Claim Filing Instructions/Reimbursement for Eye clinic Patients with USHIP


When a student is seen at the Eye clinic for some medical reason, the student will pay in full the office visit and file a reimbursement claim to Personal Insurance Administrator (PIA).

 

1. After receiving treatment, complete the insurance company claim form, which may be downloaded from the Student Health Center website at www.shc.uci.edu or www.renstudent.com/uci
2. Mail original receipt along with the Company claim form to:

 

Personal Insurance Administrators, Inc.
P.O. Box 6040
Agoura Hills, CA 91376-6040

For quicker claims payment, be sure the bills submitted include the following:
• Student’s name and address
• Student ID Number
• Policy Number 302-048-0407
• Name and address of the Doctor or Hospital
• Itemization of charges, which must include diagnostic and precedure codes (Attach original bills!)
• Date Sickness or Injury occurred.

For all claims questions, please contact Personal Insurance Administrators, Inc. (PIA) at the address above or call toll-free (800) 468-4343.
The Undergraduate Student Health Insurance Plan (USHIP) uses PIA as a third party claims administrator to process all USHIP claims.

The completed claim form and all hospital and medical bills must be submitted for payment within 90 days after the date loss occurs. Failure to furnish this information within the 90-day period shall not invalidate nor reduce your claim if it was not reasonably possible to file the claim within this time, provided that the claim form is submitted as soon as is reasonably possible. In no event, except in the absence of legal capacity, will a claim be honored later than one (1) year from the date of first medical treatment.

All claims submitted are subject to review under the terms and conditions of the policy. Verification of eligibility does not guarantee payment of claims. Always keep a copy of all documents submitted for claims.