Call 1-800-477-6472 to request a Benefit Verification and receive a faxed Summary of Benefits, or download a Sample Summary of Benefits (PDF - 429K).

A Summary of Benefits is faxed to provider within 2 business days and includes detailed explanation of coding guidelines as specified by the plan, patient cost share information, and utilization management requirements, such as prior authorization. A reimbursement specialist will also offer you a phone consultation to explain the benefits and answer any questions.