If you get sick or have an accident while covered on the Student Health Advantage or Patriot plans, then you will need to file a claim with International Medical Group (or, IMG). This blog will walk you through the steps of filing a claim, which we hope you find quick and easy!
Step 1. Go In-Network
Both the Student Health Advantage and Patriot Plans use the First Health network. Bring your ID card when you go to the doctor, hospital, or clinic so that they have your insurance information. If you don’t have your card, be sure to contact the provider and give them your insurance information. You will likely only need to pay for the deductible when you go for treatment as long as you go inside the network.
Precertification: Please note that pre-certification is required for all hospitalizations, surgeries, CAT scans, MRI’s, maternities, treatment in an extended care facility, home nursing care, prosthesis, and durable medical equipment. This requires that you call the number on your ID card as soon as possible, or prior if possible. You can also pre-certify online through your MyIMG portal.
Step 2. Submit A Claim Form
Every new condition will require a claim form to be submitted directly to firstname.lastname@example.org. If you had an accident, you will need to submit BOTH the claim form and the accident claim form. Prescription medication also requires you to submit the initial prescription from the doctor along with the pharmacy receipt as this is only paid via reimbursement.
A new claim form is needed for every new accident or illness, but you do not need to submit another claim form if it’s for a follow up visit. You will have 90 days to submit this, and you can send this along with any bills or receipts you received when seeking treatment.
IMG will accept claims in any language or currency.
Tip: If you paid out of pocket, ask your medical provider for an itemized bill and your medical records at the time of treatment in case this is requested.
Step 3. Wait for the Claim to Be Processed
Claims typically take 30 business days on average once all of the necessary documentation is received to be processed. After about a week, you can check the status of your claim in the MyIMG portal, emailing email@example.com, or by calling the number on the back of your insurance ID card to see if they are missing any additional information.
Step 4. Receive Explanation of Benefit and Reimbursement/Payment
Once a claim is processed, you will receive an explanation of benefit (EOB) in the mail detailing what was and wasn’t covered, and why. If you went in the network and provided your insurance information, the insurance company will pay the provider directly. If you went outside the network, or paid out of pocket, then the money will be reimbursed to you either by check or wire transfer (you would indicate your preferred method on the claim form). The EOB will also be available for download through your MyIMG portal.
Step 5. Pay Your Provider
If you had any out of pocket deductibles, copays, coinsurance, or if there were uncovered benefits, you will be responsible for paying this directly to the provider. To know how much to pay, refer back to the Explanation of Benefits.
If you have any questions about your claim, please email firstname.lastname@example.org or call +1 (800) 628-4664 (in the US or Canada)/+1 (317) 655-4500 (internationally).