Generali Mobile Health Plan Member Portal Overview

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1 Generali Mobile Health Plan Member Portal Overview March 2012

2 Member Portal Overview The online Member Portal allows you to access the vital information you need such as: benefit information, claims status, payment details and much more. Instructions to Access the Member Portal Log on to and enter in your username and password. NOTE: To ensure trouble free operation, your computer should have the most recent version of JAVA downloaded and installed. If you don t have the latest Java updates installed, select [First Time Users Please Click: HERE] to download the latest Java update and allow for the installation of the Java certified software. Page 2 of 8

3 Navigating the Members Portal Once you have successfully logged onto the Secure Portal, select the [Start Here] button located in the top left corner to begin. The [Start Here] dropdown allows you to access a number of tools including: Online Documents Coverage Profile Online ID Card Accumulators Claims List Page 3 of 8

4 Online Documents Selecting the online document section provides you with access to the following material: Policy Guide (PDF) Pre-authorisation Form (PDF) Generali Provider Search - Worldwide (Excludes USA) (Hyperlink) Supplementary Medical Form (PDF) Claim form (PDF) In order to seek reimbursement, we require information related to your diagnosis and treatment details be submitted along with your claim. If your invoice does not contain your diagnosis and treatment details, you must have your Treating Practitioner complete a Supplementary Medical Form. The Supplementary Medical Form must be printed and provided to you Treating Practitioner for completion. The Supplementary Medical Form must be printed and provided to you Treating Practitioner for completion; upon completion it should be included along with your claim submission for reimbursement consideration. The claim form is available to print and also to complete online. If you would like to print the form and complete by hand: Select our printable version and print the form Complete the form Mail, or fax the claim form + supporting documentation to the Generali Assistance and Service Centre for processing (Refer to [Contact Us] tab for contact details) If you would like to complete the form online: Select our electronic version Complete the form online, when complete, press the [Submit] button located on the bottom of the page Once selected your default account will open up with the addressed to the Generali Assistance and Service Centre with the claim form added as an attachment Attach all supporting documentation and press [Send] You will also have the option to download our complete claim package (printable claim form + Supplementary Medical Form). Page 4 of 8

5 Coverage Profile The coverage profile will allow you to view your medical, dental and/or visions benefits, if applicable. Once you have selected to view your coverage, the first page that appears displays your Medical Benefit Eligibility and Coverage Information. The coverage profile information is divided into essentially two sections, or two pages. Page 1 provides information regarding who the Insured is, what the plan and coverage type is and a list of dependents, if applicable Page 2 is a summary of the actual benefits that apply to the Member or their dependents. It is important to note that the eligibility summary provided on page 2 is for illustration purposes only and that in all cases; the plan document will take precedence over this summary. Insured, Plan and Dependent Information Insured Information provides information about the Member including Group Name and Employee ID number (also known as your Family ID) Coverage Information displays information specific to the Member and their coverage including: Plan Name Plan Type; i.e., is it an individual or a family plan Effective Date of the Plan Termination Date of the plan YTD Deductible - dollar amount Member has contributed towards their deductible during the calendar year YTD Out of Pocket - dollar amount Member has contributed towards their out of pocket amount during the calendar year Dependent Information provides information regarding the Member s family, if applicable. Information in this section includes: Dependent Name Relationship to Member Gender/Sex of the Dependent Date of Birth Effective Date Termination Date YTD Deductible - dollar amount Dependent has contributed towards their deductible during the calendar year, if applicable YTD Out of Pocket - dollar amount Dependent has contributed towards their out of pocket amount during the calendar year, if applicable If you do not have any dependents, this section will remain blank. Page 5 of 8

6 Medical, Dental or Vision Coverage From the top of the page, you have the option to view your medical, dental or vision benefits, as well as the option to print the eligibility information This section will then display basic information regarding your benefits. Online ID Card This selection will allow you to print a temporary ID card in the event you have misplaced or lost your current card issued by Generali. In all cases, you should contact your Plan Administrator to have your card replaced as soon as possible. Accumulators The accumulators section enables you to view your or your dependents deductible or out of pocket contribution for each plan year, if applicable. This section will display: Claimant Year Plan: medical, dental or vision Deductible carryover from the previous year In Network Deductible to date for the particular calendar year In Network Out of Pocket contributed to date for the particular calendar year Out of Network Deductible to date for the particular calendar year Out of Network Out of Pocket contributed to date for the particular calendar year Page 6 of 8

7 Claims List By selecting the [Claims List] from the Start Here drop down, you will be able to view all claims that have been processed for you or for your dependent(s). Information includes when the claim was received, as well as the date the claim was processed. To narrow down a particular claim, you have the ability to search by a number of variables, such as date of service or claim number. Please note, the initial search results will only display claims received that have a date of service within the last 90 days. Use the [Date of SVC] fields to view claims with a date of service greater than 90 days old. Each claim number is hyperlinked and by selecting the desired record you will see details pertaining to that one specific claim. Page 7 of 8

8 My Settings To maintain your privacy, the [My Setting] section will allow you to create your own unique password, as well as update information if necessary. Contact US The [Contact Us] section will provide you with instructions on how to contact the Generali Assistance and Service Centre. The obtain toll free dialing instructions; please select the country where you are located from the dropdown. Once selected, the dialing instructions will appear in the adjacent dialing instructions box. If you wish to contact us from a location not indicated in the dropdown, please contact us directly or call collect by dialing Page 8 of 8

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