UB-92 for Hospitals or HCFA 1500 All other providers
Claim forms should be mailed to:
Infinity Administrators, Inc.
P.O. Box 270
Baldwinsville, NY 13027
There is a $5.00 fee charged to claims submitted without proper HCFA forms
Bills submitted on a prescription form or note pad will not be accepted
ENROLLING IN OUR NETWORKS
Gentlemen please enroll me in your network,
Please complete the information below when completed click on the submit button
Name:
Corp. Name:
Address:
City:
State:
Zip:
Telephone:
Fax:
E-mail:
Speciality:
Hospital affiliations:
Federal ID Number:
Medical Degree Year:
School Name:
Number of malpractice claims in the past
five years:
Malpractice carrier:
Policy number:
Send a copy of your license to practice and a copy of the face page of your malpractice coverage to:
Infinity Administrators, Inc.
American Physicians Information Network
P.O Box 979
Plainview, NY 11803
LOOKING FOR BENEFIT INFORMATION
HEALTH - FLEX + AND HEALTH - FLEX PLUS
These high deductible medical plans are designed to work well with
Flex Spending Accounts (FSA)
Health Savings Accounts (HSA)
Health Reimbursement Accounts (HRA)
Or stand alone
Hospital services are covered for a full 365 days
Physicians,
diagnostic tests, medications, etc are covered subject to the level of
deductible selected. Most participants have very high deductibles.
When
you file your claim we will reprice it as any other claim. Both you and
your patient will receive an explanation of benefits(EOB) describing
the amount due to the provider, amount that will be paid by the
insurer, and the amount to be paid by the patient
If
the patient has a reimbursement account they will be reimbursed after
proof that you have been paid. If they have an FSA or HSA and have
authorized direct payment we will pay you along with the EOB.
Have a question: 9-4 (EST) 631-424-2400
LOOKING FOR CLAIM INFORMATION ON FILED CLAIMS
If you request information here we will e-mail an answer back to you usually next business day
