www.memberbenefitsonline.com Provider Portal : Verification Code
be*****@we*********.com
If you have saved the BeneSys Provider Portal link at www.memberbenefitsonline.com to your browser’s favorites, you may get an error that says: “You have been inactive for too long. Your session was terminated. Please logon again.”
To clear this error, remove the highlighted section of the URL: https://benesysuat.webspyglass.com/timedout.jsp
Once you have removed the timedout.jsp portion of the URL you will then be taken to the Login Screen. (Please note you will want to make sure your Pop Ups are Enabled on this website as certain screens will have a Pop-Up window that will provide you with additional info/benefits)
Once you have allowed the pop-ups you can then either Register or Login if you already have an account.
Registration Process for New Providers
Select New Provider User Registration
To create an account, you will need to create a Username, provide your Full Name, then provide either a valid Email or Cell Phone number. (This is needed only for two-factor authentication to help keep our members and your patient’s information protected.) Please then provide your companies address, coverage type (Medical, Dental, or Vision). Then you will be required to provide a valid TIN, NPI, and Zip Code.
Once you submit your registration you will be emailed a Verification Code. The Verification Code will be sent from
be*****@we*********.com
. If you do not receive the email in your inbox, please be sure to also check your Spam/ Junk folders to confirm if it was sent there in error.
Searching a Patient
Once you have logged in you will be taken directly to the Patient Search Screen To successfully locate your Patient please provide the Member ID/SSN/Alternate ID, Patient’s First/Last Name, and DOB. Then select what type of Coverage you are looking for. (Medical, Dental, Vision)
Once the search is complete, the Portal will load the Patients Information below the Patient Search screen.
Patient Overview Screen
Patient Overview, will provide you with the patient details, eligibility status, effective date, and plan they are enrolled in. Below the Patient Information you will be able to see the Subscriber Information, and any recent claim activity that patient has with your TIN/NPI.
Coverage & Benefits Screen
Coverage & Benefits is where you can see the patient’s current Accumulations towards Deductible and Out of Pocket Maximum. This screen will show you both how much they have currently met towards that benefit, as well as how much the total benefit is. If the deductible or out-of-pocket has been met, it will also provide you with the date of when they met the full benefit. (The accumulations will default to the current year, but you can press the drop-down menu with the year to look at previous years accumulations if needed.)
If you have any questions related to their deductible, out-of-pocket maximum, or yearly maximum for Dental/Vision, you can submit that inquiry by selecting the “Ask a Question” button at the bottom of the Coverage & Benefits screen.
Claims Screen
The Claims Screen will be where you can access all your claim history for that patient. You will be able to see the Claim Number, Date of Service, Date Paid (Finalized), Claim Status, In-Network Status under PPO ID, Assignment of Benefits, Total Charge, Patient Responsibility, and Paid Amount. Each claim will have an “Ask a Question” option if you need more details on the claim. You can filter the claims by selecting a specific Date Range, or you can view the claims in order of date of service and use the arrows at the bottom right corner to toggle to the additional pages of claims.
Documents Screen
The Documents Screen is where you will find the full Benefit Breakdowns for the patient’s plan. If their group offers multiple plan options to enroll in, you will also be able to find the Plan Code Names which will help direct you to which Benefit Breakdown to use. Documents will also have any forms that are available for that group. i.e., Pre-Determination Forms, COB Forms, Injury Details, etc.
When selecting the Benefit Breakdown to verify coverage of a specific service, it will download a PDF copy of the Benefit for you to view.
It will then open a new tab in your browser with the benefits loaded.
Important Notes Regarding Benefit Breakdowns
• Please note that the benefit outline document is a searchable document. Press (Ctrl+F) to search the benefits.
• The majority of plans do not have specific coverage based on code, but rather are categorized by type of service. i.e., surgery (outpatient, inpatient, office surgery), Mental Health (Outpatient, Inpatient, Residential Treatment Facilities), etc.
• Prior Authorization requirements are listed on the benefit outline for your reference along with the Utilization Review/Prior Authorization Company who provides the authorizations.
• Visit Limitations, Maximum Payable, and any other limitations or important requirements/clarifications on the benefit can be found in the Comments column to the far right of the benefit breakdown.
The BeneSys Provider Portal inquiry will be marked as Closed if the Portal Representative was able to answer everything in your inquiry. If the Portal Representative has items, for which they need further information from you they will respond with the inquiry still marked as “Open” so you can respond with the additional information. If you need to follow up on an inquiry that was previously closed, you can reply as normal and it will reopen the inquiry so the Provider Portal Representative can further look into the issue for you, and you will have your previous inquiry/response all connected in one place.
