What providers can I seek medical care from? You are free to visit any doctor or hospital (known as providers) that you wish. We do, however, encourage you to visit a provider that is part of the Preferred Provider Organization (PPO) in the USA or “Equian Network” outside of the USA. In many cases, submission of claims will be easier and you will likely have to pay less out-of-pocket (depending on your insurance plan).
You can access these networks by visiting your student zone page here.
Is it ok to seek medical care from any provider? Yes, you are free to seek medical care from any provider that you wish. The difference from seeking medical care from a provider that is part of our network is that an in-network provider may be able to submit the bills directly for processing, and you may have less out of pocket expenses to pay (depending on the insurance plan you have purchased).
What do I need to do when seeking medical care? To make the process as smooth as possible when seeking medical care, you should follow these steps:
What should I expect to pay at my visit? You can expect to pay the deductible (if you have one) and copay at the time of treatment. Once the claim is processed, there may be an additional portion of your bill that you may have to pay (such as the coinsurance or treatment that was excluded). You will need to pay this directly to the provider.
I called a provider but they said they don’t know this insurance — what can I do? The provider has a direct contract with the Preferred Provider Organization in the US. Because of this, it’s important that when you call them, you inform them that your plan is with the First Health Network or the UnitedHealthcare Network (depending on which network your plan uses). If you have any further issues, please call the number on the back of your card.
How can I make sure the provider will bill the insurance, and not me? To be sure that the provider will bill the insurance company directly, we recommend calling in advance of treatment to make sure that they will send the bills directly to us. Please note that you will still need to pay any deductible and copays at the time of treatment.
I will just pay for the bills out of pocket, and will submit a claim to be reimbursed. What documents can I request to expedite the process? If you plan to pay for the bills out of pocket, it’s possible that the insurance company will request the itemized bills and medical records. Because of confidentiality regulations in the US, it will speed up the process if you request this information during your consultation. Be sure to ask for a HCFA form, which will have the diagnosis codes required to process the claims. Then you can send this in along with your claims form to be reimbursed. If you are a student, please also be sure to submit a copy of your I-20.
Do I need to submit a claim form? Yes, a Claim Form is needed for every new medical condition that you seek treatment for. You can submit a claim form online in your Student Zone or download this and submit this to the claims team. We typically recommend that you email documents, as this is the quickest and easier way to submit documents — originals are not needed.
Do I need to submit a claim form for every visit? No, a claim form is not needed for every visit, just for every new injury/illness you have.
What documents do I need to submit for my claim? In order for your claim to be processed, you will need to submit the following documents:
I received a medical bill and not sure what to do? The first thing you will need to do is check if the claim has been submitted to HCC for processing. To do this, either:
In many cases, the claim may be submitted but pending for additional information. By checking the status, you will be able to find out what is missing and you can submit the necessary paperwork to get the claim processed.
If the claim is not on file and you went in-network, you will need to contact the provider and make sure they have all your insurance details on file to submit the bill directly to HCC for processing.
How long do I have to submit a claim? You have 60 days from the last day of your policy to submit a claim. After that, any claims on that policy will be denied due to timely filing.
How long does it take for me to get reimbursed? Once all the documents have been received, claims take on average 30 business days to be processed.
How will reimbursement be made to me? Reimbursement is typically paid via check, however if you have a large reimbursement, it’s possible to be wired the money as well.
How long does it take for claims to be processed? Once all the documents have been received, claims take on average 30 business days to be processed.
I don’t agree with a claims denial, what can I do? If you feel that a claim was wrongly denied, you can appeal the claim within 90 days from the date the notice was sent. To do this, simply send an email to email@example.com with an email detailing why you believe the claim was incorrectly processed, and please be sure to also submit supporting documentation. Your appeal will be reviewed within 60 days.
I need additional coverage, how do I extend coverage? If you need additional insurance coverage, you can extend before the plan ends in the Student Zone. If your plan has already expired, you can purchase a new plan and begin coverage as soon as the same day. Unfortunately there is no way to reinstate a policy that has already expired.
What if I need support in another language? Our plans offer support in other languages so simply call the number of the back of your card to request a foreign language. All documents can be submit in their native language as translation is available for claims processing as well.
Do I need to notify the insurance if I travel to another country? No, your plan automatically will cover you internationally outside your home country.