Provider Notices

New Claims Research Request Process

3/2/2018 11:41:05 AM

Beginning on April 2, 2018, PacificSource is implementing a new process for claims research requests from providers. This will pertain to all Medicare and Medicaid claim requests. 

Formerly, a provider could reach out to the Provider Service Representative and request a correction or review of a claim discrepancy.

The new process will be to implement a uniform approach for providers, and require all requests be sent to the claim research mailbox at:

All Claim Research Request emails must be accompanied by the attached Claim Research Request form. For multiple claim requests (3 or more affected claims), the list of claims must be attached on an excel spreadsheet (provided).

Due to the process workflow, if a Claim Research Request Form is incomplete or if multiple claims are not listed on an attached excel sheet, the request will be returned to the provider for completion.

Any questions regarding the Claims Request, will be addressed by the claims analyst, who will reach out to the contact person listed on the Form. Please be sure to include the name, email and phone number of the appropriate person who is familiar with the claim situation.

We apologize for any inconvenience that this may cause and we appreciate your patience during the implementation of this new workflow. Unfortunately, due to work volumes and reorganization of Provider Service, the department can no longer handle these types of requests.

Thank you for your cooperation, please let us know if you have any questions.