Submit Your Claim

We are unable to accept your claim because the subscriber on your policy does not have a reimbursement preference on file. Please ask the subscriber to log on to myuhc.com and enter their claim reimbursement preference under Account Settings. You, or the subscriber, may then submit your claim.

Upload Files

INSTRUCTIONS

To help us process your claim, please upload a copy of the bill(s) or receipt(s).

You may drag and drop your file(s) here or click to browse for images on your PC or mobile device.
Acceptable file types: .PDF, .JPG, .JPEG, .TIF or .PNG.
Total file size must be greater than 0MB and less than 5MB.
Files must not be password protected.
Only one period is allowed in file name (e.g. “claim.file.pdf” is not allowed).
A file name cannot contain any of the following characters: \ / : * ? " < > |

Total file size cannot be greater than 5MB.

Duplicate file cannot be uploaded.

File type must be .PDF, .JPG, .JPEG, .TIF or .PNG. Please rename file.

File name cannot contain \ /:*?"<>|. Please rename file.

At least one file must be uploaded.

By checking the box, I am attesting that the information entered is correct. Any person who knowingly files a statement of claim containing any misrepresentation or any false, incomplete or misleading information, may be guilty of a criminal act punishable under law and may be subject to civil penalties.

Enter Claim Information

We're happy to process your claim for you. Please provide your claim information below. A separate claim should be submitted for each:

Member
Provider
Claim Currency

At the end of this process you will receive a claim submission number.

All fields marked with an asterisk (*) are required.

Member*

Provider*

Provider Country*

Provider City*

Claim Nickname

Billed Amount*

Claim Currency*

Claim Currency is required.

Please enter a valid currency.

Claim Currency allows only alphabetic characters and . - & '

Date of Service*

Diagnosis*

Please provide the member's diagnosis (for example: strep throat, back pain) or, if available, the ICD10 diagnosis code from your invoice.

144

Description of Treatment*

Please provide a brief description of the treatment or services received (for example: office visit plus blood work).

244

Review Reimbursement Preference and Submit Claim

Edit Reimbursement Preference

Claim Information

Edit

Member

Member Demo

Provider

Provider Name

Provider Country

China

Provider City

Beijing

Claim Nickname

Issue Payment To

Member Demo

Billed Amount

200

Claim Currency

China Yuan

Date of Service

02-Oct-2019

Diagnosis

Diagnosis details

Description of Treatment

Treatment details

Files

Edit

card--hero.jpg

0.11 MB

Reimbursement Preference

This is your current reimbursement preference. If you change your reimbursement preference now, any claims currently being processed will be paid using that preference. Alternatively, you may elect a one-time reimbursement preference for this claim only.

Reimbursement Method

Check

You will be reimbursed via check to your mailing address. Typically payments issued by electronic funds transfer are received faster.

Payee Name

Member Demo

Country

China

Currency

China Yuan

*Choosing this option does not change your default preference for future claims.

Note: We allow dependents over the age of 18 to specify a one-time reimbursement for their claims.

Payee Name

Payee Name as it appears on your bank account.

Enter One-Time Claim Reimbursement Preference

We do not have your Reimbursement Preference on file. Please provide your preferred method of claim reimbursement.

Reimbursement Method

EFT

CHECK

Payee Name*

Payee Name is required.

Payee Name allows only alphanumeric characters and . - & '

Country*

Country is required.

Please enter a valid country name.

Country allows only alphabetic characters and . - & ' ( ) , Å ô é

Currency*

Currency is required.

Please enter a valid currency.

Currency allows only alphabetic characters and . - & '

Reimbursement Method

Payee Name

Payee Name as it appears on your bank account.

EFT

CHECK

Reimbursement Method Check

You will be reimbursed via check to your mailing address. Typically, payments issued by electronic funds transfer are received faster.

Payee Name*

Country*

Currency*

Your session is about to expire

Cancel Claim Submission?

Cancel Claim Submission?

Provider

Submit Your Claim

Enter Claim Information

Upload Files

Review and Submit Claim

Upload Files

INSTRUCTIONS

Enter Claim Information

Review Reimbursement Preference and Submit Claim

Edit Reimbursement Preference

Claim Information

Files

Reimbursement Preference

Payee Name

Enter One-Time Claim Reimbursement Preference

Reimbursement Method

Edit Reimbursement Preference

Reimbursement Method

Payee Name

Submit Your Claim

Your claim has been successfully submitted.

Submission ID: AA025733180250100009

Your session is about to expire

Cancel Claim Submission?

Cancel Claim Submission?

Provider

Submit Your Claim

Enter Claim Information

Upload Files

Review and Submit Claim

Upload Files

INSTRUCTIONS

Upload Failed.

Enter Claim Information

Review Reimbursement Preference and Submit Claim

Edit Reimbursement Preference

Claim Information

Files

Reimbursement Preference

Payee Name

Enter One-Time Claim Reimbursement Preference

Reimbursement Method

Edit Reimbursement Preference

Reimbursement Method

Payee Name

Submit Your Claim

Your claim has been successfully submitted.

Submission ID: AA025733180250100009

Submission Failed