Foreign Claims

Submission Guidelines

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

The above address should be used for claims only. All other Plans' correspondence should be mailed directly to the Plan Office.