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Rural Carrier Benefit Plan
Providing superior service to rural letter carriers nationwide
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Frequently Asked Questions

Claims Questions

  • 1. Do I need to submit a claim form?

    When you use a doctor in our network, you generally don’t need to file a claim. Just show your ID card, and your doctor files the claim for you. Make sure you carry your ID card with you at all times since it includes the address your provider will need to submit your claims. Also, you might need to buy prescriptions at a network pharmacy and you’ll need your ID card to do so.

  • 2. How do I obtain a claim form?

    For your convenience, you can view and download a copy here.

  • 3. Where do I send my claim?

    Doctors in our network usually file claims for you. But, if you need to submit a claim please use this address:

    Rural Carrier Benefit Plan
    P.O. Box 14079
    Lexington, KY 40512-4079

  • 4. How do I file a claim?

    When you use a doctor in our network, you generally do not need to file a claim. Present your ID card at the time of service and your doctor will file the claim for you. When you use out-of-network doctors you may have to file your own claim. To file your claim, print this form. Complete the form and mail it to the address provided on the form. If you have questions, call us at 800-638-8432.

  • 5. What should I do to file a disputed claim?

    Follow the Federal Employees Health Benefits Program disputed claims process outlined in section 8 of your RCBP Plan Brochure if you disagree with our decision on your claim.

Precertification Questions

  • 1. What is precertification?

    Before you're admitted to the hospital as an inpatient, you need to get your stay precertified. Precertification is the process by which we evaluate the medical necessity of your proposed stay and how many days are required to treat your condition. Exceptions include:

    • Maternity admission for a routine delivery with the 48/96 hour rule
    • Admission to hospitals outside of the United States
    • Another group insurance is the primary payor for the hospital stay
    • Medicare part A is the primary payor for the hospital stay

    OPM requires all Federal Employee Health Benefits Program (FEHBP) plans to precertify hospital stays. In most cases, your doctor or hospital will take care of precertification. However, you’re still responsible for ensuring that we are asked to precertify your care. So always verify with your doctor or hospital that they have contacted us.

  • 2. How do I precertify for a hospital admission?

    You, your representative, your doctor, or the hospital must call us at least two working days before admission. The toll-free number is 800-638-8432. Provide the following information:

    • Enrollee's name and Plan identification number
    • Patient's name, birth date and phone number
    • Reason for proposed hospitalization
    • Name and phone number of the doctor who will admit you
    • Number of planned days in the hospital

    We’ll tell the doctor and hospital the number of days in which the patient is approved to stay in the hospital. Our decision will be sent to you, your doctor, and the hospital.

  • 3. Do I still need to precertify for hospital admission if I use an in-network hospital?

    Yes. The federal government requires that all members of a fee-for-service plan must precertify their hospital admissions.

  • 4. What do I do in case of an emergency?

    When there is an emergency admission you, your representative, the doctor, or the hospital must call 800-638-8432 within two business days following the day of admission, even if the patient has been discharged from the hospital.

In-Network Provider Questions

ID Cards Questions

Questions, Suggestions or Complaints