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