person Hello,
1) How does this plan work as far as PPO network is concerned?
2) Are the claims paid by direct billing or have they got to pay it first and get reimbursed?
3) If the money is reimbursed on whose name will it be reimbursed?
4) Are there any specific medical conditions you know of that might need a pre certification for this plan?
Thank you,
1) At WorldTrips we contract with First Health Network, but customers are able to see any provider they choose. It is obviously in their best interest to visit participating providers for repricing and direct billing purposes, but they would have coverage for covered expenses regardless.
2) We have direct pay capabilities with all of our plans, including Visitor Secure.With most claims incurred in the US we usually pay directly to the providers, especially if they are part of First Health Network. In the event that the provider does not want to accept our promise to pay, we would reimburse the member for their expenses accordingly based on their coverage.
3) If it is on a reimbursement basis, we would issue the reimbursement in the form of a check to the member directly. In the event the member prefers payment to another individual, or via another form of payment, i.e. wire transfer, those requests can usually be accommodated.
The following expenses must always be Pre-certified:
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