FOR PROVIDERS

The following information will help you file claims on behalf of your clients who participate in the American Red Cross Emotional Support Program for Survivors of the 2005 Hurricanes. Keep in mind that deadline to enroll in the program was May 31, 2008 5pm (CT). The program is now closed to new referrals.

Any licensed provider or facility is eligible to provide services and submit claims to the Emotional Support Program. Enrollment in a network of providers is not required to receive reimbursement from the Program. The Emotional Support Program recommends that participants work with their existing insurance to find a provider and the Program will cover out of pocket expenses for things such as co-payments, deductibles and related out-of-pocket expenses.

1. Important Information and Instruction for Submitting Claims
2. How to Submit a Claim
3. Claim Payment Request Form
4. Fee Schedule
5. Information for Mental Health Providers

For outpatient and medication invoices, claims should be mailed to:

More detailed claim submission instructions are also included in the document "Important Information and Instruction for Submitting Claims."

For general benefit inquiries contact us at (866) 762-0756. If you have additional questions about billing or reimbursement, please contact QualCare at 1-800-515-8939.

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