If you received a letter...If you received a letter from us, it is because your Health Plan has asked us to contact you about a recent visit or treatment provided to you.
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What This is All About
Your health plan has asked MCA to review your medical claims and determine if someone else may be financially responsible for your treatments, especially if they relate to an accident or injury, such as a motor vehicle accident, slip and fall. The provider listed in the letter you received may be another physician or radiologist who treated you during the relevant visit. Confirming that your treatment was not related to an accident is important for your health plan to know.
MCA will try contacting you to resolve these questions, as your health plan expects members to cooperate. We have been contracted by your health plan to review already paid claims and identify situations where another party may be responsible for payment. MCA is authorized to perform this service in compliance with HIPAA and your health plan's requirements for handling your protected health information.
This is Not a Bill
Please know that his is not a bill that you owe. It is simply an inquiry to identify if another party was at fault for your visit.
MCA will try contacting you to resolve these questions, as your health plan expects members to cooperate. We have been contracted by your health plan to review already paid claims and identify situations where another party may be responsible for payment. MCA is authorized to perform this service in compliance with HIPAA and your health plan's requirements for handling your protected health information.
This is Not a Bill
Please know that his is not a bill that you owe. It is simply an inquiry to identify if another party was at fault for your visit.
If you prefer to answer the Patient Incident Questionnaire online you can do so by clicking the button below.
Download Documents
If you prefer, you can download the Questionnaire or HIPPA release below and fax or mail it to us at...
FAX: (714) 902-2051
MCA, Inc.
15151 Springdale Street
Huntington Beach, CA 92649
FAX: (714) 902-2051
MCA, Inc.
15151 Springdale Street
Huntington Beach, CA 92649
Patient Incident Questionnaire |
HIPPA Release |
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