Enter the email address of the client/patient that you are filing for and check the box, indicating that you have permission to file claims for this person. Click here for a downloadable consent form that you can use in your practice.
Enter the information for the "responsible adult" at the top--this is usually the client/patient, but could also be a parent or guardian. If it's a parent, select "NO" for question 2 and enter the client/patient's info there. Finally, if the "responsible adult" is also the primary insured on the policy, answer "YES" to item 3. If not, enter "NO" and complete the info for the primary insured.
The insurance ID number will be required to initiate/file a claim unless this client/patient has had previous claims filed through Reimbursify.
If the client/patient is new to the Reimbursify platform, you will see the option to upload an image of the front and back of their insurance card. If you choose the "Upload Later" option, your client/patient will be notified to upload their card images through the Reimbursify app.
Type your name at the bottom of the final screen and submit the completed form. Please include your credentials or title within the practice.
Your client/patient will receive an email confirming the claim submission, directing them to download the Reimbursify mobile app to track the status of their claim(s).
Here is an example of what the email that your client/patient will receive: