Filing a Claim for Reimbursement or Payment to Provider Through GAP Supplemental Policy

If your provider bills you for services you believe are covered by your GAP Supplemental policy, you may submit the claim directly to OptiMed. Claims for covered services submitted by members will result in reimbursement directly to the member, unless you indicate on the electronic form that the provider is to be paid on your behalf. To submit your claim, please follow these instructions:

DOWNLOAD PDF OF INSTRUCTIONS

STEP 1

Obtain a claim form from your provider. Depending upon whether the provider is a doctor's office or an institution such as a hospital, you will receive either of these two forms:

SEE PHOTOS at RIGHT >

You'll get one or the other, but not both.
HCFA-9
UB-04-9

STEP 2

Wait to receive your Explanation of Benefits (EOB) from your primary major medical insurance in the postal mail.

 

PHOTO at RIGHT >

It may take about a month to arrive.
claim-EOB

STEP 3

Scan both documents and save as PDF files (preferrably) on computer to attach to submission of electronic form which you will fill out in Step 6.

Hopefully, you have a scanner or a printer-scanner-fax machine >

printer-2178753_1920

If you don’t have a scanner, take cell phone photos of the documents (holding your camera phone very steady) and transfer the photos from your cell phone to computer by emailing to yourself, or some other transfer method with which you are familiar. You’ll then be in position to upload these documents.

STEP 4

Fill out the online form carefully, and attach both documents upon submission.

BE SURE TO ATTCH BOTH DOCUMENTS >

But before going to the form, please note Step 5.

 

claim-attacment2

STEP 5

Just before submitting your form, you can check a box to request a copy of your completed form, as well as check to receive an email confirmation of your form submission. You can also contact OptiMed by email or phone:

CustomerCare@OptiMedhealth.com

(800) 482-8770