Claims Adjudication

Another aspect of Myers-Stevens & Toohey that we are especially proud of is our in-house claims unit. We have over 100 years of combined experience adjudicating claims! This enables us to carry over our superior customer service from our sales team to the claims experience. Each claim is assigned to one of our experienced examiners who will diligently guide family members, school staff, medical providers and any other parties involved throughout the entire process from A to Z. Day in and day out our examiners apply their specific and highly technical knowledge to ensure accurate and expedited processing. While most of our programs are fully insured, some clients may opt to self-fund all or a portion of their student accident program. We’re here for that too! We can operate on an exclusively Administrative Services Only (ASO) basis or seamlessly integrate partially self-funded programs with complimentary, fully-insured coverage corridors and other options.

Maximum choice - maximum savings!

When an accident or sickness occurs, access to providers is important to our students and their families. In the current healthcare environment, plan choices are becoming more limited as the network provider lists continue to contract. Our plans generally allow parents to seek treatment for their children from the provider or facility of their choice.

In addition, we partner with First Health and First Choice; two very extensive provider networks that allow for deep discounts on billed charges (averaging over 40%). This can further reduce parents’ out-of-pocket costs. The networks provide:

  • Comprehensive coverage in urban and rural markets that eliminates the “patchwork” approach
  • Over 5,000 hospitals, 90,000 ancillary facilities, and 1 million health care professional service locations nationwide
  • 98% of the U.S. population with access to a network provider
  • Electronic web directories which enable members to find network providers, office hours, languages spoken, hospital affiliation and driving directions

Annually, U.S. News & World Report publishes America’s Best Hospitals. The great majority of these hospitals are contracted, giving parents access to the best of care and lower costs!

Claim Forms

  • Standard claim form and filing instructions –

For steps on how to file a claim read more

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