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TPA Change Alert: LA County Switches Claims Administrators

Effective July 1, 2019, the County of Los Angeles is no longer utilizing third-party claims administrator (TPA) TriStar Risk Management.

Claims are transferred to either York Risk Services or Sedgwick Claims Management, depending on the specific claim number. The change affects all dates of service. Claim numbers do not change, and bill review services remain the same for all claim numbers. Providers should submit all second review appeals to the appropriate new TPA, even when the original bill was submitted to TriStar.

Read on for details.

New TPAs, by the Numbers

Refer to the table below to determine which TPA now administers LA County claims that were formerly administered by TriStar. The table also lists the mailing address, clearinghouse, and electronic billing Payer ID for LA County which applies for each clearinghouse, as well as the (unchanged) bill review service:

Claim Numbers

Previous TPA

TPA Effective 7/1/19

TPA Mailing Address

Electronic Billing Clearinghouse

Electronic Billing Payer ID

Bill Review Service

Claim numbers starting with ‘2000’ or ending with ‘B’

TriStar

York

York Risk Services

PO Box 11028

Orange, CA 92856

WorkComp EDI

CB280

Allied Managed Care

Claim numbers starting with ‘3000’ or ending with ‘C’

TriStar

Sedgwick

Sedgwick Claims Management

PO Box 51465

Ontario, CA 91761

CorVel

E4708

CorVel

Again, these changes apply to all dates of service, and providers must submit second review appeals to either York or Sedgwick, depending on the claim number. As always, we’ll keep readers updated of claims administrator changes for California employers here on our blog.


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