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July 2016

For UAW retirees, report condition dates on ER professional claims to comply with new policy

We’d like to clarify a policy that took effect Jan. 1 for members of our UAW Retiree Medical Benefits Trust. URMBT members must receive emergency room services within 72 hours of the onset of the condition for which they are seeking treatment. If they receive services after 72 hours, we won’t cover those services.

This applies to professional and facility claims.

To ensure your claim is processed correctly, begin reporting the patient’s condition date on the ER professional claim. Failure to report the condition date could result in delays or a rejected claim. The condition code date is also required on the hospital’s emergency room claim.
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If you have any questions on a rejected claim, contact our Provider Inquiry department for assistance.

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