MMC Benefits Handbook
Filing a Claim
How do I file a claim for benefits?
In almost all cases, you do not have to file a claim form. The provider will file a claim directly with the Claims Administrator. Once the claim is processed you will be billed for the appropriate coinsurance amount.
Typically, if you receive services from a provider who does not participate in the network, those services will not be covered. Out-of-network benefits are not covered under the Plan except in an emergency or if authorized by Kaiser.