Prospect Medical Group (Prospect Health)

Prospect Health (now part of Astrana Health) contact page: providers with questions about eligibility, referrals or claims status. The same page lists this number for hospital admissions prior-authorization requests and for member customer service. An older Feb 2025 provider bulletin routes providers through (800) 708-3230 instead; see the separate IVR line.

Menu published in Prospect's Bulletin 2.2 Annual Reminders (dated February 8, 2025). The current contact page lists (855) 522-2134 for provider inquiries; confirm which line your office should use. Do not fax or email STAT/urgent referral requests except when the phone lines are down.

Per the Feb 2025 annual-reminders bulletin, use this fax for STAT/urgent requests only during the 12:00–1:00 p.m. PST closure of the STAT/Urgent line; reviewed within 2–3 business hours. Routine referrals should go through Aerial Care and can take up to 5 business days.

Aerial Care is used to verify eligibility, check claim and referral status, view capitation reports and submit non-urgent referrals. Email this address for Aerial Care questions and password resets (or call (800) 708-3230, prompt 1 then 7).

Form for PCP offices to report eligibility or capitation discrepancies. Fax the completed form to Provider Relations or email it. Header lists the main line (714) 796-5900 and toll-free (800) 708-3230.

Astrana's current Prospect support page: written provider disputes within 365 days of the payment/denial, using the PDR form plus supporting documents, fax Attn: PDR. The mailing address is withheld because sources conflict: the Astrana support page gives P.O. Box 11466, Santa Ana, CA 92711 (Attn: PDR), while Prospect's PDR form (rev. 01/19/23) says 600 City Parkway West, Suite 1000, Orange, CA 92868. Confirm before mailing.

Astrana's secure web form for Prospect-related claim inquiries, routine/STAT authorization follow-up and eligibility requests (replaces phone calls for eligibility; urgent eligibility 1-hour TAT, routine 24-hour). Hours Monday–Friday 8am–5pm PST. New routine authorizations go through Aerial Care; new claims through Office Ally. Claim status: provider-portal.astranahealth.com/prospect-claim-status.

Case Management (CM) Referral Form posted on Prospect's provider resources page (updated 7/18/2025). Fax the form with a cover sheet; the phone is for questions about the referral.

Prospect accepts electronic claims/encounters through Office Ally; ERAs/835 files are posted to the Office Ally account. Prospect's provider ID at Office Ally is PROSP. The phone is Office Ally's enrollment line as printed by Prospect.

Member-facing line for Prospect's Medicare-eligible members; not a provider authorization line. TTY: dial 711 (California Relay).