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| Visit a physician's office or hospital |
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Physicians office or hospital sends the bills to PPO |
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| PPO reprices the bill and sends the bill to BenefitSource, Inc.via regular mail or EDI |
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The bills are received and prepared for scanning into our system. |
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| Bills are indexed in the system. The proper participant is selected and fields populated. |
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Claims are processed by an individual benefit analyst assigned to one case. The analyst will pay the claim according to the plan parameters. |
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| Fund request is generated and an email is directed to your employer for authorization. |
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Checks are issued with an explanation of benefits (EOB) included. An EOB is sent if a claim is denied as well as a letter if more information is required in order to process the claim. |
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