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Health Plan Coverage Summaries (eff 1/1/2014) and Forms

FORMS

Effective January 1, 2015, Moravian College has implemented an Error Reimbursement Program.  Employees who discover billing errors for medical services and who take corrective action directly with the provider and Highmark Blue Shield, will share in the recovery when the claim has been adjusted. If the adjusted claim does not result in a lower billed amount to Moravian College, there will be no reimbursement.

  • Member Submitted Health Insurance Claim Form
     
    Include an itemized statement of services from the health care provider and the Claim form to the address provided on the back of your member ID card. Cancelled checks, cash register receipts or personal itemizations are not acceptable. The itemized statement must include the name of patient, date(s) of service, type of services performed, diagnosis and charge(s). A separate claim form must be completed for each patient. However, all expenses for one patient can be submitted on the same claim form.
     
  • Member Authorization to Release Information *
* Return to the Office of Human Resources for processing

Health - Medical Expense Reimbursement Plan
Prescription Drug Plan: Medco Health Save More on Your Prescriptions - LIST of Discount Rx Programs

Create Your On-Line Membership Account with Highmark Blue Shield

Your Health is in YOUR Hands... health information and support tools available at HBS website.

Get Connected - click on this link for instructions to guide you through the process of registering for an on-line membership account. Take advantage of a wealth of health information and support on-line tools