Partner admins can manually enter claims in the Health Wallet Manager. This is useful for claims received by fax, email, or mail that need to be added to the system on the member's behalf.
Language note on expense
To request reimbursement on our platform, users must “add an expense.” This includes claims.
How to submit a claim for a member
For partner admins
This feature is only available to super partner admins, partner admins, tier 2 agents, and tier 1 agents.
Choose member
Go to Member Search or an organization's Members tab.
Find your desired member or dependent.
Select Add Expense from the overflow menu (or from the member's profile)
Under Member or Dependent Selection, search for the member or dependent by full name.
Choose the correct person from the results. The list shows the last 4 digits of their Social Security number (SSN) and date of birth to help you confirm you've selected the right record.
No bank account linked
If the selected member doesn't have a bank account on file, you won't be able to submit a claim for them or their dependent until one is linked.
Upload documentation
Under Supporting Documents, upload the receipt, bill, or explanation of benefits (EOB). Accepted file types are JPEG, JPG, PDF, and PNG.
Select Continue. The form uses the same fields and keyboard navigation as the claim form members complete in Health Wallet, including tab navigation between fields, dropdown selection, and submission.
Enter details
Under Is this expense for a dependent?, select No or Yes. If you select Yes, choose the dependent from the dropdown.
Select the Account from which the expense should be paid.
Enter the Amount, Merchant, and Date(s) of Service.
Add a Description of the expense.
Select Review.
DC-FSAs
For DC-FSA claims, you’ll also need to select a Category, Vendor, and Address.
Submit claim
Confirm the claim details on the Review Expense screen.
Select Submit Claim for [amount].
Submission from the Claims dashboard
Admins with access to the Claims dashboard (super partner admins, partner admins, and tier 2 agents) can also submit claims for members from the “Add Expense” button on the top right corner of the page.
After submission
Once submitted, the claim enters the claims queue with a status of "New" and can be processed by anyone with review permissions. The member will receive an email confirming the claim has been submitted. If the claim is returned with a status of "Needs More Information," you can add the requested details without the member needing to resubmit.
Review permissions
Here’s a quick rundown of which admin roles have permission to review claims.
Super partner admins, partner admins, and tier 2 agents have permissions to review claims.
Tier 1 agents can submit claims on behalf of members, but they cannot review claims.
Learn more
To learn more about partner admin permissions, read “Create and manage partner administrator accounts.”
Claims history for members
Under the History tab of the Claim Details page, members will see the organization affiliated with the agent for any claims entered or updated by an agent, such as “Submitted by Organization A” or “Updated by Organization B.”
Claims history for admins
Under the History tab of the Claim Details page, admins with claims review access (super partner admins, partner admins, tier 2 agents) will see the name of the admin agent who entered or updated a claim for a member, such as for any admin-entered claim submissions or updates, such as “Submitted by Jane D.” or “Updated by Jane D.”