Following are important points you need to know when filing a claim for benefits with the Sheet Metal Workers' Local 73 Welfare Fund Office:

1. All doctors and hospitals, even non-PPO doctors and hospitals, must submit claims directly to BlueCross BlueShield in order for the Welfare Fund Office to process their claim.
   
   
2. Be sure to show your I.D. card to providers to avoid any delay in claims processing.
   
   
3. Your provider should DIRECTLY bill BlueCross BlueShield for payment. AFTER your provider is paid, the provider will bill you the balance, if any.
   
   
4. If additional information is required to process your claim, the Welfare Fund Office will forward a written request to you. Please attach the requested information to the letter and return this to the Welfare Fund Office to insure prompt processing of your claim.
   
   
5. For all claims that need to be submitted directly to the Welfare Fund Office, you must submit a completed claim form provided by the Welfare Fund Office (also on the website under Welfare Forms), along with an itemized bill for services rendered.
   
   
6. To request a claim form, call or write to the Sheet Metal Workers' Local 73 Welfare Fund Office:
   Sheet Metal Workers' Local 73 Welfare Fund
   4530 Roosevelt Road
   Hillside, Illinois 60162
   708.449.7373
   Or download a form on this site under Welfare Forms
   
   
7. Submit all claims (other than prescription drug claims or provider claims submitted to BlueCross BlueShield directly) to the Welfare Fund Office at the above address. You must meet certain deadlines when filing your claims for benefits or when filing an appeal for a denial of benefits. These deadlines differ, depending on whether you are filing your initial claim or filing an appeal. You generally do not need to file claims for prescription drugs or PPO provider claims. You should contact the Welfare Fund Office for more detailed information about claims and appeals procedures.
   
   
8. If your claim is denied, you have the right to appeal within a limited time period. These deadlines differ, depending on the type of appeal. For more detailed information on claims and appeals procedures, contact the Welfare Fund Office or refer to the back of your Explanation of Benefits form.
   
   
9. Prescription drug benefits are available through the Caremark Retail Program and the Caremark Mail Order Service Program. Under these programs, you do not need to file claims for benefits.
   
   
   When you fill your prescription at a Caremark Retail Program Pharmacy, just show your prescription drug identification (I.D.) card and pay the applicable co-payment. When ordering prescriptions through the Caremark Mail Order Service Program, you simply complete a mail order form and pay the applicable co-payment.
   
   If you fill your prescription at a non-participating network pharmacy, you will be required to pay for the entire cost of the medication up front. You must then complete a Caremark Claim Form and submit the original prescription receipt to the Caremark Claims Department for reimbursement at the negotiated pharmacy rate less the appropriate co-payment. You may obtain a Caremark Claim Form by contacting Caremark at 1.800.776.1465, visiting their website at www.caremark.com or calling the Welfare Fund Office.