What is a claim?
Simply put, a claim is a request to be paid for a health care service.
When you visit your doctor for a check-up, your doctor submits a claim to your insurance company. Your insurance company reviews the claim, approves the claim and then pays your doctor.
Normally, your health care professionals take care of your claims. However, if you visit a doctor outside of your network, you may have to submit the claims yourself.
In those situations, you’ll pay for the service in full. We’ll reimburse you for the portion covered by your health care plan when we approve your claim.