Prospect Medical Group (Prospect Health)

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Provider Relations — eligibility/capitation discrepancy form

Official page read

Phone714-796-5900

Prospect main line (form header).

Fax

714-560-7613

Completed Eligibility/Capitation Discrepancy Form to Provider Relations.

Published email

providerinfo@prospectmedical.com

Completed Eligibility/Capitation Discrepancy Form.

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California

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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.

View source ↗ · Source checked 2026-10-24

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