What is the Geha International Claim Form Used For?

Definition of the Geha International Claim Form

The Geha International Claim Form, also known as the Member Claim Submission Form, is specifically designed for GEHA members who need to submit claims for medical expenses incurred while traveling outside the United States. This form is essential when healthcare providers do not file claims on behalf of the patient, ensuring that members can seek reimbursement for their out-of-pocket medical expenses. It serves as a formal request to GEHA for payment, detailing the services received and the associated costs.

How to Obtain the Geha International Claim Form

To obtain the Geha International Claim Form, members can visit the GEHA website where the form is available for download. The form is typically provided in a PDF format, allowing for easy access and printing. Members can also contact GEHA customer service at for assistance in acquiring the form or for any inquiries regarding the claims process.

Steps to Complete the Geha International Claim Form

Completing the Geha International Claim Form involves several key steps to ensure accurate submission and reimbursement:

• Download and print the form: Access the GEHA website to download the Member Claim Submission Form.
• Gather necessary documents: Collect an itemized bill or receipt from the healthcare provider, ensuring it includes detailed information about the services provided.
• Fill out the form: Provide essential details such as the patient’s name, GEHA ID number, dates of service, and the provider’s information.
• Attach supporting documents: Include the itemized bill and any necessary translations if the documents are not in English.
• Submit the form: Mail the completed form and attachments to the address specified by GEHA, ensuring to keep a copy for personal records.

Key Elements of the Geha International Claim Form

Understanding the key elements of the Geha International Claim Form is crucial for accurate completion. The form typically requires:

• Patient Information: Include the name of the patient and the subscriber, referencing the GEHA ID card.
• Dates of Care: Clearly state the dates on which medical services were received.
• Provider Information: Provide the name and address of the healthcare provider or facility.
• Diagnosis and Services: Describe the diagnosis and the specific services received during the visit.
• Monetary Exchange Rate: For claims related to international services, indicate the exchange rate applicable on the date of service.

Required Documents for Submission

When submitting the Geha International Claim Form, it is essential to include the following documents:

• Itemized Bill or Receipt: This should detail the services provided, including costs and dates.
• Translation of Documents: If the bill is not in English, a translation of key information must be provided.
• Proof of Payment: Attach any documentation that shows payment has been made for the services received.

Who Typically Uses the Geha International Claim Form

The Geha International Claim Form is primarily used by GEHA members who have incurred medical expenses while traveling abroad. This includes:

• Travelers: Members who seek medical care outside the U.S. for emergencies or planned procedures.
• Families: Families traveling together where one member may require medical attention.
• Individuals using Out-of-Network Providers: Members who receive care from providers that do not file claims directly with GEHA.

Legal Use of the Geha International Claim Form

The Geha International Claim Form must be used in compliance with GEHA's policies and guidelines. Members should ensure that:

• All information is accurate: Incorrect information can lead to delays or denials of claims.
• Submissions are timely: Claims should be submitted within the timeframe specified by GEHA to avoid penalties.
• Documentation is complete: Missing documents can result in the rejection of the claim.

Examples of Using the Geha International Claim Form

Real-world scenarios can illustrate the importance of the Geha International Claim Form:

• Emergency Medical Care: A member traveling in Europe requires urgent medical attention due to an accident. After receiving treatment, they complete the form to seek reimbursement for the hospital bill.
• Routine Check-up Abroad: A member visiting family in another country decides to have a routine check-up. They use the form to submit their expenses for reimbursement since the provider is not in-network.