Other Insurances FAQ
For many of the benefits provided under our insurance products, you are required to seek Pre-Authorization from WellAway®. Pre-Authorization is a process by which an insured person obtains approval for: (i) certain non-emergency medical procedures prior to the commencement of the proposed procedure and prior to incurring costs or undertaking any medical treatment; or (ii) before being admitted to a hospital (except in an emergency situation, in which event WellAway® must be informed within 48 hours). Please refer to your policy for a list of services that require Pre-Authorization.
Pre-Authorization may be undertaken by: an insured person, the medical practitioner, or the hospital administrator; subject to all information being available and verifiable and must be obtained at least 5 business days prior to the scheduled procedure date. Some procedures may require longer than 5 business days for Pre-Authorization to be provided.
Your policy wording contains important terms, conditions, and instructions on Pre-Authorization. Please ensure you carefully adhere to these requirements. Failure to follow Pre-Authorization procedures will result in the assessment of a 50% penalty on the entire episode of care, may invalidate your claim or, in certain circumstances, result in a loss or reduction of cover.
What is my Excess?
Any excess or deductibles will be stated in your specific policy. This must be satisfied before we can pay eligible claims. For example, if your excess is £100.00 and your eligible claim is £200.00 we will reimburse you £100.00.
How do I submit a claim (outside the US?
You must submit a complete claim directly to the Plan Administrator (PayerFusion Holdings, LLC) within the time period specified in your chosen policy. The claim form is available on WellAway’s member portal at www.wellaway.com or you may request the claim form by contacting a WellAway® ConciergeCare Counselor. All claim forms must be accompanied with the following:
- Patient’s name
- Physician’s specialty
- Detailed description of the service rendered (office visits, surgery, etc.)
- Original itemized invoices with fees on physician/hospital letterhead. Invoice must include patient’s full name, date of birth, diagnosis (type of Illness), date of the visit, treatment type, physician’s charges and acceptable proof of payment (credit card receipt)
- Prescription medications must clearly provide the name of the patient, the price of the drug, and prescription quantity. Copy of the physician’s script is required
- In the case of hospitalization, you must attach the hospital medical notes or reports, and our Pre-Authorization provided to you. Please ensure that your invoice details the cost of private or semi-private room
- Type of currency
Claims may be submitted via e-mail to firstname.lastname@example.org, courier, or by postal service.
Mail your completed claim documents to:
WellAway® Limited c/o PayerFusion Holdings, LLC
5200 Blue Lagoon Drive, Suite 100
Miami FL 33126
Copies of claims are accepted; however, WellAway® reserves the right to request original documents at its discretion. WellAway® encourages its members to keep copies of the invoices for their records.
How do I get help with my claim?
Assistance is available from us or WellAway® at the contact information set forth below:
WellAway® ConciergeCare Counselor:
Telephone: +1 855 773 7810
How will you pay my eligible claims?
WellAway® will reimburse the member in accordance with the terms and conditions of the member’s Policy. Please refer to your Policy for the specific time frames required to submit a claim. If WellAway® does not receive your completed claim within the time frame stated in your Policy, your claim may be denied.