What do my receipts need to have on them?

To help us process your claim quickly, please be sure that your receipts and claims forms include: 

• The enrollee’s name
• Your health insurance contract number
• The patient's name 
• The date the service was performed 
• Your health care professional’s name
• Your health care professional’s address
• Your health care professional’s tax identification number 
• A description of the service performed (HCPCS or procedure code) 
• The diagnosis 
• How much the service cost (itemize the charges if there’s more than one service on a receipt)