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ClaimsClaims Reference Guide

Claims

Claims Reference Guide

The Claims Reference Guide provides information on the following:

  • Claims and Medical Management Overview
  • Initial Claims Reporting
  • Interim Claims Reporting
  • Medical Management Advisory Services
  • Settlement of Claims
  • Per-Occurrence Coverage
  • Subrogation Waivers and Recoveries
  • Reimbursement Request Procedures
  • Reimbursable and Non reimbursable Benefits and Expenses
  • Intervention in Legal Proceedings or Member Claims Management

The Claims Reference Guide is available on the Portal under Claims>Resources or upon request.