Step 1

Download Claim Form and fill out it.

Step 2

The claims materials that need to be submitted are as follows:

1) Completed Claim form

2) Your Insurance ID Card

3) Original itemized invoices with fees on Physician/Hospital letterhead.

Invoice must include patient’s full name, date of birth, Diagnosis (type of Illness), date of the visit, Treatment type, Physician’s charges

4) The acceptable proof of payment (credit card receipt)

Step 3

Send Claims Materials by any following ways:


PayerFusion Holdings, LLC
2100 Ponce de Leon Boulevard
Mezzanine Level-Suite 200 
Coral Gables, FL 33134

* Claims must be received by the claims department within 120 days of the date of Service to be eligible for reimbursement of covered expenses


Claim consultation or claim progress:

United States: +1-855-773-7810
International: +1-786-453-4008 (collect)


If your plan names are Atlas America (ATA Plan) above information is not suitable for use, please contact us for detailed claims guide.