CLAIM FAQS
SHORT TERM CLAIMS
NO CLAIM PLANS
HELP WITH CLAIMS
Access to Claim Forms
for Optional Group or Individual
Insurance Membership Plans.
Learn about claims process & forms below.
Questions, Call us at 866-438-4274
Members have the opportunity to access a valuable resource aimed at assisting them in effectively managing their insurance benefits. Here, you'll find a curated selection of claim forms applicable to both group and individual insurance plans. Whether you're filing a new claim or following up on an existing one, this page is designed to streamline your experience and provide essential support every step of the way. With clear instructions and easy access to necessary forms, HAA is committed to ensuring a smooth and hassle-free claims process for all its members.
Healthy America Insurance Agency, Inc and H A Partners, Inc., serve as Third-Party Administrators (TPAs) for the Healthy America Association (HAA). While we manage billing, we do not administer claims. Claims are filed with the Claims Administrators of the insurance carrier partners who have issued a group policy to the Healthy America Association or the Claims Administrator for any individual insurance plans available through the HAA enrollment platform. Below are some frequently asked questions regarding claims that we often encounter.
| Claims FAQ Category | FAQ Description |
|---|---|
| ID Card & Claims: Do I Present my ID Card to Provider |
For short term medical insurance (STMI), present your STMI insurance card to the provider. Make sure you are following any pre-authorization requirements (if applicable). For vision plans through VSP, an ID card is not necessary. Simply tell your provider that you have VSP and they will look you up in their system. As for the non-insurance benefit boost services like Healthcare2U Direct Primary Care and Lyric Health Virtual Visits, you do not need to present an ID card for these services. The Benefit Boost ID cards are digital only and are primarily for your convenience, providing access to your Member ID# and the contact information for your service. |
| Provider Payments: How are providers paid |
In most cases, you will pay the provider at the time of service for any applicable deductibles, copayments, and coinsurance amounts for which the member is responsible. Be sure to keep all receipts related to the claim and request the diagnosis codes and procedure codes from your provider to submit with your claim form. It is crucial to start the claims process as soon as possible after receiving a covered medical service. If your plan has a different claims process, detailed instructions can be found on your Member Portal. |
| Claim Forms: When Do I submit a claim form |
While you or your provider can submit your claim directly through the Claims Administrator Website, you can also submit claim forms (HCFA 1500 and/or UB04 for STMI claims), which can be accessed via the Member Portal or below, as soon as possible after receiving the covered service. Each insurance benefit has specific time limits for filing claims, so it's important to review your Certificate(s) of Insurance or Policy to ensure your claim is submitted within the accepted timeframe. |
| Forms to Submit: What Forms do I submit with Claim |
Include the claim form along with all diagnosis and procedure codes and Federal Tax ID for the provider and any other requested information. Send these documents to the Claims Administrator specified on the claim form. Verify that you are using the correct claim form for your insurance carrier by logging into your Member Portal. For assistance, you can also contact us at: 866-438-4274. |
| Claim Payout: When Am I Going To receive my claim payment |
The timeline for receiving your claim payment (subject to policy details, terms, limitations & exclusions) varies depending on the claim type. Delays may occur if all required information is not provided. Ensure that you promptly supply any documents requested by the claims administrator to avoid delays. |
| Claim Status: How do I find out status of claims |
To check the status of your claims, visit the claims administrator portal listed in the Member Portal or on the claim form. Alternatively, you can call the number on the back of your ID card. If you encounter any issues, please call us at 866-438-4274 for assistance. We are here to help you navigate the claims process smoothly. |
We hope this FAQ section helps answer your questions regarding claims. If you need further assistance, please don't hesitate to reach out to us at 1-866-438-4274.
Navigating your HealthBridge Short Term Medical Insurance (STMI) plan is designed to be straightforward, offering flexibility and comprehensive support. This guide is crafted to help you understand how to access the insurance network and file short-term medical insurance claims efficiently. By leveraging the available resources, you can maximize your benefits and ensure a seamless experience.
Jump to Sections: HealthBridge Insurance Network | Short Term Medical Claims
All individuals enrolled in HealthBridge STMI plans have the flexibility to utilize the PHCS Practitioner and Ancillary network providers*, ensuring a wide range of high-quality care options. Information about the PHCS network is conveniently available on your HealthBridge ID card.
If you have any questions or require assistance, please do not hesitate to reach out to our customer service team. We are here to help and ensure your experience with us is satisfactory.
Disclaimer: The amount of reduction varies by state and type of medical service received. Members must pay for all services, no portion of any provider's fee will be reimbursed or otherwise paid by MultiPlan PHCS network. PHCS does not process claims, they only provide a network of providers who have agreed to accept negotiated prices. The list of participating providers is subject to change without notice. For more information about this network, please visit MultiPlan.com. Also Nebraska members do not access the PHCS network. All Practitioner, ancillary, and facility charges are reimbursed at 150% of Medicare Allowable Rates.
Filing claims for your short-term medical insurance should be hassle-free and efficient. Here’s how to ensure your claims are processed smoothly:
Understanding and utlizing these resources will help you manage your claims more effecticely and ensure that you receive the benefits you deserve. With HealthBridge, your insurance journey is made simpler and more accessible.
Some insurance plans, like VSP Individual Vision and Healthcare2U (HC2U) Direct Primary Care, offer streamlined access to services without the need for traditional claim forms. These plans are designed to simplify the process for members, allowing easier access to care and benefits.
Jump to These No Claim Form Sections: VSP Individual Vision Plan | HealthCare2U Direct Primary Care
The VSP Individual Vision Plan provides members with easy access to vision care without the requirement of an ID card. Here's how it works:
Your VSP member account is the key to managing your vision benefits. Once you create or log in to your account, you can:
Member Tip: New VSP members need to wait until their benefits effective date to create their account.
With a vast network of in-network eye doctors, finding care is straightforward:
Schedule regular eye exams to monitor your vision and overall health. Eye doctors can detect signs of over 270 diseases through exams. Simply inform your provider you have VSP, and no ID card is needed.
Member Tip: Your eye doctor may request your member ID. You can retrieve your member ID number from your welcome letter, the Member Portal, or by calling us at 1-866-438-4274. If you have dependents covered under your vision plan and they are asked for a member ID, they should use the same one you do.
Shop for glasses, contacts, and more at in-network practices or retail locations like Visionworks® and Eyemart Express. You can also use Eyeconic®, VSP's in-network online store.
Member Tip: Look for Featured Frame Brands to receive additional discounts.
Benefit from special offers and savings on eye care, wellness products, and more. Access over $3,000 in savings through the VSP member account.
Member Tip: Benefits at retail locations may be different or not apply; view your plan details on your member account to confirm your coverage at retail locations and find in-network retail providers.
For eye care services from an out-of-network provider, you may be able to submit a claim to request partial reimbursement. Your benefits will always go further when you select an in-network doctor. However, if you'd like to submit an out-of-network claim, be sure to answer all the questions and attach any itemized receipts related to your claim.
Member Tip: To submit a claim, attach a readable copy of itemized receipts, invoices, or statements that contain all of the following information:
After completing the claim form, you may upload your receipt(s) or print and mail copies of your claim form and receipt(s) to:
VSP Member Claims
PO BOX 495933
Cincinnati, OH, 45249
Claims / Receipts mailed in must include the claim form.
Healthcare2U's Direct Primary Care offers members direct access to healthcare services without needing to file claims. Here’s how it works:
To utilize HC2U services, follow these steps:
Disclaimer: No walk-ins allowed. Unlimited services (including virtual dpc / telehealth) must be accessed through Healthcare2U's Patient Advocacy Line (PAL) and all care is provided through Healthcare2U's Private Physician Network (PPN). In-office appointments are only available within business hours (Monday through Friday, 7 am to 6 pm CST). PAL may direct member to another level of care if appropriate, depending on the member's condition and utilization of services. Applicable visit fees apply. After hours? Member have the option to speak to a physician virtually. Telehealth programs are provided through third-party organizations and are not connected to Healthcare2U. Well-woman pap smear pathology interpretation is not included in any applicable annual physicals. The annual physical (if applicable) may only be accessible after six consecutive month of membership. Healthcare2U's membership does not include inpatient or outpatient hospital services or critical illness. This is not isnsurance.
f you have questions about your coverage or the claims process, whether for standard group association or individual insurance claims or specific inquiries about vision insurance claims or how to use HC2U, don't hesitate to reach out. Contact us at 1-866-438-4274 for personalized assistance. Our team is ready to help you to navigate your insurance benefits and ensure you receive the coverage you deserve.
All descriptions about claims and insurance coverage above are a broad overview and not state specific. Some coverage availability may vary by state. Always review the state specific Certificate of Insurance or Policies available on your Member Portal for each plan enrolled to determine coverage benefits, availability, terms, conditions, limitations, and exclusions. If there are any discrepancies between the descriptions above and the Certificate or Policies, the Certificate or Policies will govern.
Also, HealthyAmerica, H A Partners, Inc., and the Healthy America Association (HAA) are not authorized to pay claims or be involved in the claim decision process. All claim decisions are made by the Third-Party Claim's Administrator and the insurance carrier.