How do I add the Adjudicare software as a carrier for e-dental claim submission?

Answer: 

The Adjudicare system has a unique carrier/BIN number used for e-dental claim submission. Contact the Automated Benefits customer support team at 1.877.944.7100 to obtain this information.

What is the e-dental support number from Automated Benefits?

Answer: 

1.866.483.5862. This number is also on the back of the employee/claimant cards.

What is the ESI pharmacy help desk number?

Answer: 

1.800.563.3274. If a pharmacy is experiencing an issue submitting a drug card claim, they should call the ESI pharmacy help desk directly. If assistance is required from Automated Benefits, ESI will contact us.

I ordered my drug card this week, when will I receive it?

Answer: 

Cards are typically processed and printed by ESI on Tuesdays for the previous 7 days' requests. The cards are then mailed the next day with most clients receiving their cards on Thursday of the processing week.

I terminated a drug card for a claimant, why am I still being charged $1.40 for each rejected attempt?

Answer: 

The drug card can still be used even though it has been terminated with Automated Benefits and ESI. Unfortunately, ESI will still accept a request over their network, but it will reject it. A $1.40 charge is applied for any attempt made. Wherever possible, drug cards should be returned to the broker at the time of termination. The status of drug cards can also be checked by accessing the ‘Cards on Demand’ function within the ‘Manage Drug Card Order’ section of the Adjudicare software.

Can the Adjudicare system receive and adjudicate electronic transactions?

Answer: 

Yes, the Adjudicare system has full pay direct drug and e-dental adjudication capabilities.

Can the Adjudicare system import claim history from another carrier?

Answer: 

Yes, the Adjudicare system can import claim history.

Can the Adjudicare system manage Health Care Spending Accounts?

Answer: 

Yes, Adjudicare can manage HCSAs, cost plus and traditional benefit plans. Our HCSA features are robust and offer a tremendous amount of flexibility.

Are claims cheques printed on Adjudicare cheques?

Answer: 

No, all system functions are performed at the end user location so all drug cards, system generated reports and cheques are user branded. Adjudicare provides the tools you need to adjudicate claims yourself.

What claim types can be paid through the Adjudicare software?

Answer: 

Health, drug (paper and pay direct), vision, dental (paper and e-dental) and weekly indemnity claims can all be paid using the Adjudicare system.

Can the software be used in multiple locations?

Answer: 

Yes, the Adjudicare solution is an extranet-based system that may be installed on multiple computers and accessed from anywhere that has internet access. Each user is provided with a unique username and password.

Can the Adjudicare system integrate with other software solutions?

Answer: 

Yes, the Adjudicare solution can be fully integrated with TPA and insurance carrier software applications.