Term Date: 12/31/2025
Access client website for possible features such as benefits & eligibility and claims payment status.
tpa.pacificsource.com| For Benefits, Eligibility or Claims Status call: | PacificSource | 855-896-5208 |
| For Medical/Utilization Management service, call: | Call Center | 888-977-9299 |
| Submit Claims To: | PACIFICSOURCE HEALTH PLANS |
| DRG Contracted Hospitals: | First Choice Health Network |
Service Area Definition:
Washington (excluding Pacific, Wahkiakum, Cowlitz, Clark, Skamania, and Klickitat Counties).
| Group Name | Group Number |
|---|---|
| MONTANA DEMOCRATS | G0034179 |
| MONTANA DIRT WORKS LLC | G0044982 |
| MONTANA DISTRICT COUNCIL | G0041746 |
| MONTANA EDUCATORS CREDIT UNION | G0036602 |
| MONTANA ELECTRONICS COMPANY | G0037105 |
| MONTANA EMBROIDERY II INC | G0038606 |
| MONTANA EMPLOYEE BENEFITS COMPANY | G0037310 |
| MONTANA ENTERTAINMENT & FIREWORKS LLC | G0044654 |
| MONTANA EQUINE ASSOCIATES | G0038469 |
| MONTANA EXCHANGE INDIVIDUAL | NE010003 |
| MONTANA FLY COMPANY INC | G0037161 |
| MONTANA FOOD BANK NETWORK | G0037407 |
| MONTANA FOODWORKS INC | G0038793 |
| MONTANA FRESHWATER PARTNERS INC | G0046103 |
| MONTANA FRONTIER SERVICES | G0042292 |
| MONTANA GLUTEN FREE PROCESSORS LLC | G0043756 |
| MONTANA GUTTER SOLUTIONS | G0037596 |
| MONTANA HEALTH NETWORK ADMINISTRATION OFFICE | G0043607 |
| MONTANA IMPORT GROUP NFIB COBRA | G0034280 |
| MONTANA INDIVIDUAL | N0010007 |