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Providers

Health services provider

Request to cancel a claim and/or preauthorization

Please submit the following claim information to us. Once the claim or preauthorization has been cancelled, you’ll receive a confirmation email and you can then resubmit the claim if need be. If you have any additional questions, please contact us directly at 1-800-588-1195.

Please enter the patient name.
Please enter the valid date of service.
Please enter the total cost of service.

Please note: cancelling a preauthorization will result in any associated claim being cancelled.

the document or preauthorization number.
Please enter a valid email address.