Explanation of Benefits (detail)

If your claim was rejected because we need an Explanation of Benefits (EOB) from you, it means there was an indication on the documents you submitted that your expenses were partially paid or considered by an insurance carrier or another HSA. 

National HealthClaim is not insurance. Instead, we provide you with a spending account that pays for your expenses once you have used all your Group plan insurance coverage(s).

Note: This can include a spousal insurance plan. You must submit to all other plans first before submitting to us for remaining unpaid portions.

Now because insurance was involved with the expenses you are trying to claim with us (even if they paid 0) - we need you to send us their 'Explanation of Benefits' document (EOB, sometimes called a Claim Statement) from all insurance providers including other HSAs, for each expense you are claiming. 

Where can I find the Explanation of Benefits from my insurance carrier?

This detailed document is issued directly by your insurance provider(s) and shows the treatment/service date, patient name, treatment/service details, total cost of treatment, the amount paid toward each expense (even if it is 0) and all applicable messaging/notes for each expense regarding why insurance paid the amounts they did. 

Sometimes they automatically email it to you. Other times you would receive it by mail.

However, we recommend simply looking to see if you have an online account with your insurance carrier. You can often view/print this document directly from there.

If you do not have your copy, contact your insurance provider directly to obtain it. Please note, online copies or screenshots are acceptable. Summary documents are not acceptable as they do not include all of the required details listed above.

Once you have this document, send it to us by resubmitting your claim. 

Note: If you do not have coverage, you are not required to submit it to your insurance simply to get a rejection. Instead, write a quick disclaimer on the original invoice you submit to us, stating the reason you did not submit the expense to insurance (e.g no vision coverage, or insurance maximum already reached).