Health Plan (‌Setup - Health Plan Base Tables)

Health Plan (‌Setup - Health Plan Base Tables)


‌Setup - Health Plan Base Tables

Benefits>>Health Plan>>Claim Types

‌How do I set up a Claim Type?




Claim Types

A health insurance claim or a medical insurance claim is a request that is raised by the policyholder for compensation of the expenses incurred for the treatment.

A Claim Type categorizes the different types of claims which can be made by employees. E.g. Dental, Vision, Surgical, etc.


‌Enter New Claim Type



Claim Type Code: Enter a user defined code which represents the claim description.

Claim Type Description: Enter a user defined claim type based on the schedule of benefits defined by your insurance provider.

YTD Limit - Single: Enter the Year to Date limit for single coverage for the claim type. You should get hsi amount from your health plan administrator.

YTD Limit - Dependant: Enter the Year to Date limit for dependant coverage for the claim type. You should get hsi amount from your health plan administrator.

Save the record and enter additional claim types as required.

‌Enter Claim Type details



Benefits>>Health Plan>>Health Care Provider

‌How do I set up a Health Care Provider?




Health care Provider

A healthcare provider is a person or company that provides a healthcare service to you. In other words, your healthcare provider takes care of you.

Your health insurance plan will pay your healthcare provider for the services they provide to you, assuming the service is covered and you've met your cost-sharing responsibilities.


‌Enter new Health Care Provider



Company: Select the company to which the provider is being linked via an employee claim.

Provider ID: This is a user defined ID to identify the provider

Provider Name: Enter the name of the entity or medical personnel provider.

Address Line 1-3: Enter the address of the provider.

Phone No: Enter the phone number of the provider.

Provider Type: Select the provider type from the available options.

Save the record and repeat to add additional health care providers.

‌Enter Health Care Provider details




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