Benefit Eligibility Review

Benefit Eligibility Review

A Care Coordinator (CC) will contact you to review the information provided and further discuss your claim. Be prepared to discuss past and current providers (including Medicare paid), hospitalizations and physicians to ensure we have accurate information to proceed.

The CC will order all required documentation which may include, among possible others:

  • Primary Physician Records
  • Specialty Physician Records (for example: cognitive and neurological testing)
  • Care Provider Records (for example: assisted living facility, nursing home, home care, medicare home care, adult day care, Memory Care, or Hospice)
  • Plan of Treatment
  • Onsite Assessment

During the claim eligibility review process the CC will provide written updates every 30 days.

If you have any additional questions or concerns, you can contact your CC directly or customer service at (888) 687-0977.

The CC will contact you when our review is complete to discuss the outcome, next steps and answer any questions you may have. 

If you are approved for benefits, you can now submit your invoices for reimbursement. See Claim Reimbursement.

Questions or Claim Status

Call: 1-888-687-0977*

*Speak to an agent or use our automated system