POMCO Bedford Schools Health Plan free printable template
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PLAN ADMINISTERED BY Bedford Schools HEALTH PLAN RETURN TO POMCO P. O. BOX 6329 SYRACUSE NY 13217 Tel 1-800-234-9862 MEDICAL/SURGICAL/MAJOR MEDICAL BENEFIT REQUEST FORM PATIENT INFORMATION SECTION PATIENT NAME RELATIONSHIP TO EMPLOYEE SELF SPOUSE CHILD OTHER EMPLOYEE NAME FIRST F PATIENTS DATE OF BIRTH MONTH DAY MIDDLE YEAR EMPLOYEE SOCIAL SECURITY NUMBER EMPLOYER LAST EMPLOYEE MAILING ADDRESS EMPLOYEE S BIRTH DATE CITY STATE ZIP E M P L O Y SEX IF FULL TIME STUDENT GIVE NAME AND ADDRESS OF...
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How to fill out pomco insurance provider phone number form
How to fill out POMCO Bedford Schools Health Plan
01
Obtain the POMCO Bedford Schools Health Plan application form from your school administration or the POMCO website.
02
Fill in personal information including your name, address, and contact details accurately.
03
Provide details of any dependent family members who will be covered under the plan.
04
Select the desired coverage options based on your medical needs.
05
Review the policy terms and conditions thoroughly before proceeding.
06
Submit the completed application form to the designated office or email it as instructed.
07
Keep a copy of the application for your records and follow up if you do not receive confirmation of enrollment.
Who needs POMCO Bedford Schools Health Plan?
01
Students enrolled in Bedford Schools who require health insurance coverage.
02
Parents or guardians looking to protect the health and well-being of their children.
03
Staff members of Bedford Schools seeking a comprehensive health plan for themselves or their families.
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People Also Ask about pomco prior authorization form
What is the payer ID for 16111?
Payer Name: POMCO|Payer ID: 16111|Professional (CMS1500)/Institutional (UB04)[Hospitals]
Is Pomco the same as UMR?
POMCO was acquired by UMR, a UnitedHealthcare company, in April of 2017.
Is Pomco part of UnitedHealthcare?
UnitedHealth Group Inc. (NYSE: UNH) in 2017 acquired POMCO Group, which became part of UMR, UnitedHealthcare's third-party administrator (TPA) service. Minnetonka, Minnesota–based UnitedHealth Group is the parent company of UnitedHealthcare.
What is UMR formerly known as?
University of Missouri–Rolla, former name of the Missouri University of Science and Technology.
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What is POMCO Bedford Schools Health Plan?
POMCO Bedford Schools Health Plan is a healthcare insurance plan specifically designed for employees and their dependents of the Bedford School District, providing coverage for various medical services and procedures.
Who is required to file POMCO Bedford Schools Health Plan?
Employees of the Bedford School District who participate in the health plan are required to file the POMCO Bedford Schools Health Plan for claiming benefits.
How to fill out POMCO Bedford Schools Health Plan?
To fill out the POMCO Bedford Schools Health Plan, individuals should complete the required forms provided by POMCO, ensuring to include personal information, details about the services received, and any necessary documentation.
What is the purpose of POMCO Bedford Schools Health Plan?
The purpose of the POMCO Bedford Schools Health Plan is to provide comprehensive health insurance coverage to employees and their families, helping to reduce out-of-pocket expenses for medical care.
What information must be reported on POMCO Bedford Schools Health Plan?
The information that must be reported on the POMCO Bedford Schools Health Plan includes the insured’s personal details, policy number, dates of service, type of treatment received, and any associated medical bills.
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