Follow these steps to submit a claim:
- Click here to download a claim form.
Please note: The form is in Adobe® PDF format. If you to not have Adobe® Acrobat Reader®, Click here to download a free copy.
- Complete and print the form, and be sure to sign it.
- Mail the completed, signed form, along with a copy of the receipt for the services you received, to:
PO Box 7805
London, KY 40742
Participating providers have agreed to submit claims on your behalf. Many non-participating providers will also submit claims for you, or they will help you with the process.
Employers, members, and providers can view claim status and claim payments on a secure Web site 24 hours a day, seven days a week.
View claim status & payments
You may also contact a representative Monday through Friday, 6:30 a.m. to 5:00 p.m at 1-866-498-7912.