Employees - How It Works

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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.

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.