Prescription Drug Claim
Choice Plus Claim

Frequent Issues:

  • Assistance with referral forms for special care

  • Emergency room  copays

  • Reasonable and customary reimbursement issues

  • Resolution of medical expenses debts with collection agencies

  • Verification of coverage for medical emergencies

  • Resolution of provider billing as to contracted vs. market rate

  • Assistance in pre-certification of hospital stays

  • Coordination of medical, workers compensation and state DBL

  • Out of area claims issues

  • Assistance with completing claims forms

  • Prior plan deductible credit

  • coverage for non-routine services and equipment

  • Preauthorization for new or experimental treatments

  • Rx: Brand name vs. Generic drugs

  • Assistance with mail order continuation drug program

  • In-network vs. out-of-network Rx claims issues

  • Calendar year vs. Plan year deductible issues

  • Explaining medicare benefits to employees

  • Coordinating insurance payments with medicare payments

  • Assisting eligible employees in applying for medicare and supplemental coverage

  • Expediting dental pretreatment authorizations

Please email us the problem/question:

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