Providers

Supporting Health Care Providers

As a health care provider, you are an integral part of our team. The long tenure of our employees means they are extremely knowledgeable with what your practice needs to support our members. Our online tools will give you all the information access you need to utilize patients’ health benefits to support their care. We strive to provide service excellence and a smooth experience to all our health care providers as they navigate our system to provide care.

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BENEFIT Information

My Benefits ManagerSM Provider Portal is now live! Use the secure portal to submit or check the status of a claim, view remittances, check member eligibility and view a member’s benefit usage and limitations.

Provider Portal Guide - Use this guide for information on how to register for and use My Benefits Manager.

Legacy Provider Portal - Use this link for historical data.

Quick Benefit Lookup, no log in required - Providers can verify benefits by entering the Member ID, SSN (last four digits), and birthdate.

Pharmacy Information

PAI's preferred pharmacy benefit manager is OptumRx, a pharmacy care services company that creates smarter health care connections to help more than 65 million Americans realize improved care, lower costs, and a better overall experience. View the drug lists that apply to members with PAI’s pharmacy benefit coverage with OptumRx. Contact the Customer Service number on the member ID card if you need assistance.

Provider Information

Refund Requests and Payments

Please forward your refund repayments to:
Attention: Refund Analyst
PAI
P.O. Box 6927
Columbia, SC 29260

Provider’s Refund Request Right of Appeal

If you receive a request for refund, you have the right to an appeal, if you do so within 30 days of the refund request. PAI will not require that you repay the refund until PAI has concluded its review.

Provider Address Change

Fax an updated W-9 to (803) 264-9089
Attn: Provider Maintenance or email the updated W-9 to PAI Provider Maintenance at paiprovmtn@paisc.com