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How to use or fill out chwclaims com with our platform
- Click ‘Get Form’ to open the Claim Reimbursement Form in the editor.
- Begin by entering your Customer Information. Fill in your Policy Number, Name, Mailing Address, City, State Zip, Home Phone, and Work Phone accurately.
- Next, provide the Coverage Address and its corresponding City, State Zip. Ensure that you also enter your Claim Number and Authorization Number.
- In the Total field, input the total amount for reimbursement including all applicable fees as per the Rules & Regulations outlined in the form.
- Review the Rules & Regulations section carefully to ensure compliance with CHW’s reimbursement policies before proceeding.
- Finally, sign and date the form at the bottom. Make sure to print your name clearly above your signature.
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