Bills and receipts should be itemized and show:
• Patient’s name, date of birth, address, phone number and relationship to enrollee
• Patient’s Plan identification number
• Full name and address of the provider, including city, postal code and country
• Dates that services or supplies were furnished
• Diagnosis/reason for the visit (include a description of the sickness or accident)
• Type of each service or supply
• Charge for each service or supply
Note: We will provide translation and currency conversion services for claims for overseas (foreign) services. For more information, refer to the Plan’s official brochure.
• Patient’s name, date of birth, address, phone number and relationship to enrollee
• Patient’s Plan identification number
• Full name and address of the provider, including city, postal code and country
• Dates that services or supplies were furnished
• Diagnosis/reason for the visit (include a description of the sickness or accident)
• Type of each service or supply
• Charge for each service or supply
Note: We will provide translation and currency conversion services for claims for overseas (foreign) services. For more information, refer to the Plan’s official brochure.
