Q: What will I need to supply SWA in order for someone else to inquire on personal information for me?
A: A PHI Authorization form (PHI form is available under e-forms on the website)
Q: Up to what age can I inquire on my children's claims without their consent?
A: Varies depending upon the State which you reside in. For the state of California, Nevada and Hawaii
the age is for anyone under 18.
Q: Why didn't my Plan cover more of the expense?
A: There can be several reasons why the Plan payment is less than the total amount billed:
- Did you use a preferred provider? If not, you will have a larger portion of the bill to pay out-of-pocket.
- Have you met your annual deductible? If not, part or all of the bill may have been applied to meeting that annual amount.
- Does your Plan have limitations of the services you received
- (for example, a limit on the number of chiropractic visits within a specified time period or an allowance for tooth cleaning only every six months)?
- Did your procedure require prior authorization which you failed to obtain?
- The Plan has a specified schedule of covered procedures and benefits.
Q: What can I do if I don't agree with how my claim was paid?
A: Call the Administrative office for answers, but if you still disagree, you have the right of appeal.
Q: Can I fax over birth certificates, marriage license, and student status forms. etc?
A: This will only be allowed if it is an emergency.
A supervisor will need to approve document to be faxed and followed
up with the hard copy
in the mail. Please note that the faxed document will only be temporary for 10 days