MEDPLUS CLAIMS FLOW

MEDPLUS CLAIMS FLOW

1

Member goes to the Doctor/ Facility/Hospital and presents ID

card(s) to the Provider

6

2

MedPlus Processes claim and sends out provider payments

and Final EOB

Provider verifies benefits with Primary Health Insurance and Secondary MedPlus Insurance

5

Provider files Claim and EOB with MedPlus

4

Primary Health Insurance processes claim, returns voucher and EOB to provider

3

Provider Files Claim with Primary Health Insurance

Underwritten and Administered by Gulf Guaranty

Definition of Terms: EOB = Explanation of Benefits Primary Insurance = Medical Carrier Secondary Insurance = Gulf Guaranty MedPlus

To verify member benefits, please call 800-890-7337 and ask for the Benefit Verification department.

Claims can be submitted via Mail, Fax or EDI: Mail:Gulf Guaranty, P.O. Box 14977, Jackson, MS 39536-9505 Fax: 601-981-6805 EDI: 99943

Gulf Guaranty Employee Benefit Services ? P. O. Box 14977, Jackson, MS 39236-4977 ? P: 800-890-7337 ? F: 601-981-6805

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