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If the claim inquiry is initiated by the Employee/Claimant:

	Employee/Claimant is asked to provide a PHI authorization (if necessary)
	Employee/Claimant is asked to provide the details of the claim which may include: Explanation of Benefits (EOB) Itemized statement from the provider Collection Agency Statement If any of the above is not available, the claimant is asked for details or redirected back to the provider to obtain the above information. (We will expedite the request by telephoning or writing the provider directly.)
	Contact the insurance carrier via telephone, e-mail, or online to determine the current status of the claim and their opinion on the claimant's responsibility or validity of the balance bill
	Correspond with the employee/claimant to provide status of claim. If required re-contact the Insurance company for additional inquiries
	Advocate with insurance carrier on behalf of claimant in light of policy provision or Summary Plan Description interpretation.
	Request reprocessing of claims (if necessary), ask the claimant to follow-up when new statement or reprocessed EOB is received
	Advise claimant on appeals process (if necessary)
	Review claimant's appeal and make recommendations

If the claim inquiry is initiated by the Employer (on behalf of the Employee/Claimant):

Correspondence is referred back to the employer contact who initiated the request, unless advised to contact the employee/claimant directly.