Other Information

Filing Medical Claims

If you obtain care from a Yale New Haven Health System or Anthem PPO provider, there generally are no claim forms to file. You simply pay any required copay directly to the provider and the plan will pay benefits directly to that provider.

Benefits for out-of-network hospital expenses are paid directly to the hospital unless you submit a bill as proof that you already paid the hospital. Other benefits to which you are entitled for out-of-network services are paid directly to you unless you assign them to a specific provider. If you assign benefits, you’ll be notified of the payments made so that you’ll know if any portion of the bill isn’t covered by the plan.

Both Anthem and Delta Dental will require information from you regarding other coverage. You will receive a letter at your home address requesting information on other coverage and you are required to respond. Claims for you and your covered dependents may be pended until you have provided Anthem and Delta with the required information.