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| Frequently Asked Questions (FAQs) |
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| Changes To Your Information or Status |
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How do I change my name or address? |
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Answer: You will need to contact your health plan in order to change your name or address. Because your health plan relies on your employer to regularly provide member eligibility information, members are encouraged to contact their employers with name or address changes to ensure that eligibility information is current and correct. After you have updated your information with your health plan, please contact our customer service department to ensure that we have your updated information. |
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How can I cover my newborn? |
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Answer: Contact your employer's benefits department for instructions and to obtain the proper forms. In general, an eligible newborn child is covered for 31 days from his/her date of birth. To continue coverage beyond this initial 31 day period, the eligible child must be enrolled within 31 days of birth and any applicable premium must be paid. Special provisions may apply to legally adopted children. Contact your health plan for details. |
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What if I have an emergency while on vacation or outside of my network? |
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What are my options after I turn 65? |
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| Physicians, Urgent Cares & Facilities |
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What is my Primary Care Physician's phone number? |
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Answer: Your Primary Care Physician phone number is on your insurance card or you may call Customer Service at 1-800-956-8000. |
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What Urgent Care can I go to? |
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Answer: To get the correct Urgent Care you need to call your Primary Care Physician first to see if the doctor can see you. If your doctor is unable to see you he/she will direct you to the correct Urgent Care. If after hours the office voicemail will have directions for you to follow. You may also call Customer Service for this information at 1-800-956-8000. |
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How do I change my Primary Care Physician? |
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Answer: To change your Primary Care Physician you will need to call your insurance company who will make the change for you. Once this is done the insurance company will notify the medical group. |
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Is my specialist a PrimeCare doctor? |
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Answer: To find out if your Specialist is a part of PrimeCare Medical group please call Customer Service at 1-800-956-8000. |
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What if my Primary Care Physician (PCP) leaves the network? |
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Answer: If your doctor leaves the network, you will be contacted in advance by your health plan. You will be given the opportunity to select a new PCP who participates in your network. You may call your health plan or access your health plan's webpage for a listing of participating credentialed PCPs.
You can also obtain PCP information on our website or contact our customer service department if you have questions regarding PCPs in your current network. |
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| Billing & Co-pays |
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Q. |
I am receiving a bill? |
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Answer: If you received a bill please call Customer Service at 1-800-956-8000. |
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What is my co-payment? |
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Answer: For your correct co-payment or benefits you need to call your insurance company directly. The phone number is on your insurance card or you may call Customer Service at 1-800-956-8000 to get that phone number. |
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| Referrals/Authorizations |
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How do I obtain an authorization? |
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Answer: To get an authorization you need to have your Primary Care Physician submit the request to the medical group. |
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What is the status of my authorization? |
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Answer: To get status of your authorization you need to call your Primary Care Physician. |
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My authorization was denied how do I appeal that decision? |
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Answer: To appeal a denied authorization/referral you need to contact your insurance company. The insurance company will review your denied authorization and either overturn or uphold the decision. |
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| Physicians Putting Patients First! |
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Call Customer Service |
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Toll Free |
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(800) 956-8000 |
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Hours of Operation: |
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Mon, Wed & Fri |
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8:00 a.m. to 4:30 p.m. PST |
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(Fri - Closed 11:30 a.m. to 12:30 p.m.) |
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Tue & Thurs |
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8:00 a.m. to 6:00 p.m. PST |
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Outside these hours, please leave a message and your call will be returned the next business day |
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