PennPRIME takes a proactive approach to claims administration. We provide advice and guidance to members from the beginning of the claims process to the end. That advice includes guiding you on what occurrences qualify as a claim and what you should do once you have a claim. As your advocate, we hope to help mitigate and reduce your ultimate cost in claims. In addition, PennPRIME can advise you on how to proceed when a member does not submit a claim and is solely dealing with other insurance carriers. Proper guidance during the entire claims process ensures that everything runs smoothly. Advice from PennPRIME will ensure the correct amounts are paid in a timely manner with all parties being kept in the loop. No matter the type of claim.
Member Claim Reviews
PennPRIME is always available to you to review claims but also we like to touch base with a visit, if possible. Claim reviews allow the member to ask specific questions about past and current claims. These reviews are held in person typically, allowing for sensitive topics to be discussed in a comfortable environment. By working together, PennPRIME and its members form a better understanding of the claims process and work toward solutions.
Claims Reporting Help
Many PennPRIME members don’t often have a claim to report. But when they do, the Director or Member Services individuals can help you get the claim reported timely and properly. In addition, we can discuss the occurrence that is causing the need for a claim and verify an actual claim is warranted.
Claims Filing Documents
We have claims reporting documents and an online claim filing system on our website. Using the correct documents, forms, and format for reporting claims ensures that the claims are promptly and properly set up. Getting claims set up properly from the beginning helps all parties feel secure during the entire process.