Last Updated v.12.1.0

Allows for the viewing of Claims and Ded/Plan Max information.

  1. Viewing a Participant's Claims - Select a person by clicking on the folder icon to the left of the person's name. Claims and Ded/Plan Max selections will be made available after a person is selected.
  2. What Does the Lock Symbol Mean? - The family member is 18 years of age or older, and the member must allow access from their account to other family members. This is due to HIPAA (Health Insurance Portability and Accountability Act section 108). Other family members must sign up for their own account before being able to provide access to their information.

** A Spouse with a Terminated status is restricted from viewing any dependent claims unless the the dependent authorizes the spouse using the process listed in #2 above.



Claim List


All claims are shown in DOS order from newest to oldest.

  1. Searching Claims - Claims can be filtered by typing in search criteria below the respective column heading. Filtering will happen as the criteria is typed in. There is no need to click any additional buttons to perform the search.
    Filters can be cleared by removing the search criteria from the boxes.

    The Charges filter must omit the $ sign and must include the decimal even if there are no cents.


  2. Viewing a Claim - Click anywhere in the row of the claim to be viewed. This will pop up the claim detail screen.
  3. Paging - The bottom of the grid contains the current page being viewed and the total number of pages. The page can be changed by using the forward or back arrows.
  4. Export to Excel - Use this option to export all claims currently listed in the grid to an Excel sheet (includes all pages in the grid).
  5. Back - The back button on the top right can be used to return to the family member selection list.


Claim Detail

The claim detail screen is valuable for seeing how your claim was submitted from your doctor, and how you claim is paid in accordance with your health plan.

  • Ask a Question - When clicked, a box will be presented to ask a question regarding the current claim being viewed. Enter the question into the “Type Your Question Below” text area. Click the “Ask” button to submit your question to customer service. The status of your question can be viewed at a later date under My Account > My Transactions in the main menu.
    • **The Ask a Question button will not be available of the member's employer has disabled this functionality.
  • Insured EOB - When clicked, a new window will open displaying the actual EOB that was sent for this claim, or a replica EOB, if the original is not available online.
  • Plan Document - When clicked, a new window will open displaying the corresponding plan document.
    • Please review the Coverage menu option for detailed plan and amendment information as well as coverage dates and history.
  • Amendments - When clicked, a new window will open displaying any plan amendment documents (if available).
  • Check Detail - Hover the mouse over the $ symbol next to the "Check" label (PAID claims only).  This will show the check details.
  • Service Line Detail - Hover the mouse over the ! symbol next to any detail line item (if present).  This will show the explanation of denied charges details.

Ded/Plan Max

  • Select the Year and Product to view the deductible, out of pocket, plan maximum(if available), and other accumulator information.
  • Web eXchange shows information for the years the participant has coverage.
  • Click the Plan Document icon to view the related Plan Document (if available).



HRA (Conditional)

***The HRA tab is only available for certain employer groups that have custom HRA information stored on the HealthSmart core claim system.  Web eXchange does not show HRA information from third party vendor systems.  The HRA tab will not display if the member does not have any HRA amounts accumulated in the core claim system.


  • Select the Year to view the related HRA information.



COB (Conditional)

***The COB tab is only available for certain employer groups that have custom COB information stored on the HealthSmart core claim system.  Web eXchange does not show COB information from third party vendor systems.  The COB tab will not display if the member does not have any COB information in the core claim system.