The First Health® Network
The First Health® Network is a national healthcare provider network that includes physicians, hospitals, and other outpatient care facilities. Our contract with them makes these providers available when you need medical care outside of Oregon, Idaho, and southwestern Washington. You will receive your plan’s participating provider benefits when you use First Health providers.
What happens if I need emergency care while outside your network area?
For a true medical emergency, wherever you are, call 911 or go directly to the nearest hospital emergency room or appropriate treatment facility. In emergencies, your plan pays benefits at the participating provider level even if you are treated at a nonparticipating hospital.
How can I find a First Health provider?
- Online: Look up providers in your area using First Health’s online directory.
- By phone: Call First Health toll-free at (800) 226-5116, Monday through Friday, 5:00 a.m. to 5:00 p.m. Pacific Standard Time.
- Printed directory: Call us at (541) 684-5580 or toll-free at (800) 624-6052, ext. 2580.
What if the provider I want to use is not in the First Health Network?
If the provider does not participate with First Health, and a First Health provider is available in that area, you will receive your plan’s nonparticipating provider benefits. You are also encouraged to submit a First Health Provider Nomination Form.
What if there are no First Health providers where I live or where I'm traveling?
In these instances, contact our Customer Service Department. In general, your plan pays your covered expenses based on the UCR (usual, customary, and reasonable) charge for that area.
What if I need nonemergency hospitalization?
Call First Health at (800) 226-5116 to find out if there is a participating hospital in the area. Then check with your physician to see if he or she has hospital privileges with that hospital. Finally, have your physician preauthorize your admission by calling our Health Services Department at (888) 691-8209.
As part of your policy with PacificSource coverage, you also have access to no-cost global emergency services from Assist America.
How are my claims paid when I receive treatment?
Always show your PacificSource Member ID Card. The First Health provider will submit your claim to us. If you use a nonparticipating provider, the provider may or may not bill us directly. If not, you will need to pay for the services up front and send a claim to us for reimbursement.