Members can submit claims for reimbursement. Here's how administrators can approve or deny claims.
Claims dashboard
The claims dashboard will show the following:
Number of open claims and how long they have been open
Member name
Benefit type
Claims status
Organization
How to review claims from Claims tab
Log into your Health Wallet Manager
Navigate to your Claims dashboard, follow these steps:
Select and open the desired claim.
Review the claim details.
For plan details, select the hyperlink next to Benefit within the claim. More on this below.
For member details, select the hyperlink next to Member within the claim.
Leave notes as necessary, and
Select Approve or Deny.
Refer to plan details and company guidelines for approval or denial of claims.
Review claims from Member profile
Log into your Health Wallet Manager
Navigate to Members and search member by first and last name
Select the benefit the claim was submitted for
Select Claims History, follow these steps:
Select and open the desired claim.
Review the claim details.
For plan details, select the hyperlink next to Benefit within the claim. More on this below.
Leave notes as necessary, and
Select Approve or Deny.
Refer to plan details and company guidelines for approval or denial of claims.
Claim status
Status change
Opening a New claim will change its status to In Review
Let's get familiar with each status below.
Approved: A claim that has been approved.
Denied: A claim that has been denied.
In Review: An open claim that's in review.
New: A new and unassigned claim.
Pending-Info Requested: A claim returned to a member for additional information.
Benefit details
After opening a claim, select the benefit under the Benefit field to access the following benefit details that can be helpful for review:
Plan Details: Does the plan have an extension period? A receipt requirement?
Eligible Expenses: What categories of expenses are considered eligible?
Merchant Category Code: Where the card will be accepted?
Resolved claims
To revisit a processed claim, select the Resolved tab at the top of the Claims dashboard to view your claims history.