Claims

The Claims Department is responsible for the timely and accurate payment of medical claims submitted to Partnership HealthPlan of California (PHC).

In addition to timely and accurate payment of medical claims, the department is responsible for the Claims Call Center, first and second level provider claim appeals, systems configuration related to benefits, edits, rates and coding, audits and recoveries (internal and external), and management of several vendors utilized by the department.

 

Looking for Coding Tips (Click here)

 

Electronic Claims Submission - Electronic Data Interchange (EDI):

Please submit claims electronically through Online Services. For EDI assistance, contact the EDI team at (707) 863-4527  or visit the EDI page by clicking here

Note: Medi-Cal, Healthy Kids, and PartnershipAdvantage have different claims mailing addresses for medical claims. Mental Health Claims should be billed to Beacon.

​Medi-Cal

Medi-Cal Provider Manual​

Billing Address

Partnership HealthPlan of California
Medi-Cal Claims
P.O. Box 1368
Suisun City, California 94585-1368

Healthy Kids

Healthy Kids Provider Manual

Billing Address

Partnership HealthPlan of California
Healthy Kids Claims
P.O. Box 3172
Suisun City, California 94585-3172

PartnershipAdvantage

The PHC PartnershipAdvantage line of business closed on 12/31/2014.   PHC has been accepting claims for dates of service prior to 12/31/2014.  As of 07/08/2016 PHC will no longer accept PartnershipAdvantage claims.

​Mental Health

Billing Address

Beacon Health Strategies
Cypress Service Center / Partnership HealthPlan Claims
5665 Plaza Drive, Suite 400
Cypress, CA 90630-5023