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General Instructions For Filing A Claim
If the claim has
not
been previously filed with Benicorp
Insurance Company, please complete the following
steps:
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For claims from providers who are in the
insured's’ primary PPO network (the first
address listed), please send the claim to
the address on the back of the member’s
identification card. The network will apply
any available discounts and forward the
claim to Benicorp Insurance Company for
processing.
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Please send claims for providers who do not
participate in the primary network to the
second address listed on the back of the
member’s identification card. This “travel
network” will apply any available discounts
and forward the claim to Benicorp Insurance
Company for processing.
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All other claims should be mailed directly
to Benicorp Insurance Company at the address
listed below. In order to expedite the
processing of the claim, please be sure to
write on the claim that the provider is not
a member of either the first or second
network.
Benicorp Insurance Company
Attention
Claims
P.O. Box
68917
Indianapolis,
IN 46268
For questions, please contact our Customer Care
Department at 800-438-4002.
Claim Reimbursement
What If The Insured Pays The Claim Prior to
Receiving Reimbursement From Benicorp?
Due to delays in processing caused by the
liquidation of the company, the insured might
find it necessary to pay the provider before the
claim can be processed and reimbursed by
Benicorp Insurance Company.
We highly discourage this situation because the
amount paid by the insured is not likely to
reflect discounts available through the PPO
network agreements listed on the back of the
member’s identification card. As a result, the
claim could be overpaid by the insured who will
then need to seek reimbursement from the
provider following Benicorp’s payment.
Benicorp will only pay or reimburse based on a
discounted claim basis.
If the insured must pay the claim prior to
Benicorp’s processing, then it is important for
the insured to “change the payee” of the claim
to himself or herself rather than the provider.
Benicorp’s policy is to always pay the provider
unless proof is submitted that indicates the
insured paid the claim directly to the provider.
Before going further,
please check the status of your claim to ensure
Benicorp has not paid the claim. If the claim
has been paid by Benicorp, then you must pursue
recovery from the provider. Please
click here for helpful suggestions on
recovering paid claims from the provider
To change the payee of the claim, please
complete the following steps (after reviewing
the claim status and confirming that the claim
is not paid):
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Click the following link to download a claim
form:
Paid Claim Reimbursement Form.
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Complete the claim form indicating clearly
that the claim has been paid by the member.
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Obtain proof of payment in the form of the
cancelled check or a statement from the
provider indicating that payment was
received.
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Send both the completed Claim Form along
with the proof of payment to us by one of
two methods:
By Mail:
By Fax:
Benicorp Insurance Company
(317) 524-5219
P.O. Box
68917
Indianapolis,
IN 46268
If you have questions, please contact our
Customer Care Department at 800-438-4002.
Recovery of Claims
Resulting From Both the Member and Benicorp
Reimbursing the Same Claim
In some situations, both Benicorp and the member
may pay the provider for the same claim. In
these situations, the member will need to seek
reimbursement from the provider as Benicorp
cannot reimburse a member for a claim previously
paid by the company.
To assist the member with this process we
suggest the following steps be completed:
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Go to the View Your Claims
On-line / Print Explanation of Benefits
.
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Print the Explanation of Benefits (EOB)
demonstrating Benicorp’s payment.
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First print and then complete the
information on the Request for Reimbursement
letter below.
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Obtain proof of your payment such as a
cancelled check or credit card receipt.
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Send your provider the letter, the EOB’s,
and your proof of payment in order to
expedite recovery.
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