Get Aob Form Pro - Indefree

Completing the AOB Form Pro - IndeFree online is a straightforward process that ensures your benefits are properly assigned. This guide will walk you through each section and field of the form to help you navigate it with ease.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling in the benefit information. You will need to provide your deductible amount and coinsurance percentage for the services you are seeking. If you are unsure of this information, you can call the '800' number on your insurance card for assistance.
3. If you have a coinsurance or unmet deductible, enter your credit card information in the designated fields. Ensure you select the correct credit card type and include the expiration date and card number.
4. Next, fill out the policy information section. Enter the patient’s name, ID number, date of birth, insurance policy number, and group number. If the insured is different from the patient, provide their name and date of birth as well.
5. Specify your relationship to the insured by choosing the appropriate option from the relationship section.
6. Provide the claim number and indicate the insurance company you are directing the payment to. Fill in the complete mailing address for Star Rehabilitation Corp to ensure proper handling of the payment.
7. Review the statements provided below the instructions regarding direct payment assignments and authorizations. Ensure you check each box to confirm your understanding and agreement.
8. Complete the form by dating it, signing as the policyholder, and having a witness sign if required. If the claimant is different from the policyholder, they should also provide their signature.
9. Finally, after verifying all the information is accurate and complete, you can save your changes, download, print, or share the completed form as needed.

Complete your documents online for a seamless experience.