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  • Member Is Active: Health Care Eligibility Benefit Response

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    Stella Maria Otero-Souffront
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    Member Lillian Pacheco Vazquez has active health insurance coverage through Triple-S Salud from January 1, 2014 through December 31, 2078 according to a verification completed on March 4, 2014. The verification confirms she has an active health benefit plan with supplemental medical care coverage and her benefits began on January 1, 2014, though authorization may be required.

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    EligibilityResponse (10)

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    Member Lillian Pacheco Vazquez has active health insurance coverage through Triple-S Salud from January 1, 2014 through December 31, 2078 according to a verification completed on March 4, 2014. The verification confirms she has an active health benefit plan with supplemental medical care coverage and her benefits began on January 1, 2014, though authorization may be required.

    Copyright:

    Attribution Non-Commercial (BY-NC)
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    12 views1 page

    Member Is Active: Health Care Eligibility Benefit Response

    Uploaded by

    Stella Maria Otero-Souffront
    Member Lillian Pacheco Vazquez has active health insurance coverage through Triple-S Salud from January 1, 2014 through December 31, 2078 according to a verification completed on March 4, 2014. The verification confirms she has an active health benefit plan with supplemental medical care coverage and her benefits began on January 1, 2014, though authorization may be required.

    Copyright:

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    of 1

    PROVIDER: HOSP AUXILIO MUTUO

    Health Care Eligibility Benefit Response


    Insured Status: Member ID: Name: DOB: Gender: Address: Insurance Payer: Policy No.: Group No.: Group Name: Other Information: Coverage Dates Eligibility Begin: 01/01/2014 Eligibility End: 12/31/2078 Plan: 03/04/2014

    VERIFICATION DATE: 03/04/2014

    Member is Active
    0012346616910 LILLIAN PACHECO VAZQUEZ 03/31/1938 CALLE 4 S 1 35, VILLAS DE PARANA, SAN JUAN, PR, 00926-0000

    Triple-S Salud

    Disclaimer: This eligibility report is provided for informational purposes only and does not guarantee the payment of services. The information herein is based on the plans response at the time of this request and reflects the most current information which has been provided to the plan.

    Active Coverage
    Coverage Level Service Type Insurance Type/Plan Coverage Description Health Benefit Plan Coverage D Supp Medical Care Amount/Percent In-Net Period/Freq/Restric Benefit Begin: 01/01/2014 Auth. Req.

    By User: Hospital223.-- Source: Inmediata.-- Print Date: 03/04/2014

    Page 1 of 1

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