Generali Mobile Health Plan Member Portal Overview

Transcription

Generali Mobile Health Plan Member Portal Overview
Generali Mobile Health Plan
Member Portal Overview
March 2012
Member Portal Overview
The online Member Portal allows you to access the vital information you need such as: benefit information, claims status,
payment details and much more.
Instructions to Access the Member Portal
Log on to https://services.hi-techhealth.com/geb/pages/signon.shtml and enter in your username and password.
NOTE: To ensure trouble free operation, your computer should have the most recent version of JAVA downloaded and
installed. If you don’t have the latest Java updates installed, select [First Time Users Please Click: HERE] to download the
latest Java update” and allow for the installation of the Java certified software.
Member Portal Instructions
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Navigating the Members Portal
Once you have successfully logged onto the Secure Portal, select the [Start Here] button located in the top left corner to
begin.
The [Start Here] dropdown allows you to access a number of tools including:
• Online Documents
• Coverage Profile
• Online ID Card
• Accumulators
• Claims List
Member Portal Instructions
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Online Documents
Selecting the online document section provides you with access to the following material:
• Policy Guide (PDF)
• Pre-authorisation Form (PDF)
• Generali Provider Search - Worldwide (Excludes USA) (Hyperlink)
• Supplementary Medical Form (PDF)
• Claim form (PDF)
In order to seek reimbursement, we require information related to your diagnosis and treatment details be submitted along
with your claim. If your invoice does not contain your diagnosis and treatment details, you must have your Treating Practitioner
complete a Supplementary Medical Form. The Supplementary Medical Form must be printed and provided to you Treating
Practitioner for completion. The Supplementary Medical Form must be printed and provided to you Treating Practitioner for
completion; upon completion it should be included along with your claim submission for reimbursement consideration.
The claim form is available to print and also to complete online.
If you would like to print the form and complete by hand:
• Select our printable version and print the form
• Complete the form
• Mail, email or fax the claim form + supporting documentation to the Generali Assistance and Service Centre for
processing (Refer to [Contact Us] tab for contact details)
If you would like to complete the form online:
• Select our electronic version
• Complete the form online, when complete, press the [Submit] button located on the bottom of the page
• Once selected your default email account will open up with the email addressed to the Generali Assistance and Service
Centre with the claim form added as an attachment
• Attach all supporting documentation and press [Send]
You will also have the option to download our complete claim package (printable claim form + Supplementary Medical Form).
Member Portal Instructions
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Coverage Profile
The coverage profile will allow you to view your medical, dental and/or visions benefits, if applicable.
Once you have selected to view your coverage, the first page that appears displays your Medical Benefit Eligibility and
Coverage Information.
The coverage profile information is divided into essentially two sections, or two pages.
• Page 1 provides information regarding who the Insured is, what the plan and coverage type is and a list of dependents,
if applicable
• Page 2 is a summary of the actual benefits that apply to the Member or their dependents.
It is important to note that the eligibility summary provided on page 2 is for illustration purposes only and that in all cases; the
plan document will take precedence over this summary.
Insured, Plan and Dependent Information
Insured Information – provides information about the Member including Group Name and Employee ID number (also known
as your Family ID)
Coverage Information – displays information specific to the Member and their coverage including:
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Plan Name
Plan Type; i.e., is it an individual or a family plan
Effective Date of the Plan
Termination Date of the plan
YTD Deductible - dollar amount Member has contributed towards their deductible during the calendar year
YTD Out of Pocket - dollar amount Member has contributed towards their out of pocket amount during the calendar
year
Dependent Information – provides information regarding the Member’s family, if applicable. Information in this section includes:
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Dependent Name
Relationship to Member
Gender/Sex of the Dependent
Date of Birth
Effective Date
Termination Date
YTD Deductible - dollar amount Dependent has contributed towards their deductible during the calendar year, if
applicable
YTD Out of Pocket - dollar amount Dependent has contributed towards their out of pocket amount during the calendar
year, if applicable
If you do not have any dependents, this section will remain blank.
Member Portal Instructions
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Medical, Dental or Vision Coverage
From the top of the page, you have the option to view your medical, dental or vision benefits, as well as the option to print the
eligibility information
This section will then display basic information regarding your benefits.
Online ID Card
This selection will allow you to print a temporary ID card in the event you have misplaced or lost your current card issued by
Generali. In all cases, you should contact your Plan Administrator to have your card replaced as soon as possible.
Accumulators
The accumulators section enables you to view your or your dependents deductible or out of pocket contribution for each plan
year, if applicable.
This section will display:
• Claimant
• Year
• Plan: medical, dental or vision
• Deductible carryover from the previous year
• In Network Deductible to date for the particular calendar year
• In Network Out of Pocket contributed to date for the particular calendar year
• Out of Network Deductible to date for the particular calendar year
• Out of Network Out of Pocket contributed to date for the particular calendar year
Member Portal Instructions
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Claims List
By selecting the [Claims List] from the Start Here drop down, you will be able to view all claims that have been processed for
you or for your dependent(s).
Information includes when the claim was received, as well as the date the claim was processed. To narrow down a particular
claim, you have the ability to search by a number of variables, such as date of service or claim number.
Please note, the initial search results will only display claims received that have a date of service within the last 90 days. Use
the [Date of SVC] fields to view claims with a date of service greater than 90 days old.
Each claim number is hyperlinked and by selecting the desired record you will see details pertaining to that one specific claim.
Member Portal Instructions
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My Settings
To maintain your privacy, the [My Setting] section will allow you to create your own unique password, as well as update
information if necessary.
Contact US
The [Contact Us] section will provide you with instructions on how to contact the Generali Assistance and Service Centre.
The obtain toll free dialing instructions; please select the country where you are located from the dropdown. Once selected,
the dialing instructions will appear in the adjacent dialing instructions box.
If you wish to contact us from a location not indicated in the dropdown, please contact us directly or call collect by dialing
+ 1 905 532 3648.
Member Portal Instructions
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