Call our award winning team 704.940.6654 today!

Support for Pivot Heath

We always do our best to help agents. Please understand that our help is on a first come, first serve basis.

If you need help signing up because you are about to lose coverage, please:

Call us at 704.940.6654 and follow the prompt for “Existing Policy.”

Then email us at: team@insurance4agents.com

Use the subject line “Need Coverage ASAP!”

If you are a current client and have an issue with your policy, please:

Call us at 704.940.6654 and follow the prompt for “Current Client Issue.”

Then email us at: team@insurance4agents.com

Use the subject line” Current Client Issue!”

We thank you for your patience as we expand!

PIVOT Healthcare (No Network) Policy Holders

Thanks for being one of our valued clients!

As your brokers, we look forward to helping you as needed to navigate how to use your plan. You may call us to review your plan at (704) 940-6654.

Questions that you may have, include:

*How do I obtain my ID card(s)?

*Can you review my documents and confirm that I’m enrolled in the correct plan/s?

Please keep reading below for Smart Tips!

Wishing you continued good health!

Best regards,

Pam, Brian, Scott, Alicia, and Jake

Smart Tips for our Pivot Customers

Did you know?  All ID cards are available electronically.  

You will receive a Welcome email with instructions on how to log into the member portal, where you can download your ID card as well as policy documents.

If you request a hard copy of your ID card, it will not be laminated.

Did you know? There is a three (3) day waiting period before coverage is available on certain claims.

Did you know?  The Client Services department can answer all claims, billing, and policy questions. 

Call Client Services at 844-630-7500

Email Client Services at clientservices@insurancebenefitadministrators.com

Mobile App for Android and iPhone HERE

Did you know?  Some services are excluded from your plan.  Please read the brochure carefully.  

Ask us!  We can help you determine if a service is excluded.

Or call for preauthorization. 

Did you know?  Some states require short-term carriers to include services such as a preventive annual screening type of mammogram; some states do not.

Did you know? Before hospital admission or surgery (outside the physician’s office) or for other services as specified in your plan, your physician must call the number listed on your ID card for pre-treatment authorization (precertification). Failure to comply may result in a reduction of benefits. 

Emergency admissions must be reported within 48 hours or by the next regular working day following admission (72 hours in some states).

Did you know?  Only you can make changes to your plan(s). 

If you need to make changes:

Call Client Services at 844-630-7500

Email Client Services at clientservices@insurancebenefitadministrators.com 

Mobile App for Android and iPhone HERE

IMPORTANT:  Did you purchase supplements or dental/vision plans?  Your supplements, such as “TrioMED,” and benefits like LIFE Association, will continue to be available to you even after your STM health insurance has expired.  If you wish to cancel these supplements, please contact the carrier.  Unfortunately, we can not do this on your behalf.

REMEMBER:

Some of PIVOT Health Plan’s Have No Network

They Have Reference Based Pricing
Reference-based pricing occurs when a provider submits a claim to the Claim Administration. The administrator then pays the provider based on Medicare allowable amounts. Pivot Health reimburses medical providers based on a percentage above payment maximums which are higher than Medicare allowable amounts, paying up to 150% of Medicare allowable amount for medical facilities and up to 125% of Medicare allowable amount for medical professional services and supplies.

All Provider Access

With All Provider Access plans, members choose providers that best fit their needs without network restrictions. There is simply one benefit level for all providers, differing from a PPO plan where there are separate in-network and out-of-network benefits.

No Balance Bill

If a member is presented with unexpected charges on covered benefits for which the member is not liable, due to cost share or limitations, the Plan’s Claim Administrator is authorized to resolve the balance bill on their behalf. The member is required to notify Plan’s Claim Administrator if an unexpected charge is incurred.

If you have not found the help you need, then please:

Click the SIS logo below to set an appointment. 

Send us an email describing the issue in the subject line. 

Call or text us at 704-940-6654.

Please allow time for us to respond.

If the matter can’t wait then, please call the carrier directly.