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FUND NEWS IS YOUR NEWS
By: Arthur J. Orzano, Administrator
 

 HOW TO OBTAIN REIMBURSEMENTS FOR YOUR
OUT-OF-NETWORK VISION, DENTAL, AND PHARMACY PLANS


 

Attention all eligible members and dependents currently enrolled in the Insurance Trust Fund vision, dental, and pharmacy benefit plans:
The following information is to assist you in obtaining reimbursement for any out of network claims you may incur. Please keep in mind that if you use an in-network provider, then none of the following steps are necessary.


VISION
Vision Plan (annual eye exam, glasses or contact lenses):


Your vision plan is administered by the Comprehensive Professional Systems, Inc. (CPS) eye care/vision network with an increased benefit
annual limit to $150 effective January 1, 2017. CPS has partnered with another large vision network, which will greatly improve accessibility to
providers in outlying areas such as upstate New York and Connecticut. To obtain a listing of “IN-NETWORK” Vision providers, please visit: www.cpsoptical.com or call CPS Customer Service at 212-675-5745.


If you choose to use an “OUT-OF-NETWORK” provider, you may get reimbursement from CPS directly by completing a CPS Optical-NOITU Out-of-Network Claim Form by using the steps below as a guide:
    • Contact CPS Customer Service to get a copy of the Reimbursement form.
    • Submit 2016 optical claims to NOITU and for 2017 and future claims to CPS.
       - Enter your NTU ID# and all the other required information in the “Patient Info” space. NOTE-CPS is unable to process your refund if this information is missing.
       - If you do not have your NTU ID#, please contact NOITU Member Services at 718-291-3434 (Option #3).
       - Attach your itemized receipt[s] to the CPS reimbursement form.
    • Mail completed CPS Vision claim form to:

          COMPREHENSIVE PROFESSIONAL SYSTEMS INC.
          11 HANOVER SQUARE, 8TH FLOOR
          NEW YORK, NY 10005


DENTAL
NEW Empire Dental Plan: Dental XPO administered by Empire Blue Cross Blue Shield:


Effective January 1, 2017, your new dental benefits are administered by Empire Blue Cross Blue Shield (BCBS) (Your previous Dental Plan, HealthPlex, was terminated on 12/31/2016). You should have received your new dental cards in the mail back in December 2016 and the document that describes your new dental benefits in detail in February 2017. If not, please contact NOITU Member Services at 718-291-3434 (Option #3).


To obtain a listing of “IN-NETWORK” Dental providers, please visit:
www.empireblue.com/findadoctor or call Empire Dental customer service at 1-844-852-1553 Monday through Friday 9:00am to 5:30pm.


If you choose to use an “OUT-OF-NETWORK” dentist, you may get reimbursed by using the steps below as a guide:
   PLEASE NOTE:
NOT PERFORMING THESE SIMPLE STEPS CAN DELAY REIMBURSEMENTS:
        • Ask your dentist to complete an ADA Dental claim form or provide an itemized receipt.
        • If your dentist has completed an ADA Dental Claim Form, please complete the following sections of the form:
            - The “AUTHORIZATIONS” Box on the dental claim form, so BCBS know where to send the payment. With your permission, BCBS can send payments to you or the dentist.
             - Have the dentist complete the “Record of Services Provided” and “Ancillary claim/ treatment” section on the form.


                                          Mail the completed claim form or itemized receipt or both to:
                                          EMPIRE BLUE CROSS BLUE SHIELD DENTAL BENEFITS PROGRAM
                                          PO BOX 810
                                          MINNEAPOLIS, MN 55440-0810


For claim status, you may visit www.empireblue.com or go to URL: mydentalapps.com/empiremember


PRESCRIPTION DRUGS
Your prescriptions/drugs carrier is CVS/Caremark. For more information, visit: www.caremark.com or call CVS/Caremark Customer Care representative toll-free number at 1-888-202-1654. Present the CVS/Caremark Prescription Card to fill your prescription at any participating retail pharmacy.


If you have paid for your prescription in full, you may be eligible for a reimbursement from CVS by using the steps
below as a guide.


FOR REIMBURSEMENT OF PRESCRIPTION DRUGS COVERED UNDER THE PLAN, PLEASE DO THE FOLLOWING:
      • Request a CVS reimbursement form by calling CVS Customer service at 1-888-202-1654, contacting NOITU or go to
www.caremark.com/wps/portal.
      • Once you receive the form, follow the mailing instructions on the back of the CVS/Caremark Prescription Reimbursement Claim Form.
      • Enter the
RXBIN# 004336 located on the front of your CVS/Caremark Prescription ID Card.
      • Mail the completed form to:
CVS CAREMARK
                                                     PO BOX 52136,
                                                     PHOENIX, AZ 85072-2136


We hope the above information is helpful to you. If you have any questions and need further assistance, please contact the NOITU Insurance Trust Fund, Member Services Department at 718-291-3434 (Option #3).

 



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