Claims Technology

A key piece of our data integration relies upon claims automation.  Our claims processing engine allows for “auto claims” or “crossover claims” functionality to automatically reimburse the patient responsibility portion of a participants’ eligible expenses, directly from their HRA, FSA, or HSA. Claims are validated for reimbursement based on employer plan stacking rules, consumer eligibility, and available account balances. You can also use the Pay to Provider feature to automate direct provider payments.

Debit Card Technology

With our integrated payment network through the HRC Total Access Card, we can offer you a solution that provides you with a simple and easy to use claim and payment system. Combining this system with the Total Access Card, you can enjoy a seamless, hassle-free and paper-free process to submit your HSA, HRA and FSA claims. Claims are submitted and substantiated automatically, payments are made directly to providers, and consumers pay no out-of-pocket expenses at the time of service.

Automated Claims Processing and Substantiation

The HRCTS automatic claim submission and hassle-free processing decreases the risk of losing HRA or FSA funds at year-end.  By utilizing a fully HIPAA compliant debit card and claims solution we can improve the participant experience and break down the barriers currently preventing them from participating in a pre-tax spending account which provides greater tax savings for individuals and their employers.  There are no out-of-pocket expenses with payments made directly to providers, no need for participants to write checks, copy and submit receipts or file claims.   A truly hassle free experience when employees can show their Total Access Card once and they won’t need to show it again!

Carrier Partnerships & Integration

HRC Total Solutions enjoys strong partnerships with many of the insurance carriers throughout New England.  Our integrated claim feeds with carriers such as HPHC, BCBSMA, Tufts Health Plan among others, allow HRCTS to provide an easy to use HRA claims experience.  Claims are adjudicated, substantiated, and processed based upon plan rules defined for your organization.  Claims can be paid to the participant or paid to the provider directly on an automated basis saving time and money in the reimbursement process.

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