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Similar to Claims Exchange Automatically Processes & Pays Medical Claims
Similar to Claims Exchange Automatically Processes & Pays Medical Claims (20)
Claims Exchange Automatically Processes & Pays Medical Claims
- 1. Claims Exchange and Pay the Provider Claims Exchange is a data integration solution that accepts and automatically processes electronic data files that contain consumers’ eligible medical expenses not covered by the Health Plan Reimburses the consumer or the provider for these eligible expenses out of the consumer’s Flexible Spending Account (FSA) and/or Health Reimbursement Arrangement (HRA). Also known as “auto-claims” or “crossover claims” Participants can have both Claims Exchange and a Debit Card, but there are limitations that apply.
- 2. Claims Exchange & Pay the Provider Workflow Health Plan OR If Patient Responsibility > 0 then EOB is transferred using secured FTP to Peak1 Effective way to link with health plan No substantiation of out-of-pocket expenses is required when a claim is received directly from a Health Plan – 100% Auto Substantiation
- 3. Carrier Integrations Advance PCS BlueCross BlueShield of Vermont Merck Medco Aetna Premera Blue Cross Mercy Health Plan Aultcare PTI-BCBS (IL/TX) Met Life Anthem BlueCross BlueShield Blue Choice Met Dental Anthem BlueCross BlueShield Virginia Highmark BlueCross BlueShield PacifiCare Anthem BlueCross BlueShield HMSA / BlueCross BlueShield Hawaii Pharmaceutical Tech Virginia/Trigon Mountain State BlueCross BlueShield Preferred Care PMD Anthem Trigon Caremark Preferred Plus Kansas Anthem BlueCross BlueShield Ohio CatalystRx Presbyterian Health Plan Blue Cross of Idaho CDPHP / CDPHN New York Prime Therapeutics BlueShield of California Cigna Priority Health BlueCross of California Cigna Behavioral Health United Healthcare BlueCross BlueShield of Alabama Davis (Vision) United Healthcare Midwest BlueCross BlueShield of Minnesota Delta Dental United Healthcare Chicago BlueCross BlueShield of Georgia Delta Dental of California (Dental) United Healthcare Cleveland BlueCross BlueShield of New Jersey Express Scripts United Healthcare Colorado BlueCross BlueShield of New Mexico First Health United Healthcare Tennessee BlueCross BlueShield of North Carolina Humana Louisville United Healthcare Utah BlueCross BlueShield of Oklahoma Hyde Rx United Healthcare Wisconsin BlueCross BlueShield of Texas Kaiser Foundation Health Plan UPMC BlueCross BlueShield of Illinios Lumenos VSP BlueCross BlueShield of North Dakota Medco Wausau