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:
System features allow members to:
View paid claim information
Check eligibility status
Retrieve the summary plan description
Access to online customer service
How to Submit a Claim to Coastal
Coastal makes claims submission easy for our members. Most providers will even submit claims on your behalf.
Paper Submission
Coastal TPA
Po Box 80308
Salinas, CA 93912
Electronic Submission
Smart Data Solutions
Payor ID 77052
If you are a member and are submitting your own claims:
- Please print out and complete the member claim form. You can find complete instructions here if needed.
- 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.
- 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.
- 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:
forms require Adobe Reader, click here to download Adobe
Reader