Provider Network
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US PPO Network Search
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International Provider Access
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You may seek treatment with the hospital or the doctor of your choice. Preferred Provider Organization (PPO) contracted by IMG, a
seperately-organized network of approximately 475,000 physicians and 4,500 privately owned and operated hospitals.
For treatment received within the U.S. & Canada: Inside the PPO Network: After deductible, plan pays 90% of eligible expenses up to US$5,000,
then 100% up to the Policy Maximum.
Outside the PPO Network: After deductible, plan pays 80% of eligible expenses up to US$5,000, then 100% up to the Policy Maximum.
For treatment received outside the U.S. & Canada: No coinsurance which means after deductible plan will pay 100% up to the policy maximum.
* All PPO Providers are contracted seperately through First Health Group Corp.
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IMG Claims Filing Information
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Direct Payment to Providers
In many cases IMG works directly with the hospital or clinic, including those outside our independent Preferred Provider Organization, for payment
of eligible medical expenses. To file a claim, complete the Claim Form and submit it with original itemized bills. In this case, you will be responsible
for your deductible, coinsurance amounts and non-eligible expenses. You can also use IMG Interactive Claim Form (123 kb) Microsoft Word is
required to use the interactive form.
Reimbursement
If you have received treatment and need to be reimbursed for out-of-pocket medical expenses, complete the Claim Form and submit your original
itemized bills and paid receipts within 90 days. IMG will reimburse your eligible medical expenses after applying the deductible and coinsurance.
Please remember to submit your bills and receipts as soon as you receive them. Do not hold them until the end of the year. IMG will apply eligible
medical expenses to your deductible and coinsurance throughout the year.
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For additional information please contact
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IMG
Inside US and Canada:- 1-800-628-4664
Fax:- 1-317-655-4505
Outside US and Canada:- +44(0) 1444-46-5577 or 01-317-655-4500
MCIS Multichoice Insurance Services
Inside US and Canada:- 1-510-456-5304
Inside US and Canada:- 1-510-353-1180
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