Confirmation number: [confirmation-number]
Submission date: [submission-date]
Provider name: [provider-name]
Date of service: [date-of-service]
Here's what happens next:
- We will start processing your request soon.
- If you provided your email address, we will send you a confirmation email and status updates about your reimbursement request.
- It may take up to 30 days from the time we receive all the information until we complete our review.
- When your request is complete, details can be viewed here
Submission of a claim is not a guarantee of payment, or payment in the full amount. If the services are deemed covered services, then the health plan will reimburse you up to the benefit amount minus any applicable deductibles, coinsurance, or copayments.