GEO Group - International Group Health Insurance

What types of assistance does IMG provide members?

• Collect calls to IMG from anywhere in the world; toll-free 800 number from US/Canada
• 24-hour availability for emergency services, medical evacuation and precertification
• On-site, physician-directed emergency medical services and large claim management
• Ability to reimburse claims in most major currencies via wire transfer
• Foreign language translation for claims

What forms, information and assistance are available in the "Current Client" portion of the IMG web site?

• Live help from IMG customer service via internet (Monday - Friday, 8am - 5pm CT)
• Independent PPO network search (applicable in US only)
• Plan descriptions & certificate wordings
• Initiate precertification
• Claims information
• Update client information
• Request information
• Privacy and Confidentiality Policy
• Forms library (many forms available in Spanish)
• IMG medical plan brochures and applications
• Assignment of benefits
• General accident questionnaire
• Medical claim
• Dental claim
• Vision reimbursement
• Medical insurance continuation forms
• Precertification information
• Overseas benefit request

Do I need to carry the card with me at all times?

Yes, this way you have the medical telephone information available in the event it is needed for you or others. Making a copy, as you would do with your passport, is recommended.

What if the original card is lost?

You can secure a new or duplicate card by simply contacting IMG Customer Service.

What is a Provider?

A Provider is a Hospital, Physician, Surgeon, Laboratory, or an organization or person generally involved in the diagnosis and/or treatment of medical conditions.

What is a PPO? (Applicable in the US only)

A PPO or Preferred Provider Organization is a network of Hospitals, Physicians and ancillary medical care personnel who have contracted with an organization to provide medical care at a price reduction. Using the provider network could significantly reduce your out-of-pocket expenses.

How do I find a PPO provider (US only)?

Your independent PPO is The Coventry/First Health Network inside the United States. You can locate providers by going to the "PPO Network Search".

Will IMG pay directly to providers?

In many cases IMG works directly with the hospital or clinic as an accommodation, including those outside the independent PPO, for direct payment of eligible medical expenses on your behalf.To be eligible to have a claim paid in this fashion, you or the provider must complete a claim form and submit it with original itemized bills. In this case, you will be responsible for direct payment of your deductible, coinsurance amounts and non-eligible expenses and charges.

What happens if the Provider bills me before IMG pays the bill?

Providers generally send copies of bills to the insurance companies and to the patient. If you receive a bill after treatment from a Provider, please contact IMG at the number listed on your ID Card. Chances are, the Provider sent the bill to IMG and the bill will be paid shortly. Help IMG avoid duplicate payments by allowing IMG to make payments to Providers on your behalf.

How do I submit a claim?

• If overseas and you pay for medical treatment, complete a claim form, attach original receipts and mail to IMG at the address listed on the form or your ID card.

• If you receive a bill from a Provider while in the U.S.A., please send it to IMG at the address on your ID card. If you pay your bill directly to the Provider, you may miss a discount and pay the Provider more than they are due. Keep copies of all receipts and documentation for your records.

PLEASE NOTE: Claims must be filed within 90 days from the date the Eligible Expenses are incurred.

What must a member do prior to a hospital admission or surgery?

• Prior to receiving treatment you need to contact IMG to precertify your treatment. Precertification means calling IMG's Utilization Review department to receive a determination of medical necessity for the proposed treatment or services. It is important to note that precertification is only a determination of medical necessity, not an assurance of coverage, verification of benefits or a guarantee of payment. Precertification may be done by you, the doctor, a hospital administrator or a relative.

• Verification of benefits is the process of verifying your general coverage and the available benefits under the plan. You may do this by contacting IMG's Customer Care department whether or not your treatment or services require precertification. Verification of benefits is not a guarantee of payment or assurance of coverage, and all medical expenses must meet eligible payment guidelines in accordance with the terms and conditions of the plan. While precertification and verification of benefits are separate determinations, both are made in reliance on the completeness and accuracy of the information provided by you and your healthcare providers to IMG.

What must a member do when she becomes pregnant?

In order to comply with the maternity precertification requirements, the member must contact IMG as soon as possible, but always within the first ninety (90) days of pregnancy. Please notify all physicians, hospitals and other providers that this insurance contains precertification requirements and ask them to fully cooperate with the company. If for any reason after the initial precertification you become aware of complications, you must precertify again in accordance with the General Requirements for Precertification.

Why does my Explanation of Benefits (EOB) show a "Patient Portion" balance due?

The EOB shows your benefits available with the insurance company. The "Patient Portion" is your amount to be paid to the Provider of services. This will include the deductible, coinsurance and any other amounts not covered.