FILE A CLAIM INSTRUCTIONS

Please send claims to the following address:

 

Mail to:  Administrative Concepts Inc.

                PO Box 4000

                Collegeville, PA 19426-9000

 

Fax#: 610-293-9299

 

EDI Payor ID#: 22384

For Accident Claims:

• Download the appropriate Claim Form from the Forms button
• Fill out all sections of the Form
• If the Form requires, have the Form signed by the appropriate Group Representative
• Attach the Claim Form and Proof of Payment (described below) with your bills
• Submit to the above address

Helpful information for submitting claims and expediting payment:

• Complete Claim Information - ACI suggests providers submit standardized billing statements ("UB-04") for hospital charges and "CMS-1500" for Physician Charges)
• Proof of Payment - Check copy of payment, Cash Receipt, or Credit Card Statement
• Payment to Medical Providers - Unless Proof of Payment is submitted with the medical bill claim payment is sent directly to the medical providers
• Other Insurance - If a primary insurance carrier paid a portion of your claims, include the Explanation of Benefits (EOBs) with your claim submission
• Accident Claims - Follow the instructions above

Need Assistance?

Any questions regarding benefits available under your Policy or you need guidance in how to submit your claim, please…

Call us at: 888-293-9229
Or Email us at: aciclaims@acitpa.com

Hours of Operation: 8am – 8pm EST, Monday through Friday