Claim Filing Instructions/Reimbursement for Prescriptions that are filled outside of the Student Health Center (For USHIP Students ONLY)

For prescriptions that are filled outside of the SHC, students/patients must pay for the prescription in full.

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 drug bills/prescription receipt (not cash register receipts) showing prescription number, name of drug, date prescribed, and name of person for whom drug is processed 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
• Doctor’s diagnosis
• 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 drug bills/prescription receipt 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.

Also keep in mind that if you are covered by another insurance policy, the other policy must pay its portion first and then the explanation of benefits (EOB) must then be provided to PIA to pay their portion (if any). If the primary insurance denies the benefit, have the pharmacy print out the denial and attach to the claim form.

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.