We want to make the claims process as easy as possible for our health care providers.
To learn about submitting your claims electronically, please contact our Provider Relations Department at firstname.lastname@example.org or (213) 694-1250.
L.A. Care Claims Department
PO Box 811580
Los Angeles, CA 90081
Complete the order form below to request copies of the PM-160 Forms.
- Click on this sentence to order PM-160 Forms.
- Click on this sentence to learn how to fill out the PM-160 Request Form. (PDF)
CMS 1500 Forms
- Click on this sentence to print the CMS 1500 Claim Form. (PDF)
- Click on this sentence to learn how to fill out the CMS 1500 Claim Form. (PDF)
If you have any questions about a previously submitted claim, contact our Claims Department at 1 (888) 4LA-CARE (452-2273).