Claims Submission

CLAIMFORMS

Fill out and submit this form:

After visiting the doctor or hospital, you will need to file a claim for each new injury or illness with Point Comfort Group directly. Please follow the steps below:
  • Complete and submit the Claimant Statement and Authorization (CSA) form with more details about your visit to the doctor.

  • Submit any other necessary forms if directed to when you answer questions on the CSA (links to additional forms are provided within the CSA form pdf). 

  • Submit copies of any bills, receipts, or claims related documents you’ve received.

  • If you were required to pay out of pocket, you will need to submit an itemized invoice or paid receipt from the doctor showing the diagnosis codes of your treatment.

If you need to follow up with Point Comfort directly:
 
Toll-Free: (844) 210-2010

Claims Submission

Your Name*(Required)
Your Email Address(Required)
Let us know if you have any specific comments or questions with this claim.
Submit copies of any bills, receipts, or claims related documents you’ve received
Drop files here or
Accepted file types: pdf, doc, docx, xls, xlsx, jpg, png, Max. file size: 20 MB.