60 likes | 85 Views
Online Claims Submission. Online Claim Submission Tool found under the “Claims” tab Consists of 5 Parts to be completed One claim submission per person!. Online Claims Submission. PART A Pre-populated employee information Option to change mailing address, email address, and birth date
E N D
Online Claims Submission • Online Claim Submission Tool found under the “Claims” tab • Consists of 5 Parts to be completed • One claim submission per person!
Online Claims Submission • PART A • Pre-populated employee information • Option to change mailing address, email address, and birth date • These changes will be sent to Admin
Online Claims Submission • PART B • Choose Patient’s name – this could be “Self” or any covered dependents • Birth date, gender, and relationship to Employee will automatically populate • If other coverage, details must be provided
Online Claims Submission • PART C • Select Diagnosis or Chief Complaint • Select whether accident case or injury during employment
Online Claims Submission • PART D • Payment to Employee • Check/Wire? • Currency preference • Authorization to pay provider
Online Claims Submission • PART E • Confirm whether medical/dental claim • E-signature • Options to print, save, and add attachments (receipts, itemized bills, etc.) • Link to specific information on what is needed to reimburse • Claim submission button