How to Submit a Claim

In most cases, your provider will submit your claim for you. Sometimes, a provider may bill you directly instead of submitting a claim to PacificSource. For example, non-participating providers (those that do not participate in our provider networks) may only bill you. When this happens, it becomes your responsibility to submit your claim to PacificSource for processing.

All claims for benefits must be turned in to PacificSource within 90 days of the date of service. If it is not possible to submit a claim within 90 days, turn in the claim with an explanation as soon as possible. In some cases PacificSource may accept the late claim. However, please be aware that they will not pay a claim that was submitted more than a year after the date of service.

Submitting a claim to PacificSource for services received at the Student Health Center

PacificSource’s guide on how to submit a claim.

Claim Form to submit to PacificSource for reimbursement

You will need to register on the Health Information Portal to obtain copies of your receipts and statements to send to your insurance company for reimbursement.

Click here for directions on how to register and log in to the Health Information Portal.

Click here to register/login to the Health Information Portal.