Search results
Results from the WOW.Com Content Network
HOSPITAL INDEMNITY CLAIM FORM INSTRUCTIONS. To avoid delays in processing of your claim form, complete each section attaching documentation below when it applies. Supporting Documentation Needed . Itemized bill if there was a hospital stay (UB04 from the hospital or medical facility)
DATE. 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.com or call 1-800-99-AFLAC (1-800-992-3522) Claims may be faxed to 1-877-44-AFLAC (1-877-442-3522) S2029. Page 2 of 2. 02/14.
File your claim via fax or mail. Consider filing online for faster claims payment! Download form
Some types of tests and/or treatment listed may not be covered by your policy. Please keep a copy of this completed form for your records. Please print a separate form for each additional family member or call 1-800-99-AFLAC (1-800-992-3522) to request additional forms.
Follow these five easy steps to file a claim and get paid fast: Schedule and complete your checkup or screening with your doctor. Visit aflac.com/login to log in or register your account using your Social Security Number and Mobile Phone Number. Once logged in, select Submit a new claim.
PDF forms for web. DUCK. PHYSICIAN'S VISIT BENEFIT CLAIM FORM. To file your claim online, upload documentation on an existing claim, check claim status or get paid fast by signing up for direct deposit, register on Aflac.com or download the MyAflac mobile app.
What you need to file a claim. Patient’s name and date of birth. Patient’s relationship to policyholder. Date of injury or when symptoms first occurred. Physician’s name, address and phone/fax number.
HOSPITAL INDEMNITY CLAIM FORM. Failure to complete all sections may result in a delay in processing this claim. To prevent delays, please provide documentation from your healthcare provider to support this claim. Please review your policy for specific benefits covered under your plan.
Details of all requirements can be found by downloading your state-approved claim form here. File your claim faster using the MyAflac mobile app: Log in to MyAflac or download the MyAflac mobile app. (If you haven’t registered on aflac.com/myaflac you will need your policy number.) SmartClaim or File a Claim on the MyAflac mobile app.
HOSPITAL INDEMNITY CLAIM FORM INSTRUCTIONS . To avoid delays in processing of your claim form, complete each section attaching documentation below when it applies. Supporting Documentation Needed Itemized bill if there was a hospital stay (UB04 from the hospital or medical facility)