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Member FAQ's
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Important Member Resources 

Member Guide

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ConciergeCare HelpDesk Guide

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Member Portal Guide

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How to add your member portal to your phone.

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UnitedHealthcare Member Guide

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Getting Started With Teladoc

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WellAway Covid-19 Policy

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How to File a Claim

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How to File for Reimbursement

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Wire Instructions

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How to appeal a denied claim : Pristine

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How to appeal a denied claim : ORBE

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How to appeal a denied claim : New American & LVE

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Understanding Your Zone 1 WellAway ID card

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Understanding Your Zone 2 WellAway ID card

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Member Guide

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ConciergeCare HelpDesk Guide

Here

arrow

Member Portal Guide

Here

arrow

How to add your member portal to your phone.

Here

arrow

UnitedHealthcare Member Guide

Here

arrow

Getting Started With Teladoc

Here

arrow

WellAway Covid-19 Policy

Here

arrow

How to File a Claim

Here

arrow

How to File for Reimbursement

Here

arrow

Wire Instructions

Here

arrow

How to appeal a denied claim : Pristine

Here

arrow

How to appeal a denied claim : ORBE

Here

arrow

How to appeal a denied claim : New American & LVE

Here

arrow

Understanding Your Zone 1 WellAway ID card

Here

arrow

Understanding Your Zone 2 WellAway ID card

Here

arrow

Member Guide

ConciergeCare HelpDesk Guide

Member Portal Guide

How to add your member portal to your phone.

UnitedHealthcare Member Guide

Getting Started With Teladoc

WellAway Covid-19 Policy

How to File a Claim

How to File for Reimbursement

Wire Instructions

How to appeal a denied claim : Pristine

How to appeal a denied claim : ORBE

How to appeal a denied claim : New American & LVE

Understanding Your Zone 1 WellAway ID card

Understanding Your Zone 2 WellAway ID card

 


 

 
English Forms 

Claim Form (International)

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Claim Form (US Claims Only)

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Policy Change Form

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Policy Change Form- New American & La Vie A L'Etranger

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Change of Contact Information Form

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Release of Health Information Form

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Appeal - Patient Consent for Authorized Representative

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Member Appeal Form

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Accident and Subrogation Questionnaire

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International ACH Form

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International ACH Form Spanish

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International ACH Form French

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ACH Form

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ACH Form Spanish

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ACH Form French

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Claim Form (International)

Here

arrow

Claim Form (US Claims Only)

Here

arrow

Policy Change Form

Here

arrow

Policy Change Form- New American & La Vie A L'Etranger

Here

arrow

Change of Contact Information Form

Here

arrow

Release of Health Information Form

Here

arrow

Appeal - Patient Consent for Authorized Representative

Here

arrow

Member Appeal Form

Here

arrow

Accident and Subrogation Questionnaire

Here

arrow

International ACH Form

Here

arrow

International ACH Form Spanish

Here

arrow

International ACH Form French

Here

arrow

ACH Form

Here

arrow

ACH Form Spanish

Here

arrow

ACH Form French

Here

arrow

Claim Form (International)

Claim Form (US Claims Only)

Policy Change Form

Policy Change Form- New American & La Vie A L'Etranger

Change of Contact Information Form

Release of Health Information Form

Appeal - Patient Consent for Authorized Representative

Member Appeal Form

Accident and Subrogation Questionnaire

International ACH Form

International ACH Form Spanish

International ACH Form French

ACH Form

ACH Form Spanish

ACH Form French