New Claim Intake Option
Telephonic claim intake with verbal HIPAA authorization for accident and critical illness.
- Call your Designated Team at MetLife at 800-638-2880 Monday – Friday from 5:00 a.m. to 5:00 p.m. PST
- New starting 4/1/2021 – submit paperless Accident and Critical Illness claims with our new telephonic claim intake option, with HIPAA voice authorization.
- A designated team of experts will assist with any questions and help to initiate your claim telephonically.
- After verifying your enrollment and eligibility, a message will be played for you to listen to regarding HIPAA authorization. This allows MetLife to assist in gathering medical records.
- During claim intake, you will be asked to confirm you understood the details from the recording explaining HIPAA authorization, and that we will be ordering medical records on your behalf.
- A case manager will confirm all details required to initiate your claim over the phone. A letter will be sent to you, advising medical information is required before review can be completed. While we will be requesting medical information from your provider(s), you may be able to expedite the process by providing any medical information you have.
- The claim will be set-up over the phone. If your physician requires a wet signature in order to release medical information, we will mail a paper copy of the HIPAA authorization for your signature.
- A survey will be sent to you following our review, we appreciate any feedback from your experience.
- While medical information needed will be dependent upon the type and nature of your claim, medical information may consist of the following:
- Itemized invoices and bills – critical illness and accident
- Admission and Discharge papers from hospital – critical illness and accident
- Treatment notes – accident
- X-rays (CAT scans, MRI’s, and/or other types of imaging) – critical illness and accident
- Detailed treatment plans – critical illness and accident
- Referrals to other physicians for tests/consultations – critical illness and accident
- Death certificate – critical illness and accident
- Autopsy – critical illness and accident
- Blood tests for alcohol and drug screening – accident with motor vehicles
- Specific tests for individual diagnoses (for example, PSA for prostate exam) – critical illness
- Hospital and rehab invoices, notes, bills, treatment plans – critical illness and accident
- Orthopedic notes and information on assistive devices/durable medical equipment - accident
- Any other medical information that allows us to make an accurate claim decision – critical illness and accident
