How to File a Claim

The Insured should contact USA Medical Services at least 72 hours in advance of receiving any medical
care. Emergency treatment should be reported within the first 48 hours of receiving medical treatment. If the Insured fails to
contact USA Medical Services as indicated, the he/she will be responsible for 30% of all payable medical and
hospital charges related to the claim in addition to the plan“s deductible and coinsurance (If applicable).
In case of illness, please send us the following:
- The Claim form signed and completed in its entirety.
- Copy of medical history.
- In case of a surgical procedure or biopsy, a pathology report will be needed.
- All the original bills.
- Laboratory costs including detailed analysis.
- Pharmaceutical expenses, including a list of all
the medications acquired.
- If the Insured has another medical insurance policy, the claim
must first be processed by the other insurer and then
presented to USA Medical Services with an
explanation of how the claim was processed in
order to proceed with any further related claims.
- Full-time student certificate (only applies
to those Insured within the ages of 19 and
24 years of age).
In case of accident, please send us the following:
- The Claim form signed and completed in its entirety.
- Copy of medical history.
- All the original bills.
- In case of nasal trauma, the x-rays and the
hospital's emergency room report will be needed.
- In case of an automobile accident, the police
report will be needed. (If a police report cannot be obtained, we will require a letter
with a full description of the accident). We
also need an explanation of benefits from
the automotive insurance company. (If the
medical costs are not covered under the
policy, we require a letter from the automotive insurance company explaining it). If the
Insured does not have automotive insurance,
an explanatory letter of the sort will be required.
To pre-notify a claim, please call:
+1 (305) 275-1500
Note:
Please remember that any bills for medical services must be submitted within 120 days following the
treatment or service.
It is very important to submit all necessary documentsto process your claim as quickly as possible.
Failure to submit any of the required documents at the with the claim may delay the process and/or be grounds for the claim to be denied.

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