If your provider files the claim on your behalf:
- The claims administrator still requires certain information from you. You will need to fill out a form indicating whether or not you have other insurance coverage. You will need to do this only once per academic year. You can find the Other Insurance Coverage Form below.
- You will receive an Explanation of Benefits (EOB) that outlines what the insurance company paid and what is your responsibility to pay, if applicable. The claims administrator will contact you if they need other information; otherwise, they will pay the claim as indicated on the EOB. Do not ignore calls or letters from the claims administrator, as this may delay payment of your claim.
If the provider does not file a claim directly with the insurance company on your behalf, you will need to submit a claim for reimbursement for the portion of the charges the company is responsible for paying by completing these steps:
- Download a claim form below and fill it out completely.
- Include your policy number (as shown on your ID card) on the claim form.
- Attach bills for X-rays, lab charges, etc.
- Send your claim form and all bills pertaining to this claim to Administrative Concepts, Inc. at the address below. Try to have all itemized bills attached to the same claim form.
Administrative Concepts, Inc.
PO Box 4000
Collegeville, Pennsylvania 19426
Fax: (610) 293-9299
Keep copies of all the documents you submit for claims. If you have questions about claims, contact Administrative Concepts, Inc. at (800) 476-4802 or email@example.com.
Confidential Communication Request
If you would like to have confidential medical information from the claims administrator sent to an address other than the address on file with your school, you can download a Confidential Communication Request, fill out the form, and send it to the address listed. This form is available below.