Office staff can search for a member using a wide range of criteria (e.g., member first and last name, DOB, member ID and any other plan-specific criteria), or access and print the member's plan benefit summary. Eligibility verification is fast and efficient, with details provided on claims, authorizations, benefits and COB. Staff can submit authorizations and referrals online and get instant information about whether they have been approved, pended or denied.

Claims management is just as straightforward. Staff can auto-populate claims (HCFA1500 and encounter claim forms) with member and provider information to improve speed and accuracy, then submit claims electronically. Approved, pending and denied status can be easily viewed.

If you're a member, you can find information about your specific benefits plan by logging on to Member Portal as well being able to self administer various functions on-line.

• View personal information for self and dependents — e.g., contact information, PCP, employer — and update pertinent records
• Access plan documents for all enrolled products, including benefit summaries, explanations of benefits (EOBs) and plan updates
• Access and complete member surveys/polls
• View claims information (based on health plan rules)
• Request ID cards and print temporary ID cards for self and dependents