Submit claim requests and notifications to claims@usbins.net or mail to:
Attention: Claims Department
43 Corporate Park, Suite 101, Irvine, California 92606
Aggregate Claim Reimbursement
USB needs the following information to process a contract year-end aggregate claim.
- Aggregate report
- Copies of all Rx statements when applicable.
- Identification of all administrative fees, non-contractual payments or exceptions made.
- Report showing all refunds and voids for contract year
- Check register report including check numbers, amount of each check, date of payment, name of payee
- Complete census report for contract year
- Report showing paid claims that includes employee, patient, incurred dates of service for each payment and accumulated total by individual.
- Signed Aggregate Reimbursement Request.xls
|
