Download SureGo Claim Form and fill out it.
The claims materials that need to be submitted are as follows：
1) Completed Claim form
2) Your Insurance ID Card
3) Original itemized invoices with fees on Physician/Hospital letterhead.
Invoice must include patient’s full name, date of birth, Diagnosis (type of Illness), date of the visit, Treatment type, Physician’s charges
4) The acceptable proof of payment (credit card receipt)
Send the claim materials to claims@mysurego.com and CC to dian@dianins.com
Tips：
* If the member paid the bill, the member need to file the claims within 180 days of the date of Service to be eligible for reimbursement of covered expense.
* The claim processing is 30 working days after submitting all the claim materials. If you have not received any notification within 30 working days, please contact DIANins customer service. We will confirm the claim progress for you and check whether there are any problems with the claim materials.
SureGo
Toll Free: +1 (866) 264-7299
Direct: +1 (251) 322-7404
Download Wellaway Claim Form and fill out it.
The claims materials that need to be submitted are as follows：
1) Completed Claim form
2) Your Insurance ID Card
3) Original itemized invoices with fees on Physician/Hospital letterhead.
Invoice must include patient’s full name, date of birth, Diagnosis (type of Illness), date of the visit, Treatment type, Physician’s charges
4) The acceptable proof of payment (credit card receipt)
Send the claim materials to corpclaims@payerfusion.com
Tips：
* If the member paid the bill, the member need to file the claims within the specified period of the date of Service to be eligible for reimbursement of covered expense.
* Members who apply for a claim for the first time will receive an invitation email from PayerFusion to register a Tipalti collection account, please pay attention to check this email. If you cannot receive this email due to email problems, please contact corpclaims@payerfusion.com or 1-855-773-7810 to resend the email.
* The claim processing is 30 working days after submitting all the claim materials. If you have not received any notification within 30 working days, please contact DIANins customer service. We will confirm the claim progress for you and check whether there are any problems with the claim materials.
(If you received medical services at a medical institution within the network, the medical institution within the network should send a claim application to the hospital network or pharmacy network within the specified period after you received the medical services)
United States: +1-855-773-7810
International: +1-786-453-4008 (collect)
E-mail: Conciergecare@payerfusion.com
If your plan names are Atlas America(ATA)/Student Secure(SS)/Patriot Exchange Program(PEP),above information is not suitable for use, please contact us for detailed claims guide.