Allied Benefit Systems

This is a self-funded plan administrator, so each employer plan differs: the provider number, claim address and payer ID printed on the member's ID card are authoritative. Allied's claim form says 'Contact Allied at (800) 288-2078' and its pharmacy forms print the same number. The contact page says to use the number on the back of the member's ID card to reach the designated member services team; hours are the member services hours it publishes. Claim form says the claim mailing address is on the back of the employee's ID card.

This is a self-funded plan administrator, so each employer plan differs: the provider number, claim address and payer ID printed on the member's ID card are authoritative. Contact page: the Chicago corporate address does not receive mail; mail documents related to a benefits plan to the USPS address. The claim form instead says the claim mailing address is on the member's ID card, so use the ID card address for claims when it differs.

Allied lists two payer IDs: 37308 for Allied Benefit Systems and 75068 for Allstate Benefits. Always use the payer ID shown on the member's ID card. Providers submit through their clearinghouse.

Provider Portal: eligibility and benefits, claim status, deductible and out-of-pocket data, ID card images, plan information and forms. Provider FastTrack: claim and eligibility status check with no login. Forms hub (claim forms, formulary and pharmacy prior authorization forms, HIPAA authorization, W-9) is on the provider resources documents page.

Retail Pharmacy Prior Authorization Request Form: send completed form with clinicals to this fax; receipt is not a guarantee of benefits. The Specialty Pharmacy Medical Request Form lists the SpecialtyRx email and the same fax for specialty-pharmacy medical requests. Members of plans with a different PBM may be directed to the phone number on the ID card.