Update Enrollment Forms

As we are nearing the middle of the year, ClaimLinx is updating its forms and processes. This will affect all current members and administrators.

Starting June 15, 2022, all enrollments (existing Members & New Hires) must complete the following forms:

  1. Provider Information Form
  2. Protected Health Information Release Form

The ClaimLinx service team will be working with administrators to collect the Provider Information Form and the Protected Health Information Release Form from members. They are crucial for communicating with provider offices and insurance companies.

What is the Provider Information Form?

This form tells our team members which provider offices members and their families will be using. Having this information allows ClaimLinx to update its database and reach out to the provider’s office.

Typically, ClaimLinx sends information to the provider office to let their billing office know how and what documents to send to ClaimLinx. We find being proactive provides a better experience for members.

What is the Protected Health Information Release Form (or HIPAA Release Form)?

Once signed by the member, the form authorizes ClaimLinx staff members to speak with other companies, such as provider offices or insurance companies, on the member’s behalf.

We must have a copy of this form for each member and for each person on the plan who is over the age of 18.

Signing the form allows our team members to provide a more seamless service experience.

How can I sign the forms? 

The forms are available to sign on the ClaimLinx website. Click here to fill out and sign the form.

Once complete, the form will automatically be sent to the ClaimLinx enrollment team and added to our records.

Or you can download a copy of the form and send it to enrollments@claimlinx.com.

Where can I send the form?

If you fill out the form on the ClaimLinx website, you do not have to send the form separately. Click here to get started.

Or you can download a copy and send the completed form to enrollments@claimlinx.com.

For any questions, please contact enrollments@claimlinx.com

 When does ClaimLinx need the form?

ClaimLinx needs these forms for all members as soon as possible. Please click here to fill out the form now.

Or download a copy and send the complete form to enrollments@claimlinx.com.

The Service Team will be working with the plan administrators for each client to collect these forms from members.

Who to contact with questions?

If you are having trouble filling out the forms or are not sure if you need to submit the forms, contact service@claimlinx.com. Our team members are happy to assist.

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