Global Medical Insurance has a network all over the world. Outside the USA, some of the providers
are contracted with IMG for direct billing but there is no network negotiated fee arrangement.
You are free to visit any hospital, doctor or provider
and you may have to first pay and then get reimbursed from the insurance company by filing a claim form. The doctor's office or local hospital has
a choice to be paid by the patient or by the insurance company. However, for larger eligible expenses like hospitalization/surgery etc, the insurance company can make arrangements for direct payment to the provider.
Global Medical Insurance from IMG participates in
First Health PPO Network. When you go to the doctors in the network,
please mention that you have First Health PPO Network plan, as the doctor
sometimes
may not be aware of IMG or Global Medical Insurance.
When you go to the doctors and hospitals in the network, they will
take the insurance card and bill the insurance company directly. And they
will also charge only the Network Negotiated Fee(NNF) which is a discounted
fee in many cases. When you visit the providers in the network, your deductible
is reduced by 50% and you don't have to pay 20% co-insurance for first $5,000.
When you go to the providers outside the network, you can
present the insurance card. Insurance card has all the information
doctor's office needs to bill the insurance company directly such as the certificate
number, claims filling address in US, toll-free number to call and verify the coverage.
But it still depends upon the doctor whether
to bill the insurance company directly or not. Even if the doctor accepts the card,
there is no network negotiated fee. If the doctor does not accept
the card, you have to first pay and then get reimbursement by filing a
Claim Form.
You can either use the claim form you receive in the mail along with the insurance
card or you can download the
Claim Form from this website.
IMG will reimburse you usually within 2 weeks of they receiving the claim.
However, when there is hospitalization/surgery involved and the costs
are quite high to pay first, IMG will make neccessary arrangements to pay the provider
directly.
There is no network of providers for prescription drugs(medicines).
Even if the provider agrees to bill the insurance company directly,
you should still file a
Claim Form to expedite
the claim process. When the provider sends the bills to insurance company,
insurance company would need to request medical records from the provider
which provider can't give until they have authorization from you to release
the records. Filing a claim form provides such authorization.
All your claims will be handled by IMG in USA. You never have to contact
the carrier, Sirius International, for any purpose whatsoever.
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