This internal support guide consolidates the main Regal Medical Group and ADOC contacts, routing rules, REA workflows, prior-authorization and claims guidance, care-management resources, compliance channels, and call-handling steps used by BESA Health Medical Group.
Use this guide as the starting point for Regal and ADOC support questions.
For a life-threatening emergency, direct the caller to 911 or the nearest emergency room. Contact assignments, networks, facilities, plan participation, portal screens, and operational rules can change. Verify high-change information in REA, the current provider manual, or RegalMed.com before committing the caller.
Before You Route A Call
Clinical And Privacy Boundaries
- Support staff who are not licensed clinicians must not assess symptoms or provide medical advice.
- Verify the caller before disclosing member-specific information and use only the minimum necessary protected health information.
- Never request, record, or share an REA password. Accounts are individual.
- Send protected health information only through approved secure channels.
Minimum Call Intake
- Caller name, organization, role, callback number, and relationship to the member.
- Member name, date of birth, member ID, health plan, assigned medical group, and date of service when relevant.
- Provider name, NPI or tax ID, service location, and referring or rendering provider when relevant.
- Reason for the call, urgency stated by the caller, action already taken, tracking or claim number, and any deadline.
- Action promised, destination or owner, and follow-up time.
Quick Contact And Routing Guide
| Issue | Primary Resource | Contact Or Next Step |
|---|---|---|
| General customer service | Customer Service | (818) 357-5000, Monday-Friday, 8:00 a.m.-5:00 p.m. |
| Senior member navigation | Senior Concierge | (818) 357-5000, Option 1, then Option 6 |
| 24/7 patient assistance | PAL | (888) 787-1712 |
| Possible hospital admission or urgent home services | HELP Line for physicians | (844) 877-6020 |
| Prior authorization | Prior Authorization | (714) 539-3100; check REA first |
| After-hours nurse triage or Medical Management | Clinical line | (866) 323-0108 |
| Eligibility | Member Services | (866) 654-3471, Option 1; verify health-plan data |
| REA access or training | Network Manager or UM Provider Liaison | Confirm the current regional assignment |
| Claims status | REA | Review the claim, line detail, and EOB; route to the Network Manager if unresolved |
| High-risk case management | Vital Care | (844) 416-5194 or VCReferralsSouth@regalmed.com |
| Behavioral health | Behavioral Health | (844) 528-1986 or Bhc-group@premierbhc.com |
| Social barriers or community resources | Social Services | SWReferralSouth@regalmed.com; fax (818) 540-3243 |
| Medication support | Pharmacy | PharmacyDeptSouth@regalmed.com; fax (626) 204-7490 |
| Advance care planning | ACP Team | (844) 241-8862 or ACPTeamSouth@regalmed.com |
| Credentialing | Credentialing | (818) 357-5031 |
| Compliance, privacy, or fraud/waste/abuse | Compliance Hotline | (844) 752-3921 or (818) 810-4633 |
No direct Claims line: The provider manual does not list a direct Claims phone number. Check REA first, then route unresolved claim questions to the assigned Network Manager.
REA Portal Access And Support
Regal Express Access (REA) is the primary provider portal for eligibility, capitation, claims, authorization status, and referral requests.
New Access Or Login Help
- Confirm that the caller is a contracted provider or authorized staff member.
- Route new-user access and login issues to the assigned Network Manager.
- Route referral-process training to the Utilization Management Provider Liaison.
- Remind the user that REA credentials are individual and may not be shared.
What REA Can Answer
- Eligibility: Search by member ID or demographics, include termed members, and select the record covering the date of service.
- Claims: Review received date, claim number, status, billed and paid amounts, check information, line-level denial or adjustment detail, and EOB.
- Authorizations: Review status, dates, notes, referred-from and referred-to providers, services, and authorized units.
- Referrals: Submit the request, attach clinical support, and retain the tracking number.
Member not found: Verify health-plan eligibility first. If the member is active with Regal or ADOC but missing or incorrect, use REA Main Menu > Support > Member Not Found and submit the required details.
Authorization Request Workflow
- Confirm eligibility: Verify the health plan, medical group, and effective dates for the date of service.
- Choose request type: Select Outpatient or Inpatient.
- Set the category: Select Routine or Urgent based on the requesting clinician's determination. Support staff must not determine urgency.
- Select providers and location: Identify the referring and referred-to providers, facility, and place of service.
- Enter codes and units: The provider enters diagnosis, procedure, modifier, and requested units.
- Document medical necessity: Include the reason, history, exam, labs or imaging, prior treatment, and other supporting information.
- Attach records: Upload relevant clinical records with a clear description.
- Submit and save: Retain the tracking number, status, and submission date.
- Monitor: Check REA status and notes. Do not submit a duplicate merely because the original is pending.
Status And Timing
| Status | Support Action |
|---|---|
| Approved | Confirm provider, service, units, validity dates, member eligibility, and notification. |
| Pended | Read the REA note, identify missing information, and direct the provider to upload requested records. |
| Denied | Use the decision notice and appeal or grievance rights; do not reinterpret the clinical reason. |
| Cancelled | Review the note and next step before any resubmission. |
Routine referrals are described in the manual as approximately three to five working days when complete. Urgent requests are described as a 72-hour turnaround after receipt of a complete submission. Check the live status and never promise a decision date.
Claims And Appeals
- Electronic submission is preferred. The current Regal provider page identifies payer ID REGAL for Regal submissions.
- Office Ally support: (866) 575-4120. Confirm payer mapping with the clearinghouse before first submission or after setup changes.
- Manual-listed payer IDs: Office Ally REGAL / ADOC; Emdeon 95449 / 27344. Verify current routing.
- Regal paper claims: Attn. Claims Department, P.O. Box 371330, Reseda, CA 91337.
- ADOC paper claims: Attn. Claims Department, P.O. Box 371000, Reseda, CA 91337.
- Regal / ADOC appeals: Attention Appeals Coordinator, 8501 Fallbrook Ave., #300, West Hills, CA 91304.
Claim-Status Workflow
- Open REA and search from View Claims or the member's Eligibility record.
- Verify member, provider, date of service, claim number, received date, status, billed amount, paid amount, and check information.
- Open Show Line Detail for the denial or adjustment code and reason.
- Review the EOB for payment detail or documentation requests.
- If unresolved, document the claim number and route the case to the assigned Network Manager.
Coverage, Facilities, And Care Management
Plan participation varies by county, network, line of business, member benefit, and effective date. Never guarantee participation from a static list. Verify eligibility and the current network in REA or with the health plan.
Vital Care And Clinical Escalation
- Vital Care: (844) 416-5194 or VCReferralsSouth@regalmed.com for high-risk senior or commercial members.
- PAL: (888) 787-1712 for 24/7 patient assistance or urgent case-management connection.
- HELP Line: (844) 877-6020 when a physician is considering hospital referral or needs urgent home services or direct SNF coordination.
Access Standards And Complaints
Operational reference points in the manual include routine primary care within 10 business days, routine specialty or ancillary care within 15 business days, urgent appointments without prior authorization within 48 hours, urgent appointments requiring prior authorization within 96 hours, after-hours triage callback within 30 minutes, and practitioner phone answer within 30 seconds. Program and health-plan rules may differ.
- Confirm appointment type, requested date, earliest date offered, provider, health plan, and prior-authorization status.
- Do not give clinical advice or downgrade urgency. Direct emergencies to 911 or the emergency room.
- Document exact dates and times and whether an interpreter or accommodation is required.
- Escalate through the designated Network Management or Customer Service channel and give the caller the case or reference number.
Compliance, Privacy, And Fraud Reporting
| Channel | Contact |
|---|---|
| Compliance Hotline | (844) 752-3921 toll-free or (818) 810-4633 |
| ReportFraud@regalmed.com | |
| Fax | (818) 933-0598 |
| Compliance Officer/Privacy Officer, Regal Medical Group, 8501 Fallbrook Ave., Ste. #300, West Hills, CA 91304 | |
| General questions | Compliance@regalmed.com |
- Do not investigate, confront, or promise a result. Preserve the caller's description and route the concern.
- Anonymous reporting is available; a callback number may help with follow-up.
- For active privacy or security exposure, follow the immediate incident process in addition to the hotline.
Standard Call-Handling Playbook
- Open: State your name and role. Confirm who is calling and a safe callback number.
- Verify: Complete identity and minimum-necessary verification.
- Clarify: Restate the issue in one sentence and confirm the desired outcome.
- Check: Use REA, the current directory, current manual, or approved public page.
- Resolve or route: Work within scope or perform a warm handoff to the correct owner.
- Set expectations: Give the next action, owner, and realistic time window without promising authorization, payment, eligibility, or coverage.
- Close: Confirm the callback plan and whether the caller needs the reference number repeated.
- Document: Record verification, issue, facts reviewed, live status, advice within scope, handoff destination, and follow-up date or time.
Warm-handoff template: I have [caller name/role] from [organization] on the line regarding [member/issue]. I verified [items], reviewed [live source/status], and the unresolved need is [specific action]. The callback number is [number], and the deadline or urgency stated by the caller is [detail].
Source And Maintenance
This guide summarizes the RMG/ADOC Provider Manual and official Regal provider resources. Validate phone numbers, hours, email addresses, Network Manager and UM liaison assignments, clearinghouse payer IDs, paper-claim and appeals addresses, authorization timeframes, portal screens, and status definitions on a monthly or release-based schedule.
Verify changing network, contact, portal, authorization, and claims information before operational use.
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