*Important Note: This only applies to users who have Forma Benefits Card.
A balance due is created under two scenarios:
Ineligible Card Transaction
Ineligible Approved and Paid Claim
For example, say you have made a $100 ineligible card transaction. Once the transaction is adjudicated as ineligible, it will create a $100 balance due. Or, if you submit a $100 claim and it was approved and paid, while later on it was found to be ineligible, we will reverse the claim and create a balance due.
Think about the balance due as the amount that you or the merchant is paid, while the payment shouldn't be processed. You would need to "pay back" the amount that is wrongly posted or reimbursed with the following two options:
Submit manual claims
Say you have a $100 balance due. You submit a $200 claim after the balance due amount is created. When the $200 claim is approved, it will offset the $100 balance due, and you will get only reimbursed with $100 for the $200 claim.
Please note that all your future claims after the ineligible transactions may be used to offset the balance due until it is fully paid off.
Please send the repayment to:
47000 Warm Springs Blvd Ste 1-170, Fremont, CA 94539
If a balance due is created, your card and dependent cards would be temporarily suspended. Please refund your account the balance due to activate your benefits card.
Balance due is not currently shown in the Forma portal, but we are striving to launch an enhancement for you to capture your account details better! Before that, please feel free to reach out to our Member Experience Team via live-chat, or email to firstname.lastname@example.org, or call us at 844-902-2902, to see if you have any balance due amount or if you have any concerns.