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Claim Procedures - Southern Administrators and Benefits

Claim Procedures - Southern Administrators and Benefits 2026

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The document provides instructions for submitting claims for reimbursement under the Montana University System's Take Control program. It outlines the necessary information required from the claimant, including personal details and insurance information, as well as specific types of reimbursable items that must be pre-authorized by a health coach. The document also details how to submit receipts and where to send the completed claim form.

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Click ‘Get Form’ to open the Claim Procedures - Southern Administrators and Benefits in the editor.
Begin by entering your personal information, including your name, birth date, insurance card member ID, address, and email address. This ensures that your claim is processed accurately.
Select your claims administrator from the options provided: Allegiance, BCBS, or PacificSource. This is crucial for directing your claim to the correct entity.
Indicate the type of reimbursement request by checking the appropriate box(es). Ensure that all reimbursable items have been pre-authorized by a Take Control Health Coach.
Fill in details for any medical office visits or additional counseling visits. Attach receipts as required for each entry.
Calculate and enter the total claim amount based on allowed expenses. Make sure to multiply monthly costs by the number of months applicable.
Finally, submit your completed form via fax, email, or mail as instructed at the bottom of the document.

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2018	4.8 Satisfied (204 Votes)

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Is there a SABC Flex app?

PLEASE NOTE! You must have registered for SABCs online portal to use the mobile app. If you have not registered for an account, please click here.

What are the benefits of SABC Flex?

SABC and WEX have teamed up to provide you with the best, fastest service available in Flexible Spending Reimbursements. SABC FlexCard participants can now pay for their medical, dental and vision expenses with the card and funds will be deducted directly from your Unreimbursed Medical account.