Question: How does the claims process outside the U.S. (1-2-3) work?
Answer: GeoBlue contracts with world class providers in over 180 countries. By visiting a contracted doctor or facility, GeoBlue is able to arrange direct billing* and help member’s to avoid having to pay up front for services.
3 easy options to arrange medical services and enjoy GeoBlue Direct Billing:
- Visit our Member Services area and log in
- Call 1 + 610-254-8769 for assistance
* Please note: direct billing may not be available in every situation.
You are free to use providers outside of the GeoBlue Community. When you do so, please pay for outpatient services and submit a claim to GeoBlue Worldwide. Upon request, GeoBlue will make our best effort to guarantee payment directly to a non-contracted facility.
Question: How does the claims process inside the U.S. (Broad, Deep PPO Access) work?
Answer: Benefit from access to one of the largest U.S. networks available. The Aetna Passport PPO offers more than 700,000 doctors and 4,400 hospitals for you to choose from.
- Simply show your ID card at time of service
- Pay the required co-pay or deductible
Question: What is the process for physician appointments?
Answer: GeoBlue has contracted with highly-qualified physicians in over 180 countries to provide care to GeoBlue members. These physicians bill GeoBlue directly for covered services when the services are pre-authorized and guaranteed by GeoBlue in conjunction with GeoBlue’s appointment scheduling service. Please note, direct billing may not be available in all situations.
If GeoBlue members seek treatment from an GeoBlue-contracted physician without notifying GeoBlue in advance, the physician will expect payment in full at the time of service. Members who elect to pay the physician at the time of service should request an itemized invoice and receipt from the physician and must submit these documents with a claim form (see below) to GeoBlue for reimbursement of covered charges. GeoBlue members are free to seek care from any physician. If the physician is not contracted with GeoBlue, the member should pay the physician at the time of service and submit a claim to GeoBlue.
Question: What is the process for planned hospital admissions?
Answer: GeoBlue can assist members with access to over 900 leading international medical centers called GeoBlue Partner Facilities, which have agreed to bill GeoBlue directly for pre-authorized inpatient services. These facilities are identified in the CityHealth Profile with an GeoBlue logo. Please note, direct billing may not be available in all situations.
To arrange for an GeoBlue Partner Facility to bill GeoBlue directly, members must contact GeoBlue by calling +1 610 254 8772 The request should be made at least 2 business days prior to scheduled treatment. If GeoBlue members seek treatment at an GeoBlue Partner Facility without notifying GeoBlue in advance, the Facility may expect payment in full at the time of service.
Question: How do you submit a claim to GeoBlue Worldwide?
Answer: Following the steps below will help us processing your claim as quickly as possible. Submitting an incomplete form will result in delays in the payment of your claim.
- Complete Part A of the claim form in full each time you are seen for a new sickness or injury. Answer all questions, even if the answer is “none” or “N/A.”
- Submit the original detailed provider bill, which should include the following:
- Patient’s Name
- Insured’s Name
- Charges Incurred
- Date of Service
- When services are rendered at a clinic, hospital or other medical facility, you will need to ask the provider to complete Part B of the claim form indicating the date seen and the diagnosis. Please include the full name and address of the provider. Part B is found on the reverse side of the claim form.
- If another health insurance plan is the primary payer, please indicate the insurance company name, address and phone number along with your policy number.
- Be certain that the name on the bill you are submitting is the same as that which is indicated on your ID card. If not, please enclose a short note of explanation.
- Benefits payable under this plan will be coordinated with any automobile coverage. Benefits under our plan will also be coordinated with benefits provided or required by any no-fault automobile coverage statute, whether or not a no-fault policy is in effect. This plan will be applied on a secondary basis to any state mandated automobile coverage for services and supplies eligible for consideration under this plan.
- All claims must be filed with our office within the twelve (12) month period from the date of the incurred expense. Please submit all claims forms with attached receipts to the following address:
C/O Claims Department
One Radnor Corporate Center
100 Matsonford Road
Radnor, PA 19087 USA
(Fax) 610.293.3529 Attn: Claims Department