Public Health Department (PHD)

MEDICAL PROVIDER

 

Provider Referral and Claims Information

  • In order to begin the referral process, the patient must establish care with a Primary Care Provider at one of the SBC Health Care Centers.
  • A referral is required for all non-emergent ICP and Tobacco Settlement (TS) Services.
  • All referrals must be requested through the patient’s Primary Care Provider.
  • Claims must be submitted within 90 days of date of service.

The Benefits and Referral Center (BRC) provides authorization and payment of claims for services for the following programs:
  • Indigent Care Program (ICP)
  • Tobacco Settlement Funds (TS)
  • Children Health and Disability Program -Dental
  • Ryan White Funding
  • TB Waiver
  • Health Care for the Homeless

Claim forms accepted:
  • UB-04 CMS 1450 (Hospital Services)
  • CMS 1500 (Office Services)
  • DC-217 or DC-202 Denti-Cal form (CHDP)

 

Submit Claims to:
SBCPHD Benefits and Referral Center
300 N San Antonio Rd, Room B 100
Santa Barbara, CA 93110

For questions regarding eligibility, claims status and billing:
Email: PHDBRC@sbcphd.org
Phone: (805) 681-5393
FAX: (805) 681-5424

 

Benefits and Referral Center - 300 N San Antonio Rd,  Room B100, Santa Barbara, CA 93110
Telephone: (805) 681-5393 * FAX: (805) 681-5424