Common Insurances
If you are unsure of insurance please see
the back of the card.
COMMON MEDICARE PLANS
● Medicare (Traditional they only have Medicare the patient) Red, Blue, White card.
● Amerihealth Caritas VIP Care Plus Dual Plan
● Medicare Plus Blue (XYL)
● BCN Advantage (XYK)
● HAP Senior
● Humana Advantage
● Molina Advantage
● Wellcare (Medicare plan)
● Mclaren Advantage
● Reliance (or CCA Health MI)
● Aetna Medicare
● UHC Medicare
● UHC Dual Plan
● MI Complete Health
● Preferred Care Partners (through UHC)
● Meridian Complete Care
● Sierra Medicare (through UHC payer ID 87726)
● Wabash Memorial (Medicare Railroad)
● Care Improvement Plus (through UHC payer ID 87726)
● Careplus Health Plan (Florida Medicare…we do not take)
● Centene Venture
● Ascension Complete Health (MI Complete Health payer ID 68069)
● Allsavers UHC (payer ID 81400)
COMMON MEDICAID PLANS
● St. Medicaid
● Blue Cross Complete
● Molina Medicaid
● Meridian Medicaid
● Hap Empowered
● Priority Medicaid
● UHC Community Plan
● Aetna Better Health Plan
● Mclaren
● MI Complete Health
COMMON DUAL PLANS
● Molina Dual
● Amerihealth Dual
● Aetna Better Health
● MI Complete Health
● UHC Dual
Medicaid Plans in Kareo:
ST. MEDICAID
Always has 10 digits...if you only see 7 or 8 then fill in the
BEGINNING with zeroes to make 10 digits (ei: 91234567….you
would enter 0091234567
Name: St. Medicaid
Payer Scenario: Medicaid
Plan: Medicaid
Payor ID 17111
Website to check Medicaid : https://milogintp.michigan.gov/
BLUE CROSS COMPLETE
(BCC) POLICY ALWAYS STARTS WITH XYU followed by 9 consecutive numbers
If the Medicaid ID is entered (10 digits) please update to
the XYU policy as found on Navinet WEBSITE.
Name of Insurance: Blue Cross Complete
Payer Scenario: Medicaid HMO
Plan: Blue Cross Complete
Payer ID: 7771M
Website to check eligibility for BCC https://identity.navinet.net/
Molina Medicaid
Uses the Medicaid ID (use 10 digits)
Name: Molina
Payer Scenario: Medicaid HMO
Plan: Molina
Payor ID: 38334
Website to check eligibility https://apps.availity.com/availity/web/public.elegant.login
Molina can be checked on Kareo for eligibility.
Meridian Medicaid
Payor ID: 52563 before 4/1/22
MHPMI after 4/1/22
Name: Meridian
Payer Scenario: Medicaid HMO
Plan: Meridian
Payor ID: MHPMI after 4/1/22
Website to check eligibility https://www.mimeridian.com/providers.html
MCLAREN MEDICAID
Name: MHP
Payer Scenario: Medicaid HMO
Plan: Mclaren Health Plan
Payor ID: 38338
Website to check eligibility:
Mclaren
UHC Community Plan
Name: UHC Community Plan
Payer Scenario - Medicaid HMO
Plan: United Health Care Community Plan
Payor ID: 95467
Website to check eligibility https://www.uhcprovider.com/
***need to use the UnitedHealthCare Community Plan ID
103349485***
AETNA BETTER HEALTH
Name: Aetna BH
Payer Scenario: Medicaid HMO
Plan: Aetna Better Health
Payor ID: 128M1
Website to check eligibility
https://apps.availity.com/availity/web/public.elegant.login
HAP EMPOWERED
Name: Hap Empowered
Payer Scenario: Medicaid HMO
Plan: Hap Empowered
Payor ID: 38224
When checking eligibility and the patient on champs comes up as Hap empowered but
the patient only provides the medicaid ID you can check it in Kareo to get the Hap ID
by entering the insurance under Hap Empowered and medicaid ID.
See video below:
Website to check eligibility WWW.HAP.ORG
Hap Empowered Can be checked in kareo.
PRIORITY MEDICAID
policy is the same as the patient’s Medicaid number
Name: Priority
Payer Scenario: Medicaid HMO
Plan: Priority Medicaid
Payor ID: 38217
Website to check eligibility https://provider.priorityhealth.com/
MI COMPLETE HEALTH
MEDICAID
policy is the same as the patient’s Medicaid number
Name: MI Complete Health
Payer Scenario: Medicaid HMO
Plan: Michigan Complete Health
Payor ID: 68069
Website to check eligibility https://www.mimeridian.com/providers.html
MEDICARE INSURANCES:
All Medicare dashes must be removed from the ID when
entering into Kareo or any other PM systems.
TRADITIONAL MEDICARE
Name: Medicare
Payer scenario: Medicare
Insurance plan: Medicare
Payer ID: 08202
Website to check eligibility www.wpsgha.com
Medicare can be checked through Kareo.
PACE MEDICARE
Name: PACE Medicare
Payer scenario: PACE Medicare
Insurance plan: Medicare
NOTE: PACE uses the same ID as traditional Medicare!!!!
Each county has their own address:
Example: PACE Southeast
MEDICARE RAILROAD
Check the Card carefully!!!
For Medicare Railroad you will see a bold Red line that says
RAILROAD RETIREMENT BOARD—This is NOT Traditional Medicare!!
Name: Medicare Railroad
Payer scenario: Medicare
Insurance plan: Medicare
Payer ID 00320
Website to check eligibility www.wpsgha.com
This can be checked through Kareo
MEDICARE PLUS BLUE
Always starts with XYL followed by 9 digits
This insurance is also called BCBS Advantage.
Name: MR Plus Blue
Payer scenario: Medicare
Insurance plan: BCBS Medicare Advantage or Medicare Plus Blue
Payer ID: 00778
Website to check eligibility
https://apps.availity.com/availity/web/public.elegant.login
BCN ADVANTAGE
Always starts with XYK followed by 9 digit
Name: BCN Adv.
Payer scenario: Medicare
Plan: Blue Care Network
PAYER ID: 77910
Website to check eligibility
https://apps.availity.com/availity/web/public.elegant.login
MCLAREN ADVANTAGE
Name: MHP
Payer Scenario: Commercial
Plan: Mclaren Health Plan
Payer ID: 38338
Website to check eligibility:
https://secure.healthx.com/v3app/a/?6713520D04184E071C0D1D261C0E191A0C0A1C00240
0133E0600410A0A1D552D0B151A1D0D16111B195C6A1D13081C114B1300310A5A350658155
B0740117004535D590B55450C425A26570544570000455E724B54645601565E534B402E18471
F1701050C545F48360B151F0706001B177C09076655570D0D57430C7E520555595C574C08425
6245B03440A535110117510523103555914431B593B0C0651412D50305F2B28715E545E5F5D5
6334B78435C6423552C2F2135630A555029465B57452C56570758/&redir=3
Humana Medicare
Name: Humana Adv.
Payer Scenario: Medicare
Plan: Humana
Payer ID: 61101
Website to check eligibility
https://apps.availity.com/availity/web/public.elegant.login
Tip: Policy begins with “H”
Aetna Medicare
Aetna Medicare, Commercial, and Aetna Better Health are often
confused for each other!! If the ID is a Medicaid ID it is Aetna
Better Health, Not Aetna Medicare or Aetna Commercial!!
Name: Aetna Medicare
Payer Scenario: Medicare
Plan: Aetna
Payer ID: 60054
Website to check eligibility
https://apps.availity.com/availity/web/public.elegant.login
Tip: **NOTE: OLD IDs (2021 and before) are all letters…Newer Aetna
MR IDs are all numbers****
Priority Health Medicare
Name: Priority Adv.
Payer Scenario: Medicare
Plan: Priority
Payer ID: 83217
Website to check eligibility https://provider.priorityhealth.com/
Tip: Most Medicare Policies starts with 800
HAP SENIOR
Name: HAP Senior
Payer Scenario Medicare
Plan: HAP.
Payer ID: 38224
Website to check eligibility www.hap.org
MOLINA MEDICARE
ID: 600- Dual Plan (Molina Medicare/Molina Medicaid
ID: 800- Molina Medicare by itself
Name (for both): Molina
Payer Scenario (for both): Medicare
Plan (for both): Molina
Payer ID (for both): 38334
Website to check eligibility
https://apps.availity.com/availity/web/public.elegant.login
Tip: For the dual Plan Molina will be entered 2x in Kareo so the patient doesn’t
receive a bill in error (the 600xxx ID and the Medicaid ID)
UHC MEDICARE
Name: UHC Advantage
Payer Scenario-Medicare
Plan: United Health Care
Payor ID: 87726
Website to check eligibility https://www.uhcprovider.com/
Preferred Care Partners
Medicare (through UHC)
Name: Preferred Care Partners MR
Payer Scenario: Medicare
Plan: Preferred Care Partners
PAYER ID: WELM2
Website to check eligibility https://www.uhcprovider.com/
See sample below—NOTICE THE PAYER ID ON THE CARD
WELLCARE MEDICARE
Name: Wellcare
Payer Scenario: Medicare
Plan: Wellcare Medicare
Payor ID: 14163
Wellcare can be checked on Kareo for eligibility.
TIP: *If you only have the Medicare ID you can check Wellcare
with the Medicare ID and Kareo will give you the Wellcare ID.
*Please note if a patient has Medicare and Medicare refers to Meridian as the
Part C payer (or Medicare HMO)....this will be WELLCARE or MI COMPLETE
HEALTH, not Meridian. *see below for an example.
MI Complete Health Medicare
Name: MI Complete Health
Payer Scenario: Medicare
Plan: Michigan Complete Health
Payor ID: 68069
TIP: policy starts with the letter “C” followed by 10 numbers (ex: C0012449501)
Website to check eligibility https://www.mimeridian.com/providers.html
*Please note if a patient has Medicare and Medicare refers to Meridian as the
Part C payer (or Medicare HMO)....this will be WELLCARE or MI COMPLETE
HEALTH, not Meridian. *see below for an example.
CENTENE VENTURE
(also known as Ascension
Complete)
Name: Ascension Complete MR
Payer Scenario: Medicare
Plan: Ascension Complete
Payor ID: 68069
Website to check eligibility https://www.mimeridian.com/providers.html
This can be checked through Kareo
TIP: Policy number: Starts with C followed by 1 digits (ex: C4056253501), also
recognizes the Medicare ID
CCA HEALTH MICHIGAN
MEDICARE
(also known as Reliance)
Name: Reliance MR
Payer Scenario: Medicare
Plan: CCA Health Michigan
Payor ID: RHP01
Website to check eligibility https://rhpprovider.prod.healthaxis.net/
Policy number: Starts with R followed by 7 digits (ex: R0001668), also recognizes
the Medicare ID.
Provider and Member Line: 855‐959‐5855
Address:
Medicare Advantage AP/GR
PO Box 94770 Lubbock, TX 79493 – 4770.
COMMERCIAL INSURANCE (PRIVATE)
AMBETTER
Name: Ambetter from Meridian
Payer Scenario: Commercial
Plan: Ambetter
Payer ID: 68069
Website to check eligibility https://www.ambettermeridian.com/
TIP: Policy starts with U
BLUE CROSS BLUE SHIELD
(BCBS)
Local BCBS policies will begin with 3 letters (alpha prefix)
Out of State policies may have numbers and letters mixed, but will still be billed to the
local BCBS.
Name: BCBS
Payer Scenario: BC/BS
Plan: BCBS
Payor ID: 77710
Website to check eligibility
https://apps.availity.com/availity/web/public.elegant.login
BCBS FEDERAL
starts with an R followed by 8 digits with (BCBS payer scenario)
Name: BCBS Federal ( R59812145)
Payer Scenario: BC/BS
Plan: BCBS Federal
Payer ID: 77911
Website to check eligibility
https://apps.availity.com/availity/web/public.elegant.login
AETNA COMMERCIAL
policy starts with the Letter (W)
Name: Aetna
Payer Scenario: Commercial
Plan: Aetna
Payor ID: 60054
Website to check eligibility
https://apps.availity.com/availity/web/public.elegant.login
BLUE CARE NETWORK
(BCN)
HMO PREFIX LETTER STARTS WITH (XYH-XYW-XYS-XYJ/XYB)
Name: BCN
Payer Scenario: HMO
Plan: Blue Care Network
Payor ID: 77910
Website to check eligibility
https://apps.availity.com/availity/web/public.elegant.login
PRIORITY PLAN priorit
Name: Priority
Payer Scenario Commercial
Plan: Priority
Payor ID: 38217
Website to check eligibility https://provider.priorityhealth.com/
TIP: Policy starts with a 9 and each family member has their own suffix at the end
of the ID (ex: 00, 01, 02, etc)
UNITED HEALTH CARE(UHC)
Name: UHC
Payer Scenario-Commercial
Plan: United Health Care
Payor ID: 87726
Website to check eligibility https://www.uhcprovider.com/
TIP: Commercial policy starts with a 9
UNITED HEALTH CARE
STUDENT RESOURCE
Name: Student Resource
Payer Scenario-Commercial
Plan: United Health Care
Payor ID: 74227
CIGNA
Name: Cigna
payer scenario commercial.
Plan: Cigna
Payor ID: 62308
Website to check eligibility https://identity.navinet.net/
TIP: Policy number starts with the letter (U)
(HAP)HEALTH ALLIANCE
HAP
Name: HAP
Payer scenario: Commercial
Insurance plan: Hap
Payor ID: 38224
Website to check eligibility www.hap.org
This can be checked through Kareo
TRICARE
(not to be confused with CHAMPVA, Community Care, or
TriWest!)
Name: Tricare
Payer scenario: Tricare
Insurance Plan: Tricare
Payor ID: TREST
Website to check eligibility https://www.humanamilitary.com/log-in
GOLDEN RULE
Name: Golden Rule
Payer Scenario: Commercial
Insurance name: Golden Rule
Payor ID: 37602
UMR
Sometimes it can be beaumont health
Name: UMR
Payer Scenario: Commercial
Insurance Plan: UMR
Payor ID: 39026
This can be checked through Kareo
APOSTROPHE
Name: Apostrophe
Payer Scenario: Commercial
Insurance Plan: Apostrophe
Payor ID: 81312
Website to check eligibility https://www.apostrophe.health/
ZELIS
HEALTHCARE/PHP-ZELIS
Name: Zellis
Payor Scenario: Commercial
Insurance Plan: Zelis Healthcare
Payor ID: 07689
VARIPRO
Name: Varipro
Payer Scenario: Commercial
Insurance Plan: Varipro
payor ID: 92187
Website to check eligibility
https://www.mediconnx.com/MediClm/Login.aspx?clientid=3412
ID:ogalal2022
Password: Summer@2022
ASR HEALTH BENEFITS
Name: ASR
Payer Scenario: Commercial
Insurance Plan: ASR
Payor ID: 38265
Website to check eligibility www.asr.com
CLEARCHAIN
Payor Scenario: Commercial
https://www.wltmediportal.com/MediClm/Login.aspx
ID: Delmasri2022
Password: Mousty@03144me
TRUSTMARK SMALL
BUSINESS:
Health Benefits (formerly CoreSource)
https://www.trustmarkbenefits.com/
TRUSTMARK HEALTH
BENEFITS
VA COMMUNITY CARE
NETWORK
Name: VA Community Care Network
Scenario: VA
Payer ID: VACCN
Please call for eligibility 877-881-7618
PORTAL (working to get a user): https://www.myvaccn.com/site/vaccn/main/public/login#/home
Authorization is required AND MUST BE ON THE CLAIM!. Please call for
eligibility 877-881-7618
BENESYS
TriWest (Always 2nd to
Medicare)
Name: TriWest
Scenario: VA
Payer ID: VACCN
Address: TriWest VA CCN Claims
PO Box 108851
Florence, SC 29502-8851
Eligibility:
Call 877-226-8749 or email to ProviderServices@TriWest.com
BENESYS
Name: Benesys
Scenario: Commercial
Insurance: HAP
Payer ID 38224
Website to check eligibility
https://benesys-prod.webspyglass.com/logonE.jsp;jsessionid=5F82C260EA12ED6
656612FEEF97C5516
SMARTHEALTH
Name: BCBS
Payer Scenario: BC/BS
Plan: BCBS
Payor ID: 77710
Website to check eligibility
https://apps.availity.com/availity/web/public.elegant.login
Alpha Prefix: ASY
HEALTHCHOICE
Name: HealthChoice
Payor Scenario: Commercial
Plan: HealthChoice
Payer ID: 71064
Website to check eligibility https://oklahoma.gov/healthchoice.html
*Be careful, there is also a Health Choice of MI (or
Community Care Associates…do not get these
confused) please make sure you recognize this by the
payor ID.
HEALTH CHOICE OF MI OR
COMMUNITY CARE ASSOCIATES
(Wayne County Health Choice)
Name: Community Care Associates or Wayne County Health Choice
**This is different than Health Choice on the previous page
Payor Scenario: Commercial
Plan: Wayne County Health Choice
Payer ID: 17902
Website to check eligibility https://www.ccarei.com/Eligibility.aspx
Instructions on how to use the portal:
Login to the portal
Enter Member ID
You will have to select a “person number” to reflect which family member you are
searching for. *** Please look below to see how**
you may have to try a few different numbers to find your patient. (they do not allow a
name search) See example below:
ALL SAVERS
Name: All Savers
Payer Scenario: Commercial
Plan: All Savers
Payor ID: 81400
Website to check eligibility https://provider-allsavers.optum.com/tpa-ap-web/
Claims can be faxed to 801-478-7582.
Sisco (Cofinity plan)
To check eligibility (no user ID needed)
https://www.siscoconnect.com/ProviderPortal/Inquiry/Eligibi
lity
DUAL PLANS
Dual plans are always Medicare and Medicaid plans.
When you have a dual plan You must I repeat you must add 2 payers
to prevent the patient getting a statement.
AMERIHEALTH CARITAS VIP CARE PLUS:
Name: Amerihealth Dual Plan
Payer Scenario: Medicare
Payer ID: 7701P
Plan: Amerihealth
Website to check eligibility on navinet: https://identity.navinet.net/
MOLINA DUAL PLAN:
MEMBER ID: 600- Dual Plan (Molina Medicare/Molina Medicaid)
Name: Molina Dual Options
Payer Scenario: Medicare
Payer ID : 38334
Plan: Molina (x2: 1 with the 600 ID, 1 with the Medicaid ID)
https://apps.availity.com/availity/web/public.elegant.login used to check ELIGIBILITY
AETNA BETTER HEALTH DUAL
Name: Aetna BH Dual Plan
Payer Scenario: Medicaid HMO
Payor ID: 128M1
Plan: Aetna Better Health (x2)--Both will be entered in as the medicaid ID
This is sometimes a dual plan, sometimes only for Medicaid–Watch carefully!!!
Example: If you see that it’s Medicare Aetna and Medicaid ID. Put the plan 2
times.
https://apps.availity.com/availity/web/public.elegant.login – USED TO CHECK ELIGIBILITY
EXAMPLE: 0123456789 AETNA BETTER HEALTH
0123456789 AETNA BETTER HEALTH
MI COMPLETE HEALTH DUAL
Name: MI Complete Health Dual Plan
Payer Scenario: Medicare
Payor ID: 68069
Plan: Michigan Complete Health (x2)
1. The 1st entry in Kareo will be for the Medicare portion: policy starts with
the letter “C” followed by 10 numbers (ex: C0012449501)
2. The 2nd entry in Kareo will be for the Medicaid portion: Uses the Medicaid
number
https://www.mimeridian.com/providers.html – USE TO CHECK ELIGIBILITY
UHC DUALPLAN
(Medicare/MD combined)
Name: UHC Dual Plan
Payer Scenario-Medicare
Payor ID: 95647
Plan: UHC Community
https://www.uhcprovider.com (checking eligibility)
***Tip: When entering this insurance you will enter UHC Community 2x so the patient
doesn’t receive a bill in error
MEDICARE SUPPLEMENT
PLANS
A Medicare supplement plan will always be your second payer.
This means the payer scenario is based on the primary payer. (ex: Medicare
scenario stays Medicare scenario)
AARP
Name: ALWAYS YOUR 2ND PAYER! (Example Medicare/Aetna Supplement)
Payer Scenario-Medicare/AARP
Payor ID: 36273
Plan: AARP
AETNA MEDICARE
SUPPLEMENT
Name: ALWAYS YOUR 2ND PAYER! (Example Medicare/Aetna Supplement)
Payer Scenario-Medicare (Remains Medicare for the primary payer)
Payor ID: 62118
Plan: Aetna Supplement (DO NOT CHOOSE AETNA OR AETNA BETTER
HEALTH!!)
MUTUAL OF OMAHA
Name: ALWAYS YOUR 2ND PAYER! (Example Medicare/Aetna Supplement)
Payer Scenario-Medicare (Remains Medicare for the primary payer)
Plan: Mutual of Omaha
Payor ID: 29076
