Important Notice To Plan Participants Regarding The End Of The Covid-19 National Emergency

Provider Tools

Simple business solutions that save money and time

Finding what you need

FCE Benefits is committed to providing Health Care Professionals with simple business solutions that save money and time.

Verify
Benefits

Verify Patient Benefits
Get Started

File
Upload

Securely upload files
Get Started

Claim
Forms

Need to file a claim?
Get Started

Provider
Resources

EDI and NPI Information
Learn More

Our Affiliates. Providers. Partners.

FCE maintains working relationships with health plans and preferred provider networks internationally. FCE Benefits works with all carriers including but not limited to:

Claim Forms & Documents

FCE provides a wide variety of Claims Administration services

The following claims forms are available for download for FCE administered benefits (Note: these forms can be completed online. Simply place your cursor in the space provided and start typing. Press the Tab Key to the progress through the document. Then, print out the form, sign, and return to us using one of the means below):

Claims Mailing Address:

Hard copies of claims may be mailed to the following address for processing

FCE Benefit Administrators, Inc.
PO Box 211757
Eagan, MN 55121

Claims & Forms

Medical Claim

For submitting medical claims

Prescriptions Claim

For reimbursement of covered prescription drug claims.

PT Mini-Claim Form

For Part-timers to submit with EOB or visit summary

Vision Claim

For reimbursement of covered vision care claims.

Eyemed Vision Claim

For Out of Network Vision Services Claim Form

FCE Short-Term Disability

Short-Term disability claim form

RSL Short-Term Disability

Short-Term Disability Benefits Initial Statement of Claim for Reliance Standard

RSL Life Insurance

Life Insurance Claim for Reliance Standard

Flexible Spending Account (FSA)

For reimbursement of FSA expenses

Health Reimbursement Arrangement (HRA)

For reimbursement of HRA expenses

Commuter Benefit Claim Form

For reimbursement of Commuter (Parking and/or Transit) expenses

Life and AD&D Conversion Forms

Please reference your summary plan description to determine which Life or AD&D conversion form applies to you.