Flex Care: Self-Pay Claims & Reimbursements

If you have paid out-of-pocket for a qualifying medical expense, you may be eligible for reimbursement. Approved claims will either be refunded to you or applied toward your annual deductible, depending on your plan status.

Note: This process is for Medical claims only. Please submit Dental, Vision, and Pharmacy claims to their respective carriers (e.g., Beam, VSP, SmithRx)

1. Before You Start

To avoid delays, please verify the following:

• Provider Status: Confirm your provider is not directly contracted with Sana and will not submit the claim for you.
• Payment Status: Your bill must be paid in full. We cannot process claims based on fee estimates, payment plans, or bills with outstanding balances.

2. Prepare Your Documents

You will need to upload an Itemized Bill (Superbill) that includes all of the following:

• Patient and Provider names
• Provider NPI
• Date(s) of service
• Diagnosis code(s)
• CPT/revenue code(s) with units and charges for each
• Proof of Payment: The bill must show the Amount Paid and a zero balance.

Pro Tip: If you have multiple dates of service for the same provider and member, please include them all in a single submission.

3. Submit Your Claim

• Go to the Submit a Claim tab on your dashboard.
• Payment Method: Reimbursements are sent as electronic checks by default. To receive a paper check instead, select "Change how you get paid" during submission.
   

What Happens Next?

1. Submission Received: You will receive an initial email confirming your upload.
2. Processing: Once our team officially submits your claim, you will receive a second email. The 60-day processing window begins on this date.
3. Status Updates: You can track your claim in your "Medical Claims" tab.
4.  Final Decision:
   • Approved: You will receive a payment email from CheckbookIO (support@checkbook.io).
   • Missing Info: We will email you if we need more documentation.

Important Considerations

• Timeline: Processing typically takes up to 60 days from the time our team submits your claim. If 60 days have passed since your second confirmation email and you haven't received an update, please contact us.
• Duplicates: Do not submit a claim if your provider has already done so, as duplicate submissions may be denied.
   

Have questions? We've got you covered.