What information do I need to include when I submit a need?

Before submitting your need, ensure your detailed, itemized medical bill includes all the following required information:

  • Name of member/patient
  • Charged Amount
  • Date of Service (DOS)
  • Diagnosis code(s) (ICD-10)
  • Procedure code(s) (CPT)
  • Provider Name
  • Provider’s Tax ID Number (TIN)
  • Provider’s billing address
  • Provider’s physical address
  • Receipt - (if already paid)
  • Explanation of Benefits (EOB) - (if you have primary insurance/Medicare)

You can submit the need within your Member Care Portal. If your medical need requires Pre-Notification, make sure that it has been reviewed by the Medical Advocacy Team. 

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