How Your Health Plan Helps You Pay Less

Your PEHT Open Access plan with EBMS includes built-in price protection and billing support so you don’t overpay for care — no matter which provider you see.

How price protection works

1. After you receive care, your provider sends EBMS a payment request called a claim.
2. EBMS reviews the claim for errors and overcharges — and providers are paid on a fair price of care.
3. If you get a provider bill, compare the amount you owe to your Explanation of Benefits (EOB).
4. If the amounts you owe don’t match, email the bill to [email protected] so you don’t overpay — include the best phone number to reach you at. Or call the member number (866) 247-1443 on your PEHT ID card for help.
5. A personal advocacy expert from EBMS will contact you. They’ll manage the bill resolution process for you, keeping you updated every step of the way.

How to get help with a balance bill

Most of the time, you won’t have a reason to reach out about a provider bill. But if you ever receive a balance bill or aren’t sure, let EBMS know right away — they’ll work on your behalf so you don’t overpay.

When you contact EBMS, always include the balance bill and the best number to reach you.

• Email: [email protected] — this is the fastest way to receive balance bill support.
• Fax: 888-560-2447
• Mail: 1550 Liberty Ridge Dr., Wayne, PA 19087

Need help? Just call the member number (866) 247-1443 on your PEHT ID card.

Advocating on your behalf

Once EBMS receives your balance bill, they’ll contact you to explain next steps. Their team does all the work, so you don’t have to.

A personal advocacy expert will:

• Manage the bill resolution process on your behalf
• Provide regular updates
• Bring in legal support, if needed, at no cost to you

Don’t overpay: helpful tips

These tips can help keep your care costs fair and reasonable:

• Compare provider bills to your EOBs to check for balance bills.
• Send in balance bills right away.
• Quickly sign the authorization forms that allow designated experts to advocate on your behalf.
• Keep a folder of EOBs and bills you receive, in case questions arise.