Set up Claims Management

Goal

Stand up the corporate benefits structure so you can enroll members and adjudicate claims.

1. Register an employer organization

Go to Claims Management → Organizations → Add Organization. Save name, city, and headcount.

Add Organization — employer client under this benefits operator.

2. Build the panel hospital directory

Go to Claims Management → Panel Hospitals → Add Hospital. Add every hospital plans will treat as on-panel.

Panel hospitals feed plan coverage and claim advisories.

3. Create a benefit plan

Go to Claims Management → Plans → New Plan. Attach it to the organization, set allowances and the enrollment code, and pick panel hospitals.

New Benefit Plan — allowances, enrollment code, and panel network.

Plans list — copy the enrollment code for HR / employees.

4. Enroll members

Go to Claims Management → Members (or Onboard) and enroll employees onto the plan. Then process claims from Claims Management → Claims.

Next

• Create an organization · Create a benefit plan · Manage panel hospitals · Run a claims day