TL;DR
• Healthcare claims are formal requests submitted by healthcare providers or members to insurance companies for reimbursement of medical expenses.
• If you use GoodRx, CostPlusDrugs, GoodRx Care, or other healthcare services (which we encourage 🙂), you need to submit a claim to get potential coverage and reimbursement.
• If you use HealthSmart or SmithRx, there is no need to submit a claim. Yuzu will handle it for you!
What are claims?
• Healthcare claims are formal requests that provider and/or patients (you) submit to Yuzu Health for reimbursement of eligible healthcare expenses.
• Claims allow you to seek financial coverage for medical treatments, prescriptions, or other qualified healthcare services you receive.
How to use claims
Depending on the type of care you receive, the process for healthcare claims may vary, as detailed here:
For HealthSmart & PHCS visits and SmithRx prescriptions:
• You don't need to worry about submitting claims
• These providers are already part of our network, and we handle the reimbursement process for you
• No additional steps required!
For non-HealthSmart, PHCS, and SmithRx care: (i.e. GoodRx Telehealth visits, Cost Plus Drugs and GoodRx prescriptions, and other care locations in which you pay cash for care)
• To seek reimbursement, you will need to follow these steps:
• pay for the healthcare service or expense upfront
• keep the itemized receipt or invoice you receive from the provider
• await reimbursement, typically occurs in a matter of days
Receiving reimbursement
Once your healthcare claim is submitted, Yuzu Health will review it and determine the eligible reimbursement amount based on your plan's coverage and any applicable deductibles or co-pays.
If and when approved, Yuzu will send you reimbursement in the form of a check.
Reminder
Again, what you have to do regarding claims differs based on where you receive care, as detailed below:
• Care through HealthSmart, PHCS, or SmithRx: we'll take care of the reimbursement process for you
• Care through GoodRx Care, CostPlusDrugs, GoodRx Drug Savings, or other “full access” care locations: you'll need to follow the steps outlined above to initiate reimbursement
Contact us
If you have questions, call us at 203-208-9898 or email us at support@yuzu.health. We respond ASAP, in most cases within minutes.
