Insurance Plans You Can Bill Through Zaya

Modified on Thu, 19 Feb at 4:13 PM

Summary
This guide outlines which insurance payers you can bill through Zaya, which services and states are covered, and where to review plan details carefully. 
Use this as a quick reference to avoid surprises when checking eligibility and submitting claims. When in doubt, always confirm the patient’s coverage through the Zaya Portal.

Zaya’s eligibility check confirms only the primary insurance. Zaya does not support secondary insurance billing (see this article for more information). Your practice must be opted in and fully enrolled for the respective insurance through Zaya. The provider must have confirmed in-network status from Zaya’s credentialing team before billing.


Insurance (incl. subsidiaries)
Programs Covered
States
Specialties Covered
Notes
Aetna
Commercial, Medicare Advantage
NY, NJ
PT, OT, RDN
Includes all known subsidiaries.
Anthem
Commercial, Medicare Advantage
NY only
PT, OT, RDN
Includes all known subsidiaries.
UHC & Oxford
Commercial, Medicare Advantage
NY only
PT, OT, RDN
Some subplans are excluded - see "Exclusion" section below.
Oscar
Commercial, Health Exchange
NY only
PT, OT, RDN
Includes Oscar EPO and Exchange plans.
Centivo
Commercial, Medicare Advantage
NY only
RDN only
PT/OT not covered.
Cigna
Commercial only
NY only
RDN only
PT/OT not covered.


Known included subplans 

Some payers have subplans not covered under Zaya’s contracts, and plan lineups change often. Use the table above to confirm payer and program type, then verify eligibility in the Zaya Portal.


Insurance NameSubplanIndicatorProgram Type
AetnaOpen ChoiceListed on Member CardCommercial
AetnaElect ChoiceListed on Member CardCommercial
AetnaManaged ChoiceListed on Member CardCommercial
MeritainMeritain HealthCommercial ONLYCommercial
MeritainAdministrative ServicesListed on Member CardCommercial
First Choice NetworkMultipleLook for Aetna AND First Choice Logo on CardCommercial
First Health NetworkMultiplePart of Aetna - Look for payer LogoCommercial
AetnaWhole Health TIERED ONLYLook for Multi-Tier or Tiered on top of cardCommercial
AetnaInnovation Health PlansListed on Member CardCommercial
AetnaSelectListed on Member CardCommercial
AetnaStudent HealthListed on Member CardCommercial
AetnaNY Tri-State EPOMust have that specific nameCommercial
AetnaSignature AdministratorsListed on Member CardCommercial
AetnaNational Advantage ProgramNAP is on top of cardCommercial
AetnaMTA NYCTListed on Member CardCommercial
AetnaQPOSListed on Member CardCommercial
AetnaVoluntary PlansListed on Member CardCommercial
AetnaAetna Affordable Health Choices Limited Benefits Insurance Plan (SRC Only)Must have that specific nameCommercial
AetnaPremier Care NetowrkListed on Member CardCommercial
AetnaChoices POS IIListed on Member CardCommercial
AetnaOpen Access (and Open Access Plus)Listed on Member CardCommercial
AetnaTraditionalHDHP/HMO/PPO/POSCommercial
AetnaIndemnity PlansListed on Member CardCommercial
Empire/BCBS/ AnthemBlue AccessListed on Member CardCommercial
Empire/BCBS/ AnthemTraditional PlansCard has PPO/HMO/POS/HDHPCommercial
Empire/BCBS/ AnthemBlue PriorityListed on Member CardCommercial
Empire/BCBS/ AnthemEmpire Gold EPOMust have that specific nameCommercial
Empire/BCBS/ AnthemEmpire Bronze Blue Access EPOMust have that specific nameCommercial
Empire/BCBS/ AnthemEmpire Silver Blue Access EPOMust have that specific nameCommercial
Empire/BCBS/ AnthemEmpire Gold Blue Access EPOMust have that specific nameCommercial
Empire/BCBS/ AnthemIndemnity PlansListed on Member CardCommercial
Empire/BCBS/ AnthemFederal Employee ProgramWill say FEP, ID# Starts with RFederal
Note - Anything from out of state Blues that meet the above criteria is in network and can be billed to the local - Watch out for out-of-state EPOs (not included)
Oscar HealthAll Plans - Includes out of StateAll PlansCommercial
UHCChoice EPOListed on Member CardCommercial
UHCChoice Plus (HMO, POS)Listed on Member CardCommercial
UHCIndemnity PlansListed on Member CardCommercial
UHCNavigate (EPO, HMO)Listed on Member CardCommercial
UHCNexus ACOListed on Member CardCommercial
UHCTraditionalPPOCommercial
UHCSelect EPOListed on Member CardCommercial
UHCSelect PlusListed on Member CardCommercial
UHCUHC Doctors Plan (and Doctors Plan Plus)Listed on Member CardCommercial
Surest (UHC Subsidiary)Choice Plus / SelectListed on Member Card
Oxford (UHC Subsidiary)FreedomListed on Member CardCommercial
Oxford (UHC Subsidiary)Freedom ChoiceListed on Member CardCommercial
UHC VACCNVACCNListed on Member CardCommercial
All Savers (UHC Subsidiary)All PlansListed on Member CardCommercial


Known excluded subplans & programs

Plan lineups change frequently, so this list is not permanent or exhaustive.

  • Zaya does not cover Medicaid plans for any payer listed above. If a card says “Medicaid,” “Managed Medicaid,” or “Medi-Cal,” it cannot be billed through Zaya, even if the payer name matches.

  • Zaya does not cover Traditional Medicare (also called Straight Medicare or Federal Medicare).

  • For UHC and Oxford, Zaya does not cover The Empire Plan or Oxford Liberty Plans.


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