Accounting and Eligibility
The Accounting and Eligibility department functions as the liaison between the patient, the provider, and the client after a claim has been finalized.
Once cleared for payment, the claim file transfers to Accounting and Eligibility for the check to be cut to the provider (or directly to the member in the event of reimbursement). The separation of duties between Claims and Accounting is critical to effective internal control in order to reduce the risk of fraud and error.
All clients have their own plan checking account from which CMRG is authorized to issue checks for benefits and Core fees. Our Accounting and Eligibility department performs claim, flexible spending account, and workers’ compensation check runs as well as the following functions:
- Produce ID cards
- Administer eligibility online via CoreLink II (Core's online manager of enrollment) or via an electronic HIPAA 834 file
- Flexible spending account administration
- COBRA administration
- Reconcile bank statements
- Provide financial statements for our clients
- Perform the billing, collection, and payment of vendors for our clients
- Year-end reporting of 1099's, monthly HCRA reporting, weekly check registers, and Form 5500 filings are also generated by the Accounting and Eligibility department.
If you need assistance, please contact us at 1-888-741-2673. CMRG representatives are available Monday – Friday from 8am – 5pm and are trained to resolve your concern at the time of the call.