Each POMCO enrollee possesses a POMCO identification card that should be presented by the patient at the time of their visit. This card carries important information for billing, such as the enrollee's plan code, identification number and co-payment amount. Inquire if the patient has other health insurance, so you are aware of dual coverage and coordination of benefits situations. A separate claim form must be submitted for each patient. Services related to Worker's Compensation or No Fault should be forwarded to POMCO only if either carrier has exhausted or denied benefits.

A copy of the written denial from the carrier must accompany the claim. If the service involves the potential of a third party lawsuit, the client benefit plan may require the patient to provide additional detail, prior to considering the services for benefits under the individual health plan. All claims must contain the enrollee's ID number, plan code, service dates, itemized charges with current CPT codes, place of service, name of actual provider rendering care, provider's tax ID number and any other pertinent information necessary for claim consideration. If the claim is related to an injury, please provide details.