Payer Guides

Payer-focused reference built from the shared payer entity model: overview, verified contacts, state and LOB differences, official sources and AR workflows. Guides appear only for payers we actually have data on.

All content is labeled VERIFIED, EDITORIAL or VERIFY — an editorial source can never produce a VERIFIED label.

Accident Fund

VERIFIED

1 line of business · Other

1 verified contact value

Acuity

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Aetna

VERIFIED

1 state · 3 lines of business · Provider Services, Other

3 verified contact values

AIG

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

Allstate

VERIFIED

1 line of business · Other

1 verified contact value

American Family Insurance

VERIFIED

1 line of business · Other, Claims

2 verified contact values

American Specialty Health

VERIFIED

1 line of business · Other

1 verified contact value

Amerigroup

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

AmeriHealth Caritas

VERIFIED

1 state · 1 line of business · Other, Provider Services, Claims

3 verified contact values

AMERISAFE

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Amerisure

VERIFIED

1 line of business · Other, Claims

2 verified contact values

AmTrust

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

Anthem Blue Cross Blue Shield

VERIFIED

2 lines of business · Other, Member Services

2 verified contact values

Anthem Blue Cross Blue Shield of Colorado

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross Blue Shield of Connecticut

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross Blue Shield of Georgia

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross Blue Shield of Indiana

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross Blue Shield of Kentucky

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross Blue Shield of Maine

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross Blue Shield of Missouri

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross Blue Shield of Nevada

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross Blue Shield of New Hampshire

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross Blue Shield of Ohio

VERIFIED

3 states · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross Blue Shield of Virginia

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross Blue Shield of Wisconsin

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Anthem Blue Cross of California

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Arkansas Blue Cross Blue Shield

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

ATRIO Health Plans

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

Auto-Owners Insurance

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Availity

VERIFIED

1 line of business · Other

1 verified contact value

Avera Health Plans

VERIFIED

2 states · 1 line of business · Other, Member Services

4 verified contact values

AvMed

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Banner Medicare

VERIFIED

1 state · 1 line of business · Other

1 verified contact value

Berkshire Hathaway GUARD

VERIFIED

1 line of business · Other, Claims

2 verified contact values

BITCO

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Blue Cross Blue Shield of Alabama

VERIFIED

1 state · 1 line of business · Other, Provider Services, Credentialing

4 verified contact values

Blue Cross Blue Shield of Arizona

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Blue Cross Blue Shield of Illinois

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Blue Cross Blue Shield of Kansas

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of Kansas City (Blue KC)

VERIFIED

2 states · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of Louisiana

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of Massachusetts

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Blue Cross Blue Shield of Michigan

VERIFIED

1 state · 1 line of business · Provider Services, Credentialing, EDI

3 verified contact values

Blue Cross Blue Shield of Minnesota

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of Mississippi

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of Montana

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of Nebraska

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of New Mexico

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of North Carolina

VERIFIED

1 state · 1 line of business · Provider Services, Credentialing, EDI

3 verified contact values

Blue Cross Blue Shield of North Dakota

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of Oklahoma

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of Rhode Island

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of South Carolina

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of Texas

VERIFIED

1 state · 1 line of business · Provider Services, Eligibility

2 verified contact values

Blue Cross Blue Shield of Vermont

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross Blue Shield of Wyoming

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross of Idaho

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Blue Cross of Northeastern Pennsylvania

VERIFIED

1 state · 1 line of business · Provider Services

1 verified contact value

Blue Shield of California

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

Blue Shield of Northeastern New York

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

BlueCross BlueShield of Tennessee

VERIFIED

1 state · 1 line of business · Provider Services

1 verified contact value

Broadspire

VERIFIED

1 line of business · Other, Claims

2 verified contact values

BSW Health Plan

VERIFIED

1 state · 1 line of business · Other

1 verified contact value

Cambia Health Solutions (Regence)

VERIFIED

4 states · 1 line of business · Provider Services

1 verified contact value

Capital Blue Cross

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

CareFirst BlueCross BlueShield

VERIFIED

3 states · 1 line of business · Other, Provider Services

3 verified contact values

Carelon Medical Benefits Management

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

CareOregon

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

CareSource

VERIFIED

1 state · 1 line of business · Other, Provider Services, Claims

3 verified contact values

Carisk Partners

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

CCMSI

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

CDPHP

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

Centene Corporation

VERIFIED

2 states · 2 lines of business · Other, Provider Services, Claims

6 verified contact values

CHAMPVA (VA)

VERIFIED

1 line of business · Other

1 verified contact value

CHRISTUS Health Plan

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Chubb

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Cigna Healthcare

VERIFIED

1 line of business · Other

1 verified contact value

Clover Health

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

CNA

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

Cohere Health

VERIFIED

1 line of business · Other

1 verified contact value

Community First Health Plans

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

Community Health Choice

VERIFIED

1 state · 1 line of business · Provider Services

1 verified contact value

CorVel

VERIFIED

1 line of business · Other

1 verified contact value

COUNTRY Financial

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

CountyCare

VERIFIED

1 state · 1 line of business · Prior Authorization

1 verified contact value

Dean Health Plan

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Delta Dental

VERIFIED

1 line of business · Other

1 verified contact value

DentaQuest

VERIFIED

1 line of business · Other, Member Services

2 verified contact values

Devoted Health

VERIFIED

1 line of business · Other, Member Services

2 verified contact values

Donegal Insurance Group

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

EBMS

VERIFIED

1 line of business · Other, Member Services

2 verified contact values

Elevance Health

VERIFIED

1 state · 2 lines of business · Other, Provider Services, Claims

3 verified contact values

EmblemHealth

VERIFIED

1 state · 1 line of business · Other

1 verified contact value

EMC Insurance

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

Empire BlueCross BlueShield

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

EMPLOYERS

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Encova Insurance

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Erie Insurance

VERIFIED

1 line of business · Other

1 verified contact value

ESIS

VERIFIED

2 lines of business · Other

2 verified contact values

eternalHealth

VERIFIED

1 line of business · Other, Member Services

2 verified contact values

EviCore Healthcare

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

Excellus BlueCross BlueShield

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

EyeMed

VERIFIED

1 line of business · Other

1 verified contact value

Fallon Health

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Farmers Insurance

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Federal Employee Program (FEP)

VERIFIED

1 line of business · Other, Member Services

2 verified contact values

Federated Insurance

VERIFIED

1 line of business · Other, Claims

2 verified contact values

FirstCare

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Florida Blue (Blue Cross Blue Shield of Florida)

VERIFIED

1 state · 1 line of business · Provider Services

1 verified contact value

Frankenmuth Insurance

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

Gallagher Bassett

VERIFIED

1 line of business · Other

1 verified contact value

GEICO

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Geisinger Health Plan

VERIFIED

1 state · 1 line of business · Other, Claims

2 verified contact values

Genex Services

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Grange Insurance

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

Great American Insurance Group

VERIFIED

2 lines of business · Other

2 verified contact values

Guardian

VERIFIED

1 line of business · Other, Member Services

2 verified contact values

Health Alliance Plan (HAP)

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Health Care Service Corporation (BCBS)

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Health New England

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

HealthNow New York (BlueCross BlueShield of Western New York)

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

HealthPartners

VERIFIED

2 states · 1 line of business · Other, Provider Services

4 verified contact values

HealthSCOPE Benefits

VERIFIED

1 line of business · Other

1 verified contact value

Highmark

VERIFIED

3 states · 2 lines of business · Other, Provider Services

3 verified contact values

HMSA (Blue Cross Blue Shield of Hawaii)

VERIFIED

1 state · 1 line of business · Member Services

1 verified contact value

Horizon Blue Cross Blue Shield of New Jersey

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

Humana

VERIFIED

2 lines of business · Other

1 verified contact value

ICW Group

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Independence Blue Cross

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Independent Health

VERIFIED

1 state · 1 line of business · Other

1 verified contact value

Johns Hopkins Health Plans

VERIFIED

1 state · 1 line of business · Other

1 verified contact value

Jopari Solutions

VERIFIED

1 line of business · Other, EDI

2 verified contact values

Kaiser Permanente

VERIFIED

1 line of business · Other

1 verified contact value

Kelsey-Seybold Clinic

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

Kemper

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Liberty Mutual

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Luminare Health

VERIFIED

1 line of business · Other

1 verified contact value

Martin's Point Health Care

VERIFIED

2 states · 1 line of business · Other, Provider Services

4 verified contact values

Maryland Physicians Care

VERIFIED

1 state · 1 line of business · Provider Services

1 verified contact value

Medicaid (State Programs)

VERIFIED

51 states · 1 line of business · Other, Claims, Provider Services

93 verified contact values

Medical Mutual of Ohio

VERIFIED

1 state · 1 line of business · Provider Services, Authorization

2 verified contact values

Medicare (CMS)

VERIFIED

1 line of business · Other, Member Services

2 verified contact values

MedRisk

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

MedStar Family Choice

VERIFIED

1 state · 1 line of business · Provider Services

1 verified contact value

MEMIC

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Mercury Insurance

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Mercy Care

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Meritain Health

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

MetLife

VERIFIED

1 line of business · Other

1 verified contact value

Moda Health

VERIFIED

3 states · 1 line of business · Other

3 verified contact values

Molina Healthcare

VERIFIED

2 states · 2 lines of business · Provider Services, Claims, Authorization

5 verified contact values

MVP Health Care

VERIFIED

2 states · 1 line of business · Other, Provider Services

4 verified contact values

Nationwide

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Network Health

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

NJM Insurance

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

One Call

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

Optum Physical Health

VERIFIED

1 line of business · Other

1 verified contact value

Optum Workers' Comp / Auto

VERIFIED

1 line of business · Other

1 verified contact value

Oscar Health

VERIFIED

1 line of business · Other

1 verified contact value

PacificSource Health Plans

VERIFIED

3 states · 1 line of business · Other, Provider Services

6 verified contact values

Paramount Health Care

VERIFIED

1 state · 1 line of business · Other

1 verified contact value

PMA Companies

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Point32 Health

VERIFIED

1 line of business · Other, Member Services

2 verified contact values

Premera Blue Cross

VERIFIED

2 states · 1 line of business · Other, Provider Services

3 verified contact values

Presbyterian Healthcare Services

VERIFIED

1 state · 1 line of business · Other

1 verified contact value

Priority Health

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Progressive

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Prominence Health Plan

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Providence Health Plan

VERIFIED

2 states · 1 line of business · Other, Member Services

4 verified contact values

PTPN

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

Safety National

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Sanford Health Plan

VERIFIED

2 states · 1 line of business · Other, Provider Services

4 verified contact values

SCAN Health Plan

VERIFIED

1 line of business · Other

1 verified contact value

Security Health Plan

VERIFIED

1 state · 1 line of business · Other, Provider Services

2 verified contact values

Sedgwick

VERIFIED

1 line of business · Other

1 verified contact value

Select Health

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

Select Health of South Carolina (First Choice)

VERIFIED

1 state · 1 line of business · Prior Authorization

1 verified contact value

Sentara Health Plans

VERIFIED

1 state · 1 line of business · Other

1 verified contact value

Sentry Insurance

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

SFM

VERIFIED

1 line of business · Other, Claims

2 verified contact values

Simpra Advantage

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

State Auto

VERIFIED

1 line of business · Other, Claims

2 verified contact values

State Farm

VERIFIED

1 line of business · Other

1 verified contact value

SummaCare

VERIFIED

1 state · 1 line of business · Other

1 verified contact value

Texas Children's Health Plan

VERIFIED

1 state · 1 line of business · Other, Member Services

2 verified contact values

Texas Mutual

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

The Cincinnati Insurance Companies

VERIFIED

1 line of business · Other, Claims

2 verified contact values

The Hanover Insurance Group

VERIFIED

2 lines of business · Other, Claims

4 verified contact values

The Hartford

VERIFIED

1 line of business · Other

1 verified contact value

The Travelers Companies

VERIFIED

1 line of business · Other

1 verified contact value

TheraMatrix

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

TRICARE

VERIFIED

1 line of business · Other, Claims

2 verified contact values

TriWest Healthcare Alliance

VERIFIED

1 line of business · Other, Claims

2 verified contact values

UMR

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

UnitedHealthcare

VERIFIED

1 state · 3 lines of business · Other, Provider Services

4 verified contact values

UPMC Health Plan

VERIFIED

1 state · 1 line of business · Other, Provider Services, Claims

3 verified contact values

USAA

VERIFIED

1 line of business · Other

1 verified contact value

VA Community Care Network

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

VSP Vision Care

VERIFIED

1 line of business · Other

1 verified contact value

W.R. Berkley Corporation

VERIFIED

1 line of business · Other

1 verified contact value

Washington State Department of Labor & Industries

VERIFIED

1 state · 1 line of business · Other

1 verified contact value

WCF Insurance

VERIFIED

1 line of business · Other

1 verified contact value

Wellcare

VERIFIED

1 line of business · Other

1 verified contact value

Wellmark Blue Cross Blue Shield

VERIFIED

2 states · 1 line of business · Provider Services

2 verified contact values

WorkCompEDI

VERIFIED

1 line of business · Other, EDI

2 verified contact values

WPS Health Solutions

VERIFIED

1 line of business · Other, Member Services

2 verified contact values

Zenith Insurance Company

VERIFIED

1 line of business · Other, Provider Services

2 verified contact values

Zing Health

VERIFIED

1 line of business · Other, Member Services

2 verified contact values

Zurich North America

VERIFIED

1 line of business · Claims

1 verified contact value