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PEIA changes third-party claims administrator

PEIA changes third-party claims administrator

PEIA has a new third-party claims administrator, UMR.
PPB Plan policyholders should have recently received a UMR welcome packet in the mail, containing new ID cards.
The packets also contains important information for policyholders regarding how to view Explanation of Benefits (EOBs), how to sign up for the new member portal and much more.

On June 26, PEIA became aware of an issue with UMR's phone system not recognizing PEIA Policyholders' member ID numbers when trying to activate their cards.

Here's what policyholders need to know at this time:
  • New medical ID card will work on July 1, whether or not the policyholder calls UMR.
  • The activation process is about collecting information about other health insurance employees and their covered dependents have. If a policyholder calls and activates their card, they will have to update their other insurance information, and their claims won't be pended for other insurance information while UMR sends a letter asking you questions. It's important, but not critical.
  • Policyholders can activate their card now by calling UMR and entering Social Security number instead of the medical ID number. Their system will recognize Social Security Number.
  • UMR has committed to having this programming problem resolved by Friday, June 28. Policyholders can call them on Friday (or after) enter ID number and follow the prompts to activate or can ignore the activation message and cards will work on 7/1, although some claims may be pended for Other Insurance Information once the plan year starts.
  • PEIA's Customer Service Unit cannot assist with this issue, since it's a contractor's programming problem.
To sign up for the new member portal, visit www.umr.com.
For additional information, visit PEIA's news center.