![]() To assure prompt, accurate action on your claim, be sure that the claim form and the attached bills are complete. If your provider does not submit your claim, it is your responsibility to do so. Generally, there are no claim forms to file if you use UHC providers for medical care,ĬIGNA Dental PPO providers for dental care, and the VSP network for vision benefits. If you are a retired participant covered under Medicare, submit your claim and Medicare Explanation of Benefits to UHC at:.If you are applying for reimbursement for charges from a dentist, contact United Concordia Dental (UDC) at 1-86 to request a claim form, and return the completed claim form to UDC at:.Return the completed, signed form, along with any attachments to UHC at:.File your claims and all requested forms within one (1) year of the date of your treatment or service in order to receive your benefit.Call UHC at 84 or go to to request claim forms if you are applying for reimbursement for charges incurred from a non-UHC medical or hospital provider.If you use a UHC provider, UHC will file your claim for you.Show your EWTF Benefit Card so that your physician will know where to submit your claim.If a claim is denied or reduced, there is a process you can follow to have your claim reviewed by the Board of Trustees. The Board of Trustees reserves the right to have you examined, at its own expense and by a physician of its own choosing, as it sees fit when deciding on a claim.įiling a claim is easy if you follow the steps described in this section. Reimbursement for claims from a non-participating vision provider must be filed with VSP within six months from the date of service. Benefits will not be paid without the patient’s social security number on file.Īll claims for medical, mental health/substance abuse and dental benefits must be properly completed and filed within one year of the date of service. Under the Medicare Secondary Payor law, the Fund Office must have social security numbers for you and each of your dependents. The Recovery Incentive Program provides a cash incentive for you if you discover and arrange for recovery of overcharges made on your hospital bills that result in savings for the Fund. If you have a claim that is denied, you may appeal to the Board of Trustees in writing within 90 days. Generally, if you use UHC providers, you will not have to file your own claim for benefits-the UHC provider will do it for you.
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