For greater efficiency, the following carriers prefer direct request of ID cards. You can contact them at the numbers below. Know that we are available to advocate on your behalf, and please don't hesitate to contact us if you need assistance.
BCBS of Georgia1-800-441-2273
Evergreen706-660-6550
Integrity Benefit Network770-428-1604
United Healthcare1-800-842-8000 ext.1
For all other carriers, please complete the form below:
Starred fields are required.
Name of Insured:*
Mailing Address Line #1:*
Mailing Address Line #2:
City:*
State:*
Zip Code:*
Policy Number:
Employer:
Group Number:
Who should we contact regarding this claim?
Contact Name:*
Contact Phone Number:*
Contact Email:*
How should we send your card? Email Fax Mail
Additional Comments:
Terms: By clicking the submit button below, I agree to understand that this is a request only and does not assert or maintain that any such policy is in force.
