Wellpoint Resources

Learn more about our health plan in partnership with Wellpoint, including resources for claims and authorizations such as PCP claims, specialist/ancillary/facility claims, and referrals/authorizations.

PCP Claims Specialist/Ancillary/Facility Claims Referral/Authorizations

PCP Claim Submission Options

You may submit PCP claims by mail, fax, or EDI.

  • Mail Claims

Send claims to:

Houston Physicians IPA c/o MSO Inc. of Southern California

2670 N. Main St., Ste. 100, Santa Ana, CA. 92705

  • Fax Claims

Fax to: (626) 552-3760

  • EDI

Use our Payer ID: MSC88

For questions about claims, please email  Ldo@MsoSocal.com or call 818-726-5278.

Specialist/Ancillary/Facility Claim Options

  • Submit Through Your Clearinghouse
  • Submit claims using the WellPoint payer ID: 01234.
  • Use the correct form type:
  • CMS‑1500 (837P) for professional claims
  • UB‑04 (837I) for facility claims
  • Be sure to include:
  • Member ID exactly as shown on the member card
  • Correct plan name (e.g., WellPoint Medicare Advantage)
  • NPI and taxonomy (if required)
  • Authorization number (if applicable)
  • Submit Through Availity Essentials
  • Log in to Availity Essentials
  • Go to Claims & Payments
  • Select the correct claim type:
  • Professional (837P)
  • Institutional (837I)
  • Choose Wellpoint as the payer
  • Enter all required claim details and submit
  • Submit by Mail or Fax
  • For mail or fax claim submission details, please contact Provider Services for the appropriate mailing address and instructions.

Referral/Authorization Steps

To submit an authorization request to Wellpoint, follow these steps:

1. Access Availity Essentials

Use the Authorizations application within Availity Essentials to begin your request.

2. Identify Required Services

Review the applicable prior authorization lists to confirm which services require authorization.

3. Submit the Request

Use the ICR (Interactive Care Reviewer) tool inside Availity Essentials to submit your authorization request.

4. Check Authorization Status

Access the ICR tool through Availity Essentials to view the status of your request and any determination updates.

5. Contact Provider Services

For assistance, contact Provider Services at 1-833-731-2162, available Monday-Friday, 8 a.m. to 5 p.m., excluding state-observed holidays.

For additional resources and detailed instructions, visit the WellPoint provider website or contact their Provider Services team.