I will be attending the Health Benefit Seminar Oct 18 - 21^st in Las Vegas. If there are any members that have a claim they have questions about or one not resolved satisfactorily let me know. At the seminar they have claims employees and terminals set up to give HBR's a resource to go over claims. Now, with that being said I will need the following information due to Federal Law on HIPAA Privacy Rule. A HIPAA Privacy Rule Personal Representative Authorization form filled out, a copy of the claim in question and a statement to the reason you would like the claim to be reviewed. I cannot guarantee anything will get resolved; at least we will have tried.
Members in the NALC's Health Benefit Plan can send in a claim dispute with the NALC Health Benefit plan as outlined in the RI71-009 booklet on page 69 any time. The booklet also gives the time limits for disputes and addresses to send claims to.  If you do not agree with the NALC Health Benefit plan's decision you can ask OPM (Office of Personnel Management) to review it.

For other fine reading in the NALC Health Benefit Plan booklet (RI71-009) please go to page 62 (Section 5(h). Special Features. Here you will find the extras in health care with titles like: CaremarkDirect Program, Disease Management Programs, Enhanced Eldercare Services, Flexible Benefits Option, Healthy Rewards Program, 24-Hour Nurse Line, 24-Hour help line for mental health and substance abuse, Personal Health Record, Services for deaf and hearing impaired, Weight Management Program and Worldwide Coverage.  This booklet will give you all the in's and out's about the NALC Health Benefit Plan and it's easy to read and understand.
In Unity,
Robert M Hinton
Br.642 & Colorado State HBR
Robert M Hinton 1-303-499-4189
Health Benefit  Plan 1-888-636-NALC
Precertification  1-877-220-NALC
Prescription Drug Program 1-800-933-NALC

ADDITIONAL NALC HEALTH BENEFIT PLAN CHANGE/IMPROVEMENT INFORMATION:

WWW.NALC.ORG     703-729-4677 or 888-636-6252

More NALC Health Benefit Information

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