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 INTERNATIONAL SUPPLY CO | G0034104 |
| MONTANA JUSTICE FOUNDATION | G0037487 |
| MONTANA KIDNEY PLLC | G0046318 |
| MONTANA LAND TO HAND | G0044850 |
| MONTANA LEATHER COMPANY | G0044749 |
| MONTANA MEDICAL ASSOCIATION | G0045608 |
| MONTANA NEUROPSYCHOLOGICAL ASSOCIATES | G0037301 |
| MONTANA OBGYN PC | G0044044 |
| MONTANA PARTY RENTALS | G0043815 |
| MONTANA PLUMBING COMPANY | G0037851 |
| MONTANA PLUMBING COMPANY | G0037851 |
| MONTANA PRIMARY CARE ASSOCIATION | G0037682 |
| MONTANA PUBLIC INTEREST RESEARCH GROUP | G0045609 |
| MONTANA PUMP COMPANY | G0045466 |
| MONTANA REAL ESTATE ASSOCIATES | G0044731 |
| MONTANA REAL ESTATE PROJECTS LLC | G0038411 |
| MONTANA RECLAIMED LUMBER NFIB | G0034512 |
| MONTANA REGIONAL MLS LLC | G0040621 |
| MONTANA ROADSIDE SERVICES LLC | G0041637 |
| MONTANA ROCKWORKS INC | G0045905 |