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)
  

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