Login Now to The ClaimLinx Private Member Portal

Have you logged in yet to the ClaimLinx private member portal? It’s the best way to receive up-to-date information on your claims and benefits and to communicate with the ClaimLinx staff.

Related Post: Members Can View EOBs on the Portal

The member portal is a secure web-based system that allows real-time access to our claims processing system. Through the portal, all members can:

  • Submit medical claims for processing
  • Verify or update dependent information
  • Download and submit commonly-used forms
  • Check medical claim status
  • Verify or change address information

You can always access the member portal by clicking the green “Member Login” button at the top of the ClaimLinx website. There are complete written instructions and a step-by-step video for how to login the first time on the website under the “Members” tab.

Related Post: Employer Portal Aids Human Resources Administration

We encourage all of our members to access the portal now to verify all of their address and contact information is correct. It is important for our claims processing staff to be able to contact members in order to ensure timely claims processing.

Please email help@claimlinx.com with any questions about the member portal.

Simple But Important Ways to Save on Medical Care

ClaimLinx is always looking for ways to help people to save money on healthcare. But sometimes we need the help of our clients and members to make this happen.

When approaching a medical visit, it’s important you’re still being a smart consumer to get the best value for your dollar. There are many small steps everyone can take to be sure money is not wasted on medical care.

Related Post: How Coordination of Benefits Saves Money for Your Employees

Here are five things you can do to improve savings now:

Remember to check your network

When making an appointment, always check that the doctor or specialist is still in your insurance plan’s network. Especially in this transitional time in the industry, networks can continuously change, and out of network visits often cost more.

Get checkups, flu shots and other preventive care

Consistent exams help physicians detect health problems early, and, thanks to the Affordable Care Act, many preventative care services are now covered 100 percent. It’s still important to verify coverage prior to obtaining services, though.

Know emergency room alternatives

If you’re not experiencing a life-threatening medical issue, try your doctor’s office or an urgent care center. Both can treat for a cut, sprain, or minor fever. In most cases, they cost less than an ER and can see patients faster, too!

Ask about generic medicine

Generic versions of medicine might look different, but the active ingredients are the same as the brand-name medicine. Choosing generic can save hundreds of dollars per year, or more. Ask your doctor if he or she can prescribe a generic version of your medicine.

Related Post: How does ClaimLinx save businesses money on health insurance?

Review all medical bills carefully

Up to 50 percent of doctor and hospital bills may contain mistakes, according to Patient Care, a consumer-advocacy group. Incorrect billing codes, mistakes in account numbers, claims misfiled or incorrect services listed are all common errors that can add hundreds of dollars to a medical bill.

6 Steps To Make The Most Of Your Doctor Visit

For many people, visiting the doctor is a frustrating experience.

You schedule an appointment, travel to the office, usually wait in the lobby, then spend more time waiting for the doctor. And at the end of it all, you walk away feeling like you may have missed something.

Related Post: Avoid Surprises on Medical Bills by Preparing for Visits

Next time, follow these six steps to do your part to get the most out of your visit to the doctor.

1. Arrive prepared

Write a list of the concerns you have to tell your doctor. For each concern, come up with dates when symptoms started, when they worsened or improved and what, if anything, has or has not helped.

2. Be thorough when scheduling

When calling to set up the appointment, mention everything you want to discuss with the doctor. Also, be sure to ask if you are due for any vaccinations, screenings or lab tests before your visit. This will help the doctor’s office schedule accordingly.

3. Invite a buddy

It can often be difficult to remember all of the doctor’s advice. Some patients benefit from bringing an adult family member or friend with them for the visit. After all, two heads are better than one.

4. Ask questions

If you need more explanation, don’t be afraid to ask. It’s also a good idea to write down any important notes or instructions yourself or have your doctor write them for you. Or if you really want to be thorough, you can record the visit. Just make sure your device works!

Related Post: Physicians Lack Tactics For Discussing Medical Costs

5. Be honest

It’s important for your physician to know any and all factors that have an affect on your health, including current medications you’re taking, sexual history, smoking habits, or even financial worries. These can all be important factors in helping your doctor understand your health.

6. Follow up right away, if needed

Before you leave, ask your doctor when you should return or if you need to see another physician or specialist. Then be sure to schedule any follow-up visits as soon as you can.

Step-By-Step How a Claim Is Processed at ClaimLinx

There are a lot of positives to your employer choosing to switch to the ClaimLinx strategy of providing group health insurance:

  • You receive personal service regarding your benefits
  • Your employer can customize benefits to fit company needs
  • The company saves money when buying health insurance

But, if your employer has recently instituted a Medical Expense Reimbursement Plan for the first time, you may be confused about how your claims are actually paid. Check out our flowchart explaining the process, or see the steps below.

The entire process typically takes 30-60 days, from the date of service to when ClaimLinx sends payment to the health care provider.

Related Post: Tips For Helping Members With Claims Issues

Step 1 – Visit your physician

– The process begins when you visit your health care provider.

– Most important during this step is that you show BOTH your primary insurance ID card and your secondary ClaimLinx ID card.

Step 2 – Your provider bills your primary insurance

– Once your visit is over, your health care provider submits the bill to your primary insurance carrier.

– Your primary insurance carrier then determines your coverage and sends an Explanation of Benefits (EOB) to you and your health care provider.

Step 3 – Submit information to ClaimLinx

– In many cases, your primary insurance carrier will not have paid the entire bill for your visit. That’s OK; you still have secondary insurance.

– Now, you and/or your health care provider will need to submit the claim, bill and/or primary carrier EOB to ClaimLinx to be processed for additional coverage.

Step 4 – ClaimLinx processes your claim and sends your physician any applicable benefit

– Once ClaimLinx receives all of the correct information, our claims processing team determines any additional coverage from the Medical Expense Reimbursement Plan (MERP).

– ClaimLinx then submits any balance for applicable MERP benefit to your employer.

– Your employer pays ClaimLinx for this balance, and ClaimLinx sends a check to your health care provider

Step 5 – You receive a ClaimLinx EOB

– Once MERP coverage has been determined, ClaimLinx sends you an EOB.

– The ClaimLinx EOB will show any remaining balance you will need to pay your health care provider.

– If there is a remaining balance, you will need to send payment directly to your provider’s billing department.

Related Post: How to file a medical claim

You can also improve this process by sending ClaimLinx a list of your physicians. You can send the list by mail, fax or email to help@claimlinx.com. Once we have this, we send information to the physician’s office to introduce our company and explain the process.