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Claims
For G.E.H.A health plan members
When providers send claims to G.E.H.A with billing information regarding your medical service, G.E.H.A processes it and covers the cost based on your medical benefit plan. Depending if you visit an in-network or out-of-network provider can determine if you need to file a claim yourself instead of your provider. For the proper steps for filing a claim with G.E.H.A, review the information below.
Filing an in-network medical claim
When you visit a health care provider that is in G.E.H.A's network, you will not have to fill out any claim forms in most cases. G.E.H.A's in-network providers and facilities file claims for you as indicated on your ID card.
Filing an out-of-network medical claim
If you visit an out-of-network provider, the claim may be submitted by either you or by the provider. If you find the claim needs to be submitted and mailed to G.E.H.A by you, please complete a Member Claim Submission Form.
Let G.E.H.A know if you’d like us to reconsider a claims decision. For more detailed information on the appeals process, please refer to your Plan Brochure.