For questions about medical claims incurred on or after August 15, 2017, please contact: UnitedHealthcare Student Resources. 1-844-377-0963. www.gallagherstudent.com/brown. Box 809025, Dallas, TX 75380-9025 . PO Box 740800 Atlanta, GA 30374-0800: 87726: United Healthcare Student Resources: PO BOX 809025 DALLAS, TX 75380: 74227: Medica health Plans Supplement Inc. Florida: PO BOX 141368 CORAL GABLES, FLORIDA 33114-1368. PO Box 809025 Dallas, TX 75380-9025 Email: [email protected] Register for Online Claims Look Up at www.uhcsr.com. A letter requesting an appeal to your claim(s), including your: Claim number(s) (located on the top of your Explanation of Benefits). Direct Bill: Supports our agents and policyholders for billing, cash processing and electronic funds transfer (EFT). 809025 Phone: (469) 417-1700 Fax: (469) 417-1970 PO BOX 803501 DALLAS, TX 75380-3501 United States Phone: 956-457-4300 | Fax: View Map: Primary Practice Address ... License Number; Yes 152W00000X - Optometrist: TX: 8666TG: No 152WC0802X - Optometrist Corneal and Contact Management: TX: 8666TG : A federal government website managed by the Email – A scanned copy of the completed form submitted by provider or student to SI.DRG@uhcsr.com; Hard Copy Submission – Provider or Student may mail to: UnitedHealthcare StudentResources. Customer Service: 1-800-767-0700 MAIL. The company's principal address is Po Box 801714, Dallas, TX 75380. PO BOX 981633 EL PASO TX 79998-1633 WWW.CAREFIRST.COM 1-800-235-5160. The response will include what the findings were, if the appeal was approved or denied, and the reason for the final decision. Copyright 2017 SHIP, Ltd. | P.O. Complaint. Just download the claim form below. The company's principal address is Po Box 803029, Dallas, TX 75380. StudentResources. Mail your claims to: UnitedHealthcare Student Resources. This gives a faster turn-around time than submitting a claim by mail. (800) 741-0185 To file an appeal, please include the following information: Once we receive the documentation, your appeal will be reviewed and a written response will be mailed to you. Dallas, Texas 75380-9025. P.O. If you did not present your ID card when you purchased your prescription out of pocket, you will need to submit this form for a refund. Phone___(800) 767-0700_____(required) Fax___(800) 506-9278_____(REQUIRED IF INFO IS TO BE FAXED OR A FEE WILL BE CHARGED) _____ NOTE: Please check the box for ONE of the following options and describe the required information to be released SEND THE FOLLOWING I hereby authorize the Student Health Center to release X We understand the hassles that come along with filing your claims, which is why we want to make this process as quick and painless for you as possible. Box 660270 Dallas, Texas 75266-0270 F or Providers: For verification of benefits in the USA: UnitedHealthcare Global: 1-855-263-0524 (toll free) Medical Claim Address: UnitedHealthcare UnitedHealthcare Global PO Box 740372, Atlanta, GA 30374 Payer ID: 87726 UnitedHealthcare Group Number: 908211 Claim Form only needed if provider does not submit claim Mail paper claims to: WebTPA PO Box 99906 Grapevine, TX 76099-9706. Pharmacy Claim Form. For questions about prescription drug claims incurred on or after August 15, 2017, please click here. Plan Administration. Plan Administration UnitedHealthcare StudentResources 2301 West Plano Parkway, Suite 300 Plano, TX 75075 Mail your claims to: UnitedHealthcare StudentResources P.O. Grievances & Appeals Department PO Box 30997 Salt Lake City, UT 84130. Please visit our My Account Center to log in to an existing account or to create a new one. Below you will find all the information you will need to file claims, appeals, and to check your claim statuses. Box 809025. Clip, do not staple, all bills to the completed form. © Copyright PGHstudent, All Rights Reserved 2020, Travel Assistance, Evacuation & Repatriation. Provider Complaint Form IF: ... Mail to: P. O. PHONE. Box 1051 | George Town | Grand Cayman | KY1-1102 | CAYMAN ISLANDS, Electronic – Provider submits electronically – Payer ID #74227 (student does not need to submit claim form with this option), Email – A scanned copy of the completed form submitted by provider or student to. It contains a 30-day cancellation period, provides discounts only at the offices of contracted health care providers, ... Ltd., Attn: Compliance Department, PO Box 803475, Dallas, TX 75380-3475.