U. S. Incurred Claims | Alliance Benefits

Submitting Claims Incurred in the U.S.

You will submit claims differently based on whether the claim was incurred in or out of the US:

Medical, Dental or Vision

Most claims are submitted by the provider, both PPO & non-PPO. This is the preferred method.

Submit Claims to:

           Meritain Health
           PO Box 27267
           Minneapolis, MN 55427-0267
           Fax: 952-541-0193
           Electronic: EDI: WebMD – #41124

Submit your own claims in certain situations:

Non-PPO providers may require you to submit your own
Miscellaneous items such as eyeglasses
Oral immunizations purchased at a pharmacy – these should be submitted to Meritain (not Express Scripts)

To submit your own claims, include the following:

Itemized receipt (includes provider’s name, contact information, tax ID, description of item or service, any relevant codes, date of service, dollar amount)
If you already paid the provider, make sure this is clear
Primary cardholder name, Meritain ID number
Patient name and date of birth
Always keep a copy

Prescriptions:

Usually you will not have to file prescription claims. Present your Meritain ID card at the local pharmacy, or place a mail order via Express Scripts, and you will be charged the applicable deductible and/or copay.

When to submit your own claims:

If you do not have your Meritain ID card
If you use an out-of-network pharmacy

Submit Claims to:

           Express Scripts Inc.
           Box 52123
           Phoenix, AZ 85072-2123
           (see procedures above)

Exception: If you purchase oral immunizations at a local pharmacy, submit the itemized receipt to Meritain (not Express Scripts)