When you see an in-network doctor, dentist, or other healthcare provider, they will submit the bill to us. That's called a claim. You might also receive a bill from your provider, but wait to hear from us before paying it.
If you saw an out-of-network provider or paid up front for your care or prescriptions, you can submit a claim yourself.
Your EOBs are available in your online member account. If you'd like to skip the paper option (U.S. Mail), you can opt to go paperless.
Family members 13 and older can create their own online accounts and can choose who can see all claims or only nonsensitive claims.
The default setting is that the subscriber spouse or parent will see nonsensitive claims. Sensitive claims have to do with any diagnosis or procedure that's related to genetic information, chemical dependency, mental health, reproductive health, pregnancy, sexually transmitted diseases, HIV, and AIDS.
To change your settings, sign into or create an online account and and look for Privacy Settings under Claims.
After a claim is submitted you’ll receive a breakdown of the charges submitted. This is your Explanation of Benefits (EOB). It shows what we pay for and the portion, if any, you are responsible for.