Outside USA:
Seven Corners has access to over 12,000 doctors and hospitals worldwide. With one phone call, Seven Corners can assist you in locating a provider. Seven Corners' Assist is trained to help you locate appropriate care.
The doctor's office or local hospital has
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.
Inside USA:
Liaison Worldwide from Seven Corners participates in
Hygeia/First Health PPO Network.
When you go to the doctors in the network,
please mention that you have Hygeia/First Health PPO Network plan, as the doctor
sometimes
may not be aware of Seven Corners or Liaison Worldwide.
When you go to the doctors and hospitals in the network, they can
take the insurance card and contact Seven Corners to verify the benefits.
Seven Corners can pay directly to the
provider if it is determined that it is an eligible expense (covered expense in the policy).
They will also charge only the Network Negotiated Fee (NNF) which is a discounted
fee in many cases.
When you go to the providers outside the network, you can
present the insurance card. The insurance card has all the information
doctor's office will need 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.
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 first pay, you can
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 web site.
Seven Corners will reimburse you usually within 4 weeks of they receiving the claim.
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. There is reduction of benefits of 20% when not using the network,
unless there are no providers within 20 miles radius. However, when you go in the
network, there will not be any reduction in benefits.
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 Seven Corners in USA. You never have to contact
the carrier, Nationwide, for any purpose whatsoever.
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