How to File a Claim

Takingcare of you before, during and after.

 

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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