How To Submit Claims To L.A. Care Health Plan

Coverage: Los Angeles County; 2026 provider manual rules distinguish L.A. Care Covered, Medi-Cal, PASC-SEIU and HMO D-SNP products and delegated provider groups.

L.A. Care Health Plan claims guidance from the reviewed sources: Use the electronic or paper direct-claim route specified for the member’s product and responsible payer. Confirm the member plan and claim type before using a payer ID or paper address.

At a glance

• L.A. Care accepts direct claims electronically or on paper. Use CMS-1500 for professional claims and UB-04 for facility claims, subject to the manual and delegated responsibility.

Submission channels

• Use the electronic or paper direct-claim route specified for the member’s product and responsible payer.

Electronic claims payer IDs

• Not clearly published in the researched sources.

Paper claims addresses

• Not clearly published in the researched sources.

Corrected claims and follow-up

• Not clearly published in the researched sources.

• Claims status resource 1

Caveats

• The claims page recommends the portal for status checks; that alone does not establish a portal claim-entry workflow.
• Supply required provider tax documentation, including W-9, and confirm whether claims belong to L.A. Care or a delegated group.
• No universal payer ID or postal address is copied into this record.

Provider resources

• Official provider policy or review source (official)
• Official provider policy or review source (official)
• Official provider policy or review source (official)
• Official provider policy or review source (official)

Sources

Update notes

Last updated: 2026-10-30.

• Reviewed the 2026 manual, October 2026 errata passages, authorization tool and claims page. Preserved product-specific initial filing limits and direct-versus-delegated responsibility. Corrected claims and contract amendments require further confirmation.