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Each
foreign claim filed with
the Health Plan should include the following information:
-
Participant's
Name
-
Participants
Health Plan ID Number (as it appears on the Health Plan ID Card)
-
Provider's Name
-
Provider's
Address
-
Patient's Name
-
Patient's Date of
Birth
-
Procedure Code
(if provided by doctor)
-
Diagnosis Code
(if provided by doctor)
-
Amount Paid (if
any)
Please mail all
Foreign Claims to:
DGA-Producer Health Plan
P.O. Box 48985
Los Angeles, CA 90048
Important: the
above address should be used for claims only. All other Plans'
correspondence should be mailed directly to the Plan
Office.
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