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 |
|---|---|
| REM MARKET LLC | G0040830 |
| REMAKE TALENT | GE000964 |
| REMAKE TALENT | G0046077 |
| RENEW AESTHETICS & IV HYDRATION BAR | G0040192 |
| REPEAT PERFORMANCE SPORTS LLC | G0039801 |
| REPEAT PERFORMANCE SPORTS LLC | GE000237 |
| RESERVATION OPERATIONS CENTER LLC | G0035802 |
| RESOLUTE LAW PLLC | G0045303 |
| RESORT RESOURCES INC | G0041303 |
| RESOURCE FOR ENVIRONMENTAL AND OCCUP HEALTH | G0037068 |
| RESTORATION NORTH LLC | G0042021 |
| RESTORE RITE LLC | G0043514 |
| RESTOREAR DEVICES LLC | G0044914 |
| RESTORED COMMUNITY CHURCH | G0042908 |
| RESTOREX LLC | G0045424 |
| RESULTS INSURANCE BILLING LLC | G0045423 |
| RETINA AND VITREOUS CENTER OF SO OR | G0013072 |
| RETIREMENT SOLUTIONS LLC | G0046046 |
| REVELATION INDUSTRIES INC NFIB | G0034569 |
| REVERSED LO BAR INC | G0037124 |