Who pays for what and when?
1.You or a member of your family visits your provider
(doctor/hospital) and shows both their medical carrier ID card
and their Benemax Card.
2.Your provider will bill your medical carrier.
3.Your medical carrier will process your claim, notify your
provider, and send a Claims Summary to you and your
provider.
4.In most cases, Benemax receives a report of your claims from
your medical carrier. Benemax reviews your claim and (if
applicable) makes additional payments on behalf of your
employer.
5.Benemax posts a Benemax Explanation of Benefits (EOB) on
your Claims Connection portal. You are responsible to pay the
amount due to your provider as shown.
Understanding Your Explanation of Benefits (EOB)
When you receive your Benemax Explanation of Benefits (EOB),
pay very close attention to it. Your Benemax EOB not only contains
all the important information about your claim(s), it also serves as
your bill. Any other documentation or invoice you may receive is
informational only.
When it comes to what you should pay, your Benemax EOB is your
guide.
If you have questions or need help understanding your Benemax
EOB, please contact a Benemax I Member Advocate either by
phone (800-528-1530) or via email
benemax.service@onedigital.com.
Do not make a payment to your provider until you have
reviewed your claim responsibility amount on your Benemax
Claims Connection portal.
Reading and Understanding your EOB
Benemax Claims Connection Portal
Understanding the Benemax Card
Accessing your Benemax EOB
Your Medical Plan and Benemax
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Plan members can track their claims history and spending through
this secure portal. The individualized claims site also offers
informational videos, the ability to access your EOB online, and the
option to use electronic upload for claims.
Medical Claims Submission
In most cases there is a weekly automatic claims feed from your
medical carrier to Benemax. Members and providers may also
submit claims using any method below.
Email: benemax.claims@onedigital.com
Fax: 508-242-6198
Mail: Benemax , POBox 950, Medfield, MA, 02052
You should include an EOB or Claims Summary and a copy of the
Provider Bill.
You can also submit claims electronically (Some of our plans are
non-reporting with the insurance carrier and employees must
submit claims manually). Submit a copy of your invoice and EOB to
benemax.claims@onedigital.com for processing. Please indicate
whether your claim is for medical coverage, dental, or FSA/DCA.
Logging In
If you are a first time user. please use your SSN as your username
and password in the following format (you must include the dashes
in your SSN):
Username: XXX-XX-XXXX00 (add two zeros at the end of your
SSN)
Password: XXX-XX-XXXX (no additional zeros needed)
You will then be directed to change both your username and your
password to complete your registration.
Forms
Benemax Claims Connection Portal
Claims Connection
HIPAA Designation of Personal Representative
HIPAA Release Form
FSA and DCA Claim Details and Submission
Commuter Claim Details and Submission
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Member Services
For questions about your benefits or your
claims, always call Benemax first - your
Independent Member Advocate (IMA) can
help! You’ll get one-on-one access to a local,
licensed Benemax team member who will
help answer questions you may have
regarding your benefits. This is not a call
center, but an extension of your employer’s
local service team dedicated to helping you.
We can help you to:
Learn how your claims are paid
Understand your covered benefits
Understand pre-tax accounts
Understand and lower costs
Navigate escalated claim issues
Benemax.service@onedigital.com
800-528-1530, prompt 3
Available Monday - Friday, 8:30am - 5pm EST
Be sure to provide your name, employer
name, and your question or issue.
Enrollment
Enrollment Coordinators can assist with all
enrollment questions.
We can help you with:
ID Cards
Eligibility Verification
Enrollment and Demographic Changes*
COBRA Support
*Enrollment Changes must be coordinated through your HR
Department. They will submit the information to Benemax.
benemax.enrollment@onedigital.com
800-528-1530, prompt 4
Online Services
We offer online support, educational videos,
and the ability to ask a question online.
Claims Connection allows members to track
their own claims and individual spending.
Online services include:
Online Videos
Online Claims Access
Helpful Links
Benemax Claims Connection Portal
FSA and DCA Claim Details and Submission
Contact Us
Medical Claims Connection Details
Commuter Benefit Claim Details and Submission
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