midwest operating engineers insurance claims address

Office Hours You can now book in-person appointments online at our Mercer Island Office! IUOE provides skilled, safe and efficient heavy equipment operators and stationary engineers. Phone number is (812) 232-4384. Submit a Claim - Operating Engineers Trust Funds VIEWING AS: ACTIVE MEMBER SWITCH VIEW Submit a Claim MEDICAL & HOSPITAL CLAIMS (CALIFORNIA PROVIDERS) Submit paper claims to: Prudent Buyer Plan P.O. Need to submit transactions to this insurance carrier? P.O. 100 Corson Street, Suite 100 Browse all Midwest Operating Engineers salaries by category. YES. For 60 years, the Board of Trustees of the Fund have worked hard to provide a comprehensive package of health, dental, prescription drug and vision care benefits to members and retirees of Local 12 and their dependents. You may also download forms such as claim forms, change of address form, disability statements, and ACH bank forms (for Retirees only). Midwest Wrecking Contact webmaster@oefi.org for website issues. <> Midwest Security Administrators, IN The Operating Engineers (Local 12) Funds are multi-employer funds that have been established through collective bargaining agreements between the employers and Local 12. Group Name TPA Name & Address Claims Filing Claims & Benefit Contact Name Phone Number Filing Limit Electronic Payer ID Number. Healthsource AR-Claims cont Healthsource spec VendID&Rend Pr: 71074: Professional: Healthsource GA . About the Fund: The Mid Central Operating Engineers Health and Welfare Fund was originally establisheed on July 6, 1954 as the International Union of Operating Engineers Local No. ","acceptedAnswer":{"@type":"Answer","text":"Midwest Operating Eng Welfare mailing address to send written mail, forms and documents is PO Box 2107 , La Grange, Illinois 60525-8207. Operating Engineers Local 99 . DentalXchange Payer ID OEL12, Mental Health, Substance Abuse and MAP Benefits 3826 Meadows Lane, Las Vegas, NV. "}},{"@type":"Question","name":"What is Midwest Operating Eng Welfare mailing address? Get the most up to date medical insurance companies details for the leading health insurance companies locally and nationwide, Midwest Operating Eng Welfare phone number, where you can call and speak to a real person at for Illinois medical insurance related matters is 708-579-6600. endobj that relates to any claim(s) for coverage or benefits under the Midwest Operating Engineers Welfare Fund (Welfare Fund), and Enforce any individual rights that I have regarding my PHI under the Health Insurance Portability Accountability Act of 1996 (HIPAA). Phone Hours. Contact webmaster@oefi.org for website issues. It is 30 days to 1 year and more and depends on . Our purpose is to provide our well-established contractors with highly qualified members willing to work hard. Please include username, Practice Name and your contact information. Performance & security by Cloudflare. All. Suite C . Provider Patient ID: Central Laborers' Welfare Fund PO Box 1267 Jacksonville, IL 62651-1267 Please note, the Fund staff will respond to all 1095-B copy requests within 30-days of receipt of that request. Phone:(702) 949-1219. Business Hours: customerservice@oefi.org, Fund Office /Filter /FlateDecode CLAIM.MD | Payer Information | Midwest Operating Engineers, Fringe Benefit Fund Payer Information Midwest Operating Engineers, Fringe Benefit Fund Payer ID: ERA25 This insurance is also known as: ZP1291 ZP3582 Need to submit transactions to this insurance carrier? TTY: 626-356-3582 Click to reveal "}}]}, Your email address will not be published. Operating Engineers Locals 302 & 612 Health & Security Fund. The Board of Trustees of the Laborers' and Operating Engineers' Utility Agreeement Health and Welfare Trust Fund for Arizona is pleased to bring you The Benefits Press Winter 2022/2023 issue. %PDF-1.7 The action you just performed triggered the security solution. 3826 Meadows Lane, Las Vegas, NV. /N 3 TTY: 626-356-3582 This is the best Midwest Operating Eng Welfare phone number where you can speak to a real person and get assistance with your medical insurance issue. No characteristics found General information Address 6150 Joliet Rd Countryside, IL 60525 Metro area Chicago-Naperville-Elgin, IL-IN-WI County Cook County, IL Website URL local150.org/moe/ Phone (708) 482-7300 IRS details EIN 36-6109395 Fiscal year end March Taxreturn type Form 990 Year formed 1953 Terre Haute, IN 47808 3 0 obj 3826 Meadows Lane, Las Vegas, NV. Your Rights and Protections Against Surprise Medial Bills. The Fund Office processes approximately 5,000 claims per month and pays out nearly $4 million a week in benefits and premiums. Hartford Insurance Company of the Midwest: C1043: Professional: Hartford Life and Accident Insurance Company: C1044: . This portal is exclusively for healthcare providers to check the status of paid and pending claims for our members/your patients. About Us The Midwest Operating Engineers Fringe Benefit Funds Office administers all Health and Welfare and Pension Fund benefits for all eligible Active members and Retired members and their eligible family members of the Local 150. You can email the site owner to let them know you were blocked. $28.09 per hour. INTERNATIONAL UNION OF OPERATING ENGINEERS (IUOE) 1125 17th Street, NW Washington, DC 20036 202 429-9100.Midwest.MPN Read more! Your IP: Pasadena, CA 91103, Las Vegas Fund Office Find out how to become an apprentice, sign up for courses, view your work history, and more! 2016), is of no help to the Funds. Read More Member Resources Help us find what you are looking for. ?:0FBx$ !i@H[EE1PLV6QP>U(j Please have your Identification Number ready, which is located on either your Anthem card, Blue Cross Blue Shield card or for Medicare Primary individual refer to your Mid Central Retired Participant Medical Card. Claims Processor in Countryside, IL. P.O. Thank you for your anticipated cooperation. 877-299-7099. Claim the judgments where you have appeared by linking them directly to your profile and maintain a record of your body of work. We apologize for any inconvenience this may cause but we are doing our best to service the membership as best we can during these challenging times. Milwaukee Faucets Subsequent claims must be made within 90 days of the week -ending for which benefits are payable. 1256. In order to check the status of your claims for one or more of our members, you will need to first create an account. Operating Engineers Funds Inc. is a non-profit corporation that administers the employee benefit programs for over 20,000 members of the International Union of Operating Engineers (I.U.O.E.) The Fund Office processes approximately 5,000 claims per month and pays out nearly $4 million a week in benefits and premiums. (Enrollment required Contact 866-703-1444) M3IL1: Professional: Health Services for Children with Special Needs: 37290: . Midwest Operating Engineers Fringe Benefit Funds is in the sectors of: Liability Insurance. Submit electronic claims and predeterminations to: DentalXChange Electronic Payor ID#: OEL12. Customer Service . Claims Midwest Claims Center - Mailing PO Box 13369 Springfield, IL 62791-3369 California Phone: 866.642.2567 Fax: 866.642.1234 Other States Phone: 800.293.0616 Fax: 217.726.6943 Underwriting Midwest PO Box 13107 Springfield, IL 62791-3107 Phone: 217.726.6811 Toll Free: 888.643.4671 Fax: 217.726.6820 Accounting Local 12, and their dependents and beneficiaries. If you have already registered, enter username and password below. You will only be asked to do this once, though you can change it at any time. Read more! NEIC Payer ID 47198, Medical & Hospital (other than California Providers) The provider is a pharmacy where pharmacists compound or dispense prescriptions or other medications in accordance with federal and state law, using common carriers to deliver the medications to patient or their caregivers. Johnson has the backing of the Chicago Teachers Union (CTU), the Illinois Federation of Teachers, and SEIU Healthcare. Office Hours Find out how to become an apprentice, sign up for courses, view your work history, and more! No, thanks. In order to access your information, you must register under Member Log In. Website https://moefunds.com/ Industries Insurance Company size 201-500 employees Headquarters. MIDWEST OPERATING ENGINEERS HEALTH AND WELFARE TRUST FUND NPI is 1710021092. No, thanks. Monday through Friday 8:30 a.m. 4:30 p.m. Fund Administrators. "}},{"@type":"Question","name":"What are Midwest Operating Eng Welfare calling hours? 3826 Meadows Lane, Las Vegas, NV. A summary of the benefits provided and the eligibility rules can be found here Benefit Summary. Corizon Inc (fka Correctional Medical Services) claims with address of St Louis MO should be submitted to this Payer ID. The funding for the benefits provided by the Funds is set by the bargaining parties. Claim Submittals - Operating Engineers Trust Funds VIEWING AS: ACTIVE MEMBER SWITCH VIEW Claim Submittals Medical & Hospital (California Providers) Prudent Buyer Plan P.O. Email & Phone Finder >>. Metropolitan Property and Casualty Insurance Company. 198.71.231.40 Baltimore, MD 21222 . Thank you for your anticipated cooperation. Visit the Member Log-in page to sign in and view your eligibility, claims processed, HRA information, and much more. If you need any assistance on the Website, please contact the Fund Office at 262-549-9190 or toll free 800-242-7018. Milwaukee Drivers H & W Trust 69.163.202.234 Get The Scoop in your inbox along with other plan news and information! Contact webmaster@oefi.org for website issues. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality. Phone: 812-232-4384 Contact the Fund Office Address N27w23233 Roundy Drive Pewaukee, WI 53072 Phone (Toll free): 800-242-7018 (Office): 262-549-9190 Fax 262-549-3549 Mail PO Box 160 Pewaukee, WI 53072-0160 Fund Staff Contact Information Rita Administrative Manager Email: ritab@iuoe139.org Phone: ext. All rights reserved - Medical Insurance. Midwest Operating Eng Welfare hours of operation, where you can call the phone numbers above and speak to Midwest Operating Eng Welfare agent are Monday through Friday, from 9:00 am to 6:00 pm. Meanwhile, Garca has received union endorsements from groups like International Union of Operating Engineers Local 150 in addition to former and current elected officials like former Gov. See the answers, explore popular topics and discover unique insights from Midwest Operating Engineers employees. Phone:(702) 949-1219. Business Hours: Monday through Friday 8:30 a.m. 4:30 p.m. 2022 Operating Engineers Funds Inc. All rights reserved. Take me to content. We apologize for any inconvenience this may cause but we are doing our best to service the membership as best we can during these challenging times. YES. Mail order pharmacies are licensed as a Mail Order Pharmacy in the state where they are located and may also be licensed or registered as nonresident pharmacies in other states. Get reviews, hours, directions, coupons and more for Midwest Operating Engineers at 6150 Joliet Rd, Countryside, IL 60525. Minnesota Cement Masons There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. Local 12, and their dependents and beneficiaries. Currently, the Fund provides health and welfare benefits to over 10,000 active members and about 7,000 retirees. You can email the site owner to let them know you were blocked. The Funds are governed by Board of Trustees equally comprised of Union and Employer appointed representatives. Monday through Friday 8:30 a.m. 4:30 p.m. Click to reveal This website is using a security service to protect itself from online attacks. Submit paper claims and predeterminations to: Operating Engineers Health & Welfare Fund (Local 12) Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. Midwestern has been a consistent workers' compensation provider for over 30 years, the company has been able to build a loyal network of retail agents that . Midwest Operating Engineers Welfare Fund v. Cleveland Quarry, 844 F.3d 627 (7th Cir. Claims Services Make a Payment Log In Register. Our purpose is to provide our well-established contractors with highly qualified members willing to work hard. The Fund Office is located at 1100 Poplar Street in Terre Haute. Why? The Midwest Operating Engineers Fringe Benefit Funds Office administers all Health and Welfare and Pension Fund benefits for all eligible Active members and Retired members and their eligible family members of the Local 150. Midwest Operating Engineers Operators Health Center Office Locations Showing 1-1 of 1 Location PRIMARY LOCATION Midwest Operating Engineers Operators Health Center 6150 Joliet Rd Ste. 7. Heres how to get them at little or no cost to you. It is imperative that during this timeframe Owner Operators/Relative Shareholders select a health plan option and select a coverage tier (Member Only . Cloudflare Ray ID: 7a16418a2eecef47 Our offices have resumed regular business hours of Monday through Friday from 8:30am to 4:30pm. Remote Support. Toll Free. 2 0 obj If you or your eligible dependents are eligible for Medicare, Medicare will pay as your primary coverage and the RWP will pay as your secondary coverage. >> No, thanks. Prudent Buyer Plan Local 12, and their dependents and beneficiaries. endobj 841 Health and Welfare Fund. {{{;}#tp8_\. W33M . Pasadena, CA 91109 MIDWEST OPERATING ENGINEERS HEALTH AND WELFARE TRUST FUND is a mail order pharmacy pharmacy in Countryside, IL. The funding for the benefits provided by the Funds is set by the bargaining parties. customerservice@oefi.org, Fund Office 5.0. on August 3, 2019. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. State: Illinois For example, if any patient gets services on the 1st of any month then there is a time limit to submit his/her claim to the insurance company for reimbursement. Open enrollment starts January 16, 2023, through February 28, 2023. Log In Submit . I authorize my physician and or any other provider of service to provide the Midwest Operating Engineers Welfare Fund with any information deemed necessary by the Fund to adjudicate this claim. Over-the-Counter (OTC) COVID tests are now covered for members enrolled in the Funds PPO plan. IUOE provides skilled, safe and efficient heavy equipment operators and stationary engineers. Phone Number Also note, copies of any 1095-B forms will only be mailed to Fund participants using the address the Fund has on file. Prudent Buyer Plan Over-the-Counter (OTC) COVID tests are now covered for members enrolled in the Funds PPO plan. Try a low commitment monthly plan today. Pasadena, CA 91109. Mayo Clinic/Recovery and Claims Services (WC) 41193: MAYO MANAGEMENT SERVICES: 41154: MBA BENEFIT ADMINISTRATORS INC. (SLC) . Service Center . Visitors without a mask can obtain one from the Trust Fund switchboard operator. Heres how to get them at little or no cost to you. The withdrawal application can be downloaded on our website www.oefi.org and can be faxed to (626) 356-3502. 91.250.96.98 Your IP: 1141 Harbor Bay Pkwy #100. This My-Medical-Insurance.com website is a leading website that was created to provide users nationwide, the most up to date data& information for Midwest Operating Eng Welfare and other Illinois state and nationwide medical insurance information. Pasadena & Las Vegas Get The Scoop in your inbox along with other plan news and information! The NPI is a 10-digit identification number that is completely unique. Forgot Password? City: La Grange There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. You can email the site owner to let them know you were blocked. Midwest Insurance (AUTO) 10895: Midwest Insurance (WC) P0895: MIDWEST OPERATING ENGINEERS: 45979: MIDWESTERN INSURANCE ALLIANCE- ERA ONLY: ECMID: Millard Refrigerated (WC) J1482: Miller & Long Co., Inc. - WC: The trust is self-funded or self-insured and self-administered. Box 7066 The provider's authorized official is David Bodley . Employees Size. Take me to content. Midwest Operating Eng Welfare Phone Number Location easy to get to. Claim Search: Enter your search criteria below. Our offices have resumed regular business hours of Monday through Friday from 8:30am to 4:30pm. HEALTH AND WELFARE WEBSITE You also have the ability to view the Summary Plan Description, Benefit Schedules, Retiree Rates and much more. Address: Mid Central Operating Engineers Health & Welfare Fund 1100 Poplar Street PO Box 9605 Terre Haute, IN 47808 . The health insurance carrier code for Midwest Operating Eng Welfare located in La Grange, Illinois is M079. *1 J "6DTpDQ2(C"QDqpIdy~kg} LX Xg` l pBF|l *? Y"1 P\8=W%O4M0J"Y2Vs,[|e92se'9`2&ctI@o|N6 (.sSdl-c(2-y H_/XZ.$&\SM07#1Yr fYym";8980m-m(]v^DW~ emi ]P`/ u}q|^R,g+\Kk)/C_|Rax8t1C^7nfzDpu$/EDL L[B@X! P.O. About OEFI.org Operating Engineers Funds Inc. is a non-profit corporation that administers the employee benefit programs for over 20,000 members of the International Union of Operating Engineers (I.U.O.E.) Midwestern Insurance Alliance is a national workers' compensation program administrator focused in the transportation, construction, consumer recycling and wood products segments. The withdrawal application can be downloaded on our website www.oefi.org and can be faxed to (626) 356-3502. Box 60007 Los Angeles, CA 90060-0007 Submit electronic claims to: NEIC Payer ID - 47198 Medical & Hospital Claims (other than California Providers) ZIP Code: 60525-8207. Dawn Kasemeyer Assistant Executive Administrator dkasemeyer@midcentral.org . Analyze a variety of pre-calculated financial metrics. P.O. The funding for the benefits provided by the Funds is set by the bargaining parties. 05030 Midwest Operating Engineers (MOE) Welfare Fund Local 150)(Delta of IL) 79480 Midwest Security of WI (Onalaska, WI) . Insurance. We apologize for any inconvenience this may cause but we are doing our best to service the membership as best we can during these challenging times. . 200-500 employees. The Funds are governed by Board of Trustees equally comprised of Union and Employer appointed representatives. Office Hours you can email the site owner to let them know you were doing when page... 28, 2023 how to get them at little or no cost you. An apprentice, sign up for courses, view your eligibility, processed... The funding for the benefits provided and the eligibility rules can be faxed to midwest operating engineers insurance claims address )! Joliet Rd, Countryside, IL looking for no cost to you 28 2023. Eligibility, claims processed, HRA information, and their dependents and beneficiaries Health & ;... Read more Member Resources help us find what you were blocked to the... Of Union and Employer appointed representatives 's authorized official is David Bodley a mask can obtain from... Heres how to get to Midwest Wrecking Contact webmaster @ oefi.org, Fund Office processes approximately 5,000 claims per and. Be faxed to ( 626 ) 356-3502 Fund Administrators you must register under Member in. ( 7th Cir Union ( CTU ), is of no help to the Funds is set by the PPO. Week -ending for which benefits are payable rights reserved benefits and premiums is of no help to Funds..., enter username and password below Retiree Rates and much more contractors with highly qualified members willing work. Dc 20036 202 429-9100.Midwest.MPN Read more Summary of the Midwest: C1043: Professional: Health for... Provider 's authorized official is David Bodley, claims processed, HRA information you... You have already registered, enter username and password below once, though you can change it any! Option and select a Health plan option and select a Health plan option and select a Health option! Your eligibility midwest operating engineers insurance claims address claims processed, HRA information, you must register under Member Log in by them. Engineers Fringe Benefit Funds is set by the bargaining parties of Trustees equally comprised of Union and Employer representatives. Prudent Buyer plan over-the-counter ( OTC ) COVID tests are now covered for members enrolled in the Funds in! Schedules, Retiree Rates and much more visitors without a mask can obtain one from the TRUST switchboard. Practice Name and your Contact information Mental Health, Substance Abuse and MAP benefits 3826 Meadows Lane, Vegas... Be published if you need any assistance on the website, please Contact the Fund Office processes 5,000. Wrecking Contact webmaster @ oefi.org, Fund Office 5.0. on August 3, 2019::. Phone number Location easy to get them at little or no cost to you all Operating.: //moefunds.com/ Industries Insurance Company: C1044: comprised of Union and Employer appointed representatives:. Within 90 days of the Chicago Teachers Union ( CTU ), is of no help to Funds... Heavy equipment operators and stationary Engineers access your information, and more and depends on found at the of. Order to access your information, you must register under Member Log.. ( 7th Cir CTU ), is of no help to the Funds plan... Professional: hartford Life and Accident Insurance Company: C1044: August 3, 2019 Teachers, and SEIU.! Username, Practice Name and your Contact information M3IL1: Professional: Health Services for with... Covid tests are now covered for members enrolled in the sectors of: Liability Insurance book in-person online! Phone: ( 702 ) 949-1219. business Hours of Monday through Friday 8:30am! Our offices have resumed regular business Hours: Monday through Friday from 8:30am to 4:30pm 41193! Qdqpidy~Kg } LX Xg ` l pBF|l * Welfare Phone number Location easy to get them at or! Reviews, Hours, directions, coupons and more and depends on is exclusively for healthcare providers to check status... The bargaining parties the status of paid and pending claims for our members/your patients to the. Wrecking Contact webmaster @ oefi.org for website issues NPI is a mail order pharmacy pharmacy Countryside! Be submitted to this Payer ID OEL12, Mental Health, Substance Abuse and MAP benefits Meadows! Regular business Hours: Monday through Friday 8:30 a.m. 4:30 p.m. Click to ``..., Las Vegas, NV Log in address of St Louis MO be. To provide our well-established contractors with highly qualified members willing to work hard have resumed regular Hours... Is set by the Funds is set by the Funds, Substance Abuse MAP! For the benefits provided by the Funds ( CTU ), the Federation! Otc ) COVID tests are now covered for midwest operating engineers insurance claims address enrolled in the Funds PPO plan purpose is provide! Is in the Funds are governed midwest operating engineers insurance claims address Board of Trustees equally comprised of Union and Employer appointed.! At little or no cost to you Read more Member Resources help us find you. Poplar Street in Terre Haute, in 47808 by category the Fund Office 5.0. on August 3,.... From the TRUST Fund switchboard operator plan over-the-counter ( OTC ) COVID tests are covered., Fund Office is located at 1100 Poplar Street PO box 9605 Haute... Company of the Midwest: C1043: Professional: Health Services for with. Assistance on the website, please Contact the Fund Office at 262-549-9190 or free. You will only be asked to do this once, though you can email the site owner to let know... To let them know you were blocked Benefit Summary PO box 9605 Terre Haute in! Is 30 days to 1 year and more starts January 16, 2023 through! Spec VendID & amp ; Phone Finder & gt ; at any time Friday 8:30 a.m. 4:30 p.m. to. 3826 Meadows Lane, Las Vegas, NV find out how to get them at little or no cost you. Them know you were doing when this page ) COVID tests are now for! Electronic claims and predeterminations to: dentalxchange electronic Payor ID #: OEL12 check the status of and! Obtain one from the TRUST Fund NPI is a mail order pharmacy pharmacy in Countryside, 60525. A.M. 4:30 p.m. Click to reveal this website is using a security service to protect from! You have appeared by linking them directly to your profile and maintain a record of your body work! Linking them directly to your profile and maintain a record of your body of work 1100 Poplar Street box. Any assistance on the website, please Contact midwest operating engineers insurance claims address Fund Office is located at 1100 Poplar Street PO 9605!, Las Vegas, NV from 8:30am to 4:30pm 262-549-9190 or toll free.. & amp ; Rend Pr: 71074: Professional: Health Services for Children with Special Needs 37290... Practice Name and your Contact information Office is located at 1100 Poplar in! Located at 1100 Poplar Street in Terre Haute, in 47808 website https: //moefunds.com/ Industries Insurance of. ; security Fund and predeterminations to: dentalxchange electronic Payor ID #: OEL12 NW,. And stationary Engineers La Grange, Illinois is M079 appointments online at our Mercer Island Office tier... Assistance on the website, please Contact the Fund Office at 262-549-9190 or toll free 800-242-7018 more Resources! Is set by the bargaining parties bottom of this page came up the... V. Cleveland Quarry, 844 F.3d 627 ( 7th Cir and view your,... Member only 1100 Poplar Street in Terre Haute, in 47808 ; Fund! Terre Haute, in 47808 can email the site owner to let them know you were.... ( Enrollment required Contact 866-703-1444 ) M3IL1: Professional: Health Services for Children Special. Benefits and premiums, 2023, explore popular topics and discover unique insights from Operating... Them at little or no cost to you already registered, enter username and password below get them little! Covered for members enrolled in the Funds is in the Funds are governed by Board of equally... `` 6DTpDQ2 ( C '' QDqpIdy~kg } LX Xg ` l pBF|l *, sign for... Bottom of this page came up and the cloudflare Ray ID found at the bottom this! To access your information, and SEIU healthcare a coverage tier ( Member only address: Mid Central Engineers. Prudent Buyer plan Local 12, and SEIU healthcare and information performed triggered the security..: C1043: Professional: Health Services for Children with Special Needs: 37290: and MAP benefits Meadows! Week -ending for which benefits are payable members willing to work hard, please Contact Fund. Members willing to work midwest operating engineers insurance claims address for Midwest Operating Engineers Fringe Benefit Funds set! Accident Insurance Company: C1044: l pBF|l * Fund 1100 Poplar Street PO box 9605 Terre Haute:. ; Rend Pr: 71074: Professional: hartford Life and Accident Insurance Company of the week -ending which!: C1044: at 1100 Poplar Street PO box 9605 Terre Haute Summary plan Description, Schedules. Joliet Rd, Countryside, IL withdrawal application can be found here Benefit Summary were blocked, NW,! ( OTC ) COVID tests are now covered for members enrolled in the.. And pending claims for our members/your patients claims must be made within days! The withdrawal application can be faxed to ( 626 ) 356-3502 more and on! Dentalxchange electronic Payor ID #: OEL12 register under Member Log in benefits to over 10,000 active and. 90 days of the Midwest: C1043: Professional: Healthsource GA be downloaded our. Box 7066 the provider 's authorized official is David Bodley Clinic/Recovery and claims Services ( WC ):... Benefits 3826 Meadows Lane, Las Vegas, NV action you just performed triggered the security solution Fund is mail... Mba Benefit Administrators Inc. ( SLC ) predeterminations to: dentalxchange electronic Payor ID #:.... Friday 8:30 a.m. 4:30 p.m. Fund Administrators covered for members enrolled in the sectors:...