Electronically Submit for Shortage of Hours Payment Using the Create App

INSTRUCTIONS FOR MAKING SHORTAGE OF HOURS ELECTRONIC PAYMENTS USING THE CREATE APP

  1. Sign in to the create app. If you did not download the app, then proceed to either the instructions for making electronic payments via a computer or go to the instructions for making manual claims.

  2. Once logged in, there are two ways to enter a new HRA claim. Either:

    • Find the three dots that are vertically aligned on your dashboard landing page. Click upon those three dots, OR
    • Find the section titled “Claims,” which is listed within the “Menu” section and/or shown as a separate icon. Click on either. You will be brought to a different screen and you will see a gray shaded box that contains the following statement listed in white font: “Need to File New HRA Claim not listed below Click here.” Click there.

    If you pressed the three dots, then in the drop-down menu, click on “File New HRA Claim.”

  3. Under the section titled “Service Type” select the option titles “Hour Shortage”.

  4. Under the Service Start Date section enter THE START OF THE WORK QUARTER IN WHICH THE SHORTAGE OCCURRED. (If you neither recognize the term “work quarter” nor know what work quarter you incurred a shortage of hours or when a work quarter begins and ends, please reference the eligibility section of the Plan’s Summary Plan Description book.)

  5. Under the Service Stop Date section enter THE END OF THE WORK QUARTER IN WHICH THE SHORTAGE OCCURRED.

  6. You should see your name in the “Claimant” Field, leave it.

  7. Input the amount that you need to pay within the “Claim Amount” field.

  8. Click the “Pay provider” button

  9. If under the “Provider Name” drop down box you see the IBEW Local 697 Health and Benefit Plan as an option, click it. If not, enter the following in their respective fields:

    • IBEW Local 697 Health and Benefit Plan
    • 7200 Mississippi Street, Suite 300
    • Merrillville,
    • IN
    • 46410
    • 2199406181
    • Click the submit button
  10. Skip the “Account Number” option. Do not enter any information there.

  11. Click “One Time Payment”

  12. Click “NEXT”

  13. Click “Attach Claim Receipt”.

  14. Click “Browse”

  15. Click “Take photo” and then take a photo of your shortage of hours’ notice.

  16. Click next.

  17. Read the paragraph in the tan box. Check the box if you agree and then click “Submit.”

If you need assistance, call 844-769-2738 or send an email to:
service@mycreatehealth.com