WorldTrips claims: Atlas filing, deadlines and appeals

Before care: the network

• WorldTrips’ ID card guide says UnitedHealthcare (UHC) is the provider network for your plan, and that you may use any provider outside the United States. [4]
• The Atlas Travel sample description of coverage says a PPO provider’s billed charges for eligible expenses may be reduced and WorldTrips pays the provider directly. For help finding a provider, it gives +1 800 605 2282. [5]

At the provider

• Inside the United States with an in network provider, present your WorldTrips ID card and the provider bills WorldTrips directly. You may still be asked to complete the Claimant’s Statement and Authorization form. [1]
• Inside the United States but out of network, or outside the United States, expect to pay at the time of service. Collect an itemized bill with diagnosis and procedure (DX and CPT) codes, medical records and your receipt. [1]

Filing the claim

• Online: log in to the Member Portal, open Claims and Appeals and select Submit New Claim via DocuSign. Upload medical records, itemized bills and receipts, and use Submit Additional Supporting Documents to add more later. [1]WorldTrips Member Portal
• By mail: print, complete and sign the Claimant’s Statement and Authorization form and send it to WorldTrips Claims Department, PO Box 240358, Apple Valley, MN 55124, U.S.A. WorldTrips can also fax, email or mail you the form on request. [2]Claimant’s Statement and Authorization form (PDF)
• For electronic reimbursement, complete Supplement B, the Payment Authorization Agreement, inside the claim form. Without it, reimbursement goes by paper check to the name and address on file for U.S. and Canadian residents. [1]
• If you file for someone else, the policyholder must sign Supplement D, the authorization for use and disclosure of protected health information. Without it WorldTrips can share only basic status updates. [1]
• Students must include a copy of an education related visa (F1, J1, OPT) or a valid I20 or DS2019, plus proof of full time student status unless submitting a valid F1 or J1 visa. [1]

Deadlines

WorldTrips publishes two different time limits. Plan around the earlier one and follow your own policy document.

• The claims resource center asks you to report the incident within 30 days or as soon as reasonably possible, and to submit all required documents within 90 days of the date of loss, unless that is not reasonably possible. [1]
• The Atlas Travel sample description of coverage says WorldTrips must receive proof of claim within 60 days of the last day of your certificate period, or within 60 days of the date incurred for claims during a benefit period. [5]
• If WorldTrips asks you or a provider for more information and gets no response within 45 days, the claim may be closed. [1]

If you disagree with a decision

• If an Explanation of Benefits says your claim was closed for missing documents, you do not need to appeal. Upload the requested documents in the Member Portal and the claim is reopened for review. [1]
• To appeal a denial, open Claims and Appeals in the Member Portal, select Appeals and Start an Appeal, then enter your claim number, a written explanation and supporting documents. Or mail it to WorldTrips Appeals Department, P.O. Box 241778, Apple Valley, MN 55124 U.S.A. [1]Claimant appeal request form (PDF)
• WorldTrips says appeals typically take about 60 days and the outcome arrives by email. [1]
• The Atlas Travel sample description of coverage requires a written appeal within 90 days of the later of the denial date or the policy termination date, and allows a second appeal reviewed by staff not involved in the first decision. [5]