Register for Camp

Archives

File a Medical Claim – The College of New Jersey

Submit a Claim by Mail


It’s easy! Just download the claim form below. Fill out the first page with your personal information, dates of injury or sickness, the cause of the injury or date of first symptoms for a sickness, sign your name with today’s date, and attach all receipts. Please fill out the entire first page and be sure not to leave anything blank.

Your doctor will need to fill out the second page of the form.

Mail Claim Forms to:
FIRSTSTUDENT
P.O. Box 809025
Dallas, TX 75380-9025

Medical Claim Form

Submit a Claim Electronically

Your Doctor can also submit a claim electronically using Emedeon (formerly WebMD). This gives a faster turn-around time than submitting a claim by mail. Check with your doctor to see if they are a participant. If they are, show them your ID Card. The Emedeon information is printed on the back of every ID Card.

If you have any problems filling-out these forms or would like to talk to a customer service representative, you can call us toll free at: 1-800-505-4160 or CONTACT US

File an Appeal – Thomas Jefferson University

To file an appeal, please include the following information:

  1.  A letter requesting an appeal to your claim(s), including your:
    • Name,
    • Address,
    • Phone number,
    • UnitedHealthcare Student ID number,
    • Date of service for your injury/sickness,
    • Claim number(s) (located on the top of your Explanation of Benefits), and
    • Email address.
  2. A copy of your Explanation of Benefits for the claim(s) in question.
  3. Medical Records including all test results from all providers visited for the specific injury/sickness that you are appealing.

Once we receive the documentation, your appeal will be reviewed and a written response will be mailed to you. The response will include what the findings were, if the appeal was approved or denied, and the reason for the final decision.

If you have a question about your claim denial, you may call our Customer Service Department at telephone number 1-800-505-4160 for further explanation to informally resolve your appeal. If you are not satisfied with our explanation of why the claim was denied, you or your authorized representative may request an internal review of the claim denial. (For more information about an authorized representative, please click on “forms” on the left.)

Check Claim Status – Thomas Jefferson University

If you are a student and would like to check on the status of a claim that you or a provider submitted to UnitedHealthcare, you will need to set up a My Account if you have not already done so.

Please visit our My Account center to log in to an existing account or to create a new one.

File a Medical Claim – Thomas Jefferson University


Fatal error: Uncaught TypeError: Cannot access offset of type string on string in D:\SR\WebSites\uhcsrinternational\wp-content\themes\uhc\functions.php:1265 Stack trace: #0 D:\SR\WebSites\uhcsrinternational\wp-includes\shortcodes.php(355): enroll_now_button_shortcode() #1 [internal function]: do_shortcode_tag() #2 D:\SR\WebSites\uhcsrinternational\wp-includes\shortcodes.php(227): preg_replace_callback() #3 D:\SR\WebSites\uhcsrinternational\wp-includes\class-wp-hook.php(308): do_shortcode() #4 D:\SR\WebSites\uhcsrinternational\wp-includes\plugin.php(205): WP_Hook->apply_filters() #5 D:\SR\WebSites\uhcsrinternational\wp-includes\post-template.php(255): apply_filters() #6 D:\SR\WebSites\uhcsrinternational\wp-content\themes\uhc\content.php(62): the_content() #7 D:\SR\WebSites\uhcsrinternational\wp-includes\template.php(785): require('...') #8 D:\SR\WebSites\uhcsrinternational\wp-includes\template.php(718): load_template() #9 D:\SR\WebSites\uhcsrinternational\wp-includes\general-template.php(204): locate_template() #10 D:\SR\WebSites\uhcsrinternational\wp-content\themes\uhc\archive.php(59): get_template_part() #11 D:\SR\WebSites\uhcsrinternational\wp-includes\template-loader.php(106): include('...') #12 D:\SR\WebSites\uhcsrinternational\wp-blog-header.php(19): require_once('...') #13 D:\SR\WebSites\uhcsrinternational\index.php(17): require('...') #14 {main} thrown in D:\SR\WebSites\uhcsrinternational\wp-content\themes\uhc\functions.php on line 1265