Members FAQS
Answering Your Questions
FREQUENTLY ASKED QUESTIONS:
Why did I receive a letter asking about my medical treatment?
Your health plan contracted with (Vengroff Williams) us to review paid medical claims information and determine if another party may be financially responsible for resulting medical treatments. Your medical claims include certain treatment billing codes that may be related to an injury or accident, such as an accident involving a motor vehicle, a slip and fall, injury on the job, medical malpractice, or defective product.
Should I be concerned if I don’t recognize the provider’s name on the letter I received?
No. The provider listed in the letter you received could be someone other than your physician. For example, this person could be an emergency room physician or radiologist who cared for you during your Date of Treatment period listed on the letter.
Do I need to respond, even if my treatment was not related to an accident?
Yes. Confirming that your treatment was not related to an accident is important information for your health plan to know. Please complete SECTION A in the Questionnaire and submit.
What happens if I don’t respond?
We (Vengroff Williams) will continue to attempt to contact you as your health plan expects members to cooperate in resolving these questions. Your health plan may suspend benefits on future claims until these questions are resolved.
How did we (Vengroff Williams) obtain my medical claims information?
Your health plan has contracted with us to review medical claims that they have already paid. We are a third-party administrator the specializes in identifying where another party may be responsible to pay those claims. We (Vengroff Williams) is/are authorized to perform this service for the health plan, and complies with all legal requirements including the Health Insurance Portability and Accountability Act (HIPAA) and your health plan’s requirements for handling your protected health information (PHI).
What should I do if I experience a technology issue and cannot complete the questionnaire?
Please call the toll-free number listed on our website (see top bar) or on the questionnaire that was mailed to you. Our representatives are available Monday through Friday between 8:00AM and 5:00PM EST
Did I receive a phone call from Vengroff Williams because something is wrong?
Subrogation means that your health plan has paid for losses associated with your insurance claim. You’ve filed an insurance claim with your health plan and received the payment. There may be another party who is responsible for the burden of that claim, they’re called a “third party”. You’ve received a phone call from Vengroff Williams to help you figure this out.
What is Subrogation?
Subrogation means that your health plan has paid for losses associated with your insurance claim. You’ve filed an insurance claim with your health plan and received the payment. There may be another party who is responsible for the burden of that claim, they’re called a “third party”. You’ve received a phone call from Vengroff Williams to help you figure this out.
