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Online Claims Submission

Streamline your claims process with our comprehensive Online Claim Submission Tool found under the "Claims" tab. This tool consists of 5 parts to complete your claim submission easily and accurately. Ensure one claim submission per person for a smooth experience.

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Online Claims Submission

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  1. Online Claims Submission • Online Claim Submission Tool found under the “Claims” tab • Consists of 5 Parts to be completed • One claim submission per person!

  2. Online Claims Submission • PART A • Pre-populated employee information • Option to change mailing address, email address, and birth date • These changes will be sent to Admin

  3. Online Claims Submission • PART B • Choose Patient’s name – this could be “Self” or any covered dependents • Birth date, gender, and relationship to Employee will automatically populate • If other coverage, details must be provided

  4. Online Claims Submission • PART C • Select Diagnosis or Chief Complaint • Select whether accident case or injury during employment

  5. Online Claims Submission • PART D • Payment to Employee • Check/Wire? • Currency preference • Authorization to pay provider

  6. Online Claims Submission • PART E • Confirm whether medical/dental claim • E-signature • Options to print, save, and add attachments (receipts, itemized bills, etc.) • Link to specific information on what is needed to reimburse • Claim submission button

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