Aflac Wellness Claim Form Printable

Aflac Wellness Claim Form Printable - American Family Life Assurance Company of Columbus Aflac ATTN Claims Department 1932 Wynnton Road Columbus GA 31999 For information or to check claim status visit aflac or call 1 800 99 AFLAC 1 800 992 3522 Claims may be faxed to 1 877 44 AFLAC 1 877 442 3522 Accident Hospital Indemnity Wellness Benefit Claim Form

Aflac wellness claims pay you money for staying on top of your health by getting yearly checkups and medical screenings such as physicals dental exams and eye exams Most accident hospital indemnity and cancer insurance policies have wellness benefits You can file your wellness claim online at aflac MyAflac or through the MyAflac

Aflac Wellness Claim Form Printable

Aflac Wellness Claim Form Printable

Download MyAflac® mobile app Understand what’s needed Get filing requirements, supporting documentation details, and more. Learn more File your claim via fax or mail Consider filing online for faster claims payment! Download form Have questions? Connect whenever you need us. Log in to to your account or Chat with us.

Post Office Box 84075 Columbus GA 31993 Phone 800 433 3036 Fax 866 849 2970 groupclaimfiling aflac WELLNESS AND HEALTH SCREENING CLAIM FORM Failure to complete all sections may result in delayed processing of this claim Review your policy for specific benefits covered under your plan

How To File A Wellness Claim Aflac

Please print a separate form for each additional family member or call 1 800 99 AFLAC 1 800 992 3522 to request additional forms Claims for all other benefits covered under this policy must be filed separately using the claim forms available at aflac or by calling 1 800 99 AFLAC 1 800 992 3522 CW061999 Page 1 of 2 02 14

Aflac Wellness Claim Form Printable

Please be sure to include the following information along with this claim form positive Pathology Report and itemized bills from facility including diagnosis and or procedure codes and charge amounts Itemized bills may include but are not limited to the following UB04 from your provider HCFA1500 from your provider etc

Accident Hospital Indemnity Wellness Benefit Claim Form

Your policy for a list of covered wellness procedures or call 1 800 99 AFLAC 1 800 992 3522 for a Wellness Form specifically tailored for your policy Please use black or blue ink only and print legibly when completing this form in its entirety

Aflac Printable Claim Forms

ACCIDENT WELLNESS BENEFIT CLAIM FORM Some of the tests listed may not be covered under the Wellness Benefit of your policy Please check TM your policy for a list of covered wellness procedures or call 1 800 99 AFLAC 1 800 992 3522 for a Wellness Form specifically tailored for your policy

Claims checklist Helpful Tips: If uploading a picture from your phone, please only submit the medical documentation for your proof of services. When taking photo copies of the documents make sure the document is flat. Flatten documents that have been folded or crumbled before uploading. Check the lighting on the document (s) before submitting.

File A Claim Aflac

Groupclaimfiling aflac Aflac Group W ellness Claim Form 2020 WELLNESS AND HEALTH SCREENING CLAIM FORM Failure to complete all sections may result in delayed processing of this claim Review your policy for specific benefits covered under your plan AUTHORIZATION

Aflac Wellness Claim Form Printable

ACCIDENT WELLNESS BENEFIT CLAIM FORM Some of the tests listed may not be covered under the Wellness Benefit of your policy Please check TM your policy for a list of covered wellness procedures or call 1 800 99 AFLAC 1 800 992 3522 for a Wellness Form specifically tailored for your policy

Aflac wellness claims pay you money for staying on top of your health by getting yearly checkups and medical screenings such as physicals dental exams and eye exams Most accident hospital indemnity and cancer insurance policies have wellness benefits You can file your wellness claim online at aflac MyAflac or through the MyAflac

Aflac Wellness Claim Form Printable