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Claims

For more information about filing medical insurance claims, electronic claims, paper claims, how to submit a payment, and frequently asked questions.

Premier Patient Care IPA
Attn: Claims Department
PO Box 7820
La Verne, CA 91750
Phone: (657) 206-8700
Email: claims@procaremso.com

Claim Submission: Electronic Claims

Electronic Claims are claims submitted electronically through a Plan-approved electronic billing system software vendor or clearing-house. Completion of electronic claim submission requirements can speed claim processing and prevent delays.

If you use EDI, you must include:

  • Billing Provider Name
  • Rendering Provider
  • Legal Name
  • License Number (if applicable)
  • Medicare Number (if applicable)
  • Federal Provider Tax ID Number
  • Medi-Cal ID Number (if applicable)
  • National Provider Identifier (NPI)

We cannot be responsible for claims never received. Providers must work with their vendors to ensure files are successfully submitted to us. Failure of a third party to submit a claim to us may risk the Providers claim being denied for untimely filing if those claims are not successfully submitted during the filing limit.

Claim Submission: Paper Claims

Paper claims are scanned for optimal processing and recording of data provided; therefore, even paper claims must be legible and provided in the appropriate format to ensure scanning capabilities. The following paper claim submission requirements can speed claim processing and prevent delays:

  • Use the appropriate form type for submission
  • Use black or blue ink; do not use red ink, as the scanner may not be able to read it
  • Use the Remarks field for messages
  • Do not stamp or write over boxes on the claim form
  • Send the original claim form to us and retain the copy for your records
  • Separate each individual claim form. Do not staple original claims together, as we would consider the second claim an attachment and not an original claim to be processed separately
  • Information is typed within the designated area of the field. Be sure the type falls completely within the text space and is properly aligned with corresponding information. If using a dot matrix printer, do not use draft mode since the characters generally do not have enough distinction and clarity for the optical character reader to accurately determine the contents