FAQs

Member

How do I sign up for paperless statements?

If you would like to go paperless and avoid fees related to administrative and postage costs, please follow the steps below.

  • Login to your online account
  • Go to ‘My Profile’ in the top right corner
  • Under your profile settings, click the ‘Edit’ box in the top right corner
  • Select the checkbox that says, ‘You’ve chosen online statements only’
  • Click ‘Save’ in the top right corner

If you don’t have an online account, setting one up is easy. Please go to portal.careguard.com/#/login and choose to register to create a new account. You can also reset your password here. For information on registering for your online CareGuard account, please see: How do I sign up for the CareGuard Member Portal?

Thank you for helping us in our mission to go paperless!

paperless statements

How will I be reimbursed?

If your patient has a Worker’s Compensation injury, we will pay according to your state Worker’s Compensation Fee Schedule.  Additionally, if we are part of any mutual PPO networks, we will honor your PPO contracted rate.

Our networks include Coventry, Rockport, TRPN, Prime, and CorVel.

What method of payment do you use to reimburse?

Ametros is partnered with WCEDI who will distribute the payment to you. You will receive a Virtual Credit Card that can be processed through your credit card terminal. For any questions regarding VCC, please contact (631-648-6020).

Do you have timely filing?

No, CareGuard members are not bound by timely filing limits; however, we highly recommend billing in a timely manner as we cannot guarantee that a member’s settlement funds will not be exhausted at any given time.

Do I need to submit a Prior Authorization request?

We do not require prior authorization for any procedures, however, CareGuard is only able to pay for claims that are related to the member’s injury and Medicare compliant.  Additionally, a member is not guaranteed to have funds to cover a procedure just because they have coverage (please see what to do if you receive a funds exhausted EOR) We always recommend obtaining authorization from secondary insurance as back up and encourage you to speak with your patient about their fund status if you have any concerns.  CareGuard is unable to provide any fund amount to you directly.

Please be advised, CareGuard only provides prior authorizations for relatedness, compliancy, and fund availability.  We do not perform prior authorizations based on medical necessity.

How do I submit a receipt for a service or item related to my injury for reimbursement?

To submit your receipt please make sure you have an itemized invoice on the provider/service letterhead that includes their name, address, phone, and Tax ID #. It must include the date of service (DOS), item description (procedure code) and cost. It can be mailed to Ametros Financial, PO Box 827, Burlington, MA 01803, emailed to [email protected] or faxed to us at 877-443-9344. You can also upload your receipt through the portal, portal.careguard.com, which is the quickest method.

Please be aware that we will only reimburse if we have the proper documentation, if the receipt is for a service related to the injury and the service is covered by Medicare. Co-pays are not covered by Medicare.”

What medical items and services are not covered by Medicare?

Pertaining to members with a Medicare Set Aside, the following list and resources indicate common items and services that Medicare does not cover, and we get asked about frequently.

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