Every claim, followed from enrollment to payment.

Enroll a member, confirm coverage, submit a claim, and see exactly how the payment was calculated - deductible, copay, and what's paid, in that order.

Submit a claim New member? Enroll first
Example claim
Two-line wellness visit
Annual wellness visit, initial (G0438)$85.00
Annual wellness visit, subsequent (G0439)$65.00
Allowed amount$150.00
Deductible applied−$100.00
Copay applied−$15.00
Paid to provider$35.00

Start here

The same five stages a claim actually moves through, in order.

  1. Enroll a member
    Sets up an active plan with a copay and a remaining deductible.
    Enroll a member
  2. Check eligibility
    Confirms coverage is active before any claim is filed.
  3. Look up a contracted rate
    Finds what a provider is allowed to bill for a procedure.
    Look up a rate
  4. Submit a claim
    Runs the full calculation: allowed amount, deductible, copay, payment.
    Submit a claim
  5. View remittance
    The final payment issued to the provider.