Step-by-Step Guide to Filing Claims with GroupHealth (ClaimSecure)
1. Log In to the ClaimSecure Portal
- New Users:
- Visit the GroupHealth ClaimSecure Portal and click “Register”.
- Enter your policy number, certificate number, and personal details (provided by your employer)
- Existing Users:
- Sign in using your credentials.
2. Select the Claim Type
Choose between:
- Health/Dental Claims: For paramedical services (e.g., physiotherapy, chiropractic care) or dental procedures.
- Reimbursement Claims: For out-of-pocket expenses at non-network providers.
- Travel Insurance: For emergencies abroad (if covered under your plan)
3. Prepare Required Documentation
Upload the following documents digitally:
- Original Receipts: Must include provider name, license number, service date, and total cost
- Completed Claim Form: Download from the portal or your employer’s HR portal.
- Medical Reports: Diagnostic tests, prescriptions, or discharge summaries (for hospitalization)
- Proof of Payment: Bank statements or credit card receipts for reimbursement claims
4. Submit Your Claim Electronically
- Navigate to “Submit a Claim” on the portal.
- Upload scanned copies of receipts and forms (JPEG/PDF/PNG).
- Review details and submit. Most claims are processed within 5–10 business days
5. Track Claim Status
- Use the “Claims History” tab for real-time updates
- Contact GroupHealth support at 1-888-711-1119 for urgent inquiries
6. Direct Billing (If Available)
- Confirm if your provider (e.g., dentist, physiotherapist) is part of GroupHealth’s network.
- Present your GroupHealth ID card at the appointment to avoid upfront payments
7. Special Cases
- Travel Insurance: Notify GroupHealth within 24 hours of an emergency. Submit receipts post-treatment
- Coordination of Benefits: Submit to primary insurers first, then to GroupHealth for remaining costs
Key Requirements & Tips
- Deadline: Submit claims within 12 months of the service date
- Direct Deposit: Enroll via the portal for faster reimbursements
- Avoid Rejections: Disclose pre-existing conditions and adhere to policy exclusions
Frequently Asked Questions (FAQs): GroupHealth
1. What documents do I need for a reimbursement claim?
- Original receipts with provider details.
- Completed claim form (download from the portal).
- Medical reports (e.g., discharge summary, prescriptions) 712.
2. Can I use direct billing for paramedical services?
Yes, if your provider is part of GroupHealth’s network. Present your ID card at the appointment to avoid upfront payments
3. How long does GroupHealth take to process claims?
- Online submissions: Processed within 5–10 business days.
- Mail submissions: Allow 7–14 business days plus mailing time
4. What if my claim is denied?
Common reasons include:
- Missing or incomplete documents.
- Claims filed during waiting periods for pre-existing conditions.
- Services excluded from your policy
Solution: Resubmit with corrections or appeal via the portal
5. How do I check my remaining coverage?
- Log in to the ClaimSecure Portal → Navigate to “My Benefits”.
- Contact HR or GroupHealth support
6. Are mental health services covered?
Most plans include coverage for psychologists or social workers. Check your policy’s “Mental Health Services” section for limits (e.g., $500/year)
7. What is the deadline for travel insurance claims?
Submit receipts within 90 days of returning home. Notify GroupHealth within 24 hours of emergencies abroad
8. How do I update my banking details for direct deposit?
- Log in to the portal → Navigate to “Profile Settings” → Update banking information
9. Can I file a claim for a family member?
Yes, if they are listed as dependents on your policy. Upload their receipts and ID proof during submission
10. What if I lose my GroupHealth ID card?
Request a replacement via the portal or contact support at 1-888-711-1119
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