If you have a financial responsibility after you use your coverage from WellFirst Health — Provided by SSM Health Plan, you will be issued an explanation of benefits (EOB). Your EOB is not a bill. It is a breakdown of services used, amount charged by the provider and your financial responsibility to pay toward deductibles or coinsurance. You can see your prior EOB documents any time by logging in to your member portal.
If you are one of our individual and family plan members and your premiums are not auto-withdrawn from your paycheck, you have access to a number of convenient ways to pay your monthly premium. We can accept online payments as well as payment through the mail.
When you are seen at a clinic location for services, you will often have the option to pay an applicable copay upon check-in. Your clinic will bill you for any deductibles for which you may be responsible. The clinic will send you a bill for any copay charges not paid at the time of service or any coinsurance for which you are financially responsible. When you receive a bill this way, you may send in a check or provide your credit card information on the payment form and send it back to us. You may also make the payment online through MyChart.
In most cases, claims are submitted directly to us by the providers or clinics. On occasion, if you’re traveling out of the area or have a college-age dependent, for example, it may be necessary for you to submit a claim for reimbursement (PDF).
When submitting the claim and the form, be sure you:
If you have other health coverage that is the primary payer, you will need to send the EOB to us or your health care provider.
If you have questions, call Customer Care at 866-514-4194 (TTY: 711). Or you can call the number on the back of your member ID card.
This information pertains only to our QHP plans.