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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
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.
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.
Yes, contact your health plan to make the change.
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
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
Call 877-558-0090 for help setting up your MyChart account.
Getting Assistance
Contact your health plan on the number listed on your insurance card for assistance with transportation.
You can schedule an appointment through the MyChart app or call 909-558-6813.
Visit ieconnect.org for assistance. You may also dial 211 using your phone.
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.
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.
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
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.
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.
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.
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.
Please call 909-651-1700, Monday through Thursday, 8 a.m. to 5 p.m. or Friday 8 a.m. to 4 p.m.
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
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.
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.
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.
Visit the insurance section in MyChart to review your referral status or contact our Managed Care Utilization Management department at 909-651-1700.
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.