Navigating the paperless claims experience

How can I access different claims for different plans?

The claims link will take you to the recent claims page to view any medical claims that are pending, denied or completed. If you wish to view claims from other plans (separate medical, dental, vision or prescription drug plans) you will need to navigate over to the respective claims sections.

I'm an adult dependent on the policy (over age 18), but I cannot see anyone else’s claims.

Due to privacy laws, only the policyholder is able to view all underage dependents' information including claims.

I'm a policyholder, but I cannot see my children's claims in my portal. 

The policyholder can potentially see claims for everyone on the contract. However, adult dependents over age 18 must register for their own accounts, and then turn on Family access to allow the policyholder to view their claims.

Note: Dependents will only see their own claims when they sign into Blueprint Portal.

How does an adult dependent turn on family access to allow the policyholder to view their claims?

Sign in to Blueprint Portal, select the profile icon in the top right corner and click "Settings."  Under the "Profile" section, adult dependents can toggle on their Family Access at any time.

What information is available to us on the claims page?

Any claims a member may have will be loaded on the page with the following information:

• Number of claims being displayed and the total number of claims
• Name of the member to whom the claim belongs (if policyholder)
  • If not policyholder, members will only see their claims
• Status of claim (pending, denied, completed)
• Doctor or Location for the service
• Claim Number
• Visit Date
• Your Responsibility (what you may owe)
• View Claims Detail
• Explanation of Benefits (EOB) once document is available to view

There are too many claims to sift through, can I filter them?

Yes! You can filter by member (if policyholder), claim status, date range and claim type.  Once on the claims page, click the "Filter" button at the top of the page and you will be able to select how you want to filter your claims. 

My EOB is not available online yet; can I view details of the claims before my EOB is ready? 

Yes, select the claim you want to see details for. Then click on the "View Claim Details" button.  You will be able to view the provider’s name, claim number, total charges, member discount, plan(s) paid total, your responsibility, claim type, claim timeline, claim breakdown (Member Discount, Net Charged, Provider Adjustment, Other Health Plan Coverage, Your Plan Paid, Copay, Deductible, Coinsurance and Total). The Claim Breakdown section will include all of the information that will be on your EOB.

I have questions about a claim, can I talk to someone without having to call?

If you need help or have questions about a claim(s), you can contact us by utilizing the "File an inquiry" option when viewing a specific claim.  Your question will be directed to a customer service team member and they will reach back out to you with information regarding your inquiry.  In addition, during business hours, you can utilize the chat within your member portal and receive answers to your questions in real time.