Claims Submission Options

Submit paper claims via mail to these addresses:

InterCommunity Health Network CCO
PO Box 887
Corvallis, OR 97339

Samaritan Choice Plans
PO Box 336
Corvallis, OR 97339

Samaritan Health Plans
Employer Group PPO plans:
PO Box 887
Corvallis, OR 97339

Medicare Advantage plans:
PO Box 1510
Corvallis, OR 97339

Paper Claim Processing Tips

For claims that must be submitted on paper there are some simple things that providers can do to speed up processing and payment:

• Use only standard red and white CMS 1500 (HCFA) and 1450 (UB) forms.
• Submit only claim forms that are typed or printed.
• Print with dark font (i.e. do not print claims when toner/ink is low).
• Correctly align text in the form boxes and do not allow text to lap over lines.  
• All claims and attachments should be printed single sided.  Do not duplex print, even on primary EOBs or attachments.
• Send full page attachments only.
• Do not staple claims or attachments together.
• Mark multipage claims with either a page number (i.e. page 2 of 3) or a “continued”.
• Ensure that each secondary claim has the primary EOB submitted with it.
• Do not write or stamp over top of the body of the claim form.

CMS 1450 and 1500 Form Requirements

Need help filling out the CMS 1450 or 1500 Form? Use the following guides to find out what each field is for and which are always required.

• CMS 1450 Form Guide
• CMS 1500 Form Guide