Claims

Employee Benefits Claims Forms

Introduction

Employee Benefits is a challenging field of insurance and G.R. Murray, a division of O'Gorman & Young can provide crucial assistance in navigating this often complicated area. G.R. Murray Insurance can help you with a host of services. We offer:

• Complete Analysis of present coverage
• Review your current plan and loss activity
• Prepare bid specifications for submission
• Review proposals and submit detailed report
• Provide a professional recommendation

Additional Services:

• Working to resolve any claim problems or disputes
• Review claim experience on an ongoing basis to spot unusual fluctuations
• Apprise the client of all new developments in the group insurance marketplace
• Negotiate renewal rates on an annual basis with current carrier and alternative markets

Implementation:

• Provide an implementation schedule outlining deadlines for G.R. Murray, the carrier and the employer
• Organize meeting to present new coverage options or plan changes. This includes preparation of plan comparisons and enrollment materials.
• Assist employees in filling out the applications to assure timely implementation
• Obtain from the carrier: Group numbers, benefits books and enrollment information
• Proof and delivery of ID cards
• Provide COBRA administration software

Claim Assistance Statement:

• You must first review your policy to be certain that the service in question is covered. Any questions that you may have can be discussed with your Benefits Administrator.
• Confirm Claim Information: group number, policy number, service date, diagnosis code, procedure code, patient name and amount charged.
• Find out who sends in your claim. If you are responsible, send it in as soon as your receive your bill. Make a copy of your claim and record date mailed and address to which it was mailed.
• Allow time for claim processing. Your carrier will notify you with the results of your claim.
• Claim Appeal: If your are in disagreement with the result of your claim you may contact your carrier using the number listed on the back of your membership card or written on your Explanation of Benefits. You may request additional information or further review of your claim. Formal complaints should be made in writing being sure to include your name, address, ZIP code, daytime phone number, policy number, and any additional information that you have supporting your claim. Make a copy of all documents before mailing.
• The Health Benefits Department at G.R. Murray will assist you with the rejected claims, after you have tried to resolve them yourself. Please use the Claim Assistance Form located on this website and fax to 609-925-9505.

Forms

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