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 Scope of Services |
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The following are standard services:
- Claims Adjudication
- Premium Billing
- Eligibility Maintenance
- Monthly Reporting
- ID Cards and Forms
- Fund Account Maintenance
- Electronic Claims Re-Pricing (PHCS, CCN, Beech Street)
- Account Management
- Vendor Interfacing/Coordination
- Monitoring Legislative Issues Through The Following TPA Associations: SPBA, SIIA, HCAA
- Renewal Marketing (Re-Insurance)
- Reinsurance Claim Filing (Specific/Aggregate)
The following services are provided at an additional cost:
- COBRA/HIPAA Administration
- Consolidated Billing (including other coverages on the EBA&M bill for one easy payment)
- Section 125 Administration
- Large Claim Negotiation
The following services are coordinated by EBA&M but outsourced to other vendors:
- Plan Document
- Benefit Booklet Printing
- Utilization Review
- Case Management
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