An IPA or an Independent Physicians Association consists of a panel of physicians who contract with health plans and hospitals to provide complete care to members of Health Maintenance Organizations (HMO). All HMO members must first select a Primary Care Physician (PCP), who belongs to an IPA or medical group. IPA doctors and their staff then coordinate a comprehensive health care delivery system among the medical providers within the network.

Anyone with HMO insurance can and needs to join an IPA.

To join Pacific Associates IPA, Please refer to How to join Pacific Associates IPA) page. For more inquiries, please call (562) 387-0403 and speak with one of our customer service representatives.

The Pacific Associates member service center is located at 9900 Lakewood Blvd., Suite 103, Downey, CA 90240. We welcome walk-in members Monday to Friday 8am-5pm. For more inquiries, please call (562) 387-0403.

Member service center: Monday to Friday from 8AM to 5PM.

In case of a life threatening emergency, please dial 911. For non-life-threatening emergencies, please call one of our contracted After Hours Urgent Care Centers.

Pacific Associates offers several After Hours Care Centers throughout Southern California to service our members in medical needs.

Family doctor is commonly referred to as PCP (Primary Care Physicians). When you enroll into a HMO plan, you need to choose a designated PCP within the IPA network. For our network of contracted PCPs, please click here. If you would like to change your PCP, please contact your Health Plans for details.

Co-pay or co-payment is a payment defined in the insurance policy and paid by the insured person each time a medical service is accessed. A member’s co-payment varies depending on the type of insurance they have. Please contact your Insurance carrier for co-payment information.

An authorization is an approval to go see a specialist that is usually requested through your primary care physician.

An authorization may be denied for many reasons. Please contact our customer service at (562) 387-0403 for complete details.

In most cases members will receive what is called a "balance bill". The reason they received a bill in these cases was because the member was seen in the ER or pathology provider who is non-contracted and did not accept the initial payment for the IPA. The balance is not the member’s responsibility for these cases and claim must be forwarded to claims department for reprocessing. The member should only be charged applicable co-payment. Please note, that members who receive non-urgent/emergency services, will be responsible to charges incurred if they did not obtain prior authorization from the IPA.

Routine referrals take up to 5 business days to be processed. Urgent referrals take up to 72 business hours to be processed. Emergency referrals take up to 24 hours to be processed.

To submit an authorization, you can: Submit online via our Web Portal under “Authorizations.” If you do not have an account, please contact your Provider Relations Representative to set you up with a username and password. Submit via fax. Please fax in a Treatment Authorization Request form (TAR) to 562-396-0403. For urgent request, please fax to (866) 574-0860.

To modify an authorization, you can: Call our customer service line. Have the first name, last name, date of birth and what you are requesting to modify available at the time of the call. Fax in modification request to (323)657-7055

An authorization may be denied for many reasons. Please contact our customer service for complete details. If you disagree with the denial, please fax a copy of the original denial letter along with your supporting appeal information to 562-396-0403.

An authorization is deferred for many reasons; please contact our customer service department, if your authorization is deferred.

Most services require an authorization. The only exceptions are well woman exams, any ER visits, and certain x-ray services referred to a contracted facility.

Sometimes, claims are not paid for various reasons. Please contact our claims department to get detailed reasons at 562-396-0403

To search member eligibility and authorization, providers can use our Web Portal to check the status of a member. Providers can also call our Eligibility Dept at (562) 387-0403 and speak with a representative regarding member status. For claims and authorization status, please contact Customer Service at (562) 387-0403.

For Web Portal help, please email to portal.help@pacipa.com

Please fax your curriculum vitae, letter of interest, NPI and W-9 to our Contracting Department at 562-396-0403.

To update your provider information, please fax the updated information to our Credentialing Department at (562) 396-0403 or email at credentialing.dept@pacipa.com