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Claim Forms: When Clients Should Use Them, Where to Get Them

April 14, 2022   |   by Staff Writer
Insurance claim form.

Whether you focus on Medical, Dental, Vision, Disability, or supplemental products like Life, AD&D, Accident, Hospital Indemnity, Critical Illness, or something else, you’re bound to get a client request from time to time for a claim form.

What Are Claim Forms?

Claim forms are available for all sort of situations. Your clients may want to make a medical, prescription drug, dental, vision, life insurance, or AD&D claim. They may need to file paperwork related to a disability, supplemental health, or voluntary coverage claim.

Word & Brown delivers a broad range of products to help your clients. We offer more than 200 carrier and administrator claims-related forms available in our Online Insurance Forms Library. These include Individual, Small Group, and Large Group forms.

Most are self-explanatory, such as claim forms for Medical, Prescription Drugs, Dental, Vision, Life, AD&D, and Disability. Others are for advanced payout in the event of a critical illness diagnosis or reimbursement in connection with an accident. A few carriers offer collateral explaining their claims processes.

 

Group Health Claim Forms

Below is a roster of available forms, organized by product type and carrier. Bolding in the lists makes it easier for you to find the carrier/administrator for which you’re looking.

Medical and Prescription Claims

Aetna, Small Group, Commercial Prescription Drug Claim Form

Aetna, Small Group, Commercial Prescription Drug Claim Form, Spanish

Aetna, Small Group, Medical Claim Form

Aetna, Small Group, HMO Network Comparison Flyer, Southern California

Aetna, Large Group, HMO Network Comparison Flyer, Southern California

Aetna, Large Group, Nevada, Medical Claim Form/Benefits Request

Anthem, Ingenio Rx, Small Group, California, Prescription Reimbursement Claim Form

Anthem, Ingenio Rx, Large Group, California, Prescription Reimbursement Claim Form

Anthem Blue Cross, Individual, California, Medical Claim Form

Anthem Blue Cross, Small Group, California, Medical Claim Form

Anthem Blue Cross Blue Shield, Small Group, Nevada, Medical Claim Form

Anthem Blue Cross Blue Shield, Small Group, Nevada, Prescription Drug Claim Form

Anthem Blue Cross Blue Shield, Large Group, Nevada, Prescription Drug Claim Form

Anthem Blue Cross Blue Shield, Small Group, Nevada, Prescription Drug Claim Form, Spanish

Anthem Blue Cross Blue Shield, Large Group, Nevada, Prescription Drug Claim Form, Spanish

Anthem Blue Cross Blue Shield, Large Group, Nevada, Qualified Healthcare Expense Claim Form

Blue Shield of California, Small Group, California, International Claim Form

Blue Shield of California, Small Group, California, Prescription Drug Benefit Claim Form

Blue Shield of California, Small Group, California, Subscriber’s Statement of Claim

Blue Shield of California, Small Group, California, Waiver of Premium Claim Form

Cigna + Oscar, Small Group, California, Medical Claim Form

Cigna + Oscar, Small Group, California, Prescription Reimbursement Direct Claim Form

CalCPA (Anthem), Small Group, California, Medical Claim Form

CalCPA (Anthem), Small Group, California, Medical Claim Form

CalCPA (Blue Cross Blue Shield Global), Small Group, California, International (Medical) Claim Form

CalCPA (Express Scripts), Small Group, California, Prescription Drug Claim Form

CalCPA (Express Scripts), Large Group, California, Prescription Drug Claim Form

CaliforniaChoice, Small Group, California, Sample Professional Employer Organization (PEO) Letter

Evolved Benefits (Transamerica), Small Group, California, Claims Express Summary

Evolved Benefits (Transamerica), Large Group, California, Claims Express Summary

Evolved Benefits (Transamerica), Large Group, Nevada, Claims Express Summary

Health Net, Individual, Medical Reimbursement Form & Foreign Claim Questionnaire

Health Net, Individual, Medical Reimbursement Form & Foreign Claim Questionnaire, Spanish

Health Net, Small Group, Medical Reimbursement Form & Foreign Claim Questionnaire

Health Net, Small Group, Medical Reimbursement Form & Foreign Claim Questionnaire, Spanish

Health Net, Large Group, Medical Reimbursement Form & Foreign Claim Questionnaire

Health Net, Large Group, Medical Reimbursement Form & Foreign Claim Questionnaire, Spanish

Health Net, Large Group, California, Large Group Purchaser Claims Data Request and Attestation

Health Net, Small Group, Member Medical Reimbursement Claim Form

Health Net, Large Group, Member Medical Reimbursement Claim Form

Health Net, Small Group, California, Prescription Drug Claim Form

Health Net, Small Group, California, Prescription Drug Claim Form, Spanish

Health Net, Large Group, California, Prescription Drug Claim Form

Health Net, Large Group, California, Prescription Drug Claim Form, Spanish

Ingenio Rx (Anthem), Small Group, California, Prescription Reimbursement Claim Form

International Medical Group, Small Group, California, Claim Form and Authorization Filing Instructions

International Medical Group, Large Group, California, AGWM Claim Form and Authorization Filing Instructions

Nippon Life Benefits, Small Group, California, Medical Claim Form

Nippon Life Benefits, Large Group, California, Medical Claim Form

Oscar, Small Group, California, Member Claim Form

Prominence Health Plan, Small Group, Nevada, Member Claim Form (Medical/Dental/Vision)

Prominence Health Plan, Large Group, Nevada, Member Claim Form (Medical/Dental/Vision)

Prominence Health Plan, MedImpact, Small Group, Nevada, Medication Claim Form

Prominence Health Plan, MedImpact, Large Group, Nevada, Medication Claim Form

Sharp Health Plan, Individual, California, Prescription Reimbursement Claim Form

Sharp Health Plan, Small Group, California, Prescription Reimbursement Claim Form

Sharp Health Plan, Large Group, California, Prescription Reimbursement Claim Form

Sutter Health Plus, Small Group, California, Member Claim Form

Sutter Health Plus, Small Group, California, Prescription Reimbursement Claim Form, Express Scripts

Total Benefit Solutions, California, Small Group Medical Claim Form

Total Benefit Solutions, California, Large Group Medical Claim Form

Total Benefit Solutions, Nevada, Small Group Medical Claim Form

Total Benefit Solutions, Nevada, Large Group Medical Claim Form

UnitedHealthcare, California, Small Group, Medical Claim Form

UnitedHealthcare, California, Large Group, Medical Claim Form

UnitedHealthcare, California, Small Group, Prescription Reimbursement Request Form, OptumRx

Unum, Small Group, Nevada, Small Group, Claims Management Process Flyer

Unum, Small Group, Nevada, Large Group, Claims Management Process Flyer

Western Health Advantage, Individual, California, Claim Reimbursement Form

Western Health Advantage, Small Group, California, PDP Prescription Reimbursement Request Form, OptumRx

Western Health Advantage, Small Group, California, Provider Search Instructions

Western Health Advantage, Large Group, California, Provider Search Instructions

Dental Claims

Aetna, Small Group, California, Dental Claim Form

Ameritas, Small Group, California, Dental Claim Form

Ameritas, Small Group, California, Dental Claim Form, Spanish

Ameritas, Large Group, California, Dental Claim Form

Ameritas, Large Group, California, Dental Claim Form, Spanish

Ameritas, Small Group, Nevada, Dental Claim Form

Ameritas, Small Group, Nevada, Dental Claim Form, Spanish

Ameritas, Large Group, Nevada, Dental Claim Form

Ameritas, Large Group, Nevada, Dental Claim Form, Spanish

Ameritas, Large Group, Nevada, Dental Claim Form

Anthem Blue Cross, Small Group, California, Dental Claim Form

Anthem Blue Cross Blue Shield, Small Group, Nevada, Dental Claim Form

BEST Life, Small Group, California, Dental Claim Form

BEST Life, Small Group, Nevada, Dental Claim Form

BEST Life, Large Group, Nevada, Dental Claim Form

Blue Shield of California, Small Group, California,

Companion Life, Small Group, Nevada, Dental Claim Form

DeltaCare, Small Group, California, Claim Form

Delta Dental, Small Group, California, PPO Claim Form

Delta Dental, Small Group, Nevada, Claim Form

Delta Dental, Small Group, Nevada, PPO Claim Form

Delta Dental, CalCPA, Small Group, California, Claim Form

Delta Dental, CalCPA, Large Group, California, Claim Form

Delta Dental, MWG, Small Group, California, Claim Form

Delta Dental, MWG, Small Group, Nevada, Claim Form

Guardian, Small Group, California, Individual Dental Claim Form

Guardian, Small Group, Nevada, Group Dental Claim Form

Health Net, Individual, California, Dental Claim Form

Health Net, Small Group, California, Dental Claim Form

Health Net, Large Group, California, Dental Claim Form

Lincoln Financial Group, Small Group, California, Dental Claim Form

Lincoln Financial Group, Large Group, California, Dental Claim Form

Lincoln Financial Group, Small Group, Nevada, Dental Claim Form

Lincoln Financial Group, Large Group, California, Dental Claim Form

MetLife, Small Group, California, Dental Expense Claim Form

MetLife, Small Group, Nevada, Dental Expense Claim Form

Nippon Life Benefits, Small Group, California, Dental Claim Form

Nippon Life Benefits, Large Group, California, Dental Claim Form

Premier Access, Small Group, California, Dental Claim Form

Premier Access, Small Group, Nevada, Dental Claim Form

Principal, Small Group, Nevada, Dental Claim

Reliance Standard, Small Group, California, Group Dental Claim Form

Reliance Standard, Small Group, Nevada, Group Dental Claim Form

United Concordia Dental, Small Group, California, Specialty Referral Claim Form

United Concordia Dental, Large Group, California, Specialty Referral Claim Form

UnitedHealthcare, Small Group, California, Dental Claim

Unum, Small Group, Nevada, Dental Claim Form

Unum, Large Group, Nevada, Dental Claim Form

Vision Claims

Aetna, Small Group, California, Out-of-Network Vision Claim Form

Ameritas, Small Group, California, Vision Claim Form

Ameritas, Small Group, California, Vision Claim Form, Spanish

Ameritas, Large Group, California, Vision Claim Form

Ameritas, Large Group, California, Vision Claim Form, Spanish

Ameritas, Small Group, Nevada, Vision Claim Form

Ameritas, Small Group, Nevada, Vision Claim Form, Spanish

Ameritas, Large Group, Nevada, Vision Claim Form

Ameritas, Large Group, Nevada, Vision Claim Form, Spanish

Anthem Blue Cross, California, Small Group, Claim Form & Instructions, Blue View Vision, Out-of-Network

Anthem Blue Cross, Small Group, California, Vision Claim Form

BEST Life, Small Group, California, Vision Claim Form

BEST Life, Large Group, California, Vision Claim Form

BEST Life, Small Group, California, Vision PPO Claim Form (EyeMed)

Blue Shield of California, Individual, California, Vision Claim Form

Camden – Avesis, Small Group, Nevada, Vision Care Claim Form

Camden – Avesis, Large Group, Nevada, Vision Care Claim Form

Health Net, Large Group, California, Vision Out-of-Network Claim Form

Lincoln Financial Group, Small Group, California, Vision Claim Form (In-Network)

Lincoln Financial Group, Small Group, Nevada, Vision Claim Form (In-Network)

Lincoln Financial Group, Large Group, California, Vision Claim Form (In-Network)

Lincoln Financial Group, Large Group, California, Vision Claim Form (In-Network)

Lincoln Financial Group, Small Group, California, Vision Claim Form (Out-of-Network)

Lincoln Financial Group, Small Group, Nevada, Vision Claim Form (Out-of-Network)

Lincoln Financial Group, Large Group, California, Vision Claim Form (Out-of-Network)

Lincoln Financial Group, Large Group, California, Vision Claim Form (Out-of-Network)

MetLife, Small Group, California, Vision Out-of-Network Claim Form

MetLife, Small Group, Nevada, Vision Out-of-Network Claim Form

Nippon Life Benefits, Small Group, California, Vision Care Claim Form

Nippon Life Benefits, Large Group, California, Vision Care Claim Form

Premier Access, Small Group, California, Vision Care Claim Form

Premier Access, Small Group, Nevada, Vision Care Claim Form

Principal, Small Group, Nevada, Vision Care Claim Form

Reliance Standard, Small Group, California, Vision Group Claim Form

UnitedHealthcare, Small Group, California, Vision Plan Out-of-Network Claim Form

Vision Plan of America, Large Group, California, PPO Claim Form

VSP, Small Group, California, Out-of-Network Claim Form

Disability Claims

Anthem Blue Cross, Small Group, California, Short Term Disability Claim Form

Anthem Blue Cross Blue Shield, Small Group, Nevada, Employer Life & Disability Claims Guide

Anthem Blue Cross Blue Shield, Small Group, Nevada, Qualified Healthcare Expense Claim Form

BEST Life, Small Group, California, STD Claim Form

CalCPA/Lincoln Financial, Small Group, California, Group LTD Claim Form

Companion Life, Small Group, Nevada, Disability Insurance Claim Form

Guardian, Small Group, California, Group STD Claim Form

Guardian, Small Group, Nevada, Group STD Claim Form

MetLife, Small Group, California, Short Term Disability Claim Form

MetLife, Small Group, California, Long Term Disability Claim Form

Nippon Life Benefits, Small Group, California, Disability Claim Form

Nippon Life Benefits, Small Group, Nevada, Disability Claim Form, Spanish

Nippon Life Benefits, Large Group, Nevada, Disability Claim Form

Principal, Small Group, California, Short Term Disability Claim Form, Spanish

Principal, Small Group, California, Disability Claims FAQs

Reliance Standard, Small Group, California, LTD Claim Form

Reliance Standard, Small Group, California, LTD Claim Form

Reliance Standard, Small Group, Nevada, LTD Claim Form

Reliance Standard, Small Group, Nevada, Integrated STD, LTD, and Group Life Waiver of Premium Claim Form

Reliance Standard, Small Group, Nevada, STD Claim Form

Unum, Small Group, California, Disability Claims Management Process Workflow

Unum, Small Group, Nevada, Disability Claims Management Process Workflow

Unum, Small Group, Nevada, Claims and Customer Satisfaction

Unum, Large Group, Nevada, Claims and Customer Satisfaction

Unum, Small Group, California, Short Term Disability Claim Form

Unum, Small Group, California, Long Term Disability Claim Form

Unum, Small Group, Nevada, Short Term Disability Claim Form

Unum, Small Group, Nevada, Long Term Disability Claim Form

UnitedHealthcare, Small Group, California, Claim Form and Instructions for Group Short Term Disability, Employer

UnitedHealthcare, Small Group, California, Claim Form and Instructions for Group Long Term Disability, Employer

Supplemental Products

Guardian, Small Group, California, Submitting an Accident Claim

Guardian, Small Group, Nevada, Submitting an Accident Claim

Guardian, Small Group, California, Accident Claim Form

Guardian, Small Group, Nevada, Accident Claim Form

Guardian, Small Group, California, Submitting an Cancer Claim

Guardian, Small Group, Nevada, Submitting an Cancer Claim

Guardian, Small Group, California, Submitting a Critical Illness Claim

Guardian, Small Group, Nevada, Submitting a Critical Illness Claim

Guardian, Small Group, California, Critical Illness Hospital Admission Claim Form

Guardian, Small Group, Nevada, Critical Illness Hospital Admission Claim Form

Guardian, Small Group, California, Hospital Indemnity Claims Workflow

Guardian, Small Group, Nevada, Hospital Indemnity Claims Workflow

Principal, Small Group, California, Critical Illness Medical Claim Form

Principal, Small Group, Nevada, Critical Illness Medical Claim Form

UnitedHealthcare, Large Group, Nevada, Notice of Claim, Accelerated Benefits

Life and AD&D Claims

Anthem Blue Cross, Small Group, California, Individual Life Claim Form

Anthem Blue Cross Blue Shield, Small Group, California, Group Life Claim Packet

Anthem Blue Cross Blue Shield, Small Group, Nevada, Life Claim Package

BEST Life, Small Group, California, Dependent Death Benefits Claim Form

BEST Life, Small Group, Nevada, Dependent Death Benefits Claim Form

BEST Life, Small Group, California, Proof of Death Claim Form

BEST Life, Small Group, Nevada, Proof of Death Claim Form

Blue Shield of California, Small Group, California, Accelerated Death Benefit Claim

Blue Shield of California, Small Group, California, Dismemberment Claim Form

Companion Life, Small Group, Nevada, Dismemberment Claim Form

Companion Life, Small Group, Nevada, Group Life Insurance Claim Form

Guardian, Small Group, California, Instructions for Submitting a Group Life Claim

Guardian, Small Group, Nevada, Instructions for Submitting a Group Life Claim

Health Net, Large Group, California, Life Insurance Claim Form

Health Net, Large Group, California, Employer Life Insurance Claim Form

Health Net, Large Group, California, Employer Life Insurance Claim Form, Spanish

Humana, Small Group, California, Group Life Claim Form

Humana, Small Group, Nevada, Group Life Claim Form

Humana, Large Group, California, Group Life Claim Form

Humana, Large Group, Nevada, Group Life Claim Form

Lincoln Financial Group, Small Group, California, Life Claim Form

Lincoln Financial Group, Large Group, California, Life Claim Form

Lincoln Financial Group, Small Group, Nevada, Life Claim Form

Lincoln Financial Group, Large Group, Nevada, Life Claim Form

MetLife, Small Group, California, Life Claim Form

MetLife, Small Group, Nevada, Life Claim Form

Nippon Life Benefits, Small Group, California, Life Claim Form

Principal, Small Group, California, Group Life Claim Form

Principal, Small Group, Nevada, Group Life Claim Form

Reliance Standard, Small Group, California, Proof of Loss Claim Statement, Group Life/AD&D

Reliance Standard, Small Group, Nevada, Proof of Loss Claim Statement, Group Life/AD&D

UnitedHealthcare, Large Group, Nevada, Notice of Claim, Accelerated Benefits

Unum, Small Group, California, Portability Life and/or Accidental Death Claim Form

Unum, Small Group, California, Group Life and/or Accidental Death Claim Form

Unum, Small Group, Nevada, Group Accidental Dismemberment Claim Form

Unum, Large Group, Nevada, Group Accidental Dismemberment Claim Form

Voluntary Benefits

Aflac, Small Group, California, Cancer Indemnity, Cancer History Form, Payroll

Unum, Large Group, Nevada, Voluntary Claims Employer Flyer

Unum, Small Group, Nevada, Voluntary Claims Employer Flyer

Where to Get Claim Forms

Visit our Insurance Forms Library to download the form(s) you need. If you have questions, contact your Word & Brown representative or Broker Resources.

We add new forms to our Insurance Forms Library whenever we get updates from our carrier and administrator partners. Check back regularly to ensure you’re using the most recent forms.

 

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