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Fixed coverage plans from Seven Corners (such as Inbound USA, Inbound Immigrant, Inbound Guest etc.) do not participate in
any PPO network. You can visit any doctor or the hospital. The link to the First Health/Hygeia PPO network is provided
only for your convenience of finding a provider.
Such insurance plans are called indemnity plans.
When you go to the provider, you can
present the insurance card, either the one you received in the email or by postal mail. The insurance card has all the information
the provider's office will need to bill the insurance company directly such as the certificate
number, claims filling address in the U.S., toll-free number to call and verify the coverage.
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 you have to pay first, you can get reimbursement by filing a Claim Form.
However, when there is hospitalization/surgery involved and the costs
are quite high to pay first, Seven Corners can make necessary arrangements to pay the provider
directly, once it is determined that it is an eligible expense.
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 the insurance company,
the insurance company would need to request medical records from the provider
which the 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 Seven Corners in the USA. You never have to contact
the carrier, Lloyds of London or The Insurance Company of State of Pennsylvania, for any purpose whatsoever.
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