For some self-insured employer groups, this means you may occasionally receive a claim determination notice (or Explanation of Benefits form, as it is called) before the check for benefits is actually released. This happens because the timing and frequency of check cycles for each group will vary depending on the funding options chosen by the group. If the benefit check has been released, the check number will be shown on the Explanation of Benefits.
Benefit checks are usually released no later than four weeks from the date the Explanation of Benefits form was mailed. If after more than four weeks you receive a “balance due” statement from your provider, call the provider to see if all benefit payments received in the office have been credited to your account. In most cases, we find that the provider has the payment but has yet to credit your account. If payment has still not been received by the provider, please call our Customer Service at 800-236-7789.