Get Myntalife

Filling out the Myntalife claim forms online can streamline your experience and assist in the efficient processing of your claim. This guide provides a step-by-step approach to completing the Wellness Benefit Claim Form and the Authorization for the Release of Health-Related Information Form.

Follow the steps to complete your claim forms successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your policy numbers in the section labeled 'List your policy number(s) here.' Ensure that all used numbers are accurate for prompt processing.
3. In the 'Policyowner Information' section, provide your full name, Social Security number, address, city, state, zip code, email address, and phone numbers for home, mobile, and work contacts.
4. Fill out the 'Patient Information' section with the patient's name, phone number, Social Security number, date of birth, height, weight, and relationship to the policyowner.
5. Complete the 'Provider Information' section by inputting the name, phone number, address, and fax of the provider or physician who treated the patient.
6. In the 'Claim Information' area, specify the nature of services received by checking the relevant procedures. If the procedure is not listed, select 'Other' and provide a description.
7. Sign the form as both the patient and the policyowner at the designated signature fields.
8. Review all entered information for accuracy before submitting. Prepare to send the completed form to the claims processing center via email, fax, or mail.

Start completing your Myntalife claim documents online today to ensure a smooth submission process.