Disability and Life Online Claims Submission

Disability and Life
Online Claims Submission
User Manual for Employers
38177CAEENABC 06/13
The contents of this manual should not be considered legal advice or recommendations. You should work with your company’s attorney
when interpreting your company’s legal responsibility under your employee disability and life plan(s). You should also review applicable
state and federal laws and regulations. The contents of this manual may change or be updated at any time.
Table of contents
Overview ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 4
Submitting a Life Insurance claim •••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 5
Submitting an Accidental Dismemberment claim •••••••••••••••••••••••••••••••••••••••• 14
Submitting a Living Benefit claim ••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 21
Submitting a Life Waiver of Premium claim ••••••••••••••••••••••••••••••••••••••••••••••• 28
Submitting a Short Term Disability claim ••••••••••••••••••••••••••••••••••••••••••••••••• 35
Submitting a Long Term Disability claim •••••••••••••••••••••••••••••••••••••••••••••••••• 44
Checking claim status •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 53
Getting statistics reports — Life and Disability ••••••••••••••••••••••••••••••••••••••••••• 59
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Introduction
Disability and Life claims submission at anthem.com/ca — your one-stop claim administration web portal.
We’re making it easier for you to do business with us.
In addition to the helpful resources already available at anthem.com/ca, our online disability and life claims submission
site provides:
A convenient way for you to submit claims on behalf of your employees.
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Fast response times.
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Status reports to keep you up to date.
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We offer you control over your life and disability claim information and accuracy. Error messages signal missing or
incomplete information, and electronic prompts guide you from one step to the next.
This manual offers step-by-step instructions on how to use disability & life online claims effectively.
If you have questions, call:
For life claims: 800-552-2137
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For disability claims: 800-813-5682
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Or, call your group’s dedicated Case Manager.
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Welcome
To access online Disability and Life Claims Submission, go to anthem.com/ca and select the Employer tab. Then click
“Submit a Disability and/or Life Claim” to access the online claims site. You’ll select the type of claim you want to submit
on the Welcome screen. The options are:
Life
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Accidental Dismemberment
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Living Benefit
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Life Waiver of Premium
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Short Term Disability
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Long Term Disability
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Fields marked with an asterisk* are required.
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Submitting a Life Insurance claim
When you select “Life” in the Type of Claim field, you’ll need to select if you are submitting a claim for an Employee
or Dependent. This example is for an Employee claim. The process is the same to submit a Dependent Life claim.
In the Type of User field, select “Employer”. Enter the characters you see in the bottom box, then click “Next”.
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If you don’t already have it, you can print the additional form needed to process the claim from this screen. Click on the
link to get a fillable PDF copy of the Beneficiary Claim Form. This screen also explains any other information you will need
to submit so we can finalize the claim.
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You’ll enter your contact information on the Employer Information screen.
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On the Employee Information screen, you’ll give us the information we need to begin processing the life claim.
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If available, enter the beneficiary information here. You will click the “Add Beneficiary” button for each beneficiary on file
(see next page).
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This is where you enter the beneficiary information. We will still need a copy of the most recent Enrollment Form or the
most recent Beneficiary Designation Form.
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This screen allows you to upload any additional forms and documents. For example, if you have the Enrollment or
Beneficiary Designation Forms, the completed Beneficiary Claim Form(s), and/or the death certificate, you can upload
them here. Simply click the “Browse” button, select your forms, and then click “Upload”.
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On this page, you can review the information you have entered. You must also acknowledge the legal statements here.
You can enter your email address and we’ll send you an email confirmation of all the information you entered. You can
also enter any additional comments pertaining to the claim in the box below.
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Once the claim is complete, you’ll receive a confirmation summary showing all the information you entered, along with a
Claim Reference number. You can use this number when checking the status of a claim. If you entered your email on the
prior screen, you’ll also get a confirmation summary by email.
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Submitting an Accidental Dismemberment claim
To submit a claim for an accidental dismemberment, select “Accidental Dismemberment” in the Type of Claim field.
In the Type of User field, select “Employer”. Enter the characters you see in the bottom box, then click “Next”.
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You can print the forms we need to process the Accidental Dismemberment claim from this screen. Click on the links to
get fillable PDF files of the forms:
Employee’s Statement
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Attending Physician Statement
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You’ll enter your contact information on the Employer Information screen.
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On the Employee Information screen, you’ll give us the information we need to begin processing the Accidental
Dismemberment claim.
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If you have completed forms at the time you enter the claim, you can scan them and upload them on this screen.
For example, if you have the Employee’s Statement and/or Attending Physician Statement, you can scan and attach
them here.
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Next, you’ll get confirmation of the information you entered and you’ll give your certification to us so we can begin
processing the claim. You can also enter your email address and we’ll send you confirmation of all the information
you entered.
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Once the claim is complete, you’ll receive a confirmation summary showing all the information you entered. If you entered
your email on the prior screen, you’ll also get a confirmation summary by email.
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Submitting a Living Benefit claim
To submit a claim for a Living Benefit (Accelerated Death Benefit), select “Living Benefit” in the Type of Claim field. In the
Type of User field, select “Employer”. Enter the characters you see in the bottom box, then click “Next”.
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You can print the forms we need to process the Living Benefit claim from this screen. Click on the links to get fillable PDF
files of the forms:
Employee’s Statement
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Attending Physician Statement
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Disclosure Statement
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You’ll enter your contact information on the Employer Information screen.
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On the Employee Information screen, you’ll give us the information we need to begin processing
the Living Benefit claim.
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If you have completed forms at the time you enter the claim, you can scan them and upload them on this screen. For
example, if you have the Employee’s Statement, Attending Physician Statement, and/or Disclosure Statement, you
can scan and attach them here.
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Next, you’ll get confirmation of the information you entered and you’ll give your certification to us so we can begin
processing the claim. You can also enter your email address and we’ll send you confirmation of all the information
you entered.
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Once the claim is complete, you’ll receive a confirmation summary showing all the information you entered. If you entered
your email on the prior screen, you’ll also get a confirmation summary by email.
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Submitting a Life Waiver of Premium Claim
To submit a claim for a Waiver of Premium for life insurance, select “Life Waiver of Premium” in the Type of Claim field. In
the Type of User field, select “Employer”. Enter the characters you see in the bottom box, then click “Next”.
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You can print the forms we need to process the Life Waiver of Premium claim from this screen. Click on the links to get
fillable PDF files of the forms:
Life Waiver of Premium Employee’s Statement
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Life Waiver of Premium Attending Physician Statement
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You’ll enter your contact information on the Employer Information screen.
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On the Employee Information screen, you’ll give us the information we need to begin processing the Life Waiver
of Premium claim.
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If you have completed forms at the time you enter the claim, you can scan them and upload them on this screen. For
example, if you have the Life Waiver of Premium Employee’s Statement or Life Waiver of Premium Attending Physician
Statement, you can scan and attach them here.
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Next, you’ll get confirmation of the information you entered and you’ll give your certification to us so we can begin
processing the claim. You can also enter your email address and we’ll send you confirmation of all the information
you entered.
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Once the claim is complete, you’ll receive a confirmation summary showing all the information you entered. If you entered
your email on the prior screen, you’ll also get a confirmation summary by email.
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Submitting a Short Term Disability claim
To submit a claim for Short Term Disability, select “Short Term Disability” in the Type of Claim field. In the Type of User
field, select “Employer”. Enter the characters you see in the bottom box, then click “Next”.
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You can print the forms we need to process the Short Term Disability claim from this screen. Click on the links to get
fillable PDF files of the forms:
Attending Physician Statement
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Individual Authorization Form
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Reimbursement Agreement
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You’ll enter your contact information in the Employer Information section of this screen. Also enter the employee’s
contact information and all the information you have about their disabling condition.
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Be sure to give us as much information you have about the employee and their disabling condition.
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Enter further information about the disabling condition on this screen. The questions will change based on the Reason
Stopped Work chosen:
Illness
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Injury
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Maternity
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Unknown
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If you have completed forms at the time you enter the claim, you can scan them and upload them on this screen.
For example, if you have the Attending Physician Statement, Individual Authorization Form, and/or Reimbursement
Agreement, you can scan and attach them here.
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Next, you’ll get confirmation of the information you entered and you’ll give your certification to us so we can begin
processing the claim. You can also enter your email address and we’ll send you confirmation of all the information
you entered.
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Once the claim is complete, you’ll receive a confirmation summary showing all the information you entered. If you entered
your email on the prior screen, you’ll also get a confirmation summary by email.
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(Continued)
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Submitting a Long Term Disability claim
To submit a claim for a Long Term Disability, select “Long Term Disability” in the Type of Claim field. In the Type of User
field, select “Employer”. Enter the characters you see in the bottom box, then click “Next”.
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You can print the forms we need to process the Long Term Disability claim from this screen. Click on the links to get
fillable PDF files of the forms:
Attending Physician Statement
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Individual Authorization Form
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Reimbursement Agreement
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You’ll enter your contact information in the Employer Information section of this screen. Also enter the employee’s
contact information and all the information you have about their disabling condition.
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Be sure to give us as much information you have about the employee and their disabling condition.
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Enter further information about the disabling condition on this screen. The questions will change based on the Reason
Stopped Work chosen:
Illness
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Injury
}}
Maternity
}}
Unknown
}}
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If you have completed forms at the time you enter the claim, you can scan them and upload them on this screen.
For example, if you have the Attending Physician Statement, Individual Authorization Form, and/or Reimbursement
Agreement, you can scan and attach them here.
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Next, you’ll get confirmation of the information you entered and you’ll give your certification to us that we can begin
processing the claim. You can also enter your email address and we’ll send you confirmation of all the information
you entered.
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Once the claim is complete, you’ll receive a confirmation summary showing all the information you entered. If you entered
your email on the prior screen, you’ll also get a confirmation summary by email.
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(Continued)
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Checking claim status
You can check the status of claims submitted for your employees online using the secure portal. We will provide a user
name and temporary password for you.
Only group administrators can check claim status, or the designated representative (TPA). Employees do not have access
to check claim status.
If you are having problems logging into your account, please call
1-800-232-0113 ext. 4044798627
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The first time you log on with your temporary password, you will be promoted to change your password. You will then get
confirmation that your password was changed.
The first time you log on, you will also need to complete your profile.
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To check the status of submitted claims, click “Claim Search”.
If you have a question about a specific claim, contact the Life and Disability Service Center at 1-800-232-0113. If you have a question
about your reporting, contact the Life and Disability Reporting area at 1-800-232-0113 ext. 4044798627.
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You can search for a claim by:

Social Security number.

Reference number — the number provided when the claim was entered online.

Claim number — assigned by us.
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Type of Claim.

Claim Status.
Only Type of Claim and Claim status are required.
If you have a question about a specific claim, contact the Life and Disability Service Center at 1-800-232-0113. If you have a question about
your reporting, contact the Life and Disability Reporting area at 1-800-232-0113 ext. 4044798627.
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You can search for open claims, closed claims, or all claims for your group. Enter the date range for which you’d like
to see claim status.
If you have a question about a specific claim, contact the Life and Disability Service Center at 1-800-232-0113. If you have a question about
your reporting, contact the Life and Disability Reporting area at 1-800-232-0113 ext. 4044798627.
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You can review claims online or export the claim report to Excel. Click the button above the list of claims to export the
information to an Excel file.
JILL JONES
JILL JONES
DAVID ANDERSON
JOHN SMITH
MARY BROWN
LINDA MILLER
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Getting statistics reports – Life and Disability
You can get reports of the life and/or disability claims for your group.
Only group administrators can access statistics reports, or the designated representative (TPA). Employees do not have
access to reports.
To access your disability claims statistics report, click “Group Statistics Reports for Disability Claims.” To access your life
claims statistics report, click “Group Statistics Reports for Life Claims”.
If you have a question about a specific claim, contact the Life and Disability Service Center at 1-800-232-0113. If you have a question
about your reporting, contact the Life and Disability Reporting area at 1-800-232-0113 ext. 4044798627.
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To perform a search on the Employee Disability Claims Status page:

Enter the activity range start and end dates in the From Date and Thru Date fields.

Select Search.
Searches will only display 12 months of results.
If you have a question about a specific claim, contact the Life and Disability Service Center at 1-800-232-0113. If you have a
question about your reporting, contact the Life and Disability Reporting area at 1-800-232-0113 ext. 4044798627.
Select the claim type you want to find from the CLAIM TYPE drop down box:

Short Term Disability (STD)

Long Term Disability (LTD)
Enter the activity range start and end dates in the From Date and Thru Date fields and select Search to prompt a search.
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You can review the report online or export the report to Excel. Click the button above the list of claims to export the
information to an Excel file.
Here is a sample Group Statistics Report for Disability Claims:
If you have a question about a specific claim, contact the Life and Disability Service Center at 1-800-232-0113. If you have a
question about your reporting, contact the Life and Disability Reporting area at 1-800-232-0113 ext. 4044798627.
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Here is a sample Group Statistics Report for Life Claims:
If you have a question about a specific claim, contact the Life and Disability Service Center at 1-800-232-0113. If you have a
question about your reporting, contact the Life and Disability Reporting area at 1-800-232-0113 ext. 4044798627.
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Life products underwritten by Anthem Blue Cross Life and Health Insurance Company; Disability products underwritten by Anthem Life Insurance
Company. Independent licensees of the Blue Cross Association. ®ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross
name and symbol are registered marks of the Blue Cross Association.
anthem.com/ca
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