Resources for Contracted Providers

Thank you for your interest in becoming an On Lok PACE network provider. To initiate the process, please email us at providerservices@onlok.org or call 415-292-8864.  

Please contact us at providerservices@onlok.org and your regional contracts administrator will be happy to assist you.

Please note that contracts generally renew automatically unless either parties are notified of any termed agreements. If there is a need to discuss changes to your contract, please contact us at providerservices@onlok.org or call 415-292-8864.

Claims for services rendered to On Lok PACE participants must be submitted on a current CMS-1500 form for professional services, CMS-1450 (UB-04) form for facility services, or ADA Dental Claim Form for dental services within the time frame stated in the Provider Services Agreement or within 365 days for non-contracted providers. You may submit claims to On Lok by mail, fax, EDI, or e-mail as follows:

US Mail

Please mail claims to:

On Lok Senior Health Services

Attn: Claims Department

1333 Bush Street

San Francisco, CA 94109

Fax

Please fax claims to:

On Lok Senior Health Services  

Attn: Claims Department

Fax: 415-292-2806 

EDI

Please send electronic claims to your clearinghouse:

On Lok Payor ID:  99485

E-mail

Please securely e-mail claims to: claims@onlok.org

If you are signed up for Instamed, you can view processed claims in your Instamed portal. To sign up, please visit https://register.instamed.com/eraeft.

For all other status questions, please contact the Claims Department at (628) 208-8454 or claims@onlok.org.

To register for the provider portal, please contact claims@onlok.org with the name and National Provider Identifier, or NPI, of the provider office or facility, as well as the name, email address, title, and contact phone number of the main user. If the practice or facility does not have a NPI, please provide the tax ID number. Once this information is received, an account will be created. You will then receive an email from our security software to verify your account; an app download is required. Please bookmark the login link where you will be able to log into the provider portal.

Please contact us at providerservices@onlok.org and your regional provider contracts specialist will be happy to assist you. Please note that contracts generally renew automatically unless either party is notified of an agreement terming. If there is a need to discuss changes to your contract, please contact us at providerservices@onlok.org or call 415-292-8864. You may submit a dispute to On Lok’s Provider Services Department. Provider disputes must be filed within 365 calendar days of On Lok’s action, or in the case of inaction, within 365 calendar days after the time for contesting or denying a claim. Please include in your provider dispute:

• Provider's name and identification number (i.e., NPI).

• Provider’s contact information, including address, telephone number, and fax number of the provider’s contact person.

• An explanation of the dispute or issue, including any relevant attachments, documentation, and supplemental information.

• The name, ID number, and date of service of the On Lok PACE participant for disputes involving a service provided to a specific participant.

Provider disputes can be submitted as follows:

Mail: 

On Lok Senior Health Services Attention: Provider Services Department 1333 Bush Street San Francisco, CA 94109  

Fax: 415-292-8894

E-mail: providerservices@onlok.org

On Lok PACE participants pay no deductibles, copayments, or coinsurance for covered services, including prescription drugs. As a reminder, upon entering into a contract with On Lok to provide services for On Lok PACE participants, all providers agree to accept On Lok’s payment(s) as payment in full with no right to seek additional payments from Medi-Cal, Medicare, other insurance carriers or providers, or On Lok PACE participants.

Balance billing of an On Lok PACE participant is prohibited.

Please refer the beneficiary to contact us at 1-855-973-1110 (TTY: 711).