Regence administers medical, dental and prescription benefits for self-funded group plans, in addition to fully-insured individual and group plans. Self-funded groups establish their own benefits and Regence is the third-party administrator that provides administrative services for their benefit plans. Due to this, self-funded groups customize their plans and may not be subject to Regence administrative guidelines. We have a dedicated service center that administers benefits for all self-funded groups located in Idaho, Oregon, Utah and Washington.

Note: Our medical management programs may or may not include ASO members. Learn more about which ASO groups are included or excluded from each of the following programs:

Identifying members

The back of the member ID card will include two key pieces of information to help you identify ASO members:

  • A disclaimer explaining that Regence provides administrative services is in the lower left corner on the back of their member ID card. The disclaimer states that we "provide administrative services and do not assume any financial risk or claims for services."
  • The Provider Contact Center number listed on the back of the card will be (866) 227-0913 for the ASO Service Center.
  • View all listed administrative services only (ASO) groups (PDF)

Obtaining pre-authorization

View our pre-authorization lists and requirements. Our Pre-authorization lists indicate which services are administered by one of our partners.

Pre-authorization requests, and first and second level appeals for ASO members should be submitted to:

ASO Correspondence, Intake, and Appeals
PO Box 2998 MS BU248
Tacoma, WA 98401-2998
Fax: (877) 663-7526

Verifying eligibility, benefits and claims information

We require physicians, dentists, other health care professionals and facilities to use the Availity Portal to access eligibility, benefits and claims related information, such as payment details and vouchers. Some self-funded groups utilize month-to-month eligibility. Availity will refer you to our Provider Contact Center if the member is on a month-to-month eligibility plan.

Submitting claims

Claims for ASO members should be submitted to us electronically, along with your other Regence patients. View our orthodontia billing guidelines before submitting claims for orthodontia services.

Receiving vouchers and payment

Receive your payment vouchers electronically via an ANSI 835 transaction. View vouchers online using Availity's remittance viewer.

Questions

If you have questions, please use our Provider Contact Center at (866) 227-0913.