Accidental Injury (Subrogation)
When you are injured and you or the at-fault party have insurance available for the injury, subrogation is a way to reimburse your health plan for all or some of the claims your health plan has paid related to the injury. Common cases are:
- Work-related injuries
- Motor vehicle accidents (whether you are hurt in or around a vehicle)
- Slip and fall injuries on someone else’s property (such as a store)
If you are ever injured, let HPSM know right away by calling the number for your health plan below
CareAdvantage & HealthWorx:
Call 866-680-0996
- That is the number for Optum, HPSM's vendor that handles subrogation cases
- Optum may ask you for facts about the accident, insurance claims and your lawyer’s contact information (if you have one)
- Optum then works with the proper parties to reimburse the health plan for accident related claims that have been paid
- If Optum does ask you follow-up questions, answer quickly; this will help Optum continue reimbursement efforts on behalf of your health plan
- If you have received a letter from Optum with a case number, visit subro.optum.com
- For more information about Optum's subrogation process, see their Frequently Asked Questions
Medi-Cal:
Call 916-445-9891 or visit the DHCS website
ACE:
Call the San Mateo Medical Center Finance Office at 650-573-2525