PACIFICSOURCE HEALTH PLANS

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
PO Box 7068
Spingfield, OR
97475-0068

WebMD Payor ID 93029

DRG Contracted Hospitals:

First Choice Health Network
PO Box 2289
Seattle, WA
98111-2289

WebMD Payor ID 93029

Service Area Definition:

Washington (excluding Pacific, Wahkiakum, Cowlitz, Clark, Skamania, and Klickitat Counties).

Group Name Group Number
KSQUARED LLC G0046044
KSR LLC G0041685
KT EXCAVATION LLC G0042090
KTTS G0046112
KUBOTA PHOTO-DESIGN INC BCOC G0033565
KUHLMAN LAW LLC G0040754
KUHN AND KUHN PC INC GE000369
KUHN PROPERTIES LLC G0035686
KUJALA LLC NFIB G0034476
KURTS POLARIS INC G0036250
KUTLESS INC G0015692
KYLAN PETERSON DO PLLC G0043293

Sample ID Card(s):