Patient Information and Instructions for Requesting Reimbursement
- All services must be paid to provider in full prior to requesting reimbursement. MHC does not accept unpaid bills or statements as an acceptable form of request for reimbursement.
- All claims that have been partially paid by another primary insurance must include an Explanation of Benefits (EOB) from your primary insurance.
- All reimbursement requests must be received by MHC within 1 year of the service date.
- Hospital ancillary charges, laboratory services, and drug testing are not covered by your mental health benefits.
- Reimbursements will come directly from your union. Please allow approximately 6-8 weeks for processing/payment.
- To request a referral to a network provider, please contact a care manager at MHC.
- Your treating provider should include the following items on your itemized receipt:
- Treating provider’s name including license/degree, address, and NPI#
- Patient’s name and date of birth
- Date(s) of service
- ICD-10 Diagnosis Code(s)
- Type of service (CPT Procedure Code)
- Charge for service
- Submit the itemized receipt/claim(s) to MHC.
Submit receipts to:
1501 Lower State Road
Bldg D, Suite 200
North Wales, PA 19454
Or fax to 215-343-8983