Property of Bind Benefits, Inc., d/b/a Surest. All rights reserved © 2026. 54 7. Claims Procedures When you receive in-network services, the Provider will generally collect your copayment from you at the time of your treatment and send a medical Claim to the Surest Plan for payment. Sometimes out-of-network Providers will do the same. Other times, out-of-network Providers may bill you for the total cost of your treatment, and you will need to submit the medical Claim to the Surest Plan to be reviewed for Benefits. Whether you pay out-of-pocket, or your Provider bills the Surest Plan directly, you are still entitled to the same Benefits. If you receive a bill from your Provider (whether in-network or out-of-network) for the Surest Plan’s portion of the costs, or you pay for your medical care out-of-pocket and need to be reimbursed, you must submit a medical Claim to the Surest Plan. This section summarizes the procedures you must follow to submit a medical Claim for payment, and the procedures the Surest Plan will use to determine whether and how much to pay for that medical Claim. If you would like more details about medical Claims procedures and your rights and responsibilities, contact Surest Member Services. Regular Post-Service Medical Claims Post-service medical Claims are non-urgent medical Claims processed after you have received treatment. Pre-Service and Urgent Care Request for Benefits are described in Section 8 (What Do I Do If My Claim Is Denied). Generally, you do not need to file a medical Claim for services from in-network Providers; the Provider will handle the filing of the medical Claim. For out-of-network Providers that do not file medical Claims or if you receive Emergency care outside the United States and are seeking reimbursement from the Surest Plan, you can submit a medical Claim using this procedure. You can submit a post-service medical Claim by mail to the address on your member ID card. You will need to provide several pieces of information for Surest to be able to process your medical Claim and determine the appropriate Surest Plan Benefits: • The name and birthdate of the Participant who received the care. • The Participant ID listed on the Surest member ID card. • An itemized bill from your Provider, which should include: − The Provider’s name, address, tax identification number, NPI number, and license number (if available). − The date(s) the Participant received care. − The diagnosis and procedure codes for each service provided. − The charges for each service provided. • Information about any other health coverage the Participant has. • Proof of payment may be requested to substantiate your medical Claim but is not required upon initial submission to Surest.