What You Need to Know

Submitting a claim or a request for reimbursement is easy. Make the most of your benefits by visiting an in-network provider. If you only have an out-of-network option, you may need to submit a claim form.

Medical Claims
HSA Reimbursements
Pharmacy Claims
Flexible Spending Account Claims
Dental Claims
Vision Claims
Weight Loss Program Reimbursement
Smoking-Cessation Program Reimbursement

Medical Claims

When you go to your doctor or hospital, you’ll be asked for your medical insurance card. Your card tells your provider that you have medical coverage and what’s typically covered under your medical plan. It also lets your provider submit claims on your behalf.

Anthem Medical Plan Members

In general, after your provider submits a claim, Anthem will pay the provider directly (based on the type of plan you have and whether you’ve met your deductible or out-of-pocket maximum). Then, you’ll owe the balance. You’ll receive a bill from the provider for the amount you owe. 

Your medical plan may also send you an Explanation of Benefits (EOB) — it’s basically a recap of the provider you saw, the services you had and how much was paid by your insurer. It’s not a bill though, and should say so on the first page.

If you need to submit a claim yourself, use the Anthem Claim Form. Questions? Contact your medical plan. Information is on the back of your ID card.

Kaiser Medical Plan Members

Your Kaiser medical plan will handle everything for you. In some cases, like if you need emergency care, you may need to submit the Kaiser Emergency Care Form. Questions? Contact your medical plan. Information is on the back of your ID card.

HSA Reimbursements

When you enroll in an HSA, you will receive an HSA Bank debit card to pay for eligible expenses within 10 to 14 days after your enrollment is processed. HSA Bank allows up to two free debit cards per account. You can also go to myaccounts.hsabank.com to set up your online account with HSA Bank. 

If you have any questions, prior to your account being opened, contact the Client Assistance Center at HSA Bank at 1-800-357-6246. You will be asked to provide personal information such as your first and last name, date of birth, the last four digits of your Social Security number and your full address. Depending on the issue, you may also be asked to confirm your employer’s name (Hitachi America, Ltd.). 

Once your account is opened, you can call our dedicated team at 1-844-650-8952 for further help. 

Pharmacy Claims

When you visit dentists that accept Delta Dental insurance, they will file claims with and accept payment from Delta Dental so you don’t need to do anything. Dentists that don’t accept Delta Dental may require payment up front; if so, simply file a claim for reimbursement.

Flexible Spending Account Claims

When you spend money on healthcare or dependent care expenses, use your FSA debit card to avoid having to submit receipts. 

For Legacy HV Employees

For healthcare expenses, you can use a WageWorks debit card to pay your share of eligible costs directly from your account. 

The debit card may only be used with merchants and service providers that have merchant category codes related to healthcare, such as:

  • Physicians 
  • Pharmacies 
  • Dentists 
  • Hospitals 
  • Vision care providers 

You may also access reimbursement forms online.  

Any claims incurred in 2021 must be submitted to WageWorks by March 31, 2022. Claims received past that date will not be eligible for reimbursement and will be considered forfeit.

As part of health care reform, OTC drugs and medications are not eligible expenses through your FSA unless you have a doctor’s prescription.

Have the Dependent Care FSA? You may use your WageWorks debit card to cover eligible care expenses, or seek reimbursement by submitting a claim form

For Legacy HCC Employees

The FSAs will continue to be administered by Businessolver using their proprietary MyChoice account administration technology. Once you are enrolled, you’ll receive a MasterCard debit card to use for your FSA expenses. 

As part of health care reform, Over the Counter (OTC) drugs and medications are not eligible expenses through your FSA unless you have a doctor’s prescription.

Dental Claims

When you visit dentists that accept Delta Dental insurance, they will file claims with and accept payment from Delta Dental so you don’t need to do anything.

If you choose to go to a dentist that is not in the Delta Dental network, you will be responsible for paying the difference between what the plan covers and the amount your out-of-network dentist charges. Out-of-network dentists may require you to pay for services up front, which means you may have to file a claim for reimbursement through your plan.

Vision Claims

If you have vision coverage and receive in-network care, there are no claim forms to complete. If you receive care from out-of-network providers, you may need to pay for services up front and then file a claim to get reimbursed. You can also contact Member Services at 1-800-877-7195 for help submitting a claim or visit VSP for more information.

VSP does not provide a vision insurance cards. You’re covered either way, though—just tell your provider that you have VSP coverage, and they will look you up.

Weight Loss Program Reimbursement

Get help and support with weight-loss programs that are designed for you! Hitachi Vantara will reimburse you 50% of the cost of an eligible weight-loss program, up to $100 each year. Just complete an online expense report through Oracle iExpense, using the “US TE Template” — be sure the “purpose” reads “weight loss reimbursement.”

Smoking-Cessation Program Reimbursement

Trying to quit? It’s tough, but you’re not in this alone. Hitachi Vantara will support you by paying up to $300 each year for a qualified program. Kicking the habit is the tough part — getting reimbursed is easy. Just complete an online expense report through Oracle iExpense, using the “US TE Template” — be sure the “purpose” reads “smoking cessation.”