more subrogation

[http://dummy.us.eu.org/robert (Robert)]

Here we go again...

 > From:	Macrosoft Subrogation Claims [http://www.PREMERABLUECROSS.com/~MacrosoftSubrogationClaims]
 > Sent:	Friday, August 07, 2009 12:50 PM
 > To:	Robert (TELL_ME)
 > Subject:, Robert / Please help us determine if recent medical claims resulted from an accident
 > 
 > Hi,
 > 
 > We have received your claim from Drew Sullivan for date of service
 > 07/20/09.  This claim was billed with a diagnosis that indicates it
 > may be related to an accident or injury.
 > 
 > Macrosoft has requested that Premera Blue Cross provide additional
 > review of medical claims that may be the result of an injury.  In
 > many cases, when a Macrosoft employee or family member is injured or
 > is hurt in an accident, a third party or insurance company is liable
 > for the medical bills.  This process is called subrogation and is an
 > industry standard tool to ensure that the appropriate insurance makes
 > payment for the claims.
 > 
 > In order to proceed with the processing of the healthcare claim(s),
 > we need your assistance in answering the questions below.  When we
 > receive the response, we will process the claim(s) within 15 days.
 > If you do not reply to these questions within 45 days, we are
 > obligated to deny payment for all related claims.
 > 
 > Thank you in advance for providing answers to the following questions:
 > 
 > 1.         Briefly describe how the injury and/or condition occurred.
 > 
 > 2.         Please indicate the date and time that the injury and/or
 > condition occurred.
 > 
 > 3.         Please identify all injuries and/or conditions sustained.
 > 
 > 4.         If any other family member was involved in this incident, please
 > identify any injuries and/or conditions they sustained.
 > 
 > 5.         Please indicate the address/location where the injury and/or
 > condition occurred.
 > 
 > 6.         Do you own or rent this property?
 > 
 > If no, have you filed or do you intend to file a claim with the homeowner's
 > insurance policy?
 > 
 > If you intend to pursue a homeowner's claim, please answer these additional
 > questions:
 > 
 >             a.         Name of homeowner:
 > 
 > b.         Name, address and phone number of the homeowner's insurance
 > company:
 > 
 >             c.         Claim or policy number:
 > 
 > 7.         If this injury took place at a public facility (e.g., business,
 > church, etc.) please provide the name and phone number of this facility.
 > Please indicate whether anyone from the facility was aware of the incident at
 > the time it took place and whether an incident report was completed.
 > 
 > 8.         Is another party responsible for this accident?
 > 
 > a.         If yes, will you pursue a liability claim (e.g., Motor Vehicle
 > Accident, Medical Malpractice, Slip and Fall, Product Liability,
 > Home/Business, etc.) against that party?
 > 
 > b.         If yes, please provide the other insurance carrier and/or
 > responsible entity's name, address, phone number and claim number.
 > 
 > 9.         Did the injury occur in, on or near a motor vehicle?
 > 
 > a.         If yes, regardless of fault or your vehicle's involvement, please
 > provide your auto insurance carrier's name, address, phone number and claim
 > number.
 > 
 > b.         If you do not carry Personal Injury Protection (PIP) or Medpay
 > coverage, please provide your auto policy number and phone number of your
 > agent or claims office as we are required to confirm.
 > 
 > 10.       If you have an attorney representing you in this matter, please
 > provide their name, address and phone number.
 > 
 > 11 .       Is there any additional information or detail regarding this claim
 > and circumstances you would like to provide?
 > 
 > Please reply to this e-mail at your earliest convenience.  If you prefer, you
 > may fax your response to 425-918-5231 or mail to Premera Blue Cross, box
 > 327, MS 139, Seattle, WA  98111-0327.
 > 
 > Should you have any questions, please feel free to contact
 > http://www.PREMERABLUECROSS.com/~MacrosoftSubrogationClaims
 > <http://www.PREMERABLUECROSS.com/~MacrosoftSubrogationClaims>  or our Macrosoft-dedicated
 > customer service team at 800-676-1411.
 > 
 > Thank you,
 > Linda Barton
 > Premera Claims Coordinator