You are always free to use the medical providers of your choice. When seeking treatment within the U.S., however, you may reduce your out-of-pocket costs by visiting a provider within your preferred provider organization (PPO).

A PPO is an organized network of hundreds of thousands of qualified medical practitioners and well-recognized hospitals in the U.S.

Refer to the "Schedule of Benefits and Limits" in the Description of Coverage for your plan to determine your coinsurance responsibility for in-network and out-of-network payments within the U.S., if applicable.

Then visit our "Find a Doctor or Hospital" page to find U.S.-based providers within your PPO. Note that there is no PPO for traveling outside the U.S.

Many providers are willing to bill us directly, and we are happy to work directly with the provider. The provider should submit original itemized bills to WorldTrips. You, the patient, will still need to submit a completed Claimant's Statement and Authorization form to WorldTrips.

If the provider requires you to pay for medical treatment at the time of service, you will need to file a claim for reimbursement. When seeking treatment, please ensure that you provide your name in the same format as provided for your insurance policy. You can check your name format on your fulfillment documents, ID card, or in Member Portal. 

At the time of service, ask your medical provider for an itemized bill with the following information:

• Provider name and address
• Provider tax ID (if U.S.-based)
• Your name, date of birth, and certificate ID number
• Itemized charges
• DX (diagnosis) code and CPT (Current Procedural Terminology) code (these are the codes your physician's office uses to tell our claims examiners which procedures, diagnoses, and services you received during your visit)

Also request your receipt for the payment and your complete medical records from the visit. You will send the itemized bill, medical records, and receipt directly to us, along with a completed Claimant's Statement and Authorization form.

See the "How do I submit the Claimant's Statement and Authorization form?" Q&A below for submission options. You can also learn more about the claims process by reading "How to Submit a Claim: A Step-by-Step Guide to the Claims Process for Members."

Yes. We can define the benefits that are available within your coverage. However, we cannot pre-approve any treatment or guarantee payment in advance.

Our World Service Center offers emergency travel assistance services 24/7. Please contact us at 1-800-605-2282 and a representative will be available to assist you.

We also accept collect calls from anywhere in the world at 1-317-262-2132. Mention the country and area code you are calling from and a representative from the World Service Center at WorldTrips will assist you.

The Claimant's Statement and Authorization form is a document that we request when we receive a claim for a new medical condition or episode of care. Your submission of a thoroughly completed and signed Claimant's Statement and Authorization form provides us with information so that we can properly evaluate whether the claim is eligible under your policy.

This form also allows us to request medical records from your medical providers.

• The Claimant’s Statement and Authorization form is available on our Document Downloads page at https://www.worldtrips.com/downloads. Or you can simply click here to download the form.
  
  
• You can also fill out the form via DocuSign online in Member Portal at https://worldtrips.my.site.com/MemberPortal. (See step-by-step instructions on how to file a claim via Member Portal.)
  
  
• You can also contact us at 800-605-2282 to request a form by mail or fax.

You can complete and submit the Claimant's Statement and Authorization form (along with supporting documents) in one of the following ways:

• Via DocuSign within Member Portal (Most Efficient Approach)
• Go to Member Portal (formerly Client Zone / Student Zone) at worldtrips.my.site.com/MemberPortal.
• Log in to your account. If this is your first time using Member Portal, view instructions for registering your new account here.
  

   

  NOTE: If you already have a Client Zone / Student Zone account, you do not need to register for a Member Portal account. Simply log in to Member Portal using your Client Zone / Student Zone login details.

  
  
• Click "Claims and Appeals" in the main navigation menu.
• Click the “Submit New Claim Via DocuSign” button under the “Claimant’s Statement and Authorization Form” subheader in the “File a Claim” section and follow the instructions.

For more extensive step-by-step instructions, including screenshots, please see our “How to Submit a Claim” guide.

• Via Online Submit Claim Request Form
• Download the Claimant's Statement and Authorization form here.
• Complete and sign the form.
• Visit www.worldtrips.com/customer-service and select "Submit a claim or appeal for your Atlas Travel, Atlas Premium, StudentSecure, Atlas Group, or Atlas MultiTrip plan" under the "Actions” header.
• Click the "Submit Claim" button.
• Fill in the requested information on the Submit Claim Request Form and upload the form, along with additional documentation (medical records, receipts, invoices, etc.).
• Click "Submit."
  
  

• By Mail
• Download the Claimant's Statement and Authorization form here.
• Print, complete, and sign the form
• Mail to:

                WorldTrips

Claims Department

Box. No. 2005

Farmington Hills, MI 48333-2005

U.S.A.

WorldTrips is also happy to fax, e-mail, or mail the form(s) to you upon request.

No. You must complete, sign, and submit a Claimant's Statement and Authorization form along with proof of claim (itemized bills, payment receipts, medical records, police reports, etc.) for every incident or condition.

We require a completed Claimant’s Statement and Authorization form for each different condition or episode of care. Therefore, if you have completed a Claimant’s Statement and Authorization form for a particular episode of care, you do not need to resubmit.

However, if you received treatment for a different condition or episode of care, you will need to complete a new Claimant’s Statement and Authorization form.

The Authorization Form for Use and/or Disclosure of Protected Health Information (HIPAA form) gives WorldTrips permission to disclose and release protected health information (PHI) to anyone specified on the form.

If you wish for your PHI to be disclosed to a specific person, you must complete and sign the section of the Claimant's Statement and Authorization form labeled "Supplement D - Authorization Form for Use and/or Disclosure of Protected Health Information." If you already submitted the claim form and you did not complete this section, you can submit the HIPAA form separately in one of several ways (see the next Q&A for submission instructions).

If you are filing a claim on behalf of another person, you MUST submit this form – signed by the policyholder – in order to speak with us regarding any of the policyholder's PHI. Without this signed form, we may only disclose to you the status of the claim.

You may complete and submit the form to us in one of the following ways:

• Electronically via Member Portal
  • Go to Member Portal at worldtrips.my.site.com/MemberPortal. 
    
    
  • Log in to your account. If this is your first time using Member Portal, please click here to view instructions for registering your new account. 
    
    If you already have a Client Zone / Student Zone account, you do not need to register for a Member Portal account. Simply log in to Member Portal using your Client Zone / Student Zone login details.
    
    
  • Click "Claims and Appeals" in the main navigation menu. 
    

     

    If You See the Protected Health Information Authorization Page:

    • Because you selected that you are not the insured or the insured's legal guardian upon registering for Member Portal, you do not yet have access to the Claims and Appeals page.
      
      
    • Under the "Protected Health Information Authorization" header, enter the insured's email address and click the "Send Request" button.
      
      
    • The insured will receive an email with a link to complete, sign, and submit the HIPPA form via DocuSign. You will gain access to the Claims and Appeals page and will be able to see the status of any pending claims within 3-5 days of the date the policyholder completed and submitted the form.
    
    

     

    If You See the Claims and Appeals Page:

    • Click the "Fill Out and Submit Via DocuSign" button under the "Authorization Form for Use and/or Disclosure of Protected Health Information (HIPPA)" subheader in the "File a Claim" section.
      
      
    • Enter the insured's name and an email address and click the "Begin Signing" button.
      
      
    • Click the yellow "Continue" button, fill out the form and the required information (as noted by the red boxes), have the policyholder sign the form, and click the yellow "Finish" button.
      
      
    • Clicking "Finish" submits the document and sends a PDF of your signed Authorization Form for Use and/or Disclosure of Protected Health Information to the email address entered. Download or print a copy of your completed form for your records. If you do not receive a confirmation email with your completed form attached within 24 hours, please contact WorldTrips to make sure your form was properly submitted.



• Via Online Submit Claim Request Form
  
  
  • Download the Authorization Form for Use and/or Disclosure of Protected Health Information. 
    
    
  • Complete the form and have the policyholder sign the form. 
    
    
  • Visit www.worldtrips.com/customer-service and select "Submit a claim or appeal for your Atlas Travel, Atlas Premium, StudentSecure, Atlas Group, or Atlas MultiTrip plan" under the "Actions" header. 
    
    
  • Click the "Submit Claim" button. 
    
    
  • Fill in the requested information on the Submit Claim Request Form and upload the form. If you've already submitted the form and supporting documents, choose "Existing Claim." Otherwise, choose "New Claim" and submit the form along with your claim form and additional documentation (medical records, receipts, invoices, etc.). 
    
    
  • Click "Submit." 
    
    
• By Mail
  
  
  • Download the Authorization Form for Use and/or Disclosure of Protected Health Information. 
    
    
  • Print, complete, and have the policyholder sign the form. 
    
    
  • Mail to: 
    
         WorldTrips
         Claims Department
         Box. No. 2005
         Farmington Hills, MI 48333-2005
         U.S.A. 

WorldTrips is happy to fax, email, or mail the form(s) to you upon request. 

Once you have signed and submitted your Claimant's Statement and Authorization form, our claims examiners will review your information.

The initial review of your claim will determine whether it will be paid, denied, or if more information is needed to make a final decision. We may request more information from you or your medical providers before your claim is paid or denied.

Final processing time of your claim depends on multiple factors. However, you can assist us in reducing your claim pending time by ensuring that we receive all requested information quickly.

To check the status of a claim, please sign into your Member Portal account at https://worldtrips.my.site.com/MemberPortal.

Then follow these steps (or see the “How to View Your Claim Status Via Member Portal” section of our “How to Submit a Claim” guide for more detailed instructions including screenshots):

1. From your Member Portal home page, click “File or View Status of Claims” under the “How Can We Help You Today?” header. This will take you to the Claims and Appeals page. (You can also get there by clicking “Claims and Appeals” in the main navigation.)
   
   
2. Scroll down and find your claim(s) under the “Claims” header. You will be able to see your claim number, the date the claim was incurred, the claim status, and the relevant provider.
   
   
3. You will be able to see your claim number, the date the claim was incurred, the claim status, and the relevant provider. You can click “View Detail” under each completed step to see more information.

You may also email your inquiry to [email protected] or contact us at 800-605-2282.

While we may have received a completed Claimant’s Statement and Authorization form from you, we may be waiting on medical records from your providers. Each time we request additional information, you will receive a letter notifying you of what is being requested.

You may assist us with these requests by contacting the medical provider to request that the medical records be expedited to us.

The EOB is not a bill. Rather, it is an explanation of how your claim has been processed.

For each claim we receive, we will send you an acknowledgement letter notifying you that we have received your claim. The acknowledgement letter will also notify you of any additional information that we need or information that is still outstanding from a prior request.

Additionally, each time we request information from you or your medical providers, we will send you a letter to notify you of the request.

There may be situations when you choose to appeal how a claim was processed. You may appeal your claim decision using one of the following methods:

• Submit the Claimant Appeal Request Form Via DocuSign within Member Portal:
  
  1. Sign into Member Portal at https://worldtrips.my.site.com/MemberPortal. You will be presented with your Member Portal home page.
     
     
  2. Click “Claims and Appeals” in the main navigation menu at the top of the page. You will be presented with the Claims and Appeals page.
     
     
  3. Switch the toggle at the top of the page under the “Claims and Appeals” header from “Claims” to “Appeals.”
     
     
  4. To file an appeal via DocuSign, click the “Fill Out and Submit Via DocuSign” button under the “Claimant Appeal Request Form” subheader in the “File an Appeal” section.
     
     
  5. Enter your name and email address on the PowerForm Signer Information page and click the “Begin Signing” button.
     
     
  6. Click the yellow “Continue” button to the right.
     
     
  7. Fill in all the required information on the form (as indicated by the red text boxes) and sign everywhere a signature is required (as indicated by the yellow “Sign” boxes).
     
     
  8. Attach your supporting documents (medical records, receipts, itemized bills, etc.), if necessary, at the bottom righthand corner of the page via the yellow attachment boxes. If you have more than 3 attachments or exceed the 5MB attachment limit, see instructions for submitting additional documents here.
     
     
  9. When you are done, click the yellow “Finish” button at the bottom of the page. Clicking “Finish” submits your documents and sends a PDF of your signed Claimant Appeal Request Form to your email.
     
     
  10. Download or print a copy of your completed form for your records. If you do not receive a confirmation email with your completed form attached within 24 hours, please contact WorldTrips to make sure your form was properly submitted.
  
  

  Want more detailed instructions including screenshots? See the “Claimant Appeal Request Form Submitted Via DocuSign within Member Portal (Most Efficient Approach)” section of our “How to Submit a Claim” guide.

   

• Submit the Claimant Appeal Request Form Via WorldTrips.com
  
  
  1. Visit worldtrips.com/customer-service.
     
     
  2. Select “Submit a claim or appeal for your Atlas Travel, Atlas Premium, StudentSecure, Atlas Group, or Atlas MultiTrip plan” under the “Actions” header.
     
     
  3. Click “Submit Appeal.”
     
     
  4. Fill in the requested information on the Claimant Appeal Request Form and upload additional documentation that supports your reasoning and position (medical records, receipts, itemized bills, etc.).
     
     
  5. Click "Submit."

   

• Submit the Claimant Appeal Request Form Via Email or Mail
  
  
  1. Download the Claimant Appeal Request Form here.
     
     
  2. Fill out the form and email it, along with additional documentation that supports your reasoning and position (medical records, receipts, itemized bills, etc.), to [email protected].
     
     OR
     
     

     Mail the form and supporting documents to:

     WorldTrips Appeals
     Box No. 2058
     Farmington Hills, MI 48333-2005
     U.S.A

      

• Submit a Written Appeal Letter Via Email or Mail

1. Write a letter of appeal following the appeal procedure instructions outlined in your policy documents/certificate of coverage.
   
   
2. Email this written letter of appeal, along with additional documentation that supports your reasoning and position (medical records, receipts, etc.), to [email protected].
   
   OR
   
   

   Mail the form and supporting documents to:

   WorldTrips Appeals
   Box No. 2058
   Farmington Hills, MI 48333-2005
   U.S.A

    

   
   

   IMPORTANT! In order for our claims department to review the appeal, you must provide additional documentation or information to support a reversal of the denial.

   Please note that submission of the appeal will lead to re-evaluation of your claim but does not guarantee that the initial benefit determination will be altered.

Our policies are not subject to the Patient Protection Affordable Care Act. They do not contain many of the coverages required by PPACA and may contain a pre-existing condition exclusion.