How to File a Claim

In most cases, your provider will bill us directly and you won't need to file claims for healthcare services. If, however, you do not receive an Explanation of Benefits (EOB) within 30 days of the date of service, or you receive a “Past Due” statement from your provider, please do the following.

Examine the bill carefully, and be sure all the charges listed are for services you actually received. Then send the bill to the claims address below. Be sure to include the following information:

• Employer name
• Group number
• Member name and number
• Itemized charges with diagnostic codes (payments cannot be based on a “Balance Due” or “Balance Forward” statement).

If you have any questions, feel free to call our Customer Service Department at (888) 532-5332 or e-mail asocustomerservice@pacificsource.com.

Claims Address
PacificSource Administrators, Inc.
PO Box 70088
Eugene OR 97401-0105