Please fax your Provider Form, Letter of Interest, W-9 and CV to our Provider Relations department at (760) 477-2915.
If you would like us to walk you through the process or have any questions, please call (714) 944-6737
Routine referrals take up to 5 business days to be processed. Urgent referrals take up to 72 business hours to be processed. Emergency referrals take up to 24 hours to be processed.
Referrals received at the end of a business day (after 5:00 pm) will be processed on the next business day.
There are two ways to submit an authorization:
- You can submit online via our Web Portal “Aerial Care.” If you do not have an account, please contact your Provider Relations Representative to set you up with a username and password.
- You can submit via fax. Please fax to (800) 709-5449.
There are two ways to modify an authorization:
- You can call our customer service line. Have the first name, last name, date of birth and what you are requesting to modify available at the time of the call.
- Fax in modification request to (800) 709-5449.
An authorization may be denied for many reasons. Please contact our Provider Relations department for complete details.
If you disagree with the denial, please submit a copy of the original denial letter along with your supporting appeal information to (800) 709-5449.
Sometimes, claims are not paid for various reasons. Please contact our Claims department to get detailed reasons at (877) 207-7600 ext. 2000.
To update your provider information, please fax the updated information to our Provider Relations department at (760) 477-2915.