Retail has Pre Ex; Corp does not have Pre Ex.

We do not have a BIN number. 

We must have the EOB for all CHAMPVA RX reimbursements and all claims filed by insured must include the claim form. 

The member must submit a claim form.

Our timely filing limit is 24 months from the primary processing date. 

Our claims fax number is 1.800.310.5514

OR 

Mail the claim form to:

Selman & Company 

Attention Claims

P.O. Box 21611

Eagan, MN 55121

The member must also include a copy of the TRICARE EOB and a copy of the prescription drug receipt (showing the name of the drug, date filled, referring doctor’s name, NDC product number and billed amount).

When a reimbursement check is issued. It is issued through CHC to the sponsor. 

You will be able to locate the check in CHC website. Please use the link  provided to access your insureds Emerge ID  number in the CHC website. 

As of 07/01/2021 our insureds who use Rite Aid pharmacies to fill their RX will need to pay for their medication up front. We will reimburse the insureds for their medication using the guidelines of the certificate. Please explain when filing reimbursement for RX we have a claim form from the insured. The claim form can be obtained at our website  www.selmanco.com  click on insured, scroll to claims section, click on claim form. 

This is a copy of the letter being sent to our insureds to notify them of the change.