Directory of Health Insurance Providers & Billing Contacts
In the world of medical billing, access to payer-specific information isn’t a luxury—it’s a necessity. From CPT modifier rules to preauthorization phone lines, every insurer has its own documentation demands and communication bottlenecks. Whether you're a solo biller or part of a large revenue cycle team, having an organized, accurate reference for health insurance contacts can shave days off your claims process and prevent costly denials.
This directory goes beyond listing phone numbers. It includes key billing terms, portal guidance, and critical documentation nuances tied to each payer. Wherever possible, we've linked essential industry terms—like medical claims submission—to more detailed reference articles, so you’re never left guessing in the middle of a claim.
Major National Payers & Their Billing Departments
When working with high-volume insurers like UnitedHealthcare, Aetna, Blue Cross Blue Shield, and Cigna, knowing exactly where and how to send claims is non-negotiable. These four dominate the U.S. private payer space, yet each uses different submission portals, remittance formats, and support workflows. Having their contacts organized is critical to avoid payment delays.
UnitedHealthcare
Provider Services: 877-842-3210
Claims Submission Portal: UHCprovider.com
EDI Clearinghouse ID: 87726
Forms: Uses CMS-1500 and proprietary appeal templates
Processing Timeframe: 15–20 business days
UHC’s online portal requires separate logins per TIN. It's optimized for electronic batch claim uploads, real-time status tracking, and automated remittance downloads.
Aetna
Provider Services: 888-632-3862
Claims Portal: Availity Essentials
EDI Payer ID: 60054
Appeals: Written requests mailed or submitted via Availity
Forms: Aetna-specific reconsideration form required
Aetna frequently updates payer ID routing for different lines of business, so always validate payer IDs based on the patient's employer group or plan type.
Blue Cross Blue Shield (BCBS)
BCBS operates regionally, meaning each state has its own contact numbers, payer IDs, and submission portals.
Example – BCBS of Texas
Provider Contact: 800-451-0287
Portal: Availity
Payer ID: 84980
Appeal Address: Listed per region on plan-specific remittance
Each BCBS affiliate has a different electronic claims processing workflow. Some allow attachments; others require faxed medical records for pended claims.
Guide to Electronic Claims Processing Terms gives a full breakdown of clearinghouse IDs, batch formats, and timing standards.
Cigna
Provider Support: 800-882-4462
Claim Portal: CignaforHCP
EDI ID: 62308
Turnaround Time: Avg. 10–14 days
Forms: Cigna internal appeal request form + clinical justification
Cigna flags inconsistencies aggressively—especially in diagnosis-to-procedure alignment. Their portal allows direct messaging with claim reviewers, which cuts accounts receivable (A/R) times when used proactively. See our full Understanding Accounts Receivable (A/R) guide for optimization strategies.
Key Takeaways
Use payer-specific forms—don’t reuse generic appeals
Double-check payer ID per clearinghouse and per line of business
Save fax, phone, and escalation paths in shared folders or billing software
Track claim aging by payer—some (like Cigna) respond faster via portals than mail
Mastering these contact points shortens reimbursement cycles and reduces costly rework. A single claim stuck in limbo due to a wrong fax number or incorrect portal login wastes hours of staff time and delays revenue.
| Payer | Provider Contact | Claims Portal | Payer ID / EDI |
|---|---|---|---|
| UnitedHealthcare | 877-842-3210 | UHCprovider.com | 87726 |
| Aetna | 888-632-3862 | Availity Essentials | 60054 |
| BCBS (Texas Example) | 800-451-0287 | Availity | 84980 |
| Cigna | 800-882-4462 | CignaforHCP | 62308 |
Medicare & Medicaid: Region-Specific Resources
Unlike commercial insurers, Medicare and Medicaid contacts vary heavily by region, adding complexity for billers working across state lines. Medicare relies on Medicare Administrative Contractors (MACs), while Medicaid is governed at the state level—each with its own forms, escalation process, and resubmission windows.
Medicare: Know Your MAC
Medicare billing support is managed by jurisdiction-specific MACs. Each MAC has its own:
Provider contact center
Claims submission PO boxes
Secure electronic data interchange (EDI) portals
Pre-claim review or documentation checklists
For example, Jurisdiction E (covering CA, HI, and NV) uses Noridian as its MAC, while Jurisdiction K (NY, MA, CT) uses National Government Services. These MACs update claims forms, timely filing limits, and appeal pathways independently.
Refer to our Medicare Reimbursement Calculator Guide to match MACs to your region and billing specialty.
Medicaid: One State, One System
Medicaid billing is even more segmented. Each state Medicaid agency provides:
A unique payer ID and portal login
Distinct prior authorization contact numbers
Different denial appeal levels and timelines
For example, Texas Medicaid requires authorization requests via TMHP (Texas Medicaid & Healthcare Partnership), while California Medicaid operates through Medi-Cal with its own approval forms and documentation requirements. Failure to follow state-specific formats leads to automatic denials.
Key Protocol Differences
Appeals timelines: Some MACs allow 120 days; others only 60
Attachments: Some states accept upload-only; others require fax
Eligibility verification: MACs often use IVR, while Medicaid uses state portals
Escalation chains: Federal vs. state systems use different language and response paths
The process of coding submission, appeal, and follow-up for these payers is not standardized. Consult our Medical Claims Submission Terminology Guide to map payer-specific language and forms to the correct MAC or Medicaid office.
To avoid denials:
Confirm the assigned MAC by provider TIN and ZIP
Use state Medicaid handbooks for current contact numbers
Document all call interactions, including rep IDs and timestamps
Log submission methods—fax, portal, mail—for follow-up clarity
Precision matters. MACs reject claims missing required documentation without review, and Medicaid programs enforce hard cutoffs for response windows. Knowing the exact contacts and protocols avoids time-draining resubmissions.
Medicare & Medicaid: Region-Specific Billing Essentials
Billing public payers means navigating a maze of region-specific rules. Medicare relies on jurisdiction-based MACs, while Medicaid is controlled by individual states—each with its own contacts, portals, and escalation protocols.
Medicare: Know Your MAC
- Jurisdiction-specific MACs handle billing and appeals
- Each MAC offers unique portals, filing limits, and contact centers
- Examples: Noridian (Jurisdiction E), NGS (Jurisdiction K)
- Refer to our Medicare Reimbursement Calculator Guide for MAC matching
Medicaid: One State, One System
- Each state has its own portal, prior auth contact, and appeal rules
- Example: Texas (TMHP), California (Medi-Cal)
- Inconsistent documentation = instant denial
- Always check the latest handbook or bulletin for form requirements
Key Protocol Differences to Track
- Appeals: 60–120 days based on payer
- Attachments: Upload vs. fax vs. hard copy
- Verification: IVR systems (Medicare) vs. state portals (Medicaid)
- Escalation: Language and logic differ between federal and state systems
✔️ Confirm your MAC by ZIP and TIN
✔️ Save all interaction details: rep name, time, submission method
✔️ Use our Medical Claims Submission Terminology Guide to align terms, IDs, and escalation steps
Commercial Insurance: Prior Auth & Payer Portals
When billing commercial insurance, real-time portal access is non-negotiable. Most denials begin upstream—at the authorization or eligibility stage—not at final claim submission. That’s why knowing where to log in, what to submit, and how to escalate pre-claim issues is crucial for commercial payers like Aetna, Anthem, Humana, and others.
Key Portal Functions to Prioritize
Nearly every major commercial payer offers a secure portal with three critical tools:
Eligibility & Benefits Verification
Allows real-time plan coverage lookup by member ID
Reduces risk of claim denials for out-of-network or excluded services
Prior Authorization Submission
Enables direct submission with clinical notes, CPT/ICD combos, and physician NPI
Offers instant approvals or requests for additional documentation
Claim Pre-Edits & Payer Rules Engine
Flags coding mismatches or missing modifiers before final submission
Some platforms provide AI-driven warnings based on historical denial trends
Common Commercial Contact Patterns
Most insurers route provider inquiries through Availity, OneHealthPort, NaviNet, or a custom portal. However, payer-specific quirks still apply:
Anthem: Prior auth for imaging requires AIM portal, not Availity
Humana: Uses Availity, but credentialing and EFT updates go through Humana’s internal system
UnitedHealthcare: Requires Optum ID for prior auth and claim tools
Molina: Each state operates with separate portals and payer IDs
Understanding these distinctions keeps first-pass claim acceptance rates high and reduces preventable rework.
Our full Detailed Reference for CPT Coding Guidelines shows how payer portals evaluate CPT combinations during auth review.
Software Compatibility Matters
To maximize efficiency, your billing software should integrate directly with commercial portals or use clearinghouses that support two-way communication. As discussed in our Top 10 Medical Billing Software Solutions Directory, solutions like Kareo and CollaborateMD streamline auth-to-claim flows using built-in portal bridges.
Final Tips
Always confirm eligibility within 24 hours of service
Document auth reference numbers in your EHR/PM software
Save payer portal screenshots or confirmations for audit defense
Recheck auth status if there's a CPT code substitution or modifier update
By leveraging portals for pre-claim intelligence, billing teams prevent denials instead of reacting to them—saving both time and revenue.
Work Comp & Auto Insurance Providers
Workers' compensation and auto medical claims require a completely different handling approach than traditional commercial payers. These payers operate under jurisdiction-specific laws, meaning billing teams must navigate unique claim intake procedures, routing paths, and timelines. Missing even one jurisdictional requirement can result in claim rejection or legal delay.
Workers’ Compensation Insurance Contacts
Major national carriers like Travelers, The Hartford, and Liberty Mutual each have:
Dedicated intake fax lines and phone numbers
Regional adjuster contact directories
Required use of specific state WC claim forms
Mandated narrative reports and initial encounter notes
Many workers’ comp carriers require paper claim submissions with physical signatures, especially in initial evaluations. You’ll also often need to submit treatment plans and progress notes at set intervals—failure to comply stalls payment.
Auto Insurance Medical Payers
For auto-related medical billing, contacts and form requirements differ significantly by state:
PIP (Personal Injury Protection) states like New Jersey and Florida require pre-certifications for most treatments
States like Illinois or Pennsylvania use liability-first models, demanding more exhaustive documentation
Insurance carriers (GEICO, Allstate, Progressive) each have PIP-specific portals or claim lines
Make sure you understand whether you’re billing under PIP, MedPay, or third-party liability, as the supporting documents and routing workflows are different.
Check our Guide to Fraud, Waste & Abuse (FWA) Terms for red flags that may trigger claim holds or carrier audits—especially common in auto and injury-related claims.
Jurisdiction-Specific Pitfalls
In New York, NF-3 forms are mandatory within 45 days
In California, all WC bills must go through the Division of Workers’ Compensation-approved clearinghouse
In Florida, denials spike when treatment isn’t initiated within 14 days post-accident
Billing for these payers demands strong documentation. As detailed in our Guide to Financial Audits in Medical Billing, missed dates, unsigned notes, or incorrect forms trigger compliance reviews and reimbursement delays.
Final Tip
Keep a separate Payer Contact Sheet for injury claims. Include adjuster names, fax/email, date of first submission, and all correspondence notes. Injury-based claims move slowly—but clean contact documentation accelerates the process.
Which area of injury-based billing do you find most complex?
Credentialing & Provider Enrollment Teams
Credentialing delays don’t just affect onboarding—they disrupt cash flow, payer eligibility, and claims acceptance for weeks or months. That’s why billing teams need direct access to credentialing departments, enrollment contacts, and revalidation schedules for each major payer. A missing W-9 or expired CAQH update can silently block thousands in pending claims.
Key Contacts to Track
Each major payer maintains separate contact channels for:
Initial provider enrollment
Recredentialing or revalidation
Roster updates and terminations
Taxonomy or address change forms
For example, UnitedHealthcare uses the Optum portal for enrollment but still processes revalidations through fax. Aetna accepts enrollment packets only via CAQH integration. Meanwhile, Blue Cross affiliates vary by state—some require mailed forms with ink signatures.
Maintain a centralized record of:
Fax numbers for form submission
Escalation emails for enrollment bottlenecks
Phone numbers with prompt paths (e.g., “Press 3 for revalidation”)
Storing this ensures your team avoids weeks of back-and-forth just to correct TIN/NPI mismatches or status updates.
Average Turnaround Times
Typical processing times by payer:
Medicare PECOS: 30–60 days (unless expedited)
Medicaid state programs: 20–90 days depending on backlog
Commercial plans: 14–45 days, longer with paper forms
Revalidations: 30 days if submitted before expiry
Delays increase when missing:
Signed attestation statements
Active malpractice policy documentation
CAQH profile attestation updates
Build internal reminders 90 days ahead of each payer’s credentialing expiration date. Systems like Modio Health or symplr can automate alerts for these milestones.
Preventing Enrollment-Related Denials
Credentialing-related rejections often show as:
“Provider not eligible on date of service”
“No matching NPI in network directory”
“Tax ID not recognized”
Use clearinghouse tools to check payer rosters proactively. Run eligibility tests before claims go out. If an issue arises, escalate immediately through the payer’s enrollment team.
Learn how to trace these issues systematically in our Understanding Medical Coding Audit Trails guide. Tracking credentials across systems protects both compliance and cash flow.
Also see our Guide to Clinical Documentation Integrity Terms for how credentialing overlaps with documentation audits—especially in hospitalist or multispecialty practices.
| Payer Type | Key Contacts Needed | Submission Channel | Avg. Turnaround |
|---|---|---|---|
| Medicare (PECOS) | Enrollment, Revalidation, Roster Changes | PECOS Portal + Fax for revalidations | 30–60 days |
| Medicaid (State-specific) | Enrollment, Prior Auth Roster, Updates | State portals, mailed forms | 20–90 days |
| Commercial Plans | CAQH Updates, Terminations, TIN/NPI Changes | CAQH Integration, Email, Fax | 14–45 days |
| Revalidations (All payers) | Taxonomy Changes, Attestations, Malpractice Docs | Depends on payer: fax, portal, CAQH | ~30 days if submitted pre-expiry |
Payer Escalation Paths & Appeals Contacts
Every medical billing team eventually hits a wall—a denied claim, a stalled payment, or a payer silence. When that happens, knowing the direct escalation path is the difference between resolution and revenue loss. First-level reps rarely resolve complex issues. You need clear access to second-level appeals contacts, payer ombudsmen, and specialized dispute units.
Critical Escalation Points to Track
Each payer has its own format for routing appeals:
Mailing addresses (often different from claims)
Appeals fax lines for expedited cases
Phone prompts or specialist lines for high-level disputes
Online portals for document submission with time-stamped logs
For instance, Cigna and UHC require appeal packets to include full clinical documentation, payer-specific denial codes, and sometimes signed provider statements. Aetna allows some appeal steps via Availity but routes complex cases by mail.
When appeals drag beyond 30 days, escalate to the payer’s provider resolution or claims integrity department.
Sample Appeal Language Structure
Appeals must be tight, code-backed, and payer-specific. A basic structure includes:
Statement of Issue (e.g., denied CPT 29881 for lack of medical necessity)
Justification referencing clinical guidelines, prior authorizations, and patient records
Request for Specific Outcome – e.g., claim reprocessing or reversal of denial
Supporting Documents: progress notes, imaging reports, and prior auth confirmations
Include language that signals urgency and compliance awareness. For example:
“Per CMS guidelines and our in-network contract with [payer], this denial lacks clinical justification based on submitted documentation…”
To reduce friction, always use the payer’s preferred submission route. Appeals sent to the wrong address often go unprocessed.
For deeper insight into quality-related appeal triggers, such as inappropriate CPT bundling or modifier mismatches, refer to our Understanding Quality Assurance in Medical Coding.
Additionally, high-cost claims (like those for outpatient surgeries) benefit from referencing the correct procedural definitions. Our CPT Codes for Ambulatory Surgery can help your appeal cite clear, defensible coding logic.
Final Escalation Strategies
Log all appeal submissions with date/time and method (mail, fax, portal)
Save reference numbers from payer portals for audit protection
Track response deadlines—most payers have 30–60 day appeal resolution policies
Escalate unresolved cases with payer-provider reps or through ombudsman portals
When contacts are centralized and response patterns are tracked, your appeal success rate increases—and A/R days shrink dramatically.
Quick Recap: Always follow the payer’s exact appeal path—use the correct fax, portal, or address. Log every step, attach supporting documents, and escalate unresolved denials after 30 days. Smart appeals shrink A/R and safeguard revenue.
Conclusion
A centralized, always-updated directory of insurance billing contacts isn’t just a convenience—it’s the backbone of an efficient revenue cycle. It empowers coders, front-desk teams, credentialing staff, and billing managers to handle denials, pre-authorizations, and escalations without delay. In today’s fragmented payer landscape, where contact protocols vary across commercial, government, and injury-related claims, even a small information gap can mean thousands in lost revenue or delayed reimbursements.
By proactively managing payer contacts—keeping portals, phone numbers, fax lines, and submission formats updated—your team can cut down rework, reduce denials, and speed up A/R cycles across the board. Whether you’re preparing for an audit or submitting high-dollar surgical claims, precise contact access means cleaner documentation, fewer bottlenecks, and better outcomes for both patients and providers.
Frequently Asked Questions
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When payer contact info is outdated, your first step is to check the official payer portal—most major insurers regularly update numbers and submission addresses there before announcing changes elsewhere. If the portal doesn’t help, use provider service hotlines, not general customer service. For government programs like Medicare or Medicaid, consult your MAC or state’s Medicaid handbook. Always document the attempt: date, time, rep name, and method of contact. If the issue persists, escalate through your clearinghouse rep or provider relations specialist. Keeping a centralized contact log inside your EHR or billing software helps identify recurring issues across payers and avoids rework. Never submit claims using unverified addresses or forms, as this increases rejection rates.
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Most payers separate first-level provider support from appeals and escalations. Standard inquiries—like claim status or eligibility—are handled through the general provider hotline or self-service portal. Appeals, however, must go through dedicated mailing addresses, fax numbers, or appeal-specific phone trees. For example, Aetna lists an appeal fax line on their remittance advice, while UnitedHealthcare routes appeals through Optum's secure fax. Always refer to the EOB or denial letter for the correct appeal channel. Using the wrong line often means your request is ignored or delayed. Maintain a payer-specific matrix showing which contacts handle what, and use appeal reference numbers for follow-up tracking.
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Yes—despite growing digitization, many payers still require fax-based submissions for appeals, medical records, and even some recredentialing packets. Medicare MACs often ask for faxed supporting documents when resolving pending claims. Blue Cross affiliates in certain states mandate mailed forms with physical signatures. Cigna and Humana also maintain secure fax lines for provider disputes. Always check the payer’s provider manual or portal guidance before assuming electronic delivery is accepted. Submitting documents to the wrong format (e.g., emailing instead of faxing) can trigger HIPAA compliance issues or delays. If fax is required, use a HIPAA-compliant digital fax platform with time-stamped delivery receipts.
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Centralize everything. Use a shared database—inside your billing software, Google Sheets, or tools like OneNote—with fields for payer name, claim portal URL, EDI ID, appeals contact, and prior auth numbers. Update it monthly, assigning one team member to verify and log changes. Include escalation contacts and the names of frequently reached reps. Color-code urgent contacts (like appeals) and list state-specific Medicaid lines separately to avoid confusion. Always record the “path” to speak to a live person (e.g., press 2 > 1 > NPI). Most importantly, back it up regularly—lost contact info can mean weeks of revenue delays if not restored quickly.
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Use your billing or practice management system’s built-in notes feature to log every contact attempt with payers. At minimum, include date, time, rep name or ID, reason for the call, and resolution status. If you send faxes, always store delivery confirmations. For portal submissions, screenshot confirmation pages and save them in the patient or claim file. Auditors and compliance officers expect detailed trails, especially for appeals, recredentialing steps, or documentation requests. Also, train staff to note any verbal instructions or callback promises. This not only ensures internal accountability but also strengthens your case during payment disputes or CMS audits.
