Your Financial Responsibility

To determine what your financial responsibility may be in advance of receiving services, you should:

  • Call the provider's office to request the CPT, DRG or APC codes that will be used to bill for services. Also, ask for each code - view the financial estimate worksheet to help you gather this information.
  • Submit the financial estimate worksheet by calling our Customer Service Department at:  
    • Commercial Group Members: 1.888.847.7902  
    • PPO Group Members: 1.855.577.7123  
    • Self-Funded Employer Groups: 1.888.816.3096

If you call the Customer Service Department, you must have the worksheet information available to provide to the customer service representative. 

Submit by fax to The Health Plan's Customer Service Department at 740.699.6163.

Mail to The Health Plan's Customer Service Department at 1110 Main Street Wheeling, WV 26003. 

Within one to two working days of a completed request, an estimate of your responsibility for the specific services will be mailed to you.