Understanding the

PROVIDER PAID HRA BENEFIT

Blue Cross and Blue Shield of Alabama has partnered with HealthEquity, an independent
company, to offer a Provider Paid Health Reimbursement Account (PPHRA) benefit to
groups interested in this option.
A PPHRA allows HealthEquity to retrieve the
money from the member’s Health Reimbursement
Account (HRA) and pay the provider for
deductibles, coinsurance and other types of
out-of-pocket expenses. Once the balance is
exhausted, the provider can bill the member for
any deductible or copayment remaining.

Note: Please remember to file these claims directly

to the Blue Cross and Blue Shield Plan in the state
the service was provided.

What is an HRA?
An HRA is a benefit offered in conjunction with a high deductible health plan and is an account funded by the
employer for each participating contract. It pays for eligible healthcare expenses typically covered under the
medical plan. If funds are exhausted for the contract, the employee is responsible for satisfying the remaining
deductible before the plan begins to pay.

How will the provider view the balance of the account?

PPHRA balance information can be obtained by checking member eligibility and benefits through your
practice management software system or ProviderAccess. On ProviderAccess Eligibility and Benefits, the
remaining balance will be displayed under the “Alerts/Messages” tab. You can also call HealthEquity at
1-877-288-0719 for the balance.

Note: There may be claims that process after you check the balance and before your claims are received.

Is the PPHRA benefit per member or per contract?

These HRA benefits are per contract.

Will providers be able to decline the benefit and collect the member’s deductible, coinsurance and/or
copayment prior to the service being provided?
Providers should not decline services to our members who have this benefit. Blue Cross encourages
providers to wait until claims have adjudicated and HRA benefits are applied before collecting money from
the patient. Providers must reimburse the member for any amounts collected up front if HRA reimbursement
is made. Once HRA amounts are exhausted, providers may collect remaining deductibles, copayments and
coinsurance amounts up front.

Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association.
Blue Cross and Blue Shield of Alabama has engaged HealthEquity, an independent company, to assist in the administration of our
Provider Paid Health Reimbursement Account (PPHRA) benefit to groups interested in this option.

(Rev. 12-2016)