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BEN-E-LECT CLAIM PROCEDURES
How a Claim is Paid with Your BEN-E-LECT Plan
1. |
Employee goes to a Contracted Provider and pays any applicable co-pay, if required. |
2. |
Provider sends claim to Insurance Company. |
3. |
Insurance Company processes claim using contracted rates, applies balance to deductible, and mails EOB (Explanation Of Benefits) to Employee. |
4. |
Employee verifies that services on EOB were performed, then faxes or mails EOB to BEN-E-LECT. |
5. |
BEN-E-LECT re-calculates claim to Employer's specifications, prints and sends check to Employer for signature. Employer gives EOB to Employee. |
6. |
Employer signs check and mails to Provider. |
7. |
Provider mails statement showing payments made by plan and any balance owed by Employee, who then pays the amount due. |
Filling Prescriptions
1. |
Go to your preferred pharmacy |
2. |
Show both ID cards |
3. |
Pay the co-pay listed on your BEN-E-LECT ID card |
Check our Pharmacy Locater for a Pharmacy Roster.
For answers to your questions or to order supplies, please call the BEN-E-LECT Customer Service department at 888-886-7973. To fax in claims use 559-733-1314. Our staff is waiting to assist you.
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Copyright © 2008 BEN-E-LECT. All Rights Reserved. |
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