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How to File a Claim

Submit a claim by mail
It’s easy! Just download a claim form, have your doctor fill out the second page of the claim form, you fill out the first page, (do not leave anything blank) with your personal information, dates of the injury or sickness, the cause of the injury or date of first symptoms for a sickness, sign your name with today’s date and attach all receipts.

For a claim form, download and print the Claim Form.
(The Claim Form can also be used for prescription reimbursements if your policy participates in MEDCO Rx Discount Program, please check your ID Card)

Mail Claim Forms to:
P.O. Box 809067
Dallas, TX 75380-9067

For a reimbursement claim form for MEDCO network pharmacies, please visit the Find a Pharmacy section of the FIRSTRISK ADVISORS website.

Submit a claim electronically
Your Doctor can also submit a claim electronically, using Emedeon (formerly WebMD). This gives a faster turn-around time than submitting a claim by mail. Check with your doctor to see if they are a participant. If they are, show them your ID Card. The Emedeon information is printed on the back of every ID Card.

If you have any problems filling-out these forms or would like to talk to a customer service representative, you can call us toll free at: 1-800-505-4160. You can also e-mail us by clicking on “Contact Us”.