Claims

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West Regional Physicians Network
Claims Department

P.O. Box 10939
San Bernardino, CA 92423

Phone: (323) 347-6815

Office Hours:

Monday-Friday: 8:30 a.m. – 5:00 p.m.

Claims Submission Process

Physical Address for paper claims mail to:
All paper claims must be mailed to:
West Regional Physicians IPA
Attn: Claims Department
P. O. Box 10939
San Bernardino, CA 92423
Requirements for complete claims
Unless otherwise directed by the IPA, Professional shall submit to IPA complete claims for Covered Services within ninety (90) days of rendition of the service. IPA will reimburse Professional in accordance to the agreed upon compensation rate no later than 45 business days after receipt of the claims, unless the claim is contested or denied.
  • Insurance type
  • Insured’s ID number
  • Patient’s name
  • Patient’s birth date
  • Patient’s address
  • Diagnosis or nature of Illness or Injury (ICD-10 code, up to Twelve codes)
  • Prior authorization number
  • Date(s) of service
  • Place of service
  • Procedures, services or supplies (CPT/HCPCS/NDC Code/Modifier)
  • Charges for each service billed
  • Days of units
  • Federal tax ID number
  • Provider license or UPIN number
  • Patient’s account number
  • Total charges
  • Signature of physician or supplier, including degrees or credentials (if billed on paper)
  • Physician billing name, address, zip code
Appeals, claims payments, contested claim or denials
If you dispute any denial, claims payment, or contested claim, please submit in writing your provider dispute to:

West Regional Physicians IPA
Attn: Claims Department
P. O. Box 10939
San Bernardino, CA 92423
Your dispute must contain the following information:
  • Provider’s name
  • Provider’s identification number
  • Provider contract information
  • A clear identification of the disputed item
  • Date of service
  • Please include a clear explanation of the basis upon which you believe the payment amount, contested item, denial or other action is incorrect. Disputes must be submitted and received within 365 days from the date of the last transaction.