HCOnline is a web-enabled application allowing real time interactive access to eligibility, claims history and other Health Plan-specific information via the Internet. HCOnline provides the ability to query real-time eligibility and claims data, submit new eligibility information, submit changes to existing eligibility information, and process open enrollment, including new Health Plan year elections. In addition, identification cards may be ordered through HCOnline. Preferred Provider Organization (PPO) networks, Health Plan documents, forms, and other group specific information can also be made available through HCOnline.
HCOnline has three access levels. The following is a brief description of each.
Query: This feature allows for access by the group's Employee Benefits Representative or the Health Plan participant, or both. Eligibility query includes all employee and dependent information, such as name, address, member ID number, birth date and coverage. Identification cards may be ordered online.
Claim history includes access to each covered participant's history. Information consists of claim number, receipt date, dates of service, type of service, billed amount, paid amount, and non-paid amount. Explanation of Benefits (EOB) may be accessed and printed from this site. However, diagnosis or sensitive information is not accessible.
Open Enrollment: This feature allows online paperless open enrollment. Welcome page(s) and enrollment may be customized to suit each group's specific needs. The group may also post other enrollment information (i.e. Section 125, 401K), along with links to other sites.
Online enrollment allows for the tracking and monitoring of the enrollment process, for example: daily monitoring will reflect how many employees have completed their enrollment, how many have started but not completed their enrollment, and how many have not yet enrolled. This information helps the employer's Human Resource Department in coordinating timely enrollment with company departments and locations.
Online enrollment can result in considerable cost savings, as well. When using the online enrollment feature, printed materials are no longer required. Furthermore, the online enrollment process may eliminate the need to travel to various company locations for open enrollment meetings, thereby drastically reducing travel expenses.
Eligibility Maintenance: This feature, which allows for ongoing eligibility and census changes, offers limited access by employees, such as adding a dependent, changing a beneficiary, or correcting an address/telephone number. Should an employee initiate one of these changes, an automatic email is sent to the employee's Human Resources Department for approval.
Eligibility maintenance also monitors any changes and provides tracking of the change status. Ongoing eligibility maintenance not only expedites changes, but eliminates the need for mailing or faxing enrollment forms. It also provides both your employees and your Human Resource Department the convenience of immediate access to information.