Strong Claims in Writing
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MEDICAL REIMBURSEMENT
CLAIM
iNext Insurance
MEDICAL REIMBURSEMENT CLAIM
PLEASE BE SURE TO WRITE CLEARLY
Complete Participants Information
Policy Number can be found in the Welcome Letter
attachment received in your Welcome Email, or by
logging into your iNext Account.
Address-where you would like a check to be sent
Legal Guardian
Only complete if under the age of 18
Travel Supplier/Provider Information
You can list Elon University
Date that you left on your flight, and scheduled date of
return
Flight numbers
Airline Carrier
Other Insurance
This insurance acts as primary, so list N/A under this section
Details of Sickness/Injury
Date you first experienced symptoms, the date you went to
seek care and the nature of the illness/accident.
MEDICAL CLAIM FORM PAGE 2
Name/Address/Phone of Attending physician
Authorization
Be sure to sign and date the claim form
Assignment of Benefits
You would sign this section if someone else paid for the
services and reimbursement is to go to that person
Claim Documentation Requirements
Statement from the doctor showing the date of service,
diagnosis and the breakdown of charges
Receipt showing you made payment for the services
Copy of your passport pages or itinerary showing your travel
outside the US to the destination in which you were treated.
Email Claim form and all Documentation
Email to
Travelteam@cbpinsure.com
the completed claim form and all
required documentation
You will receive an automated email that they have received your claim.
Claims are being processed as they are received. You will only receive
notification if they are in need of additional information to process the
claim. If they have all documentation, they will process the claim and mail a
check out for eligible expenses to the address on the claim form.
ADDITIONAL INFORMATION
Due to COVID, claims are taking longer to process. It can take up to 30 days to process a
claim and mail out a check for eligible expenses
Co-Ordinated Benefit plans is working with Chase Bank and participants could receive an
email from Chase Bank asking if they would like to receive payment through them. If they
don’t hear from the insured in 7-days, a check will be mailed out.
Co-Ordinated Benefit plans can place a trace on a check and reissue that check after 30-
days from when the check was mailed.
Co-Ordinated Benefit plans is experiencing longer than normal hold times when calling in
to them.
If Co-Ordinated Benefit plans needs additional information, they will reach out via email
to the email address you have listed in the claim form.
Keep copies of all documentation that is sent in for your claim. Please complete the claim
form in its entirety and write clearly.
Strong claims in writing are compelling, debatable, and defensible positions that can be argued with recent reliable evidence. Learn how to craft impactful claims, recognize key characteristics, and make claims stronger. Discover examples of different types of claims and how to evaluate whether a claim is effective or not.
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Presentation Transcript
MEDICAL REIMBURSEMENT CLAIM iNext Insurance
MEDICAL REIMBURSEMENT CLAIM PLEASE BE SURE TO WRITE CLEARLY Complete Participants Information Policy Number can be found in the Welcome Letter attachment received in your Welcome Email, or by logging into your iNext Account. Address-where you would like a check to be sent Legal Guardian Only complete if under the age of 18 Travel Supplier/Provider Information You can list Elon University Date that you left on your flight, and scheduled date of return Flight numbers Airline Carrier Other Insurance This insurance acts as primary, so list N/A under this section Details of Sickness/Injury Date you first experienced symptoms, the date you went to seek care and the nature of the illness/accident.
MEDICAL CLAIM FORM PAGE 2 Name/Address/Phone of Attending physician Authorization Be sure to sign and date the claim form Assignment of Benefits You would sign this section if someone else paid for the services and reimbursement is to go to that person Claim Documentation Requirements Statement from the doctor showing the date of service, diagnosis and the breakdown of charges Receipt showing you made payment for the services Copy of your passport pages or itinerary showing your travel outside the US to the destination in which you were treated. Email Claim form and all Documentation Email to Travelteam@cbpinsure.com the completed claim form and all required documentation You will receive an automated email that they have received your claim. Claims are being processed as they are received. You will only receive notification if they are in need of additional information to process the claim. If they have all documentation, they will process the claim and mail a check out for eligible expenses to the address on the claim form.
ADDITIONAL INFORMATION Due to COVID, claims are taking longer to process. It can take up to 30 days to process a claim and mail out a check for eligible expenses Co-Ordinated Benefit plans is working with Chase Bank and participants could receive an email from Chase Bank asking if they would like to receive payment through them. If they don t hear from the insured in 7-days, a check will be mailed out. Co-Ordinated Benefit plans can place a trace on a check and reissue that check after 30- days from when the check was mailed. Co-Ordinated Benefit plans is experiencing longer than normal hold times when calling in to them. If Co-Ordinated Benefit plans needs additional information, they will reach out via email to the email address you have listed in the claim form. Keep copies of all documentation that is sent in for your claim. Please complete the claim form in its entirety and write clearly.
