If you need to seek medical care, you may visit any doctor or hospital. You must pay for medical expenses directly to the provider, then submit a claim for reimbursement.

To fill a prescription, you may visit any pharmacy, but you must pay for your prescriptions in full and then submit a claim for reimbursement. See the link below for a prescription drug claim form.

In most cases, the provider will submit the claim for you.

If you are required to pay for services up front, you will need to complete a claim form in order to be reimbursed by the insurance company.

Download a claim form below, and send the completed form with all bills, receipts, and referrals for medical treatment to:

Administrative Concepts, Inc.
PO Box 4000
Collegeville, Pennsylvania 19426
Fax: (610) 293-9299

Make sure you fill out the form completely so your claim will be processed promptly. Keep copies of all the documents you submit for claims. If you have questions about claims, contact ACI at (800) 476-4802.

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.