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With your help, we can make ambitious innovations in clinical care and education for our community.
On this page, you'll find answers to some of the most common questions Managed Care members ask us. You can also contact us Monday – Thursday 8 a.m. – 5 p.m. and Friday 8 a.m. – 4 p.m:
- Member Services: 855-LLU-CARE (855-558-2273)
- Member Services email: [email protected]
- Claims phone: 909-651-1701 fax line: 909-651-1757
- Referral Authorization phone line: 909-651-1700
- Decision Tool for Medical Necessity
- Medicare Advantage Member Information Booklet: lluh.org/MA-booklet
- Commercial Member Information Booklet: lluh.org/commercial-booklet
- Current primary care physicians accepting new patients: lluh.org/hmo-physicians
Membership
Am I enrolled with Managed Care?
To check enrollment status, please contact your health plan website or the phone number on your member ID card to verify enrollment status and provider assignment.
What health plans are you contracted with?
For Medicare Advantage plans, we are contracted with Anthem Blue Cross and United Health Care. For commercial plans, we are contracted with Anthem Blue Cross, Blue Shield, and United Health Care.
Can I change my primary care clinic?
Yes, contact your health plan to make the change.
What are the available primary care clinic sites?
General Medicine
Faculty Medical Clinics
11370 Anderson St.
Loma Linda, CA 92354
Family Medicine
Redlands Boulevard
25828 Redlands Blvd., Suite 102
Redlands, CA 92373
Professional Plaza
25455 Barton Road, Suite 204B
Loma Linda, CA 92354
Beaumont – Banning
81 S. Highland Springs Ave., Suite 301
Beaumont, CA 92223
Internal Medicine
Highland
7223 Church St., Suite C1
Highland, CA 92346
Moreno Valley
11441 Heacock St., Suite C
Moreno Valley, CA 92557
Redlands Boulevard
25828 Redlands Blvd., Suite 101
Redlands, CA 92373
Where are the urgent care locations in my network?
Faculty Medical Clinics – Redlands Boulevard Urgent Care
25828 Redlands Blvd., Suite 103
Redlands, CA 92373
Open Mon – Fri, 8 a.m. – 7 p.m.
Sat – Sun & Holidays, 8 a.m. – 3 p.m.
East Campus Advanced Urgent Care
25333 Barton Road
Loma Linda, CA 92354
Daily: 24 hours
Southern California Emergency Medicine Urgent Care Centers
Moreno Valley
27640 Eucalyptus Ave.
Moreno Valley, CA 92555
Phone: 951-243-2200
Fax: 951-243-3200
Norco
1295 Hamner Ave., Suite C
Norco, CA 92860
Phone: 951-272-6500
Fax: 951-272-6900
Riverside
18876 Van Buren Blvd., Suite 101
Riverside, CA 92508
Phone: 951-429-6002
Fax: 951-429-6005
Yucaipa
33494 Oak Glen Road
Yucaipa, CA 92399
Phone: 909-797-8900
Fax: 909-797-5800
Can I get help signing up for MyChart?
Call 877-558-0090 for help setting up your MyChart account.
Getting Assistance
Where can I get assistance with transportation?
Contact your health plan on the number listed on your insurance card for assistance with transportation.
How can I make an appointment?
You can schedule an appointment through the MyChart app or call 909-558-6813.
Where can I find housing and food assistance resources?
Visit ieconnect.org for assistance. You may also dial 211 using your phone.
Do you offer case management programs for my condition?
We do offer case management programs to members who meet certain criteria. This may apply but is not limited to the following cases:
- Diabetes
- Congestive heart failure
- Chronic kidney disease
- Transplants
- Cancer
Call 909-651-1700 to be connected directly with a case manager to discuss your options.
What number do I call for after hours care?
You can check your health insurance card for a nursing care line or ask for the on-call primary care provider at 909-558-4000.
How can I get ahold of a case manager for discharge planning of a family member in the hospital?
Please call 909-651-1700 from Monday through Thursday, 8 a.m. to 5 p.m. and Fridays 8 a.m. to 4 p.m.
Referrals, Denials, and Appeals
Why was my referral denied?
CMS requires that we provide access to the coverage criteria used to approve or deny requested services. To meet this requirement, we have provided a link to MCG which is nationally recognized evidence based clinical criteria we may use when reviewing requested services for medical necessity. This requirement provides transparency into Medicare Advantage (MA) organizations’ medical necessity decision making and is consistent with CMS’s expectation that MA organizations develop and use coverage criteria in a way that aligns with Traditional Medicare.
How can I appeal a denial?
The steps to begin the appeals process can be found in the denial letter you received. As your medical group we cannot submit the appeal for you, but we can help explain the process. If you require assistance, please contact Managed Care Utilization Management at 909-651-1700.
How can I determine the status of my durable medical equipment (DME) referral?
To check the status of your DME referral, please contact Managed Care Utilization Management at 909-651-1700, Monday through Thursday, 8 a.m. to 5 p.m. or Fridays 8 a.m. to 4 p.m.
How will I know which durable medical equipment (DME) vendor I am being referred to?
Visit the MyChart app or call the Managed Care Utilization Management team at 909-651-1700, Monday through Thursday, 8 a.m. to 5 p.m. or Friday 8 a.m. to 4 p.m. for this information.
Who can I talk with about my concerns regarding the durable medical equipment (DME) vendor I was referred to?
Please call 909-651-1700, Monday through Thursday, 8 a.m. to 5 p.m. or Friday 8 a.m. to 4 p.m.
What is the status of my referral?
To check on the status of your referral, please contact the Managed Care Utilization Management team at 909-651-1700, Monday through Thursday, 8 a.m. to 5 p.m. or Friday 8 a.m. to 4 p.m.
Claims
Why was my claim denied?
Most authorized and covered services are paid within the required time frames in which a provider submits a claim for payment. However, there are circumstances when a claim is, unfortunately, denied:
- Services were not authorized or deemed not urgent or emergent
- Claim is missing pertinent billing information
- Insurance is not a plan in which Managed Care is at risk for payment
Please follow up with your provider of services to ensure one of these has not been identified.
Why do I have a copay for certain services?
Copays can change annually based on changes in your health plan. If you have a question about your copays or benefits, contact your health plan.
Why did I receive a bill for services?
If you received a bill for services and the bill is not related to an applicable copay make sure your provider has your current insurance information. This information is on your insurance card.
Why was my referral denied?
Visit the insurance section in MyChart to review your referral status or contact our Managed Care Utilization Management department at 909-651-1700.
How do I update my eligibility?
To check eligibility status, please contact your health plan website or the phone number on your member ID card to verify eligibility status and provider assignment.