Health Plan Claims: Important Information
Your provider’s office will submit claims to the Health Plan on your behalf. The claims are sent from the provider’s office to Benefit Plan Administrators. This cycle can take as long as 30 days depending on the provider’s billing office, and the processing time at BPA. Generally, within 45-60 days of your visit with the provider, you should have from BPA an Explanation of Benefits (EOB) sent to your home address.
Online Explanation of Benefits (EOB)
You are able to view your claims on line at any time. Our online services provide a summary of your claim activity including claims in line to be processed, claims processed but awaiting check cycle and claims completed through check cycle. You are only able to view your explanation of benefits once the claim has completed check cycle and the check/EOB has been released at our print vendor. If you click on the hyperlink to the EOB from our main website and receive an error message 800 then that means the EOB has not been released to print yet.
BPA Check Cycle Process
BPA processes claims daily however check cycles are generated only once a week. This takes place late on Wednesday evenings. The file containing all checks and EOBs for the week’s claim processing is sent to our printing vendor on Thursday. Checks and EOBs print and mail no later than the Monday of the following week. Once the file is released, you can view your EOBs online within a few hours of the release.
Prescription Drug Program
BPA provides coverage for your prescription drugs through Caremark. When presenting your new ID card to the pharmacy, please be sure the pharmacy updates your information. If the pharmacy does not, your prescription claim will be denied. Also, please keep in mind that any special circumstances that were in place prior to your transition to BPA will not transfer to the new program. If you have any such situation, please contact our customer service department and we can make sure your account is handled properly so you don’t experience a disruption in your prescription drug coverage. If you were using the mail order program previously, you will need to contact your physician for a new prescription and complete the Caremark mail order packet in order to continue using the mail order program.
If you receive a bill from a provider and you have not seen an EOB from BPA, call us.
If you receive correspondence from us of any kind and you aren’t sure what we need, call us.
We are here to help you resolve your claims.
Benefit Plan Administrators, Inc.
PO Box 21392
Eagan, MN 55121