The administrative services provided by insurance companies providing benefits and/or administrative services for the group health plan include, where applicable: network establishment, maintenance and management, pre-certification and other utilization review determinations and the review of all utilization review appeals, claims services, in particular claims processing and determination, pre-determinations, review of certain appeals and payment of benefit claims, and the handling of grievances and various other customer services.
IQVIA has engaged the services of the following third-party administrators who are responsible for processing claims for these self-insured plans.
The claims administrator for the medical plans is:
Aetna
P.O. Box 981106
El Paso, TX 79998-1106
For Southern California Member:
Kaiser Foundation Health Plan, Inc.
Claims Department
P.O. Box 7004
Downey, CA 90242-7004
For Northern California Members:
Kaiser Foundation Health Plan, Inc.
Claims Department
P.O. Box 12923
Oakland, CA 94604-2923
For Georgia Members:
Kaiser Foundation Health Plan, Inc.
Claims Department
P.O. Box 370010
Denver, CO 80237-9998
Claims services number:
1-800-390-3510
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