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1 Payer Name Payer ID Par/NonPar Pass Through Fee* Eligibility Claims Status Referral (Envision Portal Only) B2B Custom Eligibility Payer Search Options Aetna Non Par N Y Y Y Aetna Eligibility Anthem Blue Cross Blue Shield Blue Cross Blue Shield CO -Coming Soon! Non Par N Y Y Anthem Eligibility Blue Cross Blue Shield CT -Coming Soon! Non Par N Y Y Anthem Eligibility Blue Cross Blue Shield IN -Coming Soon! Non Par N Y Y Anthem Eligibility Blue Cross Blue Shield KY -Coming Soon! Non Par N Y Y Anthem Eligibility Blue Cross Blue Shield ME -Coming Soon! Non Par N Y Y Anthem Eligibility Blue Cross Blue Shield NH -Coming Soon! Non Par N Y Y Anthem Eligibility Blue Cross Blue Shield NV -Coming Soon! Non Par N Y Y Anthem Eligibility Blue Cross Blue Shield OH -Coming Soon! Non Par N Y Y Anthem Eligibility Blue Cross Blue Shield TX -Coming Soon! Blue Cross CA* Non Par N Y Y Blue Cross CA Eligibility CHA Health Plan 1056 Non Par Y Y N CHA Health Plan Eligibility Cigna Healthcare Non Par N Y Y Cigna Eligibility Connecticare Par N Y Y Connecticare Eligibility Coventry Of Georgia Non Par Y Y N Coventry of GA Eligibility DMERC - Region A MR030 Non Par N Y N CMS Search Options & Enroll Form DMERC - Region B MR031 Non Par N Y N CMS Search Options & Enroll Form DMERC - Region C MR032 Non Par N Y N CMS Search Options & Enroll Form DMERC - Region D MR024 Non Par N Y N CMS Search Options & Enroll Form Georgia BCBS* Non Par Y Y N Georgia BCBS Eligibility Glassman- Directors Guild Non Par Y Y N Glassman- Directors Guild Eligibility Glassman- Writers Guild Non Par Y Y N Glassman- Writers Guild Eligibility Great West Life Par N Y Y Great West Eligibility Harvard Pilgrim Non Par N Y N Harvard Pilgram Eligibility HealthNet of CA Par N Y N HealthNet of CA Eligibility Humana Non Par Y Y N Humana Eligibility Independence Blue of PA Non Par N Y N Independence Blue of PA Eligibility Inland Empire Health Plan 1081 Non Par Y Y N Inland Empire Eligibility InterValley Health Plan 1052 Non Par Y Y N InterValley Search Eligibility Kaiser Permanente Of Georgia Non Par Y Y N Kaiser Permanente Of GA Eligibility MA BCBS BS059 Non Par Y Y N MA BCBS Eligibility Medicaids CA Medicaid-MediCal Non Par Y Y N CA Medicaid Eligibility CT Medicaid Non Par Y Y N CT Medicaid Eligibility 1of 8

2 Payer Name Payer ID Par/NonPar Pass Through Fee* Eligibility Claims Status Referral (Envision Portal Only) Eligibility Payer Search Options Florida Medicaid Non Par Y Y N FL Medicaid Eligibility GA Medicaid Non Par Y Y N GA Medicaid Eligibility Kentucky Medicaid Non Par Y Y N KY Medicaid Eligibility MA Medicaid Non Par Y Y N MA Medicaid Eligibility Mississippi Non Par Y Y N MS Medicaid Eligibility Missouri Non Par Y Y N MO Medicaid Eligibility Ohio Non Par Y Y N OH Medicaid Eligibility Oklahoma Non Par Y Y N OK Medicaid Eligibility Pennsylvania Non Par Y Y N PA Medicaid Eligibility Texas Non Par Y Y N TX Medicaid Eligibility VA Medicaid Non Par Y Y N VA Medicaid Eligibility WA Medicaid Non Par Y Y N WA Medicaid Eligibility Medicare Medicare - Alabama MR054 Non Par N Y N CMS Search Options & Enroll Form Medicare - Alaska MR010 Non Par N Y N CMS Search Options & Enroll Form Medicare - Arizona MR008 Non Par N Y N CMS Search Options & Enroll Form Medicare - Arkansas MR055 Non Par N Y N CMS Search Options & Enroll Form Medicare - Colorado MR004 Non Par N Y N CMS Search Options & Enroll Form Medicare - Connecticut MR049 Non Par N Y N CMS Search Options & Enroll Form Medicare - Delaware MR039 Non Par N Y N CMS Search Options & Enroll Form Medicare - Florida MR025 Non Par N Y N CMS Search Options & Enroll Form Medicare - Georgia MR015 Non Par N Y N CMS Search Options & Enroll Form Medicare - Hawaii MR057 Non Par N Y N CMS Search Options & Enroll Form Medicare - Idaho MR003 Non Par N Y N CMS Search Options & Enroll Form Medicare - Illinois (WPS) MR023 Non Par N Y N CMS Search Options & Enroll Form Medicare - Indiana MR041 Non Par N Y N CMS Search Options & Enroll Form Medicare - Iowa MR036 Non Par N Y N CMS Search Options & Enroll Form Medicare - Kansas MR060 Non Par N Y N CMS Search Options & Enroll Form Medicare - Kentucky MR052 Non Par N Y N CMS Search Options & Enroll Form Medicare - Louisiana MR048 Non Par N Y N CMS Search Options & Enroll Form Medicare - Maine MR043 Non Par N Y N CMS Search Options & Enroll Form Medicare - Maryland MR038 Non Par N Y N CMS Search Options & Enroll Form Medicare - Massachusetts MR061 Non Par N Y N CMS Search Options & Enroll Form Medicare - Michigan (WPS) MR017 Non Par N Y N CMS Search Options & Enroll Form Medicare - Minnesota (WPS) MR019 Non Par N Y N CMS Search Options & Enroll Form Medicare - Mississippi MR050 Non Par N Y N CMS Search Options & Enroll Form 2of 8

3 Payer Name Payer ID Par/NonPar Pass Through Fee* Eligibility Claims Status Referral (Envision Portal Only) Eligibility Payer Search Options Medicare - Missouri (BCBS Arkansas) MR094 Non Par N Y N CMS Search Options & Enroll Form Medicare - Missouri (Kansas City) MR044 Non Par N Y N CMS Search Options & Enroll Form Medicare - Montana MR047 Non Par N Y N CMS Search Options & Enroll Form Medicare - Nebraska MR092 Non Par N Y N CMS Search Options & Enroll Form Medicare - Nevada MR007 Non Par N Y N CMS Search Options & Enroll Form Medicare - New Hampshire MR051 Non Par N Y N CMS Search Options & Enroll Form Medicare - New Jersey MR035 Non Par N Y N CMS Search Options & Enroll Form Medicare - New Mexico MR076 Non Par N Y N CMS Search Options & Enroll Form Medicare - New York (Empire) MR042 Non Par N Y N CMS Search Options & Enroll Form Medicare - New York (Ghi-Queens Cty) MR045 Non Par N Y N CMS Search Options & Enroll Form Medicare - North Carolina MR020 Non Par N Y N CMS Search Options & Enroll Form Medicare - North Dakota MR083 Non Par N Y N CMS Search Options & Enroll Form Medicare - Northern California MR002 Non Par N Y N CMS Search Options & Enroll Form Medicare - Ohio MR033 Non Par N Y N CMS Search Options & Enroll Form Medicare - Oklahoma MR013 Non Par N Y N CMS Search Options & Enroll Form Medicare - Oregon MR011 Non Par N Y N CMS Search Options & Enroll Form Medicare - Pennsylvania MR027 Non Par N Y N CMS Search Options & Enroll Form Medicare - Rhode Island MR075 Non Par N Y N CMS Search Options & Enroll Form Medicare - South Carolina MR028 Non Par N Y N CMS Search Options & Enroll Form Medicare - South Dakota MR084 Non Par N Y N CMS Search Options & Enroll Form Medicare - Southern California MR001 Non Par N Y N CMS Search Options & Enroll Form Medicare - Tennessee MR034 Non Par N Y N CMS Search Options & Enroll Form Medicare - Texas MR005 Non Par N Y N CMS Search Options & Enroll Form Medicare - Upstate New York MR059 Non Par N Y N CMS Search Options & Enroll Form Medicare - Utah MR046 Non Par N Y N CMS Search Options & Enroll Form Medicare - Vermont MR062 Non Par N Y N CMS Search Options & Enroll Form Medicare - Virginia (TrailBlazer) MR022 Non Par N Y N CMS Search Options & Enroll Form Medicare - Washington MR006 Non Par N Y N CMS Search Options & Enroll Form Medicare - Washington DC MR040 Non Par N Y N CMS Search Options & Enroll Form Medicare - West Virginia MR056 Non Par N Y N CMS Search Options & Enroll Form Medicare - Wisconsin MR053 Non Par N Y N CMS Search Options & Enroll Form Medicare - Wyoming MR074 Non Par N Y N CMS Search Options & Enroll Form Railroad Medicare/ Palmetto GBA MR018 Non Par N Y N CMS Search Options & Enroll Form Molina Molina CA Non Par Y Y N Molina Eligibility Molina MI Non Par Y Y N Molina Eligibility 3of 8

4 Payer Name Payer ID Par/NonPar Pass Through Fee* Eligibility Claims Status Referral (Envision Portal Only) Eligibility Payer Search Options Molina UT Non Par Y Y N Molina Eligibility Molina WA Non Par Y Y N Molina Eligibility Oxford Health Plans, Inc Transitional N Y Y Y Oxford Eligibility Pacificare Pacificare CA Non Par N Y Y Pacificare Eligibility Pacificare OK Non Par N Y Y Pacificare Eligibility Pacificare OR Non Par N Y Y Pacificare Eligibility Pacificare TX Non Par N Y Y Pacificare Eligibility Pacificare WA Non Par N Y Y Pacificare Eligibility San Joaquin Health Plan 1046 Non Par Y Y N San Joaquin Health Plan Eligibility SCAN HMO Non Par Y Y N SCAN HMO Eligibility Stanislaus County MIA 1045 Non Par Y Y N Stanislaus County MIA Eligibility United Healthcare Transitional N Y Y UHC Eligibility Western Health Advantage 1043 Non Par Y Y N Western Health Advantage Eligibility * Pass Through Fee varies by payer. Please speak to your account representative for details. * These Payers require enrollment. Please request Enrollment Forms from: provider.enrollment@medavanthealth.com: Anthem Blue Cross Blue Shield Payers- CSI only Blue Cross of CA- Eligibility and CSI Georgia BCBS- Eligibility only Par = Payers which participate with MedAvant in efforts to increase EDI volumes by subsidizing all, or a significant portion, of the cost of electronic transmiss Non Par = Payers which do not participate with MedAvant in programs to increase EDI volumes by subsidizing the cost of electronic transmission. Transitional = Payers which participate with MedAvant in efforts to increase EDI volume, but do not fully subsidize the cost of electronic transmission. 4of 8

5 mers CSI Payer Search Options Aetna CSI Blue Cross CA CSI Cigna CSI Connecticare CSI Great West CSI 5of 8

6 CSI Payer Search Options 6of 8

7 CSI Payer Search Options 7of 8

8 CSI Payer Search Options Oxford CSI UHC CSI ion. 8of 8

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