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What does my chosen provider need to put on the claim form for it to be accepted?

Your health care provider should indicate the patient’s diagnosis using an ICD-10 code, the patient’s name, date of service, what service or services was/were provided using a CPT code, and the charge for each of these services. Charges for lab tests that were performed, and the fee for each of these tests. If a surgical procedure is performed, we require the surgeon to submit an operative report.

For additional information regarding claims:

Individual medical claims – or call 396-5140/396-5146/396-5142

Group Medical claims – or 396-5140/396-5146

Life claims –

Our Customer Service Representatives are available weekdays from 9am to 5pm and will be more than happy to assist you in getting answers to your health plan questions.

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