Thursday, October 9, 2014

Filing Claims Insurance for Domestic Students (Medical Claims)



Medical Claims

 


Beginning fall, 2014, however, students who have purchased the UT Student Health Insurance Plan (SHIP) will no longer be required to make payment at the time they receive services.  The Student Health Center will start filing insurance claims directly with Blue Cross Blue Shield on behalf of students who are covered by the plan.  Services received at the UT Dallas Student Health Center are 100% covered by the UT SHIP.  Students who receive services outside of the UT Dallas Student Health Center will have to file their own claims and submit their receipts and proof of services received to their respective medical insurance company. Our office is able to explain the insurance process to insured members and the steps to take when dealing with the insurance company. 
Make a photocopy of the original itemized bill. Keep this original receipt for your records. On the photocopy, clearly print the following:
Patient Information:
1.      Name
2.      Date of birth
Insured Student Information:
1.      Name
2.      Current address
3.      Your social security number or the 10 digit number you register for UT Dallas classes with.
4.      Policy number: 101464
File claims within 30 days of Injury or first treatment for a Sickness or as soon as reasonably possible. Bills
should be received by the Company within 90 days of service. Bills submitted after one year will not be
considered for payment except in the absence of legal capacity.

After you have submitted your claim to the insurance company and it has been processed, you will receive an Explanation of Benefits (EOB) from the Blue Cross Blue Shield Insurance Company. This is not a bill. Do not pay it. An EOB is an informative statement about your claim (bill) that has been processed. Keep this EOB for your records
You will then receive a bill from the provider for your remaining balance. The balance due on the bill from your provider should match your balance due listed on the EOB. If it does not match, phone the SHI Office at 972-883-2747 to schedule an appointment.

Prescription Claims

You have two options:
Present your ID card to the network pharmacy when the prescription is filled, you will be responsible for paying the applicable co payments.  If you do not use a network pharmacy, you will be responsible for paying the full cost of the prescription.  OR
If you do not present your card, you will need to pay for the prescription and then submit a Prescription Reimbursement Form along with the paid receipt in order to be reimbursed. If you do not use a network pharmacy, you will be responsible for paying the full cost of the prescription.  Here is how to submit a reimbursement form:
  1. Print and complete from following address.
  2. https://myahpcare.com/wp-content/uploads/2014/07/UT-System-How-to-File-a-Claim-2014-2015.pdf
  3. https://myahpcare.com/wp-content/uploads/2014/06/BCBS-RX_Claim_Form-TX.pdf
  4. https://myahpcare.com/wp-content/uploads/2014/06/BCBS-dental_claim_TX.pdf
  5. https://myahpcare.com/wp-content/uploads/2014/05/BCBSTX-HIPAA.pdf
  6. Claim online : http://www.bcbstx.com/member
  7. Attach a copy of your pharmacy receipt to this form related agency
File claims within 30 days of Injury or first treatment for a Sickness or as soon as reasonably possible. Bills should be received by the Company within 90 days of service. Bills submitted after one year will not be considered for payment except in the absence of legal capacity
Please Note: The UT Dallas Student Health Insurance Office does not receive or process claims and does not have access to insured members’ claims.  Our office is able to explain the insurance process to insured members and the steps to take when dealing with the insurance company. 

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