Member portal will be unavailable temporarily

ClaimLinx is making some big changes when it comes to its digital offerings for customer service. Our current member portal has been around for years and has served our clients well. But we have some exciting changes that will require the member portal to be temporarily unavailable.

What to Do About the Change

Starting April 1, 2020, the member portal will not be available. During this time you can reach out to our team by email or using the new chat feature on our website to check on a claim or receive a copy of an explanation of benefits (EOB). Please login to your member portal before March 31, 2020 to prepare for the transition. You may print any reports or other items you need before they become unavailable.

Once the member portal is unavailable, you must contact our team directly to receive anything you would normally get through the member portal. You can reach us by email, online chat or phone.

We apologize for any inconvenience, and our service team is prepared to help with any issues that may occur because of it.

Why We’re Making the Change

It’s important to know we think this change will greatly improve service in the future. The new portal will have improved features that will enhance service. One example is it will send email notifications when claims are processed and EOBs are ready.

If you would like to add your email to our records, to make sure you are immediately enrolled in this new features, fill out the online contact form. More additional features will be coming so please look for these updates.

The new member portal will have all the same features you have grown to depend on. You will be able to view any processed claims and see any EOBs. We also know how important it is for members to see their basic information, including their address and dependents. These details will be available for members in the new system, too.

You Can Still Chat with Us

Don’t forget that during this transition period, you can contact our service team with the new chat feature on our website. Click the orange button in the bottom right corner of the website to start a conversation.

Messaging is available during our regular business hours — Monday through Friday, from 9 a.m. to 5 p.m. EST. If someone is not available on the chat, you can send a message for someone on our team to respond to via email.

We appreciate your patience and understanding during this transition period. Please be aware there are no changes to the claims processing because of this. Claims will still be processed in the same time frame and in the same way. This applies only to members’ access to the member portal.

ClaimLinx wants member feedback

We’re always looking for ways to improve our services for our members. To that end, we are asking our members to answer a few questions. The survey takes less than two minutes, but gives us a lot of insight about their priorities, how happy they are with their plan and allows us to plan for future improvements.

Anyone who completes the survey can be entered to win a $100 American Express gift card as well as ClaimLinx promotional items. So please fill it out as soon as possible.

Tips for self-care this holiday season

The holiday season is well underway, and for most Americans that means elevated stress, and with increased stress can come sickness, fatigue and depression. Fight the holiday slump this year with these tips for self-care this season.

There are many reasons people feel more stressed and blue during the holidays. There are more activities, pressure to meet families’ expectations, reminders of friends and family you may have lost, and shorter, darker days can exacerbate it all.

That’s why it’s increasingly important for everyone to take time for themselves to make sure they can truly enjoy the festive season. Try just one of these activities this year to see if it helps improve your mood and enjoyment of the season.

  • Keep your exercise routine – With a busier schedule, for most people one of the first things to go is their typical exercise routine. But with all the added activity and dietary indulgences, exercise becomes that much more important as a way to destress and  burn off excess calories.
  • Protect your sleep – Just like exercise, sleep tends to  be something we sacrifice during the holidays, but sleep helps your body recover and keeps your mood up. It’s difficult to enjoy family and friends’ delightful little quirks when you’re exhausted from the activities of the week.
  • Throw out expectations – There’s a lot of pressure at this time of year to create and capture “magical moments” to make a perfect holiday experience. Unburden yourself from these expectations, and you will have an easier time enjoying the moments for what they are.
  • Feel (don’t eat or drink) your feelings – The holidays inevitably bring up strong emotions, including anxiety about new relationships, reminders of family losses or pressure of entertaining relatives. In all of these instances, the instinct can be to eat or drink more than usual. This year try to remind yourself that all of this is normal and try to live in the discomfort of the moment, rather than run from it.
  • Keeps snacks and water with you – This may not be something you do the rest of the year, but in all the hustle and bustle of holiday shopping, holiday parties and end-of-the-year work expectations you may find yourself out and about having forgotten to hydrate or eat. Keep a high-protein snack in your car or bag as well as a water bottle at the ready to avoid this.

The most important advice for this time of year is really just to give yourself a break. Don’t have enough time to make cookies from scratch? Get some from the store. Too tired to go to a third family holiday dinner? Send your regrets and relax. Caught up worrying if people are having fun at your party? Assume they are and catch up with a friend or family member instead.

All of these are hard to put into practice, but you’ll be thanking yourself come January if you’ve been able to find the joy in the holiday season.

Tips for this article were taken from:
Psycology Today
Lifehack.org
Motherly

What is an employer-sponsored, or self-funded, plan?

Note: The below information refers only to a ClaimLinx Simple Option Solution plan. There are other types of self-funded plans that these details would not apply to. 

As our members know, the ClaimLinx SOS plan uses a different type of strategy for providing the health insurance benefits employees need. It combines two types of insurance coverage: a traditional insurance plan with a major carrier for primary coverage and a self-funded Medical Expense Reimbursement Plan (MERP) for secondary coverage.

See how these two levels of coverage work together so an employer can provide better benefits at a lower cost. But what exactly is a self-funded plan and how does it make benefits less expensive for the company?

A self-funded plan, also referred to as an employer-sponsored plan, is one in which a company pays directly for medical services.

In the case of a ClaimLinx SOS plan, an employer pays only for qualifying services according to a MERP determined at the beginning of the plan. Following its effective date, all medical claims are processed by ClaimLinx as a third party administrator and are paid with funds directly from the company.

Using an employer-sponsored plan allows companies to continue to provide benefits at a lower cost because they are no longer prepaying for services to an insurance company in the form of premiums. Insurance carriers charge for a plan under the assumption that every employee will be using large amounts of services. In most cases, that just is not true.

Instead employers can purchase a high deductible plan and pair that with a MERP. That way they are only paying for services actually rendered to employees.

In addition, because ClaimLinx provides a full customized schedule of benefits with a member ID card, members should not be required to pay up front for services and wait for a reimbursement (excepting special circumstances). Claims are processed and payment is sent at a later date directly to providers. This means members should experience the same conveniences as with a traditional insurance plan.

In its simplest terms employer-sponsored, or self-funded, plans are those in which qualifying medical services are paid by the company.

All of this is made possible using a 60-year-old tax code that allows companies to deduct medical expenses for its employees. What it means for employees, though is that their employer can provide the benefits they need at a cost the business can afford.

 

How to file a medical claim

Note: The below information is also listed in our member packets. Download your member packet now for more information like it about your plan. 

The first step for filing a medical claim for a ClaimLinx SOS Solution Plan is to show two ID cards when you visit your medical provider:

  1. Major medical insurance company ID card as primary coverage
    • Example: Anthem, Humana, Harvard Pilgrim, Cigna, National General, etc.
  2. ClaimLinx employer funded ID card as secondary coverage

Most providers will file claims with secondary coverage. However, if the provider does not file secondary or if you receive information at your home, send any of the following items by mail or email to help@claimlinx.com to assist us in processing your claim.

  1. Major medical carrier Explanation of benefits (EOB)
    • This document is usually received about a month after a visit with a provider and has the discounted bill amount. It will come from your primary insurance coverage company (Anthem, Humana, Harvard Pilgrim, Nation General, etc.).
  2. Documentation with diagnostic coding
    • Sent by the provider, diagnostic coding explains the services performed or any diagnostic informaiton. You can also ask for this when you leave your provider’s facility.
  3. Information about the provider
    • Especially important information is the phone number to reach the physical address and billing office. You may write this on any information you send or fill out a Provider Information Form.
  4. Invoices (not statements)
    • Invoices have detailed billing information, your account number, claimant name and diagnostics. Statements do not provide any additional information for processing.

Claims are processed within 10-15 business days. You can see the full process a claim goes through once it is received at ClaimLinx. You may download an explanation of benefits for your claim once it has been processed on the member portal.

Please note that if ClaimLinx is missing any information or is waiting on requested documents, a claim will take longer to process.

If you paid up front for any services you can request a reimbursement for the services. First, you must fill out the medical expense reimbursement claim form. Then send this form with a receipt indicating you paid for the services. This can include a credit card statement, receipt from a doctor’s office, pharmacy receipt, processed beck front and back or any other proof of payment. No services can be reimbursed without this information.