Submit A Claim

A-G Claims Management & Submission

Submit the claim forms by following the links below to start the A-G claims process for the treatment of injury. Be sure to include all itemized bills and an EOB from your insurance carrier.

A-G Administrators requires 3 things to process a claim:
1. Completed and Signed Claim Form
2. All itemized Bills
3. Explanation of Benefits (EOBs) from your Primary Insurance Carrier

Consult our FAQ section if you have further questions on these documents.

1. Claim Form

The claim form enables A-G Administrators to start the process for the treatment of injury.
To avoid delays in claim processing please be sure the “other insurance” portion of the claim form is completed in full. The claim form must be signed by an organization’s official such as an administrator, coach or athletic trainer.

2. Itemized Bills

A-G Administrators requires all provider invoices that apply to the injury.
Please include copies of all medical bills, showing the name and address of the provider of service, date of service, type of service and charges. We typically require a CMS-1500 (HICF) or UB04 form from the provider (they will know what these are). Account statements or “balance due” statements are helpful, but do not contain all the information needed to process the charges.

To view a sample of an itemized bill, click on the link below:

CMS-1500 (HICF)
UB04 form

3. Explanation of Benefits

Explanation of Benefits defines coverages from other health insurance providers.
If you have other medical insurance, all medical bills must be first submitted to that carrier for their determination of eligibility. If the charges are not paid in full by the other medical insurance carrier, A-G Administrators will need to see that carrier’s EOB prior to considering eligibility for benefits. If you have no primary medical insurance, the need for an “EOB” will not be applicable to your claim.

Claim Submission

Once you have all documents completed and in order, you can submit your claim via one of the following:

1. Upload documents through our secure portal:

2. Or, mail to:
A-G Administrators LLC
Attn: Claims Department
P.O. Box 21013
Eagan, MN 55121

For Indiana Residents Who Purchased an Accident and Sickness Product and those covered by a Blanket Accident and Sickness Policy issued in Indiana: You may at any time ask Us or Our Administrator for an estimate of the amount We will pay for or reimburse to you for nonemergency health care services that have been ordered for you. You may also ask Us or Our Administrator for the applicable benefit limitations that apply to the ordered nonemergency health care services you are entitled to receive under your coverage. The law requires that an estimate be provided to you within five (5) business days.

For the past ten years, I have had the pleasure of working closely with A-G Administrators as they provide stellar service for the District’s student sports insurance needs.They understand the value of providing outstanding products that are competitively priced, benefiting a school budget that relies heavily on local funds. As a local, multi-generation family business, they have consistently provided reliable and committed service while working with our families to deliver the best possible outcome in their time of need.

Arthur J. McDonnell

Business Manager

Tredyffrin Easttown School District

The PSBA Insurance Trust is proud to partner with A-G Administrators for the Student and Volunteer Accident programs made available to the PSBA membership. Out of this partnership, we are confident that our member school entities are receiving the highest level of service and support. A-G’s collaborative approach, their dedication to Pennsylvania’s public schools and their expertise make this an easy choice as a partner and the best choice for our members.

Kelsey Carbaugh

Marketing Manager

PSBA Insurance Trust

A-G Administrators, A-G for ‘Always Game’. The team led by Dixon and Jake, are always game for a challenge, always game for performance at the highest level, and most importantly based on my experience and one who considers A-G a trusted partner of the University of Pennsylvania, always game for positive results and outcomes. A-G Administrators focus is client centric.

Benjamin Evans

Associate Vice President- Office of Risk Management and Insurance

The University of Pennsylvania

Without a doubt, I can tell you that A-G Administrators is awesome! The staff at A-G is professional and courteous, focused on facilitating the care the athletes need, and they do it in a manner that saves their schools and organizations money…all while making the collection process easy for my staff. What else can I say — they get it and they are great!

Dr. William C. Meyers

Core Muscle Injury Surgeon

Founder, The Vincera Institute

Achieve Greatness!

The time is NOW for you to partner with the undisputed sports insurance leader.

ACHIEVE GREATNESS!™

A-G has the experience to offer the best custom coverage for every program and the best customer service to ensure a worry-free process for every claim. The nation’s most competitive K-12, collegiate and youth programs Achieve Greatness with A-G!

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