Solutions
Member Portal
Engaging the Members
Member Satisfaction Through Secure Transactions and Easy Communications
The member portal gives health plans a low-cost customer service outlet that provides relevant
information to members day or night, reduces phone calls and faxes to customer service areas,
and promotes member satisfaction.
Members can securely and efficiently conduct open enrollment activities using the member portal. With a few clicks, a member can choose from two or more health plan benefits and compare benefits side-by-side. In a matter of minutes, after completing enrollment, members can print their own temporary ID card.
Using a secure messaging system, members can contact the health plan regarding healthcare issues, questions, or follow-up care instructions.
Full-featured Member Satisfaction
With AboveHealth, members can take an active part in their healthcare by monitoring healthcare activities and health risk assessment. With only a browser and an internet connection, members can tap into their own health plan data. They can track authorizations, explanation of benefits, and payment of benefits. They can add dependents, change PCPs, and review eligibility.
Member Portal Activities:- View eligibility profile and history, including benefit information
- View health plan benefit descriptions and compare different plans side-by-side
- Enroll individuals and family online
- Change PCP using provider directory and mapping information
- Print temporary ID cards to reflect updates such as a changed Primary Care Provider
- Review co-pay, deductible, and accumulator information
- Check status of their own claims
- View pre-authorizations for specialists or specific procedures
- View and print explanation of benefits (EOB) information
- Access health news, documents, and other content
- Manage Personal Health Record (PHR) and view dependent PHR if dependent grants viewing privilege
- Members covered by individual products (including Medicare or Medicaid) can now view and print their invoice.
Benefits Plan Summary of Benefits
Members can view a summary of benefits for their specific benefit plan.
Claim Status List
Members can display the list of their claims according to search criteria they enter in a Claims Status search. Results are constrained by HIPAA 276 request and 277 response transactions.
Edit Personal Health Immunizations
Through the Personal Health function, members can view and edit the dates required immunizations are received, among several other things.
