Common use of Bills for Emergency Services Clause in Contracts

Bills for Emergency Services. If you receive a bill from a hospital, physician or ancillary provider for emergency Services that were provided to you, simply mail a copy of the bill to us with your medical record number written on it. Your medical record number can be found on the front of your Xxxxxx Permanente identification card. Please mail your proof to us within one (1) year at the following address: Xxxxxx Permanente National Claims Administration - Mid-Atlantic States PO Box 371860 Denver, CO 80237-9998

Bills for Emergency Services. If you receive a bill from a hospital, physician or ancillary provider for emergency Services that were provided to you, simply mail proof of payment and a copy of the bill to us with your medical record number written on it. Your medical record number can be found on the front of your Xxxxxx Permanente identification card. Please mail or fax your proof to us within one (1) year at the following address: Xxxxxx Permanente National Claims Administration - Mid-Atlantic States PO Box 371860 Denver, CO 8023700000-99980000 Fax: 0-000-000-0000