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Sagamore Health NetworkPayor Phone ListLocCode RouteCode PAYOR396, Incorporatedwww.dgatpa.comCustomer Service Num.DGA1 SAG1109 5301 Buckeystown Pike Suite 455 Fredrick MD 21704 Phone: 800-221-8490ACMG IncACMG1 SAG1852 2570 Technical Drive Miamisburg OH 45342 Phone: 800-232-6242ACT1 SAG1739SAG1896Activa Benefit Services2905 Lucerne Drive S.E., Suite 110 Grand Rapids MI 49546 Phone: 877-827-1414877-827-1414SAG6001 877-827-1414PHS1 SAG1336Administrative Service Consultantsc/o Primecare Health Services, 3301 East Royalton Road Phone: 800-634-8816Broadview Heights OH 44147WA1 SAG1394Advanced Insurance1525 Merrill Drive Little Rock AR 72211 Phone: 800-234-5453888-777-7241 For PrecertSSCSHN1 SAG1567Advantage Health PlanPO Box 33009 Indianapolis IN 46203 Phone: 800-235-8541PROSHN SAG1536www.advantageplan.com800-235-8541SAH1SAH2SAG1566SAG1619SAG1846Advantage Health SolutionsPO Box 80069 Indianapolis IN 46280PO Box 80069 Indianapolis IN 46209Phone: 800-553-8933800-553-8933800-553-8933SAH3 SAG1923 6602 E. 75th Street, Suite 300 Indianapolis IN 46250www.aetna.com800-553-8933AHP1 SAG1036Aetna Health PlansPO Box 14079 Lexington KY 40512 Phone: 800-232-5561AHP4 SAG1994 PO Box 981106 El Paso TX 79998 888-632-3862NYL1NYL2NYL3NYL4NYL5NYL6NYL7SAG1296
 
SAG1297SAG1298SAG1299SAG1301SAG1302SAG1303Aetna US Healthcare/Nylcare99 Park AVenue Third Floor New York NY 1001699 Park Avenue Third Floor New York NY 10016Phone: 800-388-5186800-388-4580800-666-3168800-955-9409800-311-1731800-695-1352800-695-31318July 21, 2009 Report No. 178 Page 1 of 35J
 
Sagamore Health NetworkPayor Phone ListPPLocCodeALL1RouteCodeSAG1037SAG1964PAYORAllied Benefit Systemswww.alliedbenefit.comPO Box 909786-60690 Chicago IL 60690 Phone:Customer Service Num.800-288-2078800-288-2078SAG1979 800-288-2078Allied National CompaniesANC1 SAG1041 PO Box 29186 Shawnee Mission KS 66201 Phone: 800-825-7531ARC1 SAG5502Alpha Review Corporation1807 W Diehl Road Naperville IL 60563 Phone: 630-305-8108800-678-8737Alt ProsALT1 SAG1569 HDM Ben Solutions, 604 N. 129th Street Omaha NE 68154www.ameraplan.comPhone: 800-667-4824AmeraplanAP1 SAG1471 22500 Metropolitan Parkway Clinton Township MI 48035 Phone: 800-221-4254American AdministratorsPBP1 SAG1844 PO Box 346 Simpsonville KY 40067 Phone: 800-777-1596American Administrators - IATR1 SAG1784 PO Box 65887 West Des Moines IA 50265 Phone: 800-456-4584American Benefit Administrators/ClarendonABA1 SAG1005 1733 Park Street Suite 300 Naperville IL 60563 Phone: 800-736-7872AC1 SAG1009American Community39201 Seven Mile Road Livonia MI 48152 Phone: 800-991-2642AC2 SAG1868www.americanhealthgroup.com800-991-2642AHG1 SAG1931American Health Group, Inc.PO Box 1500 Maumee OH 43537 Phone: 800-305-0406 Total ClaimsSolution/Grp# 16889800-861-5770 American HealthGroup/Grp# 9901877-525-3262 Pro ClaimsPlus/Grp# 1604877-525-3262 Pro Claimswww.ahappo.comPlus/Grp# 1702American Healthcare AllianceAJuly 21, 2009 Report No. 178 Page 2 of 35J
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