How to file a RedBridge claim

Ensure Your Medical Event is Covered

Whether you are involved in an unplanned accident, a scheduled surgery, or a treatment plan, precertification is required with Redbridge. The reasons for precertification are:

• To notify the insurance provider of a future medical event or emergency.
• To have the insurance provider verify that the procedure or treatment will be covered under your benefits, and not denied due to exclusions on your policy.
• To ensure the medical costs are within the UCR (Usual, Customary, Reasonable) costs of your country of residence.
• To set up a direct pay arrangement with the hospital for your procedure once the deductible has been met.

When do you precertify? When any of the following events take place:

• All overnight hospital admissions.
• All hospital or outpatient surgeries.
• Any major procedures: MRI, CT scan, PET scan, gastroscopies, colonoscopies, biopsies, etc.
• Physical/rehabilitative therapy, home health care or private nurse.
• Nasal surgery, cosmetic, reconstructive or bariatric.
• Emergency transportation via air ambulance.
• Implant or installation of durable medical equipment or a special medical device.
• Repatriation of mortal remains or local burial.
• If you aren’t sure your procedure needs to be precertified, it’s better to be safe than sorry: contact your broker.

Follow RedBridge’s instructions for precertification to avoid the 30% penalty fee:

• Medical Emergency: Must be reported within 48 hours of the event
• Scheduled and planned procedures: Precertification required at minimum 72 hours prior to the procedure; we suggest giving yourself at least a week to precertify as RB may request additional information, testing, etc.
• Travel Assistance: Precertification required within 24 hours of the event

What are your first steps to getting covered by your insurance?

Firstly, to make sure you’re fully covered when you need to have surgery, or when an accident happens that requires hospitalization, you must contact RedBridge or your broker to inform them that an emergency has occurred and you are heading to the hospital. You will find their contact info on your ID card in the Welcome Email from RedBridge. We suggest printing and laminating a copy to keep on hand at all times.

Next, when precertifying for planned surgery, test, or treatment, you must send in the precertification form, which will be filled out by your doctor, as well as any supporting documentation, at least 72 hours before it’s scheduled. Once they receive everything they need, the insurer can authorize a GOP (guarantee of payment) to the hospital. If the deductible hasn't been met, you will pay the remaining balance at the hospital. You can precertify up to a month before the event to ensure all documentation is sent in and the procedure will be covered.

Documents to submit for precertification for upcoming procedure:

• Fully completed precertification form - include claimant/patient name, date of service, treatment description, diagnosis, place of service, estimated cost of doctors and facility

• Medical reports or corresponding physician’s note that includes the date of onset of symptoms

• All diagnostic test reports

Lastly, once everything has been gathered, you will email it to service@redbridge.cc. Be sure to put your first and last name, and policy number in the subject line. In the email, specify which procedure or test you’ll be having as well as the scheduled date if applicable.

When an emergency occurs, the next steps are a little different. The hospital must be in contact with RedBridge as it is the hospital that will authorize the release of your records to determine coverage. Once it’s determined that the accident will be covered and if the hospital accepts it, RedBridge will issue a GOP, and you will have one less stressful thing to worry about while you recover. If the hospital does not accept a direct payment from RedBridge, which is their prerogative, you will be expected to pay out of pocket and file for reimbursement after the fact.

RedBridge will confirm the documents have been received and are being reviewed. Should they need anything else, they’ll communicate via email. As always, Expat Insurance is more than happy to answer your questions, and assist you in collecting documents.