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Claims Processing

Select Benefit Administrators’ (SBA) philosophy on claims is to pay according to the contract and do so in a timely manner. 

 

 
SIMPLIFIED CLAIMS PAYING PROCESS 
 
Compared to other group policies, SBA's claims process is simple. When an insured person has a covered event, SBA assigns the fixed payment to either the provider or to the insured, typically within 7 to 9 business days.
 
  • Claims are paid with a fixed dollar amount, not a percentage of total charges. This means insured employees can call SBA and ask how much their policy would pay for a covered benefit before they incur those charges.
     
  • SBA does not coordinate with any other coverage the insured may have. This allows them to respond to the claim, typically within 7 to 9 business days, without waiting to see how another insurance provider will pay. 
 
 
TIPS FOR INSUREDS 
 
Here's how insureds can simplify the claims paying process:
 
  • Show your Select Benefits card before receiving service. If you don't, the provider won’t know the type of benefits to which you're entitled and won't know to file a claim on your behalf.

  • Ask the provider to accept assignment of benefits.

  • If the provider doesn't file a claim and you pay for services at the time they're rendered, you can file for reimbursement using this Claim Form for Policy Benefits.

  • If the provider files a claim but you don't receive an Explanation of Benefits from SBA, call SBA to verify that the claim was filed.

For more information on how SBA pays claims, see “How to File a Claim In and Out of a Network” and
Using Select Benefits as Supplemental Insurance.”

 

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