How to submit a claim

Most Benefi care requires no claims — providers bill us directly. If you paid out of pocket for covered care, you can submit for reimbursement through your member portal.

When you need to submit a claim

You'll only submit claims for in-person care when the provider couldn't process your Benefi coverage at the time of service. This happens occasionally with:

• Preventive care visits where the office couldn't verify coverage
• Plus plan medical visits at smaller practices
• Out-of-network emergency situations

Virtual Primary Care through the Benefi app never requires claims. Your $0 prescriptions at the pharmacy are processed instantly with your member ID. Mental health therapy sessions are pre-authorized with no paperwork.

How to submit your claim

For preventive care, ensure your receipt shows the specific preventive services (annual physical, well-woman exam, preventive labs). Generic "office visit" descriptions may delay processing.

Plus members submitting for their covered medical visits should verify the visit type matches their remaining annual allowance. Your member portal shows how many visits you have left.

What we need from you

Submit claims within 90 days of service. Include:

• Provider name and address
• Date of service
• Itemized services with diagnosis codes
• Proof of payment

If your provider gave you a superbill, that document contains everything we need. Otherwise, request an itemized statement plus your payment receipt.

For questions about specific claims or reimbursement timing, contact us through benefi.com/contact. Our care team can check your claim status and help resolve any documentation issues.