Claim Statuses

We introduce six claim statuses to help HR and members track claims clearly, including reimbursement progress:

• Approved: Claim has been approved.

• Rejected: Claim has been rejected.

• Awaiting Amendment: The claim requires updates, and is pending amendment by the member.

• Processing Reimbursement: Reimbursement is being processed.

• Reimbursed: Claim has been reimbursed to the member.

• Unsuccessful Reimbursement: Reimbursement failed.

For more information, kindly refer to this article: How do I get notified about my claim status?

Members will receive email and push notifications in the Mednefits app when claims are Approved, Rejected, Awaiting Amendment, Processing Reimbursement, Reimbursed, keeping them informed at every stage, except for Unsuccessful Reimbursement.

When a claim updates from Processing Reimbursement to Reimbursed, members receive an email with the attached Payment Advice and a push notification via the Mednefits app.

For Unsuccessful Reimbursement, no notifications are sent, and members can view the status directly in the Mednefits app. If a reimbursement fails, the claim status changes from Processing Reimbursement to Unsuccessful Reimbursement. Once Finance resolves the issue, the status updates back to Processing Reimbursement for reprocessing.