Coastal TPA, Inc. is pleased to provide a self service online tool, which is HIPAA compliant for patient privacy, and provides you with free online access to your benefit information. Take a minute and review the exciting online services available to you.

Member/Provider Log-in:

Username: Password:  

System features allow members to:

View paid claim information
Check eligibility status
Retrieve the summary plan description
Access to online customer service
Verify provider participation
And much, much more!

How to Submit a Claim to Coastal

Coastal makes claims submission easy for our members. Most providers will even submit claims on your behalf.

If you are a member, and your provider of service has submitted a claim for you, then there is no need to fill out and submit a claim form.

CLAIM FORMS: Please use these forms if you need to send your provider the appropriate claim form for their use:


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If you are a member and are submitting your own claims:

  1. Please print out and complete the member claim form. You can find complete instructions here if needed.
  2. You will also need to attach an itemized bill from the provider of service that includes patient name, provider name/ address/ provider's taxpayer identification number, date(s) of service, diagnosis code(s), (primary/secondary) describing the condition, procedures codes(s), place of service and itemized charges.
  3. If the patient has other coverage, please attach a copy of the other claims administrator's explanation of benefits. This information is required to process your claim.
  4. Please submit your claim and the attachments to:
    Coastal TPA, Inc.
    P.O. Box 80308
    Salinas, CA 93912-0308

Coastal ensures compliance with HIPAA regulations to protect patient privacy. If you have questions about a claim that was submitted on behalf of an adult (over 18 years old) family member, please have them complete and sign this Privacy Release Authorization.

Forms:


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Customer Service: (831) 754-3800 | Toll Free: (800) 564-7475

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