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)
Submit claim materials:
Login to DIANins member account My Account
Upload claim materials through My Account - Claim Info - Submit Claim
(After the uploading, you may click View Claim to check the application record and confirm the claim status)
If you cannot upload the materials, you can also apply by sending an email and send the claim information to firstname.lastname@example.org.
* 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.
* 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 email@example.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 180 days after you received the medical services)
United States: +1-855-773-7810
International: +1-786-453-4008 (collect)
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.