Please note that claim forms are not required. To submit a claim, make a copy of the bill/receipt, write your name, medical ID number, PSU ID number, and what university you attend directly on the bill/receipt. Submit to:
P.O. Box 7068
Springfleid, OR 97477
For questions regarding claims, coverage and finding in-network providers, please contact PacificSource at 855) 274-9814, or visit PacificSource.