Check out frequently asked questions and learn more information and processes about our primary healthcare service in Imperial County, California.
I would like to contract with PPCIPA, what do I do?
Please email your Letter of interest, W9, and CV along with CAQH number to Daniel Hong, our Contracting Specialist, daniel.h@procaremso.com.
If you would like us to walk you through the process or have any questions, please call 657-206-3700.
How long do referrals take to process?
Routine referrals are allowed by CMS to take up to 14 days, but Premier Patient Care try to process it within 5 days. Urgent referrals (Urgent cases are required in order to prevent serious deterioration of a member's health that results in serious illness or injury) are within 24-48 hours. Note: Urgent requests that are not truly Urgent will be defaulted back to Routine requests.
Referrals received at the end of a business day (after 5:00 pm) will be processed on the next business day.
How do I submit an authorization?
There are two ways to submit an authorization:
- You can submit online via our Web Portal “Quickcap.” If you do not have an account, please contact your Provider Relations Representative to set you up with a username and password.
- You can submit via fax. Please fax to (888) 972-1931 or email Daniel.h@procaremso.com.
How do I modify an authorization?
There are three ways to modify an authorization:
- You can call our customer service line. Have the first name, last name, date of birth and what you are requesting to modify available at the time of the call.
- Fax in modification request to (888) 972-1931.
- Modifications can be requested in the comments section in Aerial Care.
Why was the authorization denied?
An authorization may be denied for many reasons. Please contact our Provider Relations department for complete details.
If you disagree with the denial, please submit a copy of the original denial letter along with your supporting appeal information to (888) 972-1931.
Why was the claim not paid?
Sometimes, claims are not paid for various reasons. Please contact our Claims department at claims@procaremso.com
How do I update my provider information?
To update your provider information, please email the updated information toour Provider credentialing daniel.h@procaremso.com