Claims Lifecycle - Navia Benefit Solutions

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KNOWLEDGEABLE INNOVATIVE ESTABLISHED
ClaimsLifecycle
The right administrator must show a high level of competence in their ability to process claims for payment. This process is the foundation of the relationship between the TPA and the participant. If this process is compromised or not well‐designed in any way, then the end result will be lost claims, incorrect payments and unsatisfied participants. Our claims lifecycle ensures the integrity of the claim submission process from submission to payment. The FPS claims lifecycle is a three (3) step process that starts with the participant. 1. Claim Submission by the participant via mail, fax, e‐mail or online submission. Participants fax claims to toll‐free fax line. Participants email claims to claims@flex‐plan.com Participants mail claims to the claims PO Box. Participants submit claims on www.Flex‐Plan.com. Incoming faxes processed in LaserFiche for document tracking and lifecycle management.
Received emails are placed into LaserFiche for document tracking and lifecycle management.
Claims picked up daily and scanned into LaserFiche for document tracking and lifecycle management. Online Submissions are processed in LaserFiche for document tracking and lifecycle management.
Claims are placed within LaserFiche for claims tracking and pending processing.
Mailing Address:
P.O. Box 53250
Bellevue, WA 98015-3250
Web Access:
www.flex-plan.com
flexplan@flex-plan.com
Corporate Office:
11400 SE 6th Street, Suite 125
Bellevue, WA 98004
425.452.3500
800.669.FLEX
Fax 425.451.7002
KNOWLEDGEABLE INNOVATIVE ESTABLISHED
2. Claim Processing by Flex‐Plan Services’ customer service department. Claim is placed within LaserFische
for claims tracking and pending
processing.
Claim is adjudicated by
customer service agent for expense
eligibility.
Claim is entered in FSA system for
future payment
Denial letter for ineligible
expense is sent to participant with
instructions for possible resubmission.
3. Claim Payment to the participant. is listed as pending reimbursement
Claim
until employer’s next reimbursement date.
Reimbursement is issued as hard copy
check or as direct deposit
Mailing Address:
P.O. Box 53250
Bellevue, WA 98015-3250
Web Access:
www.flex-plan.com
flexplan@flex-plan.com
Corporate Office:
11400 SE 6th Street, Suite 125
Bellevue, WA 98004
425.452.3500
800.669.FLEX
Fax 425.451.7002
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