SERVICES

Member Services:

To expedite assistance under "Member Services" please have the following information together before calling: Full name of the member and, either social security number or date of birth, the full name of the employer, the plan number and service carrier. If you are calling for some one else, such as your dependent or spouse, please be prepared to answer questions that confirm your identity. Dial 361-993-6905.

         health benefit coverage

         claims issues

         lost card replacement

         Provider Network Information

         Provider Relations Issues

        Ancillary Product Assistance such as Vision, Dental, cafeteria Plan items or assistance with Life Claims

Employer Assistance:

Falcon Insurance offers a wide range of courtesy employer services designed to accomplish the following:

         Brief executives or employees on health plan benefits and the expected impact of Health Care Reform.

        Assist Accounts Payable Personnel with the nuances of health billing and or adding and dropping members.

        In large group cases, assist/coordinate wellness events such as on-site health fairs, immunization delivery, and mid-year utilization reviews.

        Assist employers in preparing the necessary information for "Request for Proposal" (RFP) packages and assist their staff in drafting the RTF document and coordinate enrollment and other closing events.

        Share management tips on how to best apportion health care dollars to meet adequate coverage requirements in accordance with new health care reform mandates.

        Click here to see "Premium Savings" illustrations.

Faxed Service Requests:

Faxed requests for assistance must include the following:

For employee changes or adds and drops, Falcon Insurance requires a fax cover page identifying the employer and must include complete contact information (phone, email, sender name and subject), plus a change form or carrier application complete with all required fields and signed by the member and the employer representative.

All sensitive information regarding any health matters or other private health information must be safeguarded in accordance with privacy laws. In such cases it behooves employer representatives to follow-up by phone to confirm receipt by Falcon Insurance. "Sent Journal" receipts should be reviewed to insure proper routing numbers have been used and proper fax system function.

Faxed messages larger than 25 pages should be pre-coordinated with a phone call to Falcon Insurance to insure logistic sufficiency in the fax system.

Images that are shaded or darkened in the original document should be run through a copier and lightened to insure readability upon receipt by Falcon Insurance. Images that are in font smaller than 11 point should be enlarged before sending.

Postal Service Requests Including

Overnight Mail:

Senders must anticipate a 10 day delay in processing. It is advisable that any requests with deadline suspense dates be sent with sufficient time to insure timely disposition by the carrier. (See "Contact Us" on our web site for proper routing).