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Select a Payor * Indicates Required Field *Payor: AUTOMATED GROUP ADMINISTRATION INC - 110 CONTINENTAL BENEFITS THIRD PARTY ADMINISTRATORS - 8017 CORESOURCE - A TRUSTMARK COMPANY - 8015 COVENANT ADMINISTRATORS - 479 EVOLUTIONS NETWORK SOLUTIONS - 8003 FIRST BENEFIT ADMINISTRATORS - 459 GLOBAL EXCEL - 958 HEALTH EZ (AMER PPO) - 991 HHC GROUP - 480 HRGI - 1022 IHC ADMINISTRATIVE SERVICES, INC (INSURERS ADMINISTRATIVE) - 467 LOCKARD & WILLIAMS INSURANCE SERVICES - 331 MEDIPAC ASSISTANCE INTERNATIONAL INC - 999 PREFERRED BENEFIT ADMINISTRATORS INC - 488 PRIME HEALTH SERVICES INC - 998 PRO-CLAIM PLUS, INC. - 224 Q3 BUSINESS TECHNOLOGY GROUP - 997 S AND S HEALTHCARE STRATEGIES, LTD. - 8009 SANUS HEALTH - 3011 TOTAL CLAIMS CAPTURE & CONTROL AKA CHANGE HEALTHCARE - 427 ZELIS FKA GLOBALCARE - 990 Employer: (Optional)