Getting Help With Eligibility & Claims

Getting Help With Benefits Eligibility & Claims

The plans have a review process that is followed whenever you submit a benefit claim or an eligibility claim. There are dedicated teams to assist you with both benefit and eligibility issues.

When you file a claim, the claims administrator reviews the claim and, in accordance with plan provisions, either approves or denies the claim (in whole or in part). The claims administrator will notify you of this action. In some situations, the plan may need additional time to process the claim (for example, if the plan needs additional information). In these cases, you’ll be notified of the extension and the additional information needed.

Health Advocacy Solutions – Health Care Made Easy

Health Advocacy Solutions (HAS) makes navigating your health and benefits easy. You and your eligible family members can connect with a dedicated health advocate for help with health or benefits questions. HAS is a more personalized, proactive approach to care. Your health advocate will take the time to get to know you and understand your needs. Their role includes partnering with a team of doctors, nurses, and benefits specialists to help support you each step of the way.*

Call your health advocate to:

  • Understand your benefits
  • Help you save money
  • Help you find in-network doctors and providers
  • Answer questions and resolve issues with your health care bills
  • Sort out a new diagnosis and what to do next
  • Shop for quality, lower-cost health care
  • Earn cash rewards for making wise health care choices

To reach a health advocate, call 877-278-4420. You can also visit myhealth.myevive.com or download the MyEvive app to connect with a health advocate and see all of your benefits in one place.

*Health Advocacy Solutions (HAS) does not practice medicine or provide patient care. HAS is an independent resource to support and assist you as you use the health care system. You will continue to receive medical care from your own doctors, nurses, and health care professionals.