
UTILIZATION REVIEW
CONTACT EMPLOYER
HEALTHCOMP ADMINISTRATORS
INC
HEALTHCOMP ADMINISTRATORS
INC
621 SANTA FE
FRESNO CA 93703
(800) 755-7247
HEALTHCOMP
ADMINISTRATORS INC
(800) 755-7247
JEANNE SHIMODA
JEANNE SHIMODA
CHECK BENEFIT CARD
PO Box 45018
FRESNO CA 93721
(800) 442-7247
(800) 755-7247
SENENET, INC
#10473
SENIOR MANAGEMENT CONCEPTS
SERVICES
Sentry Employee Medical Plan
Affiliated With: Sentry Insurance
(800) 442-7247
75 S 500 W
BOUNTIFUL UT 84010
QUALIFIED BENEFIT SERVICES LLC UM NOT APPLICABLE
(801) 269-8723
(800) 853-3234
(800) 853-3234
Sentry Insurance
Sentry Insurance
PO Box 10983
(800) 426-7234
First Health
(800) 722-5200
CONTACT EMPLOYER
CONTACT EMPLOYER
THE LOOMIS COMPANY
HINES & ASSOCIATES
(888) 826-5769
(800) 426-7234
Sentry Insurance
Affiliated With: Sentry Insurance A
Mutual Company
Sentry Insurance
1800 N Point Dr
Stevens Point WI 54481
SEQUEL YOUTH AND FAMILY
THE LOOMIS COMPANY
(866) 425-7244
(866) 425-7244
Network.
Info as of 12/24/2007
Page PIRMI-434
www.firsthealth.com
PAYOR NAME
SEQUEL YOUTH SERVICES CLARINDA ACADEMY
Affiliated With: HEALTH NETWORK
AMERICA
Service Corporation International (SCI
Management)
* SERVICE SOURCE EMPLOYMENT
SERVICES, INC.
SFI
INC.
SFMC
INC.
SHAMROCK MANAGEMENT LLC
ADMINISTRATORS & CONSULTANTS,
INC.
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
(888) 200-8537
(732) 676-2637
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
(800) 899-9355
PO Box 607
W LONG BRANCH NJ 07764
(888) 200-8537
(800) 899-9355
PO Box 1229
(800) 673-5222
(800) 284-2273
(800) 673-5222
PO Box 1229
(800) 673-5222
(800) 284-2273
BAC
BAC
UM NOT APPLICABLE
PO Box 107
(800) 521-2654
(800) 673-5222
(614) 863-2120 Ext 3102
Network.
Info as of 12/24/2007
Page PIRMI-435
www.firsthealth.com
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SHARE BUILDERS
INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SHARE CORPORATION
BENEFIT ADMINISTRATORS INC (PBA)
CHECK BENEFIT CARD
Oakbrook IL 60523
(630) 655-3755
PAYOR NAME
SHANKLIN CORPORATION
UTILIZATION REVIEW
(630) 655-3755
SHARE MEDICAL CENTER
COMPANY
SHARON HOSPITAL
Affiliated With: MCA
SHAWNEE MEDICAL CENTER
CLINIC - 001
PO Box 26967
(405) 290-5696
CHECK BENEFIT CARD
(405) 290-5696
820 PARISH ST
PITTSBURGH PA 15220
(800) 922-4966
CHECK BENEFIT CARD
(800) 922-4966
WATERSTONE BENEFIT
WATERSTONE BENEFIT
(405) 440-8888
CHECK BENEFIT CARD
(405) 440-8888
Network.
Info as of 12/24/2007
Page PIRMI-436
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
SHEBESTER-BECHTEL
KEMPTON GROUP
Affiliated With: THE KEMPTON GROUP ADMINISTRATORS INC
INC
PO Box 54889
COMPENSABILITY
KEMPTON GROUP
ADMINISTRATORS INC
UTILIZATION REVIEW
QUANTUM CARE
(866) 412-8252
(405) 521-1711
(405) 521-1711
SHEET METAL WORKERS #16
HEALTH PLAN
WORKERS #16 HEALTH PLAN
WILLIAM C. EARHART CO. INC.
BENESYS
(248) 822-4200
(209) 951-6711
PO Box 4148
PORTLAND OR 97208
BENESYS
SHEET METAL WORKERS DBA
"LOCAL 104" HEALTH CARE PLAN
PO Box 1618
SAN RAMON CA 94583
WORKERS LOCAL 104 HEALTH CARE
(248) 822-4200
PLAN
SHEET METAL WORKERS' HEALTH
AND WELFARE FUND OF NORTHERN
CAROLINA
Affiliated With: SOUTHERN BENEFIT
ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SHELBY AUTOMOTIVE
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
HEALTH PLAN
(702) 242-7345
CONTACT EMPLOYER
CONTACT EMPLOYER
(702) 242-7700
Shell Oil Company
CONTACT EMPLOYER
Attn:
Network.
Info as of 12/24/2007
Page PIRMI-437
www.firsthealth.com
PAYOR NAME
SHEPLEY WOOD PRODUCTS INC
Affiliated With: BENEFIRST LLC
CLAIMS SUBMISSION
LLC
Houston TX 77040
UTILIZATION REVIEW
COMPENSABILITY
AMERICAN
HEALTH
HOLDINGS INC
LLC
(888) 578-1812
(877) 224-3627
(877) 224-3627
SHERIDAN VAMC 3536
SERVICES
SHERIDAN VAMC
SHERIDAN VAMC
CHECK BENEFIT CARD
SHIMADZU MEDICAL SYSTEMS
EMPLOYEE BENEFIT
SHIPPERS RENTAL COMPANY
ADMINISTRATORS LLC
NORTH AMERICA
NORTH AMERICA
MED-CERT
(800) 356-7126
PO Box 1984
NASHVILLE TN 37202
(800) 411-3650
1898 FORT RD
SHERIDAN WY 82801
PO Box 3000
(800) 411-3650
SHIPROCK ALTERNATIVE SCHOOLS
CHECK BENEFIT CARD
SHOOK BUILDER SUPPLY CO
Affiliated With: JSL ADMINISTRATORS,
INC
(910) 480-3100
DOCTORS DIRECT
(800) 443-9178
PO Box 25160
(910) 480-3100
Network.
Info as of 12/24/2007
Page PIRMI-438
www.firsthealth.com
PAYOR NAME
SHORMAN & ASSOCIATES
Affiliated With: SHORMAN &
ASSOCIATES
CLAIMS SUBMISSION
COMPENSABILITY
UTILIZATION REVIEW
7299 W. 98th Terrace #100
SHREVEPORT VAMC 3108
SERVICES
SHREVEPORTVAMC
Attn: FEE 136C2
510 E ESTONER AVE
SHREVEPORT LA 71101
SHREVEPORTVAMC
CHECK BENEFIT CARD
SIERRA ALUMINUM COMPANY
EMPLOYEE BENEFIT
SIERRA COLLEGE
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
SERVICES
SERVICES
GLOBALCARE, INC.
GLOBALCARE, INC.
PO Box 3000
PO Box 7186
BOISE ID 83707
(800) 786-7930
SIERRA COLLEGE ATHLETIC
INSURANCE
INSURANCE SERVICES
SERVICES
SIERRA HEALTH & LIFE INSURANCE
GLOBALCARE, INC.
5001 College Blvd. #216
LEAWOOD KS 66211
6875 Shiloh Rd E
ALPHARETTA GA 30005
Network.
Info as of 12/24/2007
Page PIRMI-439
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
SIERRA HEALTH SERVICES
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Sierra Health Services
Sierra Heatlh Services
(818) 846-5297
(800) 373-3054
PO Box 7858
Burbank CA 91510-7858
SIERRA HEALTH-CARE OPTIONS, INC. GLOBALCARE, INC.
6875 Shiloh Rd E
ALPHARETTA GA 30005
GLOBALCARE, INC.
GLOBALCARE, INC.
SIGMA CORPORATION
CONCEPTS INC BENEFIT
CONCEPTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SIGNATURE LABEL
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
EBC MID-AMERICA C/O CCN
CHECK BENEFIT CARD
(818) 846-5297
(800) 422-2026
SILK TREE FACTORY, INC.
Affiliated With: SILK TREE FACTORY,
INC.
PO Box 5190
TAMPA FL 33675-5190
Network.
Info as of 12/24/2007
Page PIRMI-440
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
SILVER STATE BANK
PO Box 15645
LAS VEGAS NV 89114
COMPENSABILITY
PLAN OF NEVADA
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
SILVER STATE FORD-TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
SILVERTON CASINO LLC
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
SIMI VALLEY HOSPITAL - EPO
SYSTEM/WEST
SIMPSON COLLEGE ATHLETIC
INSURANCE
INSURANCE SERVICES
SERVICES
SIMPSON NORTON CORPORATION
PO Box 619031
SERVICES
SERVICES
NORTH AMERICAN
ADMINISTRATORS
NORTH AMERICAN
ADMINISTRATORS
PO Box 1065
AMHERST NY 14226
(800) 397-2122
NORTH AMERICAN
ADMINISTRATORS
(800) 397-2122
5001 College Blvd. #216
LEAWOOD KS 66211
(800) 397-2122
Network.
Info as of 12/24/2007
Page PIRMI-441
www.firsthealth.com
PAYOR NAME
SIMPSON UNIVERSITY
#10473
CLAIMS SUBMISSION
HEALTHCOMP TPA
PO Box 45018
Fresno CA 93718
COMPENSABILITY
HEALTHCOMP TPA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 442-7247
(800) 442-7247
SIOUX FALLS VA MEDICAL CENTER
3711
SERVICES
SIOUX FALLS VA MEDICAL CENTER
Attn: FEE 00143G
2501 W 22ND STREET
SIOUX FALLS SD 57117
SIOUX FALLS VA MEDICAL CENTER CHECK BENEFIT CARD
SIOUX MANUFACTURING
SERVICES, INC
1736 E. Sunshine Ste 200
Springfield MO 65804
(800) 995-3569
SIS IMPERIAL PALACE
SISBRO INC
ADMINISTRATORS LLC
INC.
(800) 995-3569
(800) 995-3569
NHBC
NHBC
Scottsdale AZ 85260
(888) 621-7900
CHECK BENEFIT CARD
(888) 621-7900
NORTH AMERICA
NORTH AMERICA
PO Box 1984
NASHVILLE TN 37202
(800) 411-3650
MED-CERT
(800) 356-7126
(800) 411-3650
SISCO
Butler
SISCO
SISCO
PO Box 389
(800) 457-4726
SISCO
(800) 457-4726
(800) 457-4726
Network.
Info as of 12/24/2007
Page PIRMI-442
www.firsthealth.com
PAYOR NAME
SIVAGE-THOMAS HOMES
Affiliated With: HCH ADMINISTRATION
CLAIMS SUBMISSION
HCH ADMINISTRATORS
COMPENSABILITY
HCH ADMINISTRATORS
HCH ADMINISTRATORS
UTILIZATION REVIEW
PO Box 1986
PEORIA IL 61656
SIZEMORE INC
Affiliated With: NATIONAL CLAIMS
ADMINISTRATIVE SERVICES INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SIZZLER, USA
EMPLOYEE BENEFIT
SJH
INC.
PO Box 1229
(800) 673-5222
(800) 284-2273
CHECK BENEFIT CARD
PO Box 909786
CHICAGO IL 606090
(312) 906-8080 Ext 259
SJMC
INC.
SKF USA INC
Affiliated With: ALLIED BENEFITS
SYSTEMS
PO Box 3000
(800) 673-5222
PO Box 1229
(800) 673-5222
(312) 906-8080 Ext 259
Network.
Info as of 12/24/2007
Page PIRMI-443
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
THE LOOMIS COMPANY
SKF USA INCORPORATED
WYOMISSING PA 19610
COMPENSABILITY
THE LOOMIS COMPANY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 782-0392
(800) 782-0392
SKILSTAF INC
Affiliated With: SKILSTAF INC
RISK REDUCTION INC
RISK REDUCTION INC
(800) 477-3502
SKY RIVER MANAGEMENT, LLC
TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
PO Box 729
ALEXANDER CITY AL 35011
(702) 242-7700
SLAM COLLABORATIVE THE
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Smart Management Inc
SERVICE CENTER
GISC, INC
GISC, INC
PO Box 9120
MARSHFIELD MA 02050
(800) 242-4472
TOTALCARE W / APS
HEALTHCARE
(866) 598-3973
SMITH AND LOVELESS
L.C.
(800) 242-4472
EPOCH GROUP LC
EPOCH GROUP LC
CHECK BENEFIT CARD
PO Box 12170
Network.
Info as of 12/24/2007
Page PIRMI-444
www.firsthealth.com
PAYOR NAME
SMITH COLLEGE
MANAGEMENT SYSTEMS
CLAIMS SUBMISSION
123 INTERSTATE DR
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(877) 868-9060
(877) 868-9060
SMITH COLLEGE SPORTS
CONCEPTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SMITH DETROIT DIESEL ALLISON
ADMINISTRATORS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SMITH INTERNATIONAL
Affiliated With: TOWER LIFE
TOWER LIFE INSURANCE
TOWER LIFE INSURANCE
CHECK BENEFIT CARD
310 S. ST. MARY'S STREET #400
SAN ANTONIO TX 78205-3164
(888) 830-4927
(888) 830-4927
SMITH MEDIA
CORESOURCE INC
CORESOURCE INC
PO Box 2920
(800) 624-7143
CORESOURCE INC
(800) 480-6658
(800) 624-7143
SMMC
INC.
PO Box 1229
(800) 673-5222
(800) 284-2273
(800) 673-5222
Network.
Info as of 12/24/2007
Page PIRMI-445
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
SN SERVICING CORPORATION
AFFORDABLE BENEFIT
Affiliated With: AFFORDABLE BENEFIT ADMINISTRATORS, INC.
PO Box 10787
BURBANK CA 91510
COMPENSABILITY
AFFORDABLE BENEFIT
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 350-0148 Ext 240
(800) 350-0148 Ext 240
SNELL & WILMER, LLC
Affiliated With: HARRINGTON BENEFIT
SERVICES INC
HARRINGTON BENEFITS, DIV OF
FISERV
HARRINGTON BENEFITS, DIV OF
FISERV
PO Box 845
PUEBLO CO 81002
(602) 906-5042
FISERV HEALTH CARE
MANAGEMENT
(877) 294-7839
CHECK BENEFIT CARD
(602) 906-5042
SO CAL BAKER & CONFECTIONARY
UNION & INDUSTRY WELFARE FUND
NETWORK #18373
PO Box 2388 C
STOW OH 44224
(800) 266-5896
(800) 266-5896
* SODEXHO MANAGEMENT
(800) 899-9355
(800) 899-9355
SOKA UNIVERSITY OF AMERICA
AFFORDABLE BENEFIT
SOLAR INDUSTRIES
SOLUTIONS LLC
CHECK BENEFIT CARD
AFFORDABLE BENEFIT
ADMINISTRATORS INC
AFFORDABLE BENEFIT
CHECK BENEFIT CARD
ADVANCED BENEFIT
SOLUTIONS
PO Box 10787
BURBANK CA 91510
Network.
Info as of 12/24/2007
Page PIRMI-446
www.firsthealth.com
PAYOR NAME
Solin USA
CLAIMS SUBMISSION
Solin USA
COMPENSABILITY
CONTACT EMPLOYER
CONTACT EMPLOYER
UTILIZATION REVIEW
520 N Semoran Blvd Ste 220
Orlando FL 32807
(800) 293-3131
Solo Voyager Plan
Affiliated With: Cambridge Life
Insurance Company
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SOLUTIONS 4
MCMC LLC
CONTACT EMPLOYER
CONTACT EMPLOYER
MCMC LLC
MCMC LLC
Canonsburg PA 15317
(888) 350-1150 Ext 228
MCMC LLC
(888) 350-1150 Ext 228
CHECK BENEFIT CARD
CHECK BENEFIT CARD
OF UICI
OF UICI
CHECK BENEFIT CARD
PLANO TX 75075
(800) 767-0700
Canonsburg PA 15317
(888) 350-1150 Ext 228
Solutions4 - Nashvile Auto
Plan Type: Auto
(888) 350-1150 Ext 228
SOLUTIONS4 AUTO
Plan Type: Auto
MCMC LLC
Canonsburg PA 15317
(888) 350-1150 Ext 228
SOMA - STUDENT OSTEOPATHIC
MEDICAL ASSOC 1
(800) 237-0903 Ext 6352
Network.
Info as of 12/24/2007
Page PIRMI-447
www.firsthealth.com
PAYOR NAME
SOMA - STUDENT OSTEOPATHIC
MEDICAL ASSOC 2
SOMA HIGH DEDUCTIBLE PLAN
CLAIMS SUBMISSION
OF UICI
PLANO TX 75075
COMPENSABILITY
OF UICI
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 767-0700
(800) 237-0903 Ext 6352
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
SONIC INDUSTRIES INC
SONORA COMMUNITY HOSPITAL
SYSTEM/WEST
SOONER PHARMACY OF
TISHOMINGO, INC
KANSAS - 11297
FISERV HEALTH INC
FISERV HEALTH INC
PO Box 520
(800) 235-7160
AVIDYN HEALTH
(214) 647-6194
DIRECT CARE AMERICA
DIRECT CARE AMERICA
CHECK BENEFIT CARD
PO Box 2090 C
STOW OH 44224
(800) 266-5896
SOPREMA INC
PO Box 93670
IntraCorp
(800) 538-5222
PO Box 619031
(800) 235-7160
(800) 266-5896
Network.
Info as of 12/24/2007
Page PIRMI-448
www.firsthealth.com
PAYOR NAME
SOPREMA, INC
CLAIMS SUBMISSION
KLAIS & COMPANY INC
1867 W MARKET ST
AKRON OH 44313
COMPENSABILITY
KLAIS & COMPANY INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(330) 867-8443
(330) 867-8443
SOS STAFFING
SOLUTIONS
CHECK BENEFIT CARD
SOS STAFFING SERVICES, INC.
(COLORADE EEs-TRAVEL)
SOLUTIONS
PO Box 3559
(800) 426-7453
SOUTH COAST MEDICAL CENTER
SYSTEM WEST
CHECK BENEFIT CARD
CHECK BENEFIT CARD
8882650387
(800) 426-7453
(800) 426-7453
PO Box 619031
(800) 441-2524
(800) 441-2524
SOUTH GEORGIA COLLEGE
AIH0058437
PO Box 2271
CORP #14005
(843) 622-6001
AIH0058447
PO Box 2271
CORP #14005
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
Network.
Info as of 12/24/2007
Page PIRMI-449
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
UNDERGRAD UNIVERSITY
Attn: WHIT WALTERS
CORP
FLORENCE SC 29501
(800) 222-6491
* South Maine Community College
MANAGEMENT SYSTEMS
SOUTH UNIVERSITY
CONCEPTS INC
COMPENSABILITY
UTILIZATION REVIEW
UM NOT APPLICABLE
(800) 222-6491
123 INTERSTATE DR
(413) 534-8658
UM NOT APPLICABLE
(413) 534-8658
WAYNE PA 19087-1706
CHECK BENEFIT CARD
(610) 293-9229
(610) 293-9229
SOUTH UNIVERSITY
CONCEPTS INC
WAYNE PA 19087-1706
CHECK BENEFIT CARD
(610) 293-9229
(610) 293-9229
SOUTH UNIVERSITY
CONCEPTS INC
UM NOT APPLICABLE
(610) 293-9229
WAYNE PA 19087-1706
(610) 293-9229
SOUTH VALLEY BANK
INC
Attn: ACCOUNTING
DALLAS TX 75206
CHECK BENEFIT CARD
(828) 281-9000
(828) 281-9000
Network.
Info as of 12/24/2007
Page PIRMI-450
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
SOUTHEASTERN CARPENTERS AND SOUTHERN BENEFIT
MILLWRIGHTS HEALTH TRUST
ADMINISTRATORS INC
Affiliated With: SOUTHERN BENEFIT
907 TWO MILE PKWY STE C-5
ADMINISTRATORS, INC
GOODLETTSVILLE TN 37072
(800) 831-4914
COMPENSABILITY
SOUTHERN BENEFIT
ADMINISTRATORS INC
UTILIZATION REVIEW
UM NOT APPLICABLE
(800) 831-4914
Southeastern Claims Services Inc
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
SOUTHEASTERN CONTAINER
PHYSICIANCARE INC
1515 SENECA MOCKINGBIRD LN
CHARLOTTE NC 28220
(800) 446-5439
(800) 582-7774
(800) 446-5439
SOUTHEASTERN LOUISIANA
UNIVERSITY
SERVICES INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SOUTHER NAZARENE UNIVERSITY
(STUDENTS)
MANAGEMENT
TRUE CHOICE
CI
PO Box 700307
DALLAS TX 75370
(817) 479-2115
CI
(817) 479-2115
SOUTHERN CALIF. LATHING
INDUSTRY HEALTH & WELFARE
TRUST
Affiliated With: SOUTHERN CALIF.
LATHING INDUSTRY HEALTH &
WELFARE
(800) 785-2446
SO CALIF. LATHING INDUSTRY
HLTH & WELFARE C/O ABPA
SO CALIF. LATHING INDUSTRY
HLTH & WELFARE C/O ABPA
CHECK BENEFIT CARD
4401 SANTA ANITA
EL MONTE CA 91731-1607
Network.
Info as of 12/24/2007
Page PIRMI-451
www.firsthealth.com
PAYOR NAME
Southern California Dairy Industry
Security Fund
Affiliated With: Southern California Dairy
Industry Security Fund
CLAIMS SUBMISSION
Southwest Administrators, Inc.
PO Box 1121
Alhambra CA 91802-1121
COMPENSABILITY
UTILIZATION REVIEW
(877) 350-4792 Ext 618
First Health
(800) 599-8723
(877) 350-4792 Ext 618
SOUTHERN CALIFORNIA INSTITUTE
OF ARCHITECTURE
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SOUTHERN CALIFORNIA PIPE
TRADES ADMIN CORP
TRADES ADMIN
TRADES ADMIN
Affiliated With: SOUTHERN
CALIFORNIA PIPE TRADES ADMIN
CORP
501 SHATTO PLACE 5TH FLOOR
LOS ANGELES CA 90020
(800) 595-7473
TRADES ADMIN
(213) 385-6161 Ext 268
ACORDIA NATIONAL
ACORDIA NATIONAL
CHECK BENEFIT CARD
602 VIRGINIA ST EAST
CHARLESTON WV 25301
(888) 685-7774
SOUTHERN COUNCIL OF
INDUSTRIAL WORKERS
PARTY ADMINISTRATOR
* Southern Farm Bureau
Affiliated With: GILSBAR
(800) 595-7473
(888) 685-7774
GILSBAR
GILSBAR
PO Box 790
COVINGTON LA 70434
(800) 999-8932
MedCom
(800) 643-4416
(800) 445-7227
SOUTHERN NAZARENE
UNIVERSITY - FACILITY AND
EMPLOYEES
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
Network.
Info as of 12/24/2007
Page PIRMI-452
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
SOUTHERN NEVADA HCS 3193
SOUTHERN NEVADA HCS
Affiliated With: HEALTH NET FEDERAL Attn: FEE 136C
SERVICES
2455 W CHEYENNE
NORTH LAS VEGAS NV 89032
SOUTHERN NEW ENGLAND SCHOOL
OF LAW
SOUTHERN OREGON HEAD START
Affiliated With: QVI RISK SOLUTIONS
INC
COMPENSABILITY
SOUTHERN NEVADA HCS
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
UTILIZATION REVIEW
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
BEND OR 97702
(541) 312-8512
INNOVATIVE CARE
MANAGEMENT
(800) 862-3338
(541) 312-8512
SOUTHERN OREGON REHAB
CENTER & CLINICS 3117
SOUTHERN OREGON REHAB CTR &
CLINICS
SOUTHERN OREGON REHAB CTR & CHECK BENEFIT CARD
CLINICS
SERVICES
Attn: FEE 136C-7
8495 CRATER LAKE HWY
WHITE CITY OR 97503
SOUTHERN OREGON UNIVERSITY
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
AMERIBEN SOLUTIONS
(800) 786-7930
USI ADMINISTRATORS
USI ADMINISTRATORS
(800) 786-7930
SOUTHERN OREGON UNIVERSITY
USI ADMINISTRATORS
Affiliated With: FIRST UNDERWRITERS PO Box 3357
INC
FORT WORTH TX 76113
Network.
Info as of 12/24/2007
Page PIRMI-453
www.firsthealth.com
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SOUTHERN POLYTECHNIC STATE
UNIV AIH0058457
PO Box 2271
CORP #14005
(843) 622-6001
CHECK BENEFIT CARD
SOUTHERN POLYTECHNIC STATE
Attn: WHIT WALTERS
MANDATORY
419 S. COIT ST
FLORENCE SC 29501
CORP
(800) 222-6491
PAYOR NAME
SOUTHERN PAINTERS WELFARE
FUND
Affiliated With: SOUTHERN PAINTERS
WELFARE FUND
CLAIMS SUBMISSION
CHECK BENEFIT CARD
(843) 622-6001
UM NOT APPLICABLE
(800) 222-6491
& MMA INSURANCE
SOUTHLAKE CENTER FOR MENTAL
HEALTH
& MMA INSURANCE
SOUTHWEST BAPTIST UNIVERSITY
OF UICI
OF UICI
PLANO TX 75075
(800) 767-0700
SOUTHWEST BRAKE
UTILIZATION REVIEW
PO Box 483
GOSHEN IN 46527
CHECK BENEFIT CARD
(800) 237-0903 Ext 6352
ASSURECARE
ASSURECARE
(800) 968-6616
CHECK BENEFIT CARD
(800) 968-6616
Network.
Info as of 12/24/2007
Page PIRMI-454
www.firsthealth.com
PAYOR NAME
SOUTHWEST CARPENTERS TRUST
FUNDS
Affiliated With: SOUTHWEST
CARPENTERS TRUST FUNDS
SOUTHWEST ELECTRIC COMPANY
ADMINISTRATORS
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
UTILIZATION REVIEW
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 825-3540
SOUTHWEST ORTHOPAEDIC
SPECIALIST PLLC
ADMINISTRATORS
Attn: Mary Shepherd
PO Box 489
(800) 967-2077
MEDCAREONE CORP
(800) 816-1206
(800) 967-2077
SOUTHWEST SERVICES (TRAVEL)
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
SOUTHWEST SIGNAL ENGINEERING
COMPANY
PREFERRED BENEFIT
ADMINISTRATORS INC
Southwestern Benefits
Insurance Co.
PREFERRED BENEFIT
ADMINISTRATORS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 916188
PO Box 3488
Scottsdale AZ 85271
(800) 356-0850
Network.
Info as of 12/24/2007
Page PIRMI-455
www.firsthealth.com
PAYOR NAME
Southwestern Oklahoma State
MANAGEMENT
CLAIMS SUBMISSION
TRUE CHOICE
PO Box 700307
DALLAS TX 75370
COMPENSABILITY
TRUE CHOICE
UTILIZATION REVIEW
UM NOT APPLICABLE
(800) 251-9665
(800) 251-9665
SOUTHWESTERN SECURITY
SERVICES, INC
ADMINISTRATORS
(800) 899-9355
(800) 899-9355
SOUTHWESTERN VERMONT HEALTH
CARE CORP.
MERITAIN HEALTH
Attn: Claims Dept
PO Box 853921
MERITAIN HEALTH
CHECK BENEFIT CARD
UM NOT APPLICABLE
(800) 844-7979
(800) 844-7979
SOUTHWIRE AND AFFILIATES
SPACESAVER CORPORATION
ADMINISTRATORS INC
BENESIGHT C/O WAUSAU BENEFITS
PO Box 8046
VALUECHECK
VALUECHECK
MIDWEST SECURITY
ADMINISTRATORS INC
MIDWEST SECURITY
ADMINISTRATORS INC
CHECK BENEFIT CARD
2700 Midwest Dr.
ONALASKA WI 54650
(888) 672-4342
(888) 672-4342
Special Agents Mutual Benefits
Association (SAMBA)
Affiliated With: Special Agents Mutual
Benefit Association (SAMBA)
First Health
First Health
PO Box 8600
London KY 40742
ECS Payor ID 37259
(800) 638-6589
Encompass Health Management
(800) 638-6589
Network.
Info as of 12/24/2007
Page PIRMI-456
www.firsthealth.com
PAYOR NAME
SPECIAL MARKETS
BENEFIT SYSTEMS
CLAIMS SUBMISSION
SYSTEMS INC
COMPENSABILITY
SYSTEMS INC
UTILIZATION REVIEW
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
ADMINISTRATOR INC
ADMINISTRATOR INC
CHECK BENEFIT CARD
(800) 525-8788
PO Box 2365
(800) 525-8788
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
SPECIALIZED TECHNOLOGY
RESOURCES JMS
(EBPA)
SPECIALIZED TECHNOLOGY
RESOURCES WRAP JMS
(EBPA)
Specialty Accident Sickness
Group, Inc.
SPECTRUM HEALTH
GROUP
(802) 846-8060
EBPA
EBPA
PO Box 2365
(802) 846-8060
CHECK BENEFIT CARD
(802) 846-8060
407 N Fulton St
(317) 655-4500 Outside US
(800) 628-4664 Inside US
CHECK BENEFIT CARD
(317) 655-4500 Outside US
(800) 628-4664 Inside US
PO Box 2388 C
STOW OH 44224
(800) 266-5896
PRIORITY HEALTH
(800) 446-5674
Services
Services
(847) 214-2780
TUCSON AZ 85710
(520) 722-7133
(800) 266-5896
SPELLMAN HARDWOODS
(520) 722-7133
Network.
Info as of 12/24/2007
Page PIRMI-457
www.firsthealth.com
PAYOR NAME
SPELMAN COLLEGE AMH9023747
CORP #14005
SPELMAN COLLEGE ICS AII9091697
CORP #14005
CLAIMS SUBMISSION
PO Box 2439
Florence SC 29503
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(843) 622-6001
(843) 622-6001
PO Box 2439
Florence SC 29503
(843) 622-6001
CHECK BENEFIT CARD
(843) 622-6001
SPINNAKER COATING LLC
AMERICA
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SPOKANE VAMC 3181
SERVICES
CHECK BENEFIT CARD
2025 AEROJET RD
(916) 985-1259
SPORTSMANS WAREHOUSE
(916) 985-1259
AMERIBEN SOLUTIONS
AMERIBEN SOLUTIONS
PO Box 7186
BOISE ID 83707
(800) 786-7930
CHECK BENEFIT CARD
(800) 786-7930
* Springdale Liquor Association
ADMINISTRATORS
Attn: Mary Shepherd
PO Box 489
(800) 967-2077
MEDCAREONE CORP
(800) 816-1206
(918) 967-2077
Network.
Info as of 12/24/2007
Page PIRMI-458
www.firsthealth.com
PAYOR NAME
SPRINGFIELD HOSPITAL SYSTEMS
WRAP JMS
(EBPA)
CLAIMS SUBMISSION
ADMINISTRATOR INC
PO Box 2365
COMPENSABILITY
ADMINISTRATOR INC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 525-8788
(802) 846-8060
SPRINGFIELD WIRE INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SPRINGFIELD WIRE, INC.
T R PAUL INC.
T R PAUL INC.
CHECK BENEFIT CARD
PO Box 5508
8006788161 Ext 244
8006788161 Ext 244
SSM HEALTH CARE
SERVICES INC
PO Box 25946
(800) 990-9058
CHECK BENEFIT CARD
(800) 990-9058
ST ANTHONY MEMORIAL HEALTH
CENTERS
Affiliated With: J.F. MOLLOY &
ASSOCIATES, INC.
JF MOLLOY & ASSOCIATES
PO Box 68947
INDIANAPOLIS IN 46268
(800) 331-3287 Ext 3905
(800) 331-3287 Ext 3905
ST CLOUD VA MEDICAL CENTER 3705
SERVICES
ST CLOUD VA MEDICAL CENTER
4801 VETERANS DRIVE
ST CLOUD MN 56303
ST CLOUD VA MEDICAL CENTER
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-459
www.firsthealth.com
PAYOR NAME
ST EDWARDS UNIVERSITY
MANAGEMENT
ST HELENAL HOSPITAL EXCLUSIVE
SYSTEM/WEST
ST JOHNSBURY ACADEMY
SERVICE CENTER
ST JOSEPH CATHOLIC ORPHANAGE
PLANS, INC.
CLAIMS SUBMISSION
TRUE CHOICE USA
PO Box 700307
DALLAS TX 75370
COMPENSABILITY
TRUE CHOICE USA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 785-2446
(800) 785-2446
ADVENTIST HEALTH SYSTEM/WEST CHECK BENEFIT CARD
2100 DOUGLAS
ROSEVILLE CA 95661
(800) 441-2524
(800) 441-2524
GISC, INC
GISC, INC
PO Box 9120
MARSHFIELD MA 02050
(800) 242-4472
TOTALCARE W / APS
HEALTHCARE
(866) 598-3973
(800) 242-4472
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
(800) 832-8212
ST LOUIS VAMEDICAL CENTER 3528
SERVICES
ST LOUIS VA MEDICAL CENTER
Attn: FEE BASIS 04FJB
ONE JEFFERSON BARRACKS DR
ST LOUIS MO 63125
ST LOUIS VA MEDICAL CENTER
CHECK BENEFIT CARD
ST MARY'S UNIVERSITY
MANAGEMENT
TRUE CHOICE USA
TRUE CHOICE USA
CHECK BENEFIT CARD
PO Box 700307
DALLAS TX 75370
(800) 785-2446
(800) 785-2446
Network.
Info as of 12/24/2007
Page PIRMI-460
www.firsthealth.com
PAYOR NAME
ST. HELENA HOSPITAL PPO
SYSTEM/WEST
CLAIMS SUBMISSION
PO Box 619031
EMPLOYEE BENEFIT
CHECK BENEFIT CARD
PO Box 11088
CHARLOTTE NC 28220
(800) 446-5439
STA TRAVEL
STABILUS, INC
PHYSICIANSCARE INC
STAFFORD DEVELOPMENT
Affiliated With: SOVEREIGN
SOLUTIONS LLC
Standard Security Life Insurance
Company of New York
STANDARD SECURITY LIFE
INSURANCE COMPANY OF NEW
YORK
#11337
UTILIZATION REVIEW
COMPENSABILITY
CHECK
BENEFIT CARD
PO Box 3000
(800) 446-5439
SOVEREIGN SOLUTIONS, LLC
SOVEREIGN SOLUTIONS, LLC
1805 U.S. HIGHWAY 82 WEST
TIFTON GA 31794
(229) 382-1360
MedWatch
(800) 432-8421
(229) 382-1360
PO Box 828
(800) 843-3106
CHECK BENEFIT CARD
(800) 522-2161
(IAC)
(IAC)
Med-Valu
(800) 522-2161
PO Box 828
(800) 843-3106
(800) 843-3106
(800) 843-3106
Network.
Info as of 12/24/2007
Page PIRMI-461
www.firsthealth.com
PAYOR NAME
STAR AFFORDABLE HEALTH
BENEFITS
NETWORK INC
* STAR HEALTHCARE NETWORK INC
NETWORK INC
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UM NOT APPLICABLE
New York NY 10019
(212) 581-8228
CLAIMS SUBMISSION
CHECK BENEFIT CARD
UTILIZATION REVIEW
(212) 581-8228
STAR RELIABLE LIFE
NETWORK INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
STAR VALLEY MEDICAL CENTER
ADMIN. & INSURANCE CONSULTANTS
MANAGED BENEFITS
CONSULTANTS
MANAGED BENEFITS
CONSULTANTS
CRITIQUE
(800) 666-5551
3625 S WEST TEMPLE STE 200
(800) 877-3727
(800) 877-3727
STARMARK
Affiliated With: STARMARK
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
STARR COMPREHENSIVE
SOLUTIONS, INC
CompIQ Corporation
CompIQ Corporation
UM NOT APPLICABLE
35 Tesla Way #100
Irvine CA 92618
(800) 293-3131
(800) 293-3131
Network.
Info as of 12/24/2007
Page PIRMI-462
www.firsthealth.com
PAYOR NAME
State Auto Insurance Company
Affiliated With: State Auto Insurance
Company
Plan Type: Auto
State Farm California
Affiliated With: State Farm Fire and
Casualty Company
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
State Farm Fire and Casualty Company
31303 Agoura Rd
Westlake Village CA 91363-4635
(818) 707-5317
(818) 707-5317
CONTACT EMPLOYER
(818) 707-5317
Casualty Company
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
State Farm Florida
Casualty Company
State Farm Fire and Casualty Company State Farm Fire and Casualty
Company
(863) 318-3563
(863) 318-3563
State Farm Hawaii
Casualty Company
7401 Cypress Gardens Blvd
Winter Haven FL 33888
(863) 318-3563
State Farm Hawaii
8900 Amberglen Blvd
Austin TX 78729-1110
(512) 918-5608
State Farm Hawaii
(512) 918-5608
(512) 918-5608
State Farm Individual Policy Holders
Affiliated With: State Farm Individual
Policy Holders
State Farm Health Insurance - Policy
#05
State Farm Health Insurance - Policy
#05
PO Box 8629
ECS Payor ID 31053
(707) 584-6688
Excludes some freestanding psych/cd
facilities.
(707) 584-6672
CHECK BENEFIT CARD
(800) 845-6592 ECS Help Desk
Network.
Info as of 12/24/2007
Page PIRMI-463
www.firsthealth.com
PAYOR NAME
State Farm Louisiana
Casualty Company
CLAIMS SUBMISSION
PO Box 11980
Monroe LA 71211-1980
UTILIZATION REVIEW
COMPENSABILITY
CONTACT
EMPLOYER
(800) 427-1160
(800) 427-1160
State Farm New Jersey
Casualty Company
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
State Farm Texas
Casualty Company
State Farm Fire and Casualty Company State Farm Fire and Casualty
Company
(512) 918-5608
(512) 918-5608
State of Oklahoma
Affiliated With: GLOBALHEALTH AND
GENERATION HEALTHCARE
8900 Amberglen Blvd
Austin TX 78729-1110
CONTACT EMPLOYER
(512) 918-5608
GLOBALHEALTH
GLOBALHEALTH
7001 NE 10th St
(405) 280-5600
GLOBALHEALTH
(405) 230-8781
(405) 280-5600
State of Vermont
Affiliated With: FairPay Solutions, Inc.
FairPay Solutions
Attn: Jon Peebles
14295 Midway Rd Ste 300
Addison TX 75001
FairPay Solutions
STATER BROS. MARKETS
ADMINISTRATORS
AMERICAN INSURANCE
ADMINISTRATORS
AMERICAN INSURANCE
ADMINISTRATORS
13191 CROSSROADS PARK NORTH
STE 205
CITY OF INDUSTRY CA 91746-3434
(800) 654-7900
(972) 715-8000
FairPay Solutions
(972) 715-8000
CHECK BENEFIT CARD
(800) 654-7900
Network.
Info as of 12/24/2007
Page PIRMI-464
www.firsthealth.com
PAYOR NAME
* STAYWELL HEALTH PLAN
NETWORK INC
CLAIMS SUBMISSION
New York NY 10019
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(212) 581-8228
(212) 581-8228
STEPHENS MEDIA GROUP
Sterling Administrators / Goff MGA
CONTACT EMPLOYER
Attn:
CHECK BENEFIT CARD
CONTACT EMPLOYER
CONTACT EMPLOYER
THE LOOMIS COMPANY
CHECK BENEFIT CARD
PO Box 25160
STERLING MEDICAL CORPORATION
THE LOOMIS COMPANY
WYOMISSING PA 19610
(877) 634-9814
(877) 634-9814
STEWART BROTHERS DRILLING
SERVICES
STILLWATER DESIGNS
HCH ADMINISTRATORS
HCH ADMINISTRATORS
PO Box 285
PEORIA IL 61650
(309) 282-1288
CHECK BENEFIT CARD
(309) 282-1288
WATERSTONE BENEFIT
WATERSTONE BENEFIT
(888) 440-0971
WATERSTONE BENEFIT
(800) 460-0238
(888) 440-0971
Network.
Info as of 12/24/2007
Page PIRMI-465
www.firsthealth.com
PAYOR NAME
STILLWATER MEDICAL CENTER
CLAIMS SUBMISSION
WATERSTONE BENEFIT
COMPENSABILITY
WATERSTONE BENEFIT
UTILIZATION REVIEW
CHECK BENEFIT CARD
(888) 440-0971
(888) 440-0971
STOCK CAR CLUB OF AMERICA
TREVOSE PA 19053
(215) 639-6208
(215) 639-6208
STOCKMAN'S BANK
ADMINISTRATORS
SYSTEMS
SYSTEMS
17475 JOVANNA DR
HOMEWOOD IL 60430
(708) 647-3434
CHECK BENEFIT CARD
(708) 647-3434
STOCKYARD BANK
PLAN INC 962550088
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
(502) 992-4535
STONEHILL COLLEGE SPORTS
CONCEPTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
STONEHILL UNIVERSITY
KLAIS & COMPANY INC
KLAIS & COMPANY INC
CHECK BENEFIT CARD
1867 W MARKET ST
AKRON OH 44313
(800) 331-1096
(800) 331-1096
STRATACARE
StrataCare Inc
StrataCare Inc
StrataCare Inc
16800 Aston 2nd Floor
Irvine CA 92606
Network.
Info as of 12/24/2007
Page PIRMI-466
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
THE LOOMIS COMPANY
STRINE PRINTING
WYOMISSING PA 19610
COMPENSABILITY
THE LOOMIS COMPANY
UTILIZATION REVIEW
UM NOT APPLICABLE
(866) 340-7182
(866) 340-7182
STRONGHAVEN
Affiliated With: NEW WORLD
SERVICES
NEW WORLD SERVICES
STURNER AND KLEIN
HEALTHPLANS, LLC
LLC
AMERICA'S CHOICE HEALTHPLANS, CHECK BENEFIT CARD
LLC
Houston TX 77040
(713) 895-3900
NEW WORLD SERVICES
NEW WORLD SERVICES
2624 N. 5th St.
NILES MI 49120
(713) 895-3900
* Suffolk
Insurance Fund
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
SUFFOLK UNIVERSITY SPORTS
CONCEPTS INC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SUMMIT ELECTRIC SUPPLY
COMPANY INC
INC
PO Box 8046
CHECK BENEFIT CARD
(715) 841-7802
(715) 841-7802
Network.
Info as of 12/24/2007
Page PIRMI-467
www.firsthealth.com
PAYOR NAME
SUMTER COUNTY - B.O.C.C.
BENEFIT ADMINISTRATORS, INC. /
FLORID
* Sun Coast Media Group
ADMINISTRATORS INC
UTILIZATION REVIEW
CLAIMS SUBMISSION
COMPENSABILITY
Professional Benefit Administrators, Inc. Professional Benefit Administrators, Inc. CHECK BENEFIT CARD
1265 S. Semoran Blvd. #1213
WINTER PARK FL 32792-5515
PREFERRED BENEFIT
ADMINISTRATORS
PREFERRED BENEFIT
ADMINISTRATORS
PO Box 916188
(407) 786-2777
CHECK BENEFIT CARD
(407) 786-2777
SUN COUNTY AIRLINES
America's TPA
America's TPA
PO Box 398220
(952) 896-4888
CHECK BENEFIT CARD
(952) 896-4888
SUN HEALTH
HEALTHCARE
SCHALLER ANDERSON
HEALTHCARE LLC
SCHALLER ANDERSON
HEALTHCARE LLC
PO Box 60850
Phoenix AZ 85082
(866) 479-1130
SCHALLER ANDERSON
HEALTHCARE LLC
(866) 479-1130
UM NOT APPLICABLE
555 W Benjamin Holt Dr
Stockton CA 95207
(800) 422-6099
(866) 479-1130
SUN PACIFIC
SYSTEMS
SUN PACIFIC FARMING
MANAGEMENT
(800) 422-6099
CHECK BENEFIT CARD
17620 FITCH ST
IRVINE CA 92614
Network.
Info as of 12/24/2007
Page PIRMI-468
www.firsthealth.com
PAYOR NAME
SUN STATE COMPONENTS, INC.
SOLUTIONS, LLC
CLAIMS SUBMISSION
LLC
COMPENSABILITY
LLC
UTILIZATION REVIEW
CHECK BENEFIT CARD
PO Box 30570
SUN VALLEY
SOLUTIONS
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SUN VALLEY MASONRY, INC.
SOLUTIONS
TRIDENT PLAN ADMINISTRATORS
TRIDENT PLAN ADMINISTRATORS
CHECK BENEFIT CARD
5045 N 12TH St Ste A
Phoenix AZ 85014
(602) 240-2404
(602) 240-2404
COMBINED BENEFIT
ADMINISTRATORS
COMBINED BENEFIT
ADMINISTRATORS
PPC
PPC
PO Box 11088
CHARLOTTE NC 28220
(800) 446-5439
INC.
7045232758
SUN WORLD INTERNATIONAL, LLC
COMBINED BENEFIT
ADMINISTRATORS
SUNBELT RENTALS
PHYSICIANSCARE INC
SUNMED
NETWORK INC
4704 W. Jennifer #104
FRESNO CA 93722
(800) 446-5439
CHECK BENEFIT CARD
CHECK BENEFIT CARD
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-469
www.firsthealth.com
PAYOR NAME
SUNRISE CREATIVE GROUP INC
Affiliated With: BENESIGHT
CLAIMS SUBMISSION
CHECK BENEFIT CARD
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
SUNVIEW VINEYARDS OF
CALIFORNIA
CALIFORNIA
Careline UR
(763) 383-4800
CALIFORNIA
Affiliated With: SUNVIEW VINEYARDS
OF CALIFORNIA
CALIFORNIA
SUPERIOR FEDERAL CREDIT UNION
(SFCU)
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
* SUPERIOR JANITORIAL
UTILIZATION REVIEW
1998 Road 152
DELANO CA 93215
(800) 422-2026
(800) 899-9355
(800) 899-9355
SUPERIOR READY MIX
MANAGEMENT
SUPERVALU
CONTACT EMPLOYER
Attn:
CHECK BENEFIT CARD
CONTACT EMPLOYER
CONTACT EMPLOYER
17620 FITCH ST
IRVINE CA 92614
Network.
Info as of 12/24/2007
Page PIRMI-470
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
Sure Care
American Life and Health Insurance Co
Affiliated With: American Life And Health Attn: Sure Care Health Insurance
Insurance Company
PO Box 11368
SURGERY CENTER OF OKLAHOMA
CORPORATION
Attn: Mary Shepherd
PO Box 489
COMPENSABILITY
CHECK BENEFIT CARD
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 967-2077
MEDCARE ONE INC
(800) 816-1206
CHECK BENEFIT CARD
PO Box 61553
(610) 337-2600
(800) 967-2077
SURGICAL MONITORING SERVICES
INC
INC
SW RESOURCES INC
BENEFIT SYSTEMS
(610) 337-2600
SYSTEMS INC
SYSTEMS INC
PO Box 21109
ROANOKE VA 24018
(800) 283-4927
HEALTH AND WELFARE
BENEFIT SYSTEMS INC
(800) 283-4927
(800) 283-4927
SWANSON GROUP INC
MANAGEMENT ADMINISTRATORS INC
PO Box 85008
BELLEVUE WA 98015
(800) 869-7093 Ext 117
ADMINISTRATORS
(425) 289-5142
CHECK BENEFIT CARD
CHECK BENEFIT CARD
(800) 869-7093 Ext 117
SWEETWATER COUNTY SCHOOL
DISTRICT
CHECK BENEFIT CARD
Network.
Info as of 12/24/2007
Page PIRMI-471
www.firsthealth.com
PAYOR NAME
Swift Newspapers, Inc.
Group
Swiss Re
Affiliated With: Swiss Re
* Syracuse
Insurance Fund
SYRACUSE CHINA - ACTIVE
CLAIMS SUBMISSION
PO Box 34297
COMPENSABILITY
Attn: Claims Dept #60
UTILIZATION REVIEW
First Health
(800) 346-3220
(800) 877-7474
(800) 877-7474
First Health
Broadspire
PO Box 5318
Tampa FL 33675-5318
(860) 282-4960
CONTACT EMPLOYER
Attn:
CONTACT EMPLOYER
CONTACT EMPLOYER
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
CONTACT EMPLOYER
(800) 422-2026
SYRACUSE CHINA - RETIRED
ASSURECARE
ASSURECARE
HUDSON OH 44224
(800) 422-2026
Careline UR
(763) 383-4800
UM NOT APPLICABLE
(800) 422-2026
SYRACUSE FEE BASIS
SERVICES
SYRACUSE FEE BASIS
113 HOLLAND AVE
ALBANY NY 12208
SYRACUSE VAMC 3199
SERVICES
SYRACUSE VAMC
Attn: FEE BASIS 04
800 IRVING AVE
SYRACUSE NY 13210
SYRACUSE VAMC
(972) 550-2836
Network.
CHECK BENEFIT CARD
Info as of 12/24/2007
Page PIRMI-472
www.firsthealth.com
PAYOR NAME
SYSTEMAX, INC
ADMINISTRATORS (FHA)
T.P. ORTHODONTICS, INC.
GROUP
TACO BUENO RESTAURANTS
Affiliated With: WEB TPA
UTILIZATION REVIEW
CLAIMS SUBMISSION
COMPENSABILITY
FLORIDA HEALTH ADMINISTRATORS FLORIDA HEALTH ADMINISTRATORS DELPHI
(727) 573-5737
PO Box 327810
(954) 366-0111
(954) 366-0111
PO Box 5319
TAMPA FL 33675-5319
(317) 879-4054 Ext 281
CHECK BENEFIT CARD
(800) 533-5044
(800) 533-5044
WEB TPA
WEB TPA
PO Box 539508
GRAND PRAIRIE TX 75053
(888) 898-2432
AVIDYN HEALTH
(800) 580-0293
America's TPA
America's TPA
CHECK BENEFIT CARD
PO Box 398220
(866) 478-6268
(469) 417-1769
TAHER
(952) 896-4872
TAHLEQUAH CITY HOSPITAL
COMPANY
TAHOE BILTMORE LODGE & CASINO
% OF SAVINGS - TRAVEL
PO Box 26967
(405) 290-5696
CHECK BENEFIT CARD
(405) 290-5696
PLAN
PLAN
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-473
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
TAHOE BILTMORE LODGE & CASINO SIERRA HEALTH & LIFE / HEALTH
PEPM
PLAN
LAS VEGAS NV 89114
(702) 242-7700
TAHOE FOREST HOSPITAL
SYSTEMS
TAHOE TRUCKEE SIERRA DISPOSAL
COMPANY
ADMINISTRATORS INC
TAKECARE INSURANCE COMPANY
NETWORK INC
COMPENSABILITY
PLAN
(702) 242-7700
UTILIZATION REVIEW
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UM NOT APPLICABLE
New York NY 10019
(212) 581-8228
PO Box 1147
STOCKTON CA 95201
(212) 581-8228
TALBOT AGENCY INC
RESOURCES CORP
CHECK BENEFIT CARD
TAMPA VAMC 3141
SERVICES
TAMPA VAMC
CHECK BENEFIT CARD
CHECK BENEFIT CARD
4194233823
TAMPA VAMC
CHECK BENEFIT CARD
10770 NORTH 46TH ST
TAMPA FL 33617
Network.
Info as of 12/24/2007
Page PIRMI-474
www.firsthealth.com
PAYOR NAME
TANNER MEMORIAL CLINIC
CLAIMS SUBMISSION
COMPENSABILITY
(801) 274-8100
UTILIZATION REVIEW
CORVEL
(801) 269-8723
(801) 274-8100
TANOX INC
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
GROUP & PENSION
ADMINISTRATORS
PO Box 749075
(972) 238-7900
CHECK BENEFIT CARD
(972) 744-2311
TATE & SNYDER ARCHITECTS
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
TAYLORS UNITED AUTO GROUP
ADMINISTRATORS INC
3761 S 700 E SUITE 202
(801) 261-5511
SERVICE ADVOCATES
(801) 261-5511
(801) 261-5511
TBN OF TENNESSEE, INC.
INC.
WILLIS OF KANSAS, INC
TBP ARCHITECTURE
Affiliated With: EBA&M #10160
EBA&M
EBA&M
PO Box 5079
(800) 776-1545
HINES & ASSOCIATES
(800) 528-2498
CENBEN USA
CHECK BENEFIT CARD
PO Box 2697
WICHITA KS 67201
(800) 776-1545
TC CONSTRUCTION
CENBEN USA
4079 Executive Pkwy
(614) 797-5204
(614) 797-5204
Network.
Info as of 12/24/2007
Page PIRMI-475
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
Teamsters Miscellaneous Security Trust Southwest Administrators, Inc.
Fund
PO Box 1121
Affiliated With: Teamsters Miscellaneous Alhambra CA 91802-1121
Security Trust Fund
(877) 350-4792 Ext 618
COMPENSABILITY
UTILIZATION REVIEW
(877) 350-4792 Ext 618
First Health
(800) 544-2830
ADMINISTRATIVE PROCEDURES,
INC.
ADMINISTRATIVE
PROCEDURES, INC.
CHECK BENEFIT CARD
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
TEAMSTERS UNION NO. 142
RETIREES
Affiliated With: TEAMSTERS UNION
NO. 142
ADMINISTRATIVE PROCEDURES,
INC.
TECHAU'S INCORPORATED
Affiliated With: TECHAU'S
INCORPORATED
TED WIENS TIRE & AUTO CENTERS
TRAVEL
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
2111 W. Lincoln Hwy.
MERRILLVILLE IN 46410
PO Box 5190
TAMPA FL 33675-5190
(702) 242-7700
TELEFLEX
CORESOURCE, INC.
TELSMITH INC
Affiliated With: TELSMITH INC
CHECK BENEFIT CARD
CORESOURCE, INC.
CORESOURCE, INC.
CHECK BENEFIT CARD
CHECK BENEFIT CARD
PO Box 83301
LANCASTER PA 17608-3301
Network.
Info as of 12/24/2007
Page PIRMI-476
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
TEMPLE VAMC 3167
TEMPLE VAMC
Affiliated With: HEALTH NET FEDERAL Attn: MED ACCT MGT SECT
SERVICES
1901 VETERANS MEMORIAL DR
TEMPLE TX 76504
TENDER LOVING CARE HEALTH
CARE SERVICES
PO Box 9000
Affiliated With: CBCA Administrators, Inc. LONDON KY 40742
* TERO TEK INTERNATIONAL INC
TERRA CONTRACTING
COMPENSABILITY
TEMPLE VAMC
CHECK BENEFIT CARD
UTILIZATION REVIEW
(800) 899-9355
(800) 899-9355
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
TERRACON INC
PO Box 8046
CHECK BENEFIT CARD
(715) 841-7802
(715) 841-7802
TERRIBLE HERBST
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-477
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
THE LOOMIS COMPANY
TERRIBLE HERBST
COMPENSABILITY
THE LOOMIS COMPANY
UTILIZATION REVIEW
(800) 346-1223
SIERRA HEALTH OPTIONS
(800) 873-5791
BOON CHAPMAN
BOON CHAPMAN
CHECK BENEFIT CARD
PO Box 9201
AUSTIN TX 78766
(800) 252-9653
(800) 346-1223
TESSENDERLO KERLEY, INC.
ADMINISTRATORS INC PHOENIX
OFFICE
TETRA FLEX
INC.
* TETRA Technologies Inc.
Affiliated With: BOON CHAMPMAN
2001 CAMELBACK
PHOENIX AZ 85014
PO Box 2697
WICHITA KS 67201
(800) 252-9653
TEXAS AGRICULTURAL
COOPERATIVE TRUST
Texas Agricultural Cooperative Trust
c/o First Health
(800) 658-9777
(877) 202-6379 Ext 2530
TEXAS WESLEYAN UNIVERSITY
MANAGEMENT
TRUE CHOICE USA
TRUE CHOICE USA
CHECK BENEFIT CARD
PO Box 700307
DALLAS TX 75370
(800) 785-2446
PO Box 5215
Tampa FL 33675
(800) 785-2446
Network.
Info as of 12/24/2007
Page PIRMI-478
www.firsthealth.com
PAYOR NAME
TEXAS WOMAN'S UNIVERSITY
MANAGEMENT
CLAIMS SUBMISSION
TRUE CHOICE USA
PO Box 700307
DALLAS TX 75370
COMPENSABILITY
TRUE CHOICE USA
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 785-2446
(800) 785-2446
Textile Staff Fund
Insurance Co.
CHECK BENEFIT CARD
THE ARC OF SAN DIEGO
(800) 899-9355
THE ASTORIA CORPORATION TRAVEL
CHECK BENEFIT CARD
CHECK BENEFIT CARD
ECS Payor ID 13550
(800) 899-9355
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 742-7345
(702) 242-7700
THE BAMA COMPANIES
FISERV HEALTH INC
FISERV HEALTH INC
PO Box 690450
(866) 868-8230
THE BEACH GROUP INC
SOLUTIONS GROUP INC
INC.
INC.
PO Box 1309
MUSKOGEE OK 74402
(800) 749-1422
FISERV HEALTH INC
(866) 868-8230
CHECK BENEFIT CARD
(800) 749-1422
Network.
Info as of 12/24/2007
Page PIRMI-479
www.firsthealth.com
PAYOR NAME
THE BOLDT COMPANY
CONSULTANTS
THE BRINK GROUP
ADMINISTRATORS LP TENNESSEE
CLAIMS SUBMISSION
EBC
PO Box 884
APPLETON WI 54912
COMPENSABILITY
EBC
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 342-1407
(800) 342-1407
NORTH AMERICA
NORTH AMERICA
PO Box 1984
NASHVILLE TN 37202
(800) 411-3650
MED-CERT
(800) 356-7126
(800) 411-3650
THE CADMUS GROUP
SERVICE CENTER INC
CENTER, INC
CENTER, INC
PO Box 9120
MARSHFIELD MA 02050
(800) 242-4472
GISC TOTALCARE
(866) 598-3973
(800) 242-4472
THE CATO CORPORATION
Affiliated With: RRIMARY
PHYSICIANCARE INC
THE CBE GROUP
PO Box 11088
CHARLOTTE NC 28220
(800) 446-5439
INC.
(800) 446-5439
(800) 446-5439
EPOCH GROUP LC
EPOCH GROUP LC
PO Box 12170
(800) 255-6065
UM NOT APPLICABLE
(800) 255-6065
THE CHILDREN CENTER
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
MUTUAL ASSURANCE
ADMINISTRATORS
PO Box 42096
(800) 825-3540
CHECK BENEFIT CARD
(800) 825-3540
Network.
Info as of 12/24/2007
Page PIRMI-480
www.firsthealth.com
PAYOR NAME
THE CHILDRENS PLACE RETAIL
STORES INC
GROUP
THE CITADEL
CORP #14005
THE CITY OF EAST CHICAGO
CLAIMS MANAGEMENT
THE CITY OF HAMMOND
CLAIMS MANAGEMENT
THE ENCORE GROUP
SERVICES, INC
THE EXCHANGE BANK
Affiliated With: THE EXCHANGE BANK
CLAIMS SUBMISSION
PO Box 5319
TAMPA FL 33675-5319
COMPENSABILITY
UTILIZATION REVIEW
CHECK BENEFIT CARD
(800) 533-5044
(800) 533-5044
PO Box 2437
(888) 722-1668
CHECK BENEFIT CARD
(800) 722-1668
BURR RIDGE IL 60527
(800) 590-6500
CHECK BENEFIT CARD
(800) 590-6500
BURR RIDGE IL 60527
(800) 590-6500
CHECK BENEFIT CARD
(800) 590-6500
PO Box 2000
(800) 849-5370
CHECK BENEFIT CARD
(800) 849-5370
EBC MID-AMERICA
EBC MID-AMERICA
9200 Shelbyville Rd Ste 500
LOUISVILLE KY 40222-5134
(502) 423-0505 Ext 20
CHECK BENEFIT CARD
(502) 423-0505 Ext 20
Network.
Info as of 12/24/2007
Page PIRMI-481
www.firsthealth.com
PAYOR NAME
THE FEDERATED GROUP
ADMINISTRATORS - NY
CLAIMS SUBMISSION
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 9501
AMHERST NY 14226
COMPENSABILITY
NORTH AMERICAN
ADMINISTRATORS-NY
(800) 397-2122
UTILIZATION REVIEW
NORTH AMERICAN
ADMINISTRATORS-NY
(800) 397-2122
(800) 397-2122
THE FIRST NATIONAL OF FLETCHER
KANSAS - 11297
THE GREENSPUN CORPORATION
PO Box 520
(800) 235-7160
AVIDYN HEALTH
(866) 802-1328
(800) 235-7160
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
THE HERBST GAMING MIDWEST
THE LOOMIS COMPANY
CASINOS
PO Box 7011
Affiliated With: THE LOOMIS COMPANY WYOMISSING PA 19610-6011
(800) 346-1223
THE LOOMIS COMPANY
THE J DAVID GLADSTONE
INSTITUTES
ADMIN. & MANAGEMENT (EBA&M)
EMPLOYEE BENEFITS
HINES & ASSOCIATES
EMPLOYEE BENEFITS
ADMINISTRATION & MGMT. (EBA&M) (800) 787-5361
PO Box 5079
(800) 249-8440
THE KEENEY MANUFACTURING
COMPANY
UM NOT APPLICABLE
(800) 346-1223
(800) 249-8440
CORPORATION
CORPORATION
PO Box 299
(888) 322-2524
DIVERSIFIED
ADMINISTRATION
CORPORATION
(888) 322-2524
(888) 322-2524
Network.
Info as of 12/24/2007
Page PIRMI-482
www.firsthealth.com
PAYOR NAME
THE KEMPTON CO ADVANTAGE
HEALTH PLANS
THE KEMTAH GROUP INC
INC
CLAIMS SUBMISSION
CHECK BENEFIT CARD
PO Box 8046
COMPENSABILITY
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UTILIZATION REVIEW
(715) 841-7802
(715) 841-7802
THE LAYTON COMPANIES
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
THE LIFELINE HEALTH GROUP
PLANS, INC.
LOUISVILLE KY 40223
(800) 832-8212
(888) 551-7427
THE LONGABERGER COMPANY PRIMARY
THE LONGABERGER COMPANY WRAP
(502) 992-4535
Health Design Plus
Health Design Plus
HUDSON OH 44236
(877) 286-3559
Health Design Plus
(800) 385-7085
(330) 463-1181
Health Design Plus
Health Design Plus
HUDSON OH 44236
(877) 286-3559
Health Design Plus
(800) 385-7085
(330) 463-1181
Network.
Info as of 12/24/2007
Page PIRMI-483
www.firsthealth.com
PAYOR NAME
THE LUBRIZOL CORPORATION
CLAIMS SUBMISSION
Health Design Plus
PO Box 2581
HUDSON OH 44236
COMPENSABILITY
Health Design Plus
UTILIZATION REVIEW
(800) 893-0777
Health Design Plus
(888) 463-3737
THE LOOMIS COMPANY
CHECK BENEFIT CARD
(800) 893-0777
The Medical Team
THE LOOMIS COMPANY
WYOMISSING PA 19610
(866) 473-6615
(866) 473-6615
THE MIDLAND GUARDIAN COMPAN PRIMARY
THE MIDLAND GUARDIAN COMPANY
TRAVEL
THE MOBILE SOLUTION
CORPORATION
Affiliated With: SUPERIOR
ADMINISTRATORS INC
Health Design Plus
Health Design Plus
HUDSON OH 44236
(877) 286-3559
Health Design Plus
(800) 385-7085
(877) 286-3559
Health Design Plus
Health Design Plus
HUDSON OH 44236
(877) 286-3559
Health Design Plus
(800) 385-7085
CHECK BENEFIT CARD
3720 SOUTH SUSAN ST STE 200
SANTA ANA CA 92704
(714) 429-1700
(877) 286-3559
(714) 429-1700
THE MONTEREY PLAZA HOTEL & SPA COASTAL HEALTHCARE
ADMINISTRATORS
PO Box 80308
SALINAS CA 93912
COASTAL HEALTHCARE
ADMINISTRATORS
Network.
COASTAL HEALTHCARE
ADMINISTRATORS
Info as of 12/24/2007
Page PIRMI-484
www.firsthealth.com
PAYOR NAME
THE MONTEREY PLAZA HOTEL &
SPA-CCN PRIME
THE MUNDY COMPANIES
SERVICES #962501270
CLAIMS SUBMISSION
COASTAL TPA, INC.
COMPENSABILITY
COASTAL TPA, INC.
UTILIZATION REVIEW
(800) 564-7475
CYPRESS MEDICAL NETWORK
(831) 657-2600
CHECK BENEFIT CARD
12312 ST ANDREWS DR
(405) 755-2929
PO Box 80308
SALINAS CA 93912
(800) 564-7475
(405) 755-2929
THE PAPER TIGERS
Affiliated With: TRUSTMARK INS CO
#962500650
PO Box 2942
CLINTON IA 52733
(800) 544-7312
THE PARK AVENUE BANK
PO BOX 71489
Newnan GA 30271
(770) 683-1050
PHS
(800) 253-4417
DOCTORS DIRECT
HEALTHCARE
(877) 503-0388
(770) 683-1050
The Parker Group
Group
PO Box 33159
San Antonio TX 78265-3159
ECS Payor ID 37283
(877) 782-6828
(877) 202-6379 Ext 2530
ULTRABENEFITS INC
ULTRABENEFITS INC
CHECK BENEFIT CARD
PO Box 763
(866) 858-7223
(877) 782-6828
THE PATRON SPIRITS COMPANY
(866) 858-7223
Network.
Info as of 12/24/2007
Page PIRMI-485
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
NORTH AMERICAN
ADMINISTRATORS-NY
COMPENSABILITY
NORTH AMERICAN
ADMINISTRATORS-NY
UTILIZATION REVIEW
(800) 828-6922
NORTH AMERICAN
ADMINISTRATORS-NY
(800) 828-6922
THE PERMANENTE MEDICAL GROUP, CBCA Administrators Inc
INC.
PO Box 1339
Affiliated With: CBCA Administrators, Inc. Minneapolis MN 55440-1339
THE PHYSICIAN HOSP COMMUNITY
ORGANIZATION PHCO
Affiliated With: THE PHYSICIAN HOSP
COMMUNITY ORGANIZATION PHCO
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CHECK BENEFIT CARD
THE PHYSICIANS GROUP
WATERSTONE BENEFIT
WATERSTONE BENEFIT
(405) 440-8888
THE PENN TRAFFIC COMPANY
ADMINISTRATORS - NY
PO Box 9501
AMHERST NY 14226
(800) 828-6922
5094734074
CHECK BENEFIT CARD
(405) 440-8888
THE POINT ORLANDO RESORT
SOLUTIONS
THE PREFERRED PLAN
PO Box 3559
(800) 426-7453
(800) 426-7453
CHECK BENEFIT CARD
(800) 426-7453
PO Box 520
Network.
Info as of 12/24/2007
Page PIRMI-486
www.firsthealth.com
PAYOR NAME
THE PRICE COMPANY
CORPORATION
CLAIMS SUBMISSION
Attn: Mary Shepherd
PO Box 489
COMPENSABILITY
UTILIZATION REVIEW
(800) 967-2077
MEDCAREONE CORP
(800) 816-1206
MERITAIN HEALTH
MERITAIN HEALTH
CHECK BENEFIT CARD
19800 Detroit Rd.
(440) 356-8426
(800) 967-2077
THE RIGHT THING, INC
(440) 356-8426
THE SCRIPPS RESEARCH INSTITUTE
GROUP
THE SMOOT CORPORATION
MANAGEMENT CORP
PO Box 5319
TAMPA FL 33675-5319
(800) 533-5044
CHECK BENEFIT CARD
(800) 533-5044
(EBMC)
(EBMC)
PO Box 9057
Dublin OH 43017
(888) 865-7774
CHECK BENEFIT CARD
(888) 865-7774
THE SMOOT CORPORATION
MANAGEMENT CORP
(EBMC)
(EBMC)
PO Box 9057
Dublin OH 43017
(888) 865-7774
CHECK BENEFIT CARD
(888) 865-7774
THE SUNDT COMPANIES
Affiliated With: MT STATES
Services
Services
TUCSON AZ 85710
(520) 722-7133
CHECK BENEFIT CARD
(520) 722-7133
Network.
Info as of 12/24/2007
Page PIRMI-487
www.firsthealth.com
PAYOR NAME
CLAIMS SUBMISSION
THE SUNDT COMPANIES INC
SCHALLER ANDERSON
Affiliated With: SCHALLER ANDERSON HEALTHCARE LLC
HEALTHCARE
BLDG 1 #200
PHOENIX AZ 85040
COMPENSABILITY
SCHALLER ANDERSON
HEALTHCARE LLC
UTILIZATION REVIEW
(602) 659-1418
SCHALLER ANDERSON
HEALTHCARE LLC
(602) 659-1488
THE TERTELIN COMPANY, INC.
CHECK BENEFIT CARD
(602) 659-1418
THE TERTELING COMPANY INC
Affiliated With: THE TERTELING
COMPANY INC
THE TERTELIN COMPANY, INC.
THE TILE SHOP
SERVICES
1665 Hill Rd
Boise ID 83702
PO Box 59212
SERVICES
(800)
997-1750
(800) 997-1750
(800) 997-1750
THE VANTAGE GROUP, INC
Affiliated With: TR PAUL INC
TR Paul Inc
TR Paul Inc
PO Box 5508
(203) 426-8161
HINES & ASSOCIATES
(888) 826-5769
(203) 426-8161
THE VERMONT TEDDY BEAR CO
ADMINISTRATORS - NY
NORTH AMERICAN
ADMINISTRATORS-NY
NORTH AMERICAN
ADMINISTRATORS-NY
PO Box 9501
AMHERST NY 14226
(800) 828-6922
NORTH AMERICAN
ADMINISTRATORS-NY
(800) 828-6922
(800) 828-6922
THE WALTERS GROUP
PLAN OF NEVADA
PLAN OF NEVADA
PO Box 15645
LAS VEGAS NV 89114
(702) 242-7700
SIERRA HEALTH &
LIFE/HEALTH PLAN OF
NEVADA
(702) 242-7345
(702) 242-7700
Network.
Info as of 12/24/2007
Page PIRMI-488
www.firsthealth.com
PAYOR NAME
THE WELLS CENTER
CLAIMS SUBMISSION
NORTH AMERICA
COMPENSABILITY
NORTH AMERICA
NORTH AMERICA
CHECK BENEFIT CARD
CHECK BENEFIT CARD
UTILIZATION REVIEW
PO Box 1984
NASHVILLE TN 37202
THE WINE GROUP
CHECK BENEFIT CARD
THEORIS INC
CONSULTANTS INC
CONSULTANTS INC
(800) 521-2654
8007773575
BAC
(614) 863-8780
(614) 863-8780
CHECK BENEFIT CARD

The First Health® Network MICHIGAN Payor Information Report

Transcription

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