Benefits can only be paid on original accounts and receipts. All accounts must show:

• Date(s) of service
• Type of service
• Patient name
• Provider name and address on official letterhead
• Provider number

If your provider does not supply you with an account with all of the above details a benefit cannot be paid.

If claims are not made within two years of the date of service, benefits are not payable. We recommend that you submit all claims as soon as practicable after the service is provided,