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| Claims Review Process |
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| When I call about a claim; why does the claims representative ask if I’ve been injured at work? |
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| When certain types of services or diagnoses appear on a claim, our automated system flags that claim, indicating a type of service or diagnosis that might be related to a work injury. If the services are the result of an injury at work, these charges are not eligible under your CBEBT Plan and must be sent to your workers compensation carrier. If the workers compensation carrier denies these charges, only then may they be sent to our office with a copy of the denial for possible coverage.
Note: Members enrolled in the Religious Medical Trust please refer to your Trust Benefit Booklet for your benefits or contact customer service toll-free at 800-807-0500. |
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