Filing a claim

It is important that you present your member ID card at the time of service. The provider will need the information found on your member ID card to bill WHA for the Covered Service(s).

In the unlikely event that you pay for a Covered Service out-of-pocket, you will need to mail or fax the following information to WHA for reimbursement.

1. A signed and dated summary/explanation detailing the service you received
2. Any supporting documentation from the provider who performed this service
3. Indicate the specific amount you are requesting to be reimbursed
4. Proof of payment
5. Your contact information, including:
   • Full name
   • Phone number
   • Mailing address
   • Email address
   • WHA member ID

Once WHA receives the above information, you will be notified within 45 business days regarding the outcome of your claim.

Please note: Only services covered under your plan are eligible for reimbursement. Your plan's applicable copayment/coinsurance and/or deductible will determine the total amount you are reimbursed.

For more information, contact:

Member Services

916.563.2250 or 888.563.2250 toll-free

Monday through Friday (excluding holidays) 8 a.m. to 6 p.m.

For TDD/TYY: 888.877.5378

Email: memberservices@westernhealth.com or use the Secure Message Center

Fax: 916.568.0126