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ClaimsExpress™ automates the employee claim filing experience! Employees can significantly reduce or even eliminate the need to file paperwork to seek reimbursement or substantiate card transactions!

Yes!  No more submitting claims!

OCA’s ClaimsExpress™ automates the employee claim filing experience by linking to your insurance carrier portal! Once the accounts are linked, ClaimsExpress™ will automatically retrieve any new EOBs issued by the insurance company. This can significantly reduce or even eliminate the need to file paperwork to get reimbursed from your HRA benefit.

We offer three versions of ClaimsExpress.

ClaimsExpress can be offered in one of three (3) ways:

  • Reimbursement: OCA will automatically retrieve the participant EOBs and issue HRA (or FSA) reimbursements into the employee’s personal bank account (or a paper check if the banking isn’t provided). Employees will then be responsible for paying the provider directly.

 

  • Debit Card Substantiation: OCA will use ClaimsExpress to match received EOBs with pending mySource card transactions. For OCA to properly substantiate a transaction, the card swipe must match the dollar amount listed on the EOB. If the amounts do not match, OCA may ask the employee to submit documentation to substantiate the transaction. This request will be sent via an OCA system- generated email. Under this option “ClaimsExpress™ Reimbursement” is not available.

 

  • ClaimsExpress MyChoice: This option is a mix between reimbursement and substantiation (as described above). When a new EOB is issued, OCA will send an email to the employee with a simple question: What do you want to do? The employee can either request that OCA issue them a reimbursement (either check or direct deposit), resolve this claim against a mySource card transaction, or do nothing with the EOB. The employee gets to choose!

 

ClaimsExpress FAQ

ClaimsExpress FAQ

Q: What is O.C.A.’s ClaimsExpress™ ™ service?

A: ClaimsExpress™ automates the employee claim filing experience by linking to your insurance carrier portal! Once the accounts are linked, ClaimsExpress™ will automatically retrieve any new EOBs issued by the insurance company. This can significantly reduce or even eliminate the need to file paperwork to get reimbursed from your HRA benefit.

 

Q: Are employees automatically enrolled in ClaimsExpress™?

A: No. ClaimsExpress™ is a voluntary service. Employees must sign up for ClaimsExpress™. If the employee is not registered, then employees will be required to submit all claims for reimbursement.

 

Q: How do employee’s sign up?

A: Signing up is easy! Employees will receive a registration email with an activation link to log into their ClaimsExpress portal. Employees will then need to provide their insurance carrier login credentials to synchronize their account. ClaimsExpress will take care of the rest! Every time the insurance carrier issues a new EOB, O.C.A.’s ClaimsExpress™ service automatically retrieves the EOB and reimburses the employee for eligible expenses! It is that simple!

 

Q: How do employees get reimbursed under ClaimsExpress™?

A: With “ClaimsExpress™ Reimbursement” O.C.A. will automatically retrieve the participants EOBs and issue HRA reimbursements into the employee’s personal bank account (or a paper check if the banking isn’t provided). O.C.A. will always issue payment directly back to the employee. Employees will then be responsible for paying the provider directly.

 

Q: Is the data secure on ClaimsExpress™?

A: The data is retrieved using bank-level security. The employee information is safe and it cannot be altered. We are also HIPAA compliant, which means the information is completely confidential.

 

Q: Why would an employee’s ClaimsExpress™ account be suspended on ClaimsExpress™?

A: Usually, connections are suspended for two reasons. The first is that the set of carrier login credentials entered in ClaimsExpress™ are incorrect, and thus, the system cannot access the EOBs. This either happens when the participant initially provides an invalid set of login credentials, or when the participant updates their carrier account credentials and forgets to update them on ClaimsExpress™.  The second reason is when the insurance carrier prompts a ‘Terms of Service” agreement. Unfortunately, these carriers will not allow online claims access until their Terms of Service agreements have been accepted. Employees will simply need to accept the terms of agreement which will then allow the accounts to be successfully linked.