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You can check your claim status by calling Benefit Concepts, Inc. (our Claims Division) at 1-800-963-2200.
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When you see an In-Network Doctor/Hospital, show your PSI medical ID card and bring a Claim Form so the provider knows to bill us. If you do receive a bill from the provider, review the bill to make sure it's not an "information only" statement. Most providers will send you a statement showing the total amount due and informing you they billed PSI. If it is a bill, ask the provider if they've submitted the bill to Benefit Concepts, Inc. (our Claims Division).
When you visit an Out-of-Network Doctor/Hospital, you may need to pay the doctor/hospital first and mail the original medical bills and receipts along with the Claim Form to our Claims Division. Benefit Concepts, Inc. (our Claims Division) will then reimburse you according to the benefits indicated in your Policy Brochure.
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In the event of sickness or injury, the student should:
1. Report at once to the Student Health Center, if available.
2. For referral to a participating doctor. call 1-800-878-7896 PIN# 3722
3. Submit Medical Claims by MAIL or ONLINE.
BY MAIL - Send the Claim Form & All Itemized Bills to:
Benefit Concepts, Inc.
PO Box 60608, King of Prussia, PA 19406
ONLINE - Doctors/Hospitals can also send claims billing via Electronic Data interchange (EDI) Payor ID:51037
For Claim Questions, please call 1-800-963-2200
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Claim Forms can be obtained from your account, click on "GET INSURANCE DOCUMENTS"
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It should take 20 to 25 business days for the Claims Division to process your claims.
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Whether it is partially paid, pended or denied, an Explanation of Benefits (EOB) is forwarded to both the insured and the physician or hospital about the action we took. The following items will determine the amount of your out-of-pocket expense when a claim is submitted to our Claims Division:
1) Differences in payment between an In-Network Doctors/Hospitals and Out-of Network Doctors/Hospitals.
2) Circumstances on whether a Deductible or Co-Pay is applied, and the corresponding amounts.
3) The percentage PSI will pay according to your Benefits Schedule.
Remember all Claims are paid according to the benefits in your Policy Brochure.
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Most providers use systems-generated billing where their computer automatically sends out the bill. Providers belong to many different health plans and may not have billed us correctly. Always provide them with a Claim Form, which has the mailing address of Benefit Concepts, Inc.(our Claims Division) as shown below:
Benefit Concepts, Inc.
P.O. Box 60608
King of Prussia, PA 19406
1-800-963-2200
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