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INF Claims Forms

Filing claims when using your insurance is needed to make sure that you are reimbursed for any medical expense paid out-of-pocket. Although INF allows direct billing & cashless claims, it is highly advised for members to submit a claim form anytime they use the insurance, regardless if you have paid out-of-pocket or not. Sending in the proper paperwork and documentation will expedite the claims and reimbursement process. Below you can find information on how to file claims for INF insurance for visitors plans:

Additional Claims Information

For Policies starting with GLM:

All claims must be filed by completing the claim form found above in the Member portal. This form should be completed by the Policy Holder.

This form must be completed ONCE PER SICKNESS OR INJURY. The INF Claims Form for Providers should be completed by the Policy Holder & Providers (Doctors office, Hospitals etc.).

The Policy Holder should complete Section A. Providers should complete Section B of the form. The form can be mailed to the Insurance by the Provider's office or the Policy Holder. Providers can also submit claims online using EDI Pay#: 22384.

For Policies starting with SRPO:

Generally, providers file insurance claim directly with WebTPA. Additionally, all policyholders are required to complete an informational Section of the claim form found in the member portal above.

In the event a provider wishes to collect from policy holder directly, the second section of claim Form found at (or Standard Insurance Claims Form 1500 CMS/HCFA 1500 or UB92/UB04) should be completed by the doctor's office and submitted by policy holder to the Insurance Company for prompt processing.

Failure to do so would delay the claim processing or result in denial of claims by WebTPA.

Claims Process FAQs

I paid for my relatives medical care up front. How can I get reimbursed?

Simply fill out the claim form & follw their instructions, as well as providing the additional required documentation. Make sure to complete this paperwork carefully to ensure prompt payment.

If my relative or I leave the country will my claims be paid?

Yes, on the claims form you need to designate that you will be the one who receives the check from the insurance company, thus ensuring you will be reimbursed for any medical expenses you paid for on the behalf of your visitors.

I took advantage of "Cashless Claims" - do I still need to file a claim?

Yes. We highly advise individuals to file a claim with the insurance company, regardless if they have paid for the medical treatment or not. This creates a record with the insurance company, and will make the process easier in having your claims paid. By not filing a claim, the payment may not go through to the health care provider and thus causing a delay in payment and liability for you.