Member Support

 

At ClearChain Health, everything you need to manage your health plan is in your hands and your member portal. 

Our Online Member Portal Features:

  • Claims Management
  • Customer Service Communication
  • Deductibles
  • Eligibility & Plan Information
  • ID Card
  • Pharmacy & Prescription Information

View Claims in Real-Time

Effortlessly check claims status, see when the claim was paid and even view and print the Explanation of Benefits (EOB).

News & Plan Information

Get information at your fingertips, including the latest news, announcements, and network information. View plan updates and your own personal care plan. 

View Deductible, Eligibility & Plan Information

All of your plan information is right inside your portal, including your current primary care provider, coverage specifics, deductible information, out-of-pocket amounts, and cost-sharing. 

Insurance Cards

It is easy to print or request a new insurance card. Simply log in to your member portal, select the blue ID Card button, then click on Request New Card. Your new ID card should arrive within 10 – 14 days.

Pharmacy & Prescription 

Our Pharmacy RX dashboard includes an interactive tool to help you find the right pharmacy, research medication capabilities, and identify your prescription history. It provides you with easy-to-read, up-to-date prescription history along with supporting detailed claims data, benefits design information, and reference content. 

We make managing your medications easier, through:

  • Mail-order and specialty pharmacy options
  • Medication PillPacks in pre-packaged doses

Have a question about your prescription plan?

Easily send questions about your eligibility and claims to our customer support team directly through your portal. 

PROVIDER NOMINATION & VISITS

We’ve made the provider nomination process easy so you can continue working with the provider or facility of your choice. Simply complete the Provider Nomination Form here.

After your provider has acknowledged participation in the ClearChain Plan, you don’t need to nominate them again.

Be sure you take your health insurance card with you to your provider’s appointment. At ClearChain Health, you are only responsible for paying your copay during your visit and at the time of service.

  • All other patient responsibilities will be communicated on your explanation of benefits.
  • You will only be responsible for your copays, deductible, and co-insurance, which equals your out-of-pocket. You are not responsible for any additional amounts billed to you. 

Sometimes, a medical staff member might not be familiar with ClearChain. Just have them give us a call at the number on the back of your insurance card and we will walk them through the process. 

CLAIMS MANAGEMENT

The claim submission process is easy, and your providers will be familiar with these steps. The ClearChain Health benefit means lower co-pays for you and your family.

  • After your appointment, your healthcare provider will submit a medical claim to ClearChain Health. 
  • We’ll review the claim, make sure it’s accurate, calculate the fair reimbursement rate for the care you received and pay your provider directly.
  • After your medical claim is processed, you will receive an explanation of benefits (EOB). This is not a bill, but a statement that lists details of the services your healthcare team provided and how your medical benefits were applied. 
  • Remember to read the “Patient Responsibility” section of your EOB. This section communicates what you owe your provider.  Learn more about your Patient Responsibilities.

If you receive a bill with an amount greater than what is indicated in the “Patient Responsibility” box on your EOB, this may be a “balance bill.” Contact our customer support team immediately so we can review and troubleshoot.

MANAGEMENT OF CHRONIC CONDITIONS & HOSPITAL ADMISSIONS

When it comes to your healthcare, it’s important to understand which resources are available to help you navigate the system.

Whether you have a chronic condition that you need help managing, or need a guide for complex hospital admissions or emergency departments, ClearChain Health is here to put the experts in your corner so you can live a healthy and productive life.

Our case managers are registered nurses, who ensure you receive the appropriate and quality care you need. Your case manager works with you, your healthcare provider, caregivers, vendors, and community resources to coordinate quality, cost-effective care, as well as help you control chronic illnesses with ClearChain Health’s disease management programs.

ClearChain Health’s member support team is there when you have:

  • Acute healthcare needs, diagnoses, or hospitalizations
  • Medical complications and co-morbidities
  • Complex hospital discharge requirements
  • Unique social issues 

Login to your member portal to manage your insurance benefits. Contact our member support team at any time with questions.

Member Resources

Getting Started with ClearChain Health

Learn the easy steps you’ll take to start using ClearChain Health and how we’ll help you navigate the process.

Nominate Your Provider

Learn why it’s important to nominate your provider to participate, how to do it and our role before your next visit.

Member Support

Learn how we help with balance billing, chronic disease management and hospital admissions.