No forms. No phone calls. Just fast, automated claims for gap, hospital indemnity, accident and critical illness. Eligibility is verified instantly. Payments are processed without delay.
Employers and brokers get real-time dashboards with insights into claim activity, turnaround times, and savings. Members stay informed every step of the way—with full transparency and zero paperwork.
↓ How it worksHow It Works
Accepts claims from any major health plan, integrating with carriers and TPAs for a hassle-free experience.
Works with all insurance carriers and TPAs, capturing both medical and pharmacy claims automatically.
Members only provide consent and basic info once—no forms or manual uploads needed after setup.
Transforms complex EOBs into plain language, showing what’s paid, owed, and how benefits apply.
Visualizes deductibles, coinsurance, and out-of-pocket max so members always know their financial responsibility.
Eligible out-of-pocket expenses are reimbursed directly to members via ACH, check, or reloadable card.
Toggle between the Fixed Indemnity and Proactive Gap experience.
Frequently Asked Questions
Get clear answers on how Claims Assist™ works, what’s covered, and how we support your employees.
Once a claim is submitted, our automated system handles intake, review, and processing. If eligible, reimbursement is sent directly to the member or provider, depending on plan tier.
Coverage varies by tier:
- Claims Assist™ covers routine out-of-pocket medical expenses.
- Advocate Assist™ adds bill review and negotiation.
- The full solution includes pre-payment and balance bill protection for large events.
Members can reach our dedicated support team for help with claims, bill review, and provider coordination. Support is available by phone, email, or in-app chat.