Payers and plan programs, A to Z.

Payers and plan programs from public federal files; not a list of payers Payerworks can send to; payer IDs only where the payer publishes one.

Medicare Advantage and Part D contracts from CMS, Medicaid managed care plans from Medicaid.gov, insurers from their loss ratio filings, the carriers employer plans name on their Form 5500 filings, and the Medicare contractors and the plans whose own provider pages Payerworks read.

Rows from two files are joined only by a number both carry (a NAIC code, then a tax ID). Inside one file, the file’s own grouping stands: a CMS legal entity’s contracts are listed under it, and a Medicaid plan’s state programs under the plan’s name. Two rows whose names merely agree are kept apart for a person to decide.

Where a row serves is only what its file or page says. A row whose sources say nothing about where it serves says Not stated, and states offered to employer groups only are listed apart.

Most rows have no payer ID: a payer ID is a routing code each clearinghouse assigns, and Payerworks lists only the ones payers state.

A payer ID is shown only where the payer or its Medicare contractor publishes it, with the page and the day it was read. Clearinghouses can route the same payer under other IDs, and Payerworks is connected to no payer yet.