allied benefits systems claims address

2022 Allied National, LLC. 877-828-8770 info@ppsonline.com Additional PayPlus Information; Click here to become a Cigna Provider Estimated $38.6K - $48.8K a year. Claim Submission Cover Sheet. You should have your policy number, a phone number where you can be reached and contact numbers for any other parties involved. Don't worry, we can still help! HAC|EJmv6` r,!!3'LEj`V\`lvq+GDJNLJL1B VyMW } Phone: 1-866-614-4244 Click here to download our precertification form which can be submitted via secure e-mail or fax. Allied provides you with service and support via phone or online access through our provider self-service site. hXoWxHJ$EE 'vI^.FmKGR8-#y` )#"A}$$D"B{H#Q 9 (d|-S If your state is not listed, please use the ERISA form below to file your appeal. Chattanooga, TN 37422-7223. Below you'll find contact information for our various departments. 150 0 obj <> endobj Glass 1-800-287-5078 Allied Van Lines, Inc. MC 15735 U.S. Senior Claims Specialist at Allied Benefit Systems Hammond, Indiana, United States. Short , Health (4 days ago) WebSend the original, fully itemized bill to the claims address shown on the member's ID card. Call toll free: For TTY service for hearing impaired callers, call 711 for Telecommunications Relay Service , Health (7 days ago) WebProvider Services / Claims ( 877 ) 853 - 8019 ( 855 ) 297 - 4247 Enrollment ( 855 ) 593 - 5757 Care Management ( 888 ) 995 - 1689 7(32) 421 - 4317 Mailing Address for , https://cdn.cloverhealth.com/filer_public/42/81/4281d73a-da6b-4a65-a435-66018e627e04/clover-provider-manual-phone-directory.pdf, Health (Just Now) WebContact admin 2021-06-23T15:23:04-07:00. Better Business Bureau Profile Health (Just Now) WebContact Information. . Roadside 1-888-776-2778, Safeco endstream endobj 40 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 36 0 obj <>/Subtype/Form/Type/XObject>>stream Check every area has been filled in correctly. 11% of Allied Benefit Systems employees are Black or African American. DOT No.076235Texas intrastate moves are hauled under the authority of Allied Van Lines, Inc., TxDMV No. Real Time Claim Status (RTS): NO. EMC Groups. DRG Contracted Hospitals: To determine the specific claims address, please select the appropriate Employer Group from the list under the "Groups" tab. endstream endobj 26 0 obj <>/Subtype/Form/Type/XObject>>stream The Cigna LocalPlus Network plan delivers a cost effective solution designed to be flexible and help you control health care costs - without sacrificing the quality and convenience you want and expect. After an accident many people are shaken up and can be confused, it's alright, just try to stay as calm as you can and get all the information you can. Your appeal must be submitted in writing to the Plan Administrator within, Allied Administrative Services for Healthcare Providers, Provider Networks Allied Benefit Systems, Provider Request an Account Allied Benefit Systems, Allied Benefit Systems | Health Insurance Plans for Everyone, Provider Access and Services Allied National. https://www.alliedbenefit.com/ProviderNetworks. With data-driven and member-focused solutions proven to reduce costs, optimize plan performance, and elevate each member's experience. Allied Benefit Systems jobs in Remote. Enter your account number and password to login. EMC Contact Us. EMC endstream endobj 50 0 obj <>/Subtype/Form/Type/XObject>>stream H1 rt|!dFF>QtP~`lh~pQuvJ*j&yHQ;B?/` \ Register for your own website account and gain access to valuable online tools and features including member eligibility and claim status, deductible and . Access MyBenefits. Try to keep all information in the latest update and will update as per receive any new information. You can have confidence in high service level expected of a leading Third-Party Administrator (TPA). H4 endstream endobj 25 0 obj <>/Subtype/Form/Type/XObject>>stream For Medical Claims Only P209700501D E N V 8 9 5 7 2 O F 2 2 0 1 1 0 7 1 4 2 0 0 5 P209700501D. Please contact PayPlus Solutions at the following information. endstream endobj 46 0 obj <>/Subtype/Form/Type/XObject>>stream For questions about career opportunities and company policies. Grants Specialist 2 - Post Award - REMOTE. A claim for benefits is made when a claimant (or authorized representative) submits written Notice and Proof of Loss as required in the SPD to: Allied National, LLC, Attn: Claims Department, PO Box 29186, Shawnee Mission, KS 66201; or fax at 913-945-4390. Visit Website. endstream endobj 58 0 obj <>stream Since all damaged items are subject to inspection, please do not proceed with any endstream endobj 51 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream EMC Many of them are 24/7 so they can be reached at any time. Lets Talk. endstream endobj 43 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Personal 1-800-252-4633 Allied Benefit Systems describes its culture as devoted to knowledge and creativity, where team members collaborate in an environment that is flexible and innovative. has been provided at the end of the claim form should you need to provide further Allied Benefit Systems, Inc. If you sustain a loss at home make sure you contain the damage as much as possible! See BBB rating, reviews, complaints, & more. Claims/Customer Service Department: To reach the Tracing area on issues of loss of an item or an overage, e-mail claimstrace@alliedvan.com or call 1-800-470-2851, Option 2 prior to filing your claim. Allied Benefit Systems | Chicago IL endstream endobj 32 0 obj <>/Subtype/Form/Type/XObject>>stream Remote. 73% of Allied Benefit Systems employees are women, while 27% are men. Request Payer Contact Address to Send Claims by Post Please enter your account number and password after reading the website disclaimer and use policy as unauthorized user access is prohibited. Full-Time. These companies do not accept phone calls or faxes from insureds. Skip to content. In collaboration with client organizations and benefits consultants, Allied Benefits Systems helps create plans that offer the best options for employees and their dependents. 22 followers 22 connections. As may vary by group, please call the phone number listed on the member ID card. Overall Deductibles: $6,850 per individual for in-network providers. Representatives are available from 8 a.m.-4:30 p.m. Monday-Friday to assist Funding Advantage Plan members with questions about their plans and status of their claims. Roadside Assistance 1-877-762-3101. lh4Ksr |b@ Many of our Allied members have a plan that allows them to see any provider they choose without restrictions or penalties. Learn more about Multi-Factor Authentication. Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., and Cigna HealthCare of North Carolina, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their . endstream endobj 23 0 obj <>/Subtype/Form/Type/XObject>>stream Institutional/UB Claims. Full-Time. Click here to learn more. Contact Information. Our Mission is to design, implement. H*2TH2P0P04304E\i\z EMC In automobile accidents make sure everyone involved is safe and when you are sure of that try to move the cars out of the way if possible. HAC|EJmv6` r,!!3'LEj`V\`lvq+GDJNLJL1B VyMW } Allied has two payer IDs. Submit a Claim. 7143; Texas DMV Phone No. Medical claims can be sent to: Insurance Benefit Administrators, c/o Zelis, Box 247, Alpharetta, GA, 30009-0247; EDI Payor ID: 07689 You will be contacted by Insurance Benefit Administrators regarding final pricing for the claims submitted in the weeks following submission. For assistance with plan underwriting and agent contracting and licensing. Finance & Accounting Based on 52 salaries Billing Coordinator 8 salaries Claims Examiner 5 salaries View More Administrative Based on 17 salaries Eligibility Coordinator 6 salaries allied benefits provider portal access in 3 steps, allied benefits provider phone number, allied benefits claims address, www.alliedbenefit.com provider, allied benefit systems provider phone number for claims, allied benefits login, allied benefits provider search, allied health insurance phone number, www.alliedbenefit.com eligibility H1 rt|!dFF>QtP~`lh~pQuvJ*j&yHQ;B?/` \ Verification of Benefits . /Tx BMC 200 W Adams St Ste 500. Representatives are available 8 a.m.-4:30 p.m. Monday-Friday to assist you. lh4Ksr |b@ endstream endobj 55 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. How much do Allied Benefit Systems employees make? H*23754VH2P0P04304E\i@% 12 jobs. HIPAA Authorization Form. You may also request a precertification by calling the number on the member's ID card. Get spell touch! We understand you need good health insurance at an affordable cost. Please call our Customer Service Specialists between 8 a.m. and 4:30 p.m. (CST) Monday through Fridays at 800-650-6497. . Allied partners with several high-performing provider networks, so you can customize your care options to align with your needs. Youll find the payer ID (for electronic claims) and address (for paper claims) on the members ID card. Designed for People | Allied is a national healthcare solutions company that works with organizations who choose to take control of their . Box 29189 Allied Benefit Systems P 800.288.2078 PO Box 909786-60690 F Chicago, IL 60690-9786 E webinfo@alliedbenefit.com . 0BasJP lh3sr d For your convenience, we have provided an on-line version of our Claim Form to expedite Send claims to the payer. Specialty Pharmacy Request Form. endstream endobj 24 0 obj <>/Subtype/Form/Type/XObject>>stream 93 0 obj <>stream lh4Ksr L w ACS Benefit Services, Inc. 1.800.849.5370 HCP Login Affordable Benefit Administrators 1.800.350.0148 HCP Login Allegeant/LBA Healthplans, Inc. 1.800.815.8240 HCP Login Allegiance Benefit Plan Management, Inc.(1) Please refer to ID Card HCP Login Allied Benefit Systems, Inc. 1.800.288.2078 HCP Login Allied / IHC 1.888.499.3501 HCP Login Some companies (mostly commercial insurance except Travelers and The Hartford) like for the agents to report claims. Address: American Health Holding, Inc. 7400 West Campus Road, Suite 300 New Albany, OH 43054-8768 So in these cases you should contact the office in Chandler or Tucson directly. Picture. /Tx BMC 16% of Allied Benefit Systems employees are Hispanic or Latino. Retail Pharmacy Prior Authorization Request Form. For assistance with filing a claim, claim status and other claims questions. Please complete the claim form that follows. Other website users will need to. H1 rt|!dFF>QtP~`lh~pQuvJ*j&yHQ;B?/` \ Health (5 days ago) Webhealth plan participants the choice of nearly 4,400 hospitals, 79,000 ancillary care facilities and more than 700,000 healthcare professionals nationwide, whether they seek care in , https://www.multiplan.com/payers/resourcecenter/salescenter/pdfs/MKT5094_LBP_PHCS.pdf, Health (Just Now) WebName of Other Health Insurance: (Check, if applicable) Address: _____ Subscriber ID #: (Other insurance) _____ Legal Disclaimer: CONFIDENTIAL COMMUNICATION: This , https://cdn.cloverhealth.com/filer_public/fc/21/fc216262-65d2-46ad-aac2-a527a543f16f/6x067_member_reimbursement_form_update_v5.pdf, Health (7 days ago) WebProvider Services / Claims ( 877 ) 853 - 8019 ( 855 ) 297 - 4247 Enrollment ( 855 ) 593 - 5757 Care Management ( 888 ) 995 - 1689 7(32) 421 - 4317 Mailing Address for , https://cdn.cloverhealth.com/filer_public/42/81/4281d73a-da6b-4a65-a435-66018e627e04/clover-provider-manual-phone-directory.pdf, Health (Just Now) WebAllied 24/7 is seeking a travel CT Technologist for a travel job in North Bergen, New Jersey. CLIENT SERVICE REPRESENTATIVE. 94177 Allied Administrators (San Francisco, CA) No 37308 Allied Benefit Systems (Chicago, IL) No 22155 Allied National (Eagan, MN) No 54398 Allina Health (Aetna) No 63240 Alternative Risk Management (ARM) Eagan, MN) No Allied Benefit System is the worst third party insurance I have ever experienced. %%EOF ESSENTIAL FUNCTIONS: Act as the liaison between the client/broker and Allied Executives and Departments as it relates to Allied Advocate claims. Or Call 8006898684 to start your free quote! H*2TH2P0P04304 Or if you're in Illinois or Texas, call us directly at 1-800-338-6833 (TTY 711) Unfortunately, this job posting is expired. Have your Name, Contact information, and your Tax ID available. Name: Allied Benefit Systems, Inc.Parent Company: AlliedHome Office: Chicago, ILGeneral Phone Number:(800) 288 2078 Bronze Plan. All Rights Reserved. hbbd```b`` v0) G3EuAG"AR$CY=pHr$ 9v 300 IK$ Please read the Allied website disclaimer and user policy. endstream endobj 31 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Are you looking to positively affect thousands of lives each day via health benefits? Claims Department Auditor. endstream endobj 38 0 obj <>/Subtype/Form/Type/XObject>>stream repairs and do not dispose of any damaged items. Allied Benefit Systems, LLC Personal 1-800-274-4499 To file a claim on-line (U.S. domestic), click here. On the member's dental ID card, the claims address. How do I find my Allied Benefit Account number? 200 West Adams Street, Suite 500 Contact Allied Benefit Systems Learn more about "Your Rights and Protections Against Surprise Medical Bills" . Remote. https://www.alliedbenefit.com/online/login.asp. Department Contacts General Street Address Allied National 4551 W 107th St. #100 Overland Park, KS 66207-4037 Ph: 913-945-4100 Fax: 913-945-4390 General Mailing Address Allied National P.O. Durable medical equipment. Dental ID Card On the member's dental ID card, the , https://www.alliednational.com/provider.html, Health (7 days ago) WebAllied Insurance Group, Inc. 2438 East Broadway Boulevard, Tucson, Arizona 85719, United States (520) 918-2886 Hours Open today 09:00 am 04:30 pm Email Us Get directions Contact Us Phoenix Better yet, see , Health (Just Now) WebInsurance Claims Processing in Chicago, IL. Check claims status. Glass 1-800-892-8484, American Strategic Insurance (ASI) If you have questions, please call Allied Client Services to verify benefits. H~bJmb:aAS4X)3LEj}bBKW 8czZQ /]o;"}Bd=CO?a7Fo }H Join to view profile . Benefits: vision, 401k, dental, life insurance, medical, Job Description. The most common ethnicity at Allied Benefit Systems is White (63%). Plans Reviewed. After an accident many people are shaken up and can be confused, it's alright, just try to stay as calm as you can and get all the information you can. Sign , Health (1 days ago) WebQuick Reference Guide for Horizon Behavioral HealthSM Providers Claims Submission Process All behavioral health claims should be submitted electronically to Horizon, https://s21151.pcdn.co/wp-content/uploads/HBH_QRG_HBCBSNJ.pdf, Department of behavioral health san bernardino county, Health wellness and environmental studies, Health and nutrition coach certification, Example horizontal integration in healthcare, Dignity health careers job opportunities, 2021 health-improve.org. Allied is a national healthcare solutions company that supports healthy workplace cultures. If you have to have repairs done before an adjuster can see the damage make sure to take photos and save any material if possible. Claim Form - Dental. EMC PO Box 182223. Dental Claims. endstream endobj 17 0 obj <> endobj 18 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Type/Page>> endobj 19 0 obj <>/Subtype/Form/Type/XObject>>stream 1-888-368-4689 Please submit the original, fully itemized bill to: Insurance Benefit System Administrators c/o Zellis PO . If you sustain a loss at home make sure you contain the damage as much as possible! Claim Form - Vision. Youll find the payer ID (for electronic claims) and address (for paper claims) on the members ID card. Allied Benefit Systems company was founded in 1980. (312) 906-8080. https://www.bbb.org/us/il/chicago/profile/insurance-claims-processing/allied-benefit-systems-inc-0654-27006038 Category: Health Show Health Claims can be called in directly to most of the companies we represent. 1.800.426.9786. The applicant must have a history of excellent quality results and the desire to take on a new challenge if currently employed at Allied. All Rights Reserved. H411 B _Hf)jE|?0FOj>8aFK. ;rX%5UB-X5 N The Registered Agent on file for this company is C T Corporation System and is located at 330 N Brand Blvd Ste # 700, Glendale, CA 91203. HAC|EJmv6` r,!!3'LEj`V\`lvq+GDJNLJL1B VyMW } In automobile accidents make sure everyone involved is safe and when you are sure of that try to move the cars out of the way if possible. Phone 520-918-2886 or 480-634-5222, Travelers Insurance your claim process. Over forty years of small business benefits expertise. CHICAGO, June 6, 2022 /PRNewswire/ -- Allied Benefit Systems, LLC ("Allied" or the "Company"), announced today that Mitchell Wilneff will retire as Chief Executive Officer . Other Covered Services: Chiropractic care. For billing inquiries and questions on premium payments. Health (4 days ago) WebSend claims to the correct payer. Gain fast and secure online access toyour patient's benefit and accountstatus information using the Provider Self-Service Site. H*2TH2P0P04304E\i\z endstream endobj 30 0 obj <>/Subtype/Form/Type/XObject>>stream If you are a covered member, you can log into your member portal for a more personalized experience. Rush University Medical Center 4.0. Principal. Update your profile and more. H*23754VH2P0P04304E\i@% The average employee at Allied Benefit Systems makes $49,731 per year. H1 rt|!dFF>QtP~`lh~pQuvJ*j&yHQ;B?/` \ Allied Administrators is a premier third-party administration firm providing benefits to the small group market across the United States. Receipt of your claim will be acknowledged and a Claim Adjustor will be assigned. /Tx BMC The manual includes an overview of the plan with specific information on: There is no time limit for providers to make an inquiry, with the exception that an inquiry related to a specific claim cannot be made beyond the longer of the timely claims filing time period requirement within your Found on Allied Health Contracting 617.972.9411 . H*23754VH2P0P04304E\i@% Sort by: relevance - date. If a member uses a transplant facility in our Institutes , https://www.aetna.com/health-care-professionals/newsletters-news/office-link-updates-june-2021/news-for-you-june-2021/submitting-claims-for-aetna-signature-administrators-asa-plan.html, Health (6 days ago) WebGeneral Street Address Allied National 4551 W 107th St. #100 Overland Park, KS 66207-4037 Ph: 913-945-4100 Fax: 913-945-4390 General Mailing Address Allied National , https://www.alliednational.com/contact-us.html, Health (3 days ago) WebAllied Insurance 1100 Locust St. Des Moines, IA 50391 Official website: https://www.alliedinsurance.com/index.jsp Check on your claim status: You can log in to , https://www.myclaimsource.com/allied-insurance-claim/, Health (3 days ago) Webplease contact Allied Insurance Group Fax 520-918-2800 Tucson Fax 480-634-7010 Chandler Phone 520-918-2886 or 480-634-5222 Travelers Insurance Personal 1-800-252-4633 Commercial 1-800-832-7839 This , Health (8 days ago) WebContact Allstate Health Solutions with questions around your policy, claims or more. Email: ahhinfo@ahhinc.com. endstream endobj 35 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Calling direct to the company saves time, prevents redundancy, and starts the process sooner. Cigna. Group Name Group Number; ABSOLUTE AUTO BODY INC: L223354: "Your Rights and Protections Against Surprise Medical Bills". %PDF-1.6 % Electronic Remittance Advice (835) [ERA]: YES . Allied Benefit Systems | Health Insurance Plans for Everyone Company Careers Allied is a national healthcare solutions company that supports healthy workplace cultures. The company's filing status is listed as Active and its File Number is 202251414184 . Individuals & Families Administered by Allied. To register for a Provider website account, you must have a valid National Provider Identification (NPI) number on file with the . H*2TH2P0P04304E\i\z To place an order, contact Integrated Home Care Services directly: Phone 1-844-215-4264. hbbd```b``3@$da Lz`Lfe5A$'d@$["=L6``CAR >9 b'rQg`@ `\ Commercial 1-800-327-3636 95340 Adventist Health Claims (Roseville, CA) 75261 Adventist Risk Management (Grapevine, TX) Old PO Box 60054 Aetna 57604 Aetna (SRC)(Blue Bell, PA & Columbia, SC) . H1 rt|!dFF>QtP~`lh~pQuvJ*j&yHQ;B?/` \ endstream endobj 33 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream to verification of your patient's benefits, claim status or coverage information. Many of them are 24/7 so they can be reached at any time. MyBenefits, our 24/7 customer service portal, allows you to: File claims. (1) Allegiance Benefit Plan Management is responsible for administering various aspects of this patient's plan, which may include claim processing, utilization management or eligibility verification. endstream endobj 39 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream endstream endobj 57 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H*2TH2P0P04304E\i\z H*23754VH2P0P04304 Login. Claim Address- MHBP Medical Claims PO Box 8402 London, KY 40742 The timely filing limit of all the above insurance companies is updated from reliable resources of information. %PDF-1.6 % H*2TH2P0P04304E\i\z Scottsdale,Occidental, Colony, Lloyds of London, Wilshire. Login Register Benefits Consultants We're a small business, too, and we've been helping small groups for more than 50 years take control of their group health benefits. Get more options from Delta Dental's Small Business Program, The best choice in benefit administration. We support a culture of knowledge and creativity with competitive pay packages, a robust benefits package and a flexible work environment. Representatives are available 8 a.m.-4:30 , https://www.alliednational.com/provider.html, Health (4 days ago) WebSend claims to the correct payer. How to File a Claim. Some office visits, urgent care, and preventive care services does not apply in this plan. endstream endobj 20 0 obj <>/Subtype/Form/Type/XObject>>stream New guidance from the Federal Government as to extended deadlines for 1) COBRA, 2) special enrollment, and 3) healthcare claim filings/appeals. you can contact the Employee Benefits Security Administration at 1-866-444-EBSA (3272). 173 0 obj <>/Filter/FlateDecode/ID[<319EA7D84E68174596A559D1E635583A><9128AF18A8526E44940B2C7D73589710>]/Index[150 38]/Info 149 0 R/Length 114/Prev 248865/Root 151 0 R/Size 188/Type/XRef/W[1 3 1]>>stream endstream endobj startxref $40,000 to $45,000 Yearly. Health (6 days ago) People also askHow do I file a claim with Allied Insurance?How do I file a claim with Allied Insurance?Submit your claims directly to Allied through the Emdeon-Change Healthcare clearinghouse and get paid faster. Our experience focusing on the small group market has provided valuable insight on what works best. There are no preferred providers or networks required. endstream endobj 54 0 obj <>/Subtype/Form/Type/XObject>>stream Healthcare Provider FastTrack - Eligibility & Claim Status Request Provider FastTrack Eligibility and Claims Status Inquiry You can use our secure web-based Provider FastTrack system for immediate access to member claims and eligibility status including: Access plan documentation Verify member eligibility status Your one-stop shop for all your administrative needs. Personal 1-866-274-5677, Civil Service Employees (CSE) 63 0 obj <>/Filter/FlateDecode/ID[<95345966AA86B04287BA194B3F7FCB87>]/Index[16 78]/Info 15 0 R/Length 115/Prev 665305/Root 17 0 R/Size 94/Type/XRef/W[1 3 1]>>stream EMC 24 hours a day, 365 days a year. Send the original, fully itemized bill to the claims address shown on the member's ID card. Click here to , https://www.alliednational.com/provider.html. Remote in Chicago, IL 60612. . Our experience focusing on the small group market has provided valuable insight on what works best. Specialty: CT Technologist, https://www.linkedin.com/jobs/view/travel-allied-health-professional-ct-technologist-covid19-coronavirus-at-allied-24-7-3494140331, Department of behavioral health san bernardino county, Health wellness and environmental studies, Health and nutrition coach certification, Example horizontal integration in healthcare, Dignity health careers job opportunities, 2021 health-improve.org. Payer Name: Assurant Health Self-Funded (Allied Benefit) Payer ID: 75068 Enrollment Required (ENR): No Type / Model: Government/Non-Par State: Professional (CMS1500)/Institutional (UB04) [Hospitals] Real Time Eligibility (RTE): NO Real Time Claim Status (RTS): NO Electronic Remittance Advice (835) [ERA]: NO Secondary Electronic Claims (SEC): YES Reimbursementto providers is reference based on a multiple of Medicare reimbursement levels. Send Medical Claims to: Allied Benefit Systems PO Box 90978660690 Chicago, IL 60690 3129068359 Contact Allied at: 8002882078 MEDICAL CLAIM FORM EMPLOYER INFORMATION Northern Buckeye Health Plan A09103 EMPLOYEE INFORMATION Employee Name SSN / UID Birthdate Employee Address City Zip