HealthSmart offers claims management services for all types of healthcare benefit plans. We process healthcare claims for an employer that self-insures its employees. Whether we duplicate a current active employee and/or retiree plan design or add a consumer-directed healthcare plan, we custom fit our services to the needs of our clients.

HealthSmart offers employers cost-effective claims administration for self-funded employee benefit plans. With HealthSmart, we insure efficient claims operation, secure and reliable automation, timeliness and cooperation with providers, all the while reaching our goals of working more efficiently, improving our customer service and decreasing administrative costs.

HealthSmart has the experience, expertise and capability to administer all or a portion of the claims process: design, installation, network coordination, enrollment, collection and much more:

  • Design the plan
  • Prepare all necessary plan documents, descriptions, employee booklets
  • Provide all administrative material for claim processing
  • Develop cost containment measures
  • Secure stop-loss insurance coverage
  • Install the healthcare plan
  • Load enrollment information
  • Load and test Medical, Dental and Vision plans
  • Supply standard ID cards
  • Create claims and eligibility forms
  • Create EOBs and checks
  • Determine and administer reasonable and customary charges
  • Prepare itemized monthly premium statements
  • Disburse collected premiums to reinsurers
  • Set up reporting parameters and provide management reports to employers
  • Train all personnel
  • Help interpret data