Claim Filing

Provider Verifying Coverage

MedMutual Protect Phone Number: (855) 521-9345

 

US Mail Claims Submissions

MedMutual Protect
P.O. Box 14327
Reading, PA 19612-4327

Provider Must Include

  1. Itemized Bill or HCFA Form
  2. Copy of Primary Carrier EOB

EDI Claims Submission

Payer ID: 23223

graphs shows the claims process

Provider Portal 

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Provider Portal

Benefits to Providers

For services eligible under the patients’ primary health insurance, Alliance Med Bridge pays the patients’ out-of-pocket expenses such as copays, deductibles, and coinsurance. Claims are paid directly to the healthcare provider via our third party administrator MedMutual Protect. Alliance Med Bridge may provide many benefits to healthcare providers such as, but not limited to

  • Reduction in Accounts Receivable.
  • Reduction in the volume of patient services that are delayed or avoided.
  • Timely direct deposit payments.
  • Increase in patient utilization.
  • Improvement in patient’s physical and financial wellbeing.

Frequently Asked Questions

How do I file a claim for patients with MedMutual Protect GAP insurance?

First, a claim for services performed must be filed with patient’s primary insurance provider. Once the healthcare provider receives the Primary Carrier EOB, they may then submit the claim via electronically filing, by fax, or by mail. For claim adjudication, filings must include a copy of the Primary Carrier’s EOB.

Is there a network of providers and how do we join?

There is no set network of providers for the MedMutual Protect GAP insurance policy. Neither Alliance Med Bridge or MedMutual Protect require a contract with the healthcare provider. Any expenses incurred must be covered by the insured person’s Health Benefit/Major Medical Comprehensive policy before benefits will be paid under the GAP insurance policy.

What is the Fee Schedule?
There is no fee schedule. The policy pays the patient’s portion of the claim (i.e., copays, deductible, and coinsurance) directly to the providers on a dollar-for-dollar basis (if there is an assignment of benefits). The amount that the patient owes is determined by the underlying primary insurance carrier’s contract and can be found on the primary carrier’s EOB. Benefits are limited to deductible, co-payment and co-insurance amounts the insured is required to pay under their Major Medical/Comprehensive Policy.
Why should I want to file this claim on the member/patient’s behalf?
Most importantly, it will keep your patients happy, healthy, and ensure that they continue to return to your practice for care.  From a claims perspective, it will reduce the amount of uncollected Accounts Receivable by shifting the claims to a highly rated insurance company verses an individual.