Frequently Asked Questions

How do I file a claim?

First, you must submit a claim reporting form to report your injury or illness. Once submitted, this document formally opens your case with us. You must also submit an itemized medical bill (showing diagnosis codes and procedure codes) from your medical providers, along with your primary insurance Explanation of Benefits (EOB) showing any action they have taken on each bill. Please contact us to request a claim reporting form.

Please note, if you are a student athlete and need to report an athletic related injury, please report that injury directly to the Sports Medicine Department of your school.

What is an EOB?

EOB stands for Explanation of Benefits. This is a document produced by your medical insurance carrier that explains their response and action (whether it be payment, denial, or pending) to a medical claim processed on your behalf. Often, this item is requested if we are processing a claim for you and you have any other insurance. This document is necessary for us to properly adjudicate benefits after your primary insurance.

What is a HCFA? What is a UB92?

A HCFA is a specific medical billing form that is utilized by physician and outpatient offices to bill medical charges to insurance carriers or Third Party Claim Administrators. A UB92 is also a specific billing form; however, it is utilized exclusively by hospitals and outpatient surgical facilities.

What does TPA stand for?

TPA is an acronym for Third Party Administrator. We are a TPA, meaning that we are hired by insurance carriers or clients directly to process claims on their behalf.