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If we have not done so already, Thank you for being in our Health-Flex family
We hope this section is of assistance to you. If there is a topic you would like added,
please let us know. We will try to accommodate everyone if possible.
If you need additional information you may contact us either by phone, fax or e-mail.
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HOW TO SUBMIT CLAIMS |
You doctors can submit claims for you either electronically or
on paper forms. We use the industry standard type of Health Insurance Claim Form
"HCFA-1500" for all claims except hospitals they use form "UB-92".
Your should complete
the top part of the HCFA-1500 form, your doctor will complete the
bottom. Before you send the form to us make sure it is complete. Make
sure your doctor has included the following:
- A diagnosis code (ICD-9)
- Service codes (CPT) for each service performed
- The date of service and charge for each service
IMPORTANT-
Look at the services performed. Make sure there are no charges for
services you did not receive. Although there are doctors that bill for
unperformed services (fraud), it is more than likely a billing error
made by the doctor or a member of his staff. If you show them the error
they will correct it. If they don't and you feel you are being charged
for services not performed, please let us know about it. Perhaps we can be of help.
We have been asked , why this is important?
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Healthcare
fraud is everyone's business. The service provider who overcharges,
lines his pockets. You or your employer will see that extra charge in
the form of higher premiums next year. The bottom line is you ultimately are paying for it. You
have to be crazy to help someone rip you off. Instead of helping you
should be offended. In addition it is a crime to defraud an insurer or
payer of health claims. Don't let a dishonest provider make you feel
guilty for not helping them steal, especially when they are stealing
from you.
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Claim forms should be mailed to:
- Infinity Administrators, Inc.
P.O. Box 979
Plainview, NY 11803
There is a $5.00 fee charged to
claims submitted without proper HCFA forms Bills submitted on a
prescription form or note pad will not be accepted |
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HOW TO FIND A DOCTOR OR OTHER PROVIDER
(Networks) |
Your plan of benefits
provides access to our provider networks. These networks can save you a
significant amount of money when you take advantage of them. Click to
access a network as listed under your plan of coverage This will access
the networks on your plan. All links will result in a pop up window to
the sight of the database you requested. To return close the pop up
window.
- Health-Flex 365
MultiPlan - America's largest premier network of medical care providers
DDS - Dental Network
Holistic Network (H)
Optical Networks
Rx (Locate a Pharmacy, Drug Lookup, Review your Rx History, and Mail Order Information)
- Health-Flex 55
DDS - Dental Network (H)
Optical Networks
Rx (Locate a Pharmacy, Drug Lookup, Review your Rx History, and Mail Order Information)
- Health-Flex Dental Plus
DDS - Dental Network (H)
Optical Networks
- ASO/TPA Services (Check your plan booklet, not all types of providers may be covered)
MultiPlan - America's largest premier network of medical care providers (H).
DDS - Dental Network (H)
Holistic Network (H)
Specialty Networks
Optical Networks
Rx (Locate a Pharmacy, Drug Lookup, Review your Rx History, and Mail Order Information)
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Click on Rx above or here to go to the
myCatamaranRx site; to locate a list all Pharmacies in an area; enter your address,
City and State or the Zip code and the distance away, select in-plan and or 24 hour Pharmacies;
a list will appear a list of Pharmacies in your area. If no Pharmacies appear un-check the 24 hour
Pharmacies only box or change the distance from your address.
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HOW TO USE YOUR Rx BENEFITS |
Drugs play an important part of medical care. Using medicines
can reduce your need for expensive medical treatments as well as prolong
your life. Many of the great medical breakthroughs of the day are
related to new and more effective medicines. Unfortunately many
physicians tend to prescribe drugs that are popular rather than those
that are cost effective. We have compiled a listing of over 50,000 drugs
that can be purchased for $30.00. or less. This price will give you a
thirty day supply or a full course of treatment if less than 30 days.
We urge you to search
this list and show your doctor the list of drugs that are for your
ailment. It may be possible for him to prescribe one from this list and
save you from having to purchase high price medication . This list can
be researched by the medical condition you are treating. This list is
created by our Pharmacy Benefit Manager and the prices listed are
available with the Mail order program. For additional information you
may contact the Pharmacy Benefit Manager at
NATIONAL MEDICAL HEALTH CARD SERVICES - 1-800-251-3883
The drug benefit is available for participants with:
Health-Flex +, Health-Flex Plus, Health-Flex 365, Health-Flex 55 and ASO/TPA services
Although there are
53,000 Pharmacies on our network (you will have a tough time finding one
that's not in our network), you will experience the greatest savings
using our mail order program.
Your maximum savings occur when utilizing the mail order program
To find and use the mail order form go to
myCatamaranRx.
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INFORMATION BULLETINS |
HELPFUL TIPS TO MAXIMIZE YOUR AVAILABLE SAVINGS
When entering a hospital or emergency room, request to be treated by
MultiPlan network providers. If you don’t ask no one will know that’s
what you want.
Ask questions, understand your treatment, and its cost.
When you ask for a doctor appointment, you will be asked about your
medical insurance. When you are asked tell whoever asks that you are in
the MultiPlan network. If you say Healthflex they may or may not know
who Healthflex is. They will know MultiPlan.
When making an appointment with a dentist use DDS network. that is the
name of the dental network. They may not recognize the name Health-Flex.
They will know the name of the network they are on.
When laboratory services are utilized you will very often receive a
bill. If you do receive a bill do not pay it, send that bill to us. We
will reprice it as per our schedule. The saving to you is usually
30%-50%. Try to use Quest Labs, tell your doctor to use Quest Labs for
your lab tests. We have a flat 45% discount schedule with them. It’s
your money, we think its better when you get to keep it.
When a doctor is prescribing medication ask the doctor if he can
prescribe a generic medication. In most States (including New York) the
generic is exactly the same formula as the non-generic, at a much lower
cost. Use the drug database it list thousands of drugs non-generic,
generic and some that can be purchased over the counter without a
prescription that can be purchased for $30.00 or less. This list has not
been designed to replace your doctors opinion. There are usually many
drugs that can be used to treat the same problem. We believe that one
might want to try the cost effective treatment first. That is unless you
don’t care what you spend, but then you wouldn’t be reading this now.
The fact is you do care and the responsibility for effective cost
control starts with you, the consumer.
That’s why we call it:
“CONSUMER DIRECTED HEALTH CARE”
We’re here for you, call anytime you need us.
Sincerely,
Infinity Health Plans
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HOW TO CONTACT US |
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- If you need to reach us, you can contact us in a number of ways:
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Telephone:
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631-424-2400
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Elsewhere:
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631-424-2400
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Fax:
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631-424-2464
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E-Mail: Info@Infinityhealthplans.com
If you wish to e-mail us now enter your message below,
we will get back to you within two business days:
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FREQUENTLY ASKED QUESTIONS
Q: I purchased drugs
at two different Drug stores. Why was it cheaper to buy one of the
drugs at one store, while the other drug was cheaper at another store?
ANS: Drug stores
like all other business buys from manufacturers and suppliers. When a
manufacturer or supplier is overstocked they offer discounts to the
retailer to move their inventory. Stores that can take advantage of
these discounts can pass part of the savings to their customer. It pays
to check each time you shop for which store has the lowest price in your
area. The same store might not be lowest all the time. There can very
large savings here. We found over a hundred dollar savings on an
antibiotic. What really surprised us was the lowest price was not one of
the drug store chains. It was in a supermarket pharmacy dept.
Q: My friend asked me to ask about portability under H.I.P.A.A. What is H.I.P.A.A.?
ANS: Health
Insurance Portability and Accountability Act is a complex law that
covers Many areas of healthcare including; portability, Privacy,
Electronic Claim Standards, records and more. The main feature that you
address is portability. Portability is important to you because you may
want to switch your existing coverage to some other coverage (for any
number of personal reasons) at sometime in the future.
Health-Flex + meets the standard of portability under H.I.P.A.A.
and we do issue a certificate of credible coverage as provided for under
H.I.P.A.A. A topic of great concern is privacy. You should know that
Infinty Health Plans will never disclose any confidential medical
information, or other information such as your social security number,
address or phone number to anyone you have not authorized, unless
permitted under H.I.P.A.A. or by a court order. If you want to allow a
spouse or parent access to confidential medical information you must
tell us in writing.
Q: How do we make changes to our plan?
ANS: depends on the
change. Most changes are make by calling our customer service
department. They will direct you to, or send you the proper form to
effect change. You may fax the form back to us and mail the original.
Changes including terminations can only be made to be effective at the
end of the month and never backwards.
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