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We agree that some of our policyholders were not aware that their coinsurance payment was calculated without applying the covered facility discount.
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* Therefore, Trigon Blue Cross Blue Shield has agreed to this refund program for our customers. If you qualify, your refund will be determined by applying Trigon’s average percentage discount at that covered facility to your original coinsurance payment, plus interest at the legal rate of interest, compounded annually.
If you would like to receive more information and proof of claim forms, telephone us directly at 1-800-422-4662.
To file a claim, you must sign and send us a proof of claim form. This form will ask you to provide us with some basic information that will help us process your claim, such as: your name, address, policyholder ID number (this is usually your social security number), when and where you received services and the amount of coinsurance you paid. While not required, it may also help us process your claim if you include proof of your coinsurance payment by enclosing a covered facility receipt or cancelled check with your completed form. If you do not have a cancelled check or covered facility receipt you should provide us with your best estimate of the amount of coinsurance paid. Trigon reserves the right to verify payments from covered facility records.
You have until December 7,1994 to send us your proof of claim.
Trigon Blue Cross Blue Shield regrets any misunderstanding'that may have arisen from our previous published materials relating to covered facility coinsurance payments. Our current policy is to base your coinsurance payment on actual negotiated rates, including any discount we may have negotiated. This way, we apply the savings from the discount at the time you pay the covered facility bill.
In this rapidly changing health care environment, Trigon Blue Cross Blue Shield has worked hard to become one of the strongest managed care and wellness companies in the industry. Fortune Magazine recently listed Trigon among the Top 20 managed health care companies in the United States. And, we have received an “AA-” “excellent” claims-paying ability rating from Standard & Poors, an acknowledgment of our commitment to financial strength and cost-effective management. We are dedicated to offering our policyholders high quality, affordable and integrated health care and wellness services and products.
Our goal is to serve you, our policyholders. This refund program demonstrates our continuing commitment to customer trust and satisfaction.
Sincerely, Trigon Blue Cross Blue Shield
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