Before you visit a provider (doctor, hospital, pharmacy, specialist) read your Summary of Benefits and Coverage to find out what steps to follow before seeking medical treatment.

Step 1

Understanding the guidelines of your Plan may prevent you from paying unexpected out-of-pocket fees.

Step 2

Be sure to present your Student Health Insurance Card when visiting a Medical Provider. (Go to www.pacificsource.com/willamette and click on Print a member ID card).

**For the 23/24 Academic Year you will be able to print your Insurance Card on August 1, 2023.

Step 3

Confirm if the Medical Provider is a PacificSource Participating Provider. You can find a Participating Provider by visiting PacificSource Health Plans website.

Step 4

If you are being treated by a Participating Provider, your claim will automatically be submitted to the Plan by the Medical Provider. If you are being treated by a Non-Participating Provider, ask how your claim will be filed with the Medical Provider. The Provider may require you to pay immediately. If the Provider does not file the claim directly with PacificSource Health Plans, then you must file the claim by submitting an itemized bill after treatment to PacificSource Health Plans.

Step 5

Payment on filed claims for covered expenses will be mailed directly to the hospital or doctor unless proof of payment is submitted with the claim.

Step 6

Once a claim is processed, an Explanation of Benefits (EOB) Statement will be mailed to you explaining the benefit paid to the Provider. The Provider will then send you a statement indicating if a balance is due.

Step 7

If you have prescriptions take them along with your insurance card to a Preferred Pharmacy. If you are in a situation where you do not have your card and end up paying cash you can submit the receipt along with an PacificSource Health Plans Prescription Claim Form for consideration.