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We found (9) results for “Claims Not on File”.
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Choose the type of claim you'd like to submit.
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When you submit out-of-network medical and behavioral claims using the Horizon Blue app, you do not need to submit a claim form. Simply sign in to the Horizon Blue app and tap Claims, then Submit a Claim.
When you submit out-of-network claims by mail, please include the appropriate claim form below and mail it, and the required information listed on the form, to the address on the form:
- Merck members: Merck Health Insurance Claim Form
- Organon members: Organon Health Insurance Claim Form
- State Health Benefit Program (SHBP) and School Employees’ Health Benefits Program (SEHBP) members: SHBP/SEHBP Medical Plan Claim Form
- All other members: Horizon Health Insurance Claim Form
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- Under Doctors & Care, click Prescriptions.
- If you see Go to Prime Therapeutics: Mail the Prescription Drug/COVID-19 At Home Test Kit Claim Form, and the required information listed on the form, to the address on the form. If you do NOT see Go to Prime Therapeutics: Follow the instructions on screen to be redirected to the appropriate vendor’s website, where you can find information about submitting prescription claims.
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Complete the Claim Form - Dental and mail it, and the required information listed on the form, to the address on the form. You can submit out-of-network dental claims by mail only.
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- Click Vision under Doctors & Care.
- Follow the instructions on screen to be redirected to the appropriate vendor’s website, where you can locate information about submitting vision claims.
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Last updated:
Dec 20,2022
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There is a 30-day processing period for claims mailed to Horizon. You can sign in to check the status of a claim, but it may take up to 30 days to be finalized.
If it's more than 30 days since you mailed your claim and you still don't see it in your recent claims list, call the Member Services phone number on the back of your member ID card.
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Last updated:
Nov 10,2022
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If you see an in-network doctor for care, you only get a medical bill if you owe:
- A copay
- A deductible
- A coinsurance amount
- For services not covered under your plan
When you receive a bill for care, you should review your Explanation of Benefits (EOB). Your EOB tells you what costs are covered for medical care or services you’ve received.
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Last updated:
Jan 09,2022
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- Sign in to your account.
- Click Horizon MyWay under My Accounts.
- Scroll down and click View More Activity.
- Scroll down. Under "I Want To" (the blue menu on the left-hand side), click Get Reimbursed.
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Last updated:
Nov 10,2022
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The easiest way to submit out-of-network medical claims is through the Horizon Blue app. When you use the Horizon Blue app, you don’t need to submit a claim form by mail.
If you prefer to submit out-of-network medical claims by mail, you will need to include the appropriate claim form listed below and mail it, and the required information listed on the form, to the address on the form:
- Merck members: Merck Health Insurance Claim Form
- Organon members: Organon Health Insurance Claim Form
- State Health Benefit Program (SHBP) and School Employees’ Health Benefits Program (SEHBP) members: SHBP/SEHBP Medical Plan Claim Form
- All other members: Horizon Health Insurance Claim Form
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Last updated:
Dec 20,2022
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The easiest way to submit out-of-network mental health and SUD claims is through the Horizon Blue app. When you use the Horizon Blue app, you don’t need to submit a claim form by mail.
When you submit out-of-network mental health and SUD claims by mail, you will need to include the appropriate claim form listed below and mail it, and the required information listed on the form, to the address on the form:
- Merck members: Merck Health Insurance Claim Form
- Organon members: Organon Health Insurance Claim Form
- State Health Benefit Program (SHBP) and School Employees’ Health Benefits Program (SEHBP) members: SHBP/SEHBP Medical Plan Claim Form
- All other members: Horizon Health Insurance Claim Form
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Last updated:
Dec 20,2022
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- Click Vision under Doctors & Care.
- Follow the instructions on screen to be redirected to the appropriate vendor’s website, where you can locate information about submitting vision claims.
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Last updated:
Dec 16,2022
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Audience:
-
- Under Doctors & Care, click Prescriptions.
- If you see Go to Prime Therapeutics: Mail the Prescription Drug/COVID-19 At Home Test Kit Claim Form to the address on the form. If you do NOT see Go to Prime Therapeutics: Follow the instructions on screen to be redirected to the appropriate vendor’s website, where you can find information about submitting prescription claims.
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Last updated:
Dec 16,2022
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Complete the Claim Form - Dental and mail it, and the required information listed on the form, to the address on the form. You can submit out-of-network dental claims by mail only.
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Last updated:
Dec 20,2022
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