For Provider's

Established in 1999, Exclusive Care was created as a high value health plan option for the employees of the County of Riverside, retirees, their families and other contracted employer groups. Exclusive Care provides office visits for primary and specialty care, hospital care, urgent care and access to Centers of Excellence.

Unlike other managed healthcare plans, Exclusive Care’s primary care providers are not paid a fixed amount per month. All of our providers are paid for each treatment no matter how frequently the patient is seen. Members receive hospitalization at our many contracted hospitals and specialty services are rendered at private practice physician offices.

Exclusive Care is committed to keeping our providers informed with the latest information. This area will provide our physicians with a variety of information to assist them in making the best health care decisions.

Summary of Benefits for both the Medicare and Non-Medicare eligible retirees.
MultiPlan/PHCS Network, the nation's largest proprietary preferred provider organization, offering 40 million people access to over 720,000 doctors and hospitals nationwide.
Exclusive Care's Network Provider Directory.
Exclusive Care's Centers of Excellence.
Navitus, the prescription drug benefit managers who have made a commitment to provide retail prescription drug services for Exclusive Care members.
Exclusive Care's Rubidoux Pharmacy located near downtown Riverside. The Pharmacy provides both retail and mail order prescription drug services for our members. Opening in January of 2008.
A copy of the Exclusive Care Select Member ID card.
Summary Plan Documents (SPD) for Medicare Eligible and non-Medicare Eligible retirees.
Direct Referral Form
Treatment Authorization form.
Claims Submission
Claims Form - This form is to be used for services obtained through a provider who is not contracted directly with Exclusive Care or PHCS/MultiPlan network under the Exclusive Care Select Plans. Contracted providers should follow the regular billing procedures described in their contract.

Please always verify our member's eligibility, at each visit, by calling Member Services Department at 1-800-962-1163, option 1.