HMO - Claims Department
The
healthcare excess of loss claims department
is committed to providing a superior
customer service experience with every
interaction, including:
- Timely response to your general
questions via phone, fax or e-mail
- Low documentation requirements for
claim submission and streamlined claim
filing procedures
- eClaims electronic claim submission
program
We also work in partnership with our
expert medical management team, referring
cases to them for additional review when
opportunities for impact are identified.
This helps to assure that the clinical and
cost aspects of claims are coordinated.
Claim filing
process
Information regarding early notification and
claim filing can be found in the
Claims
Implementation document in the
Resources section of this Web site.
When actual or anticipated payments reach
75% or more of the deductible, please
complete and send us a
Large Claim
Notice, also found in the Resources
section.
The most efficient method of claim filing is
electronically through the HCC Life eClaims
Management Program. Electronic claim
filing utilizes our secure Web site so
privacy is maintained. You will save
time, as well as paper and mailing costs,
using eClaims.
However, we do also accept paper claims.
To submit claims manually, please complete a
Claim Form and submit all supporting
claim documentation by mail or fax to:
HCC Life Insurance Company
Attn: HCRM Claims
11100 Wayzata Blvd., Suite 350
Minnetonka, MN 55305
Fax: (763) 647-5011
By choosing to file claims
manually, claim reimbursement processing may
take longer than if it was submitted via eClaims.
The claim filing process includes:
- Time Limitations: Claims must be
filed within the time limitations of the
Excess of Loss contract.
-
Claim Form: Submit a separate form
for each eligible member being claimed.
- Enrollment Documentation:
Documentation reflecting original
enrollment to the present time.
- Claim Detail: Report listing (but
not limited to) the patient name,
provider name, date of service, type of
service provided, billed amount, and plan
paid amount, etc.
- Proof of Payment: Clear
documentation of the claim payments made
by your plan.
For more complete information,
please
contact an HCC Life Insurance Company
Representative.
Appointment Process
