[fusion_builder_container hundred_percent=”no” hundred_percent_height=”no” hundred_percent_height_scroll=”no” hundred_percent_height_center_content=”yes” equal_height_columns=”no” menu_anchor=”” hide_on_mobile=”no” class=”” id=”” background_color=”” background_image=”https://f46c77.p3cdn1.secureserver.net/wp-content/uploads/2016/01/header-image-contact.jpg” background_position=”center center” background_repeat=”no-repeat” fade=”no” background_parallax=”fixed” enable_mobile=”no” parallax_speed=”0.3″ video_mp4=”” video_webm=”” video_ogv=”” video_url=”” video_aspect_ratio=”16:9″ video_loop=”yes” video_mute=”yes” video_preview_image=”” border_size=”0px” border_color=”” border_style=”solid” margin_top=”” margin_bottom=”” padding_top=”20px” padding_right=”” padding_bottom=”20px” padding_left=””][fusion_builder_row][fusion_builder_column type=”1_1″ layout=”1_1″ last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”” padding_top=”” padding_right=”” padding_bottom=”” padding_left=”” margin_top=”” margin_bottom=”” animation_type=”” animation_direction=”” animation_speed=”0.1″ animation_offset=”” class=”” id=”” min_height=””][fusion_text]

Submit a Claim

Please call 888-227-5583 to verify eligibility of the member and services before treatment where possible.

[/fusion_text][fusion_separator style_type=”none” top_margin=”40px” alignment=”center” /][fusion_text]

[fusion_one_page_text_link link=”#contact” class=”” id=””][fusion_fontawesome icon=”fa-angle-down” circle=”no” size=”80px” iconcolor=”#ffffff” circlecolor=”” circlebordercolor=”” rotate=”” spin=”no” animation_type=”fade” animation_direction=”up” animation_speed=”0.6″ animation_offset=”” alignment=”center” class=”” id=””/][/fusion_one_page_text_link]

[/fusion_text][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container][fusion_builder_container hundred_percent=”yes” hundred_percent_height=”no” hundred_percent_height_scroll=”no” hundred_percent_height_center_content=”yes” equal_height_columns=”yes” menu_anchor=”contact” hide_on_mobile=”no” class=”” id=”” background_color=”” background_image=”” background_position=”left top” background_repeat=”no-repeat” fade=”no” background_parallax=”none” enable_mobile=”no” parallax_speed=”0.3″ video_mp4=”” video_webm=”” video_ogv=”” video_url=”” video_aspect_ratio=”16:9″ video_loop=”yes” video_mute=”yes” video_preview_image=”” border_size=”0px” border_color=”” border_style=”solid” margin_top=”” margin_bottom=”” padding_top=”0″ padding_right=”0″ padding_bottom=”0″ padding_left=”0″][fusion_builder_row][fusion_builder_column type=”1_1″ layout=”3_5″ last=”no” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”solid” padding_top=”100px” padding_right=”10%” padding_bottom=”100px” padding_left=”10%” margin_top=”” margin_bottom=”0″ animation_type=”0″ animation_direction=”down” animation_speed=”0.1″ animation_offset=”” class=”” id=”” min_height=””][fusion_text]

Medical Providers

[/fusion_text][fusion_text]

There are 2 options to submit a claim please choose the best that works for you.

[/fusion_text][fusion_content_boxes layout=”icon-boxed” columns=”2″ title_size=”28px” title_color=”#ffffff” body_color=”#ffffff” backgroundcolor=”#374f2f” icon=”” iconflip=”horizontal” iconrotate=”” iconspin=”no” iconcolor=”#d6d6d6″ icon_circle=”” icon_circle_radius=”” circlecolor=”” circlebordersize=”” circlebordercolor=”” outercirclebordersize=”” outercirclebordercolor=”” icon_size=”” icon_hover_type=”” hover_accent_color=”#cccccc” image=”” image_width=”” image_height=”” link_type=”” link_area=”” link_target=”” icon_align=”left” animation_type=”” animation_delay=”” animation_offset=”” animation_direction=”left” animation_speed=”0.3″ margin_top=”” margin_bottom=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””][fusion_content_box title=”OPTION 1″ backgroundcolor=”” icon=”fa-stethoscope” iconflip=”” iconrotate=”” iconspin=”” iconcolor=”” circlecolor=”” circlebordersize=”” circlebordercolor=”” outercirclebordersize=”” outercirclebordercolor=”” image=”” image_width=”35″ image_height=”35″ link=”” linktext=”Read More” link_target=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]

Please mail completed claims forms to:
Keystone Claims Services
3143 South 840 East Suite 346
St. George, UT 84790

[/fusion_content_box][fusion_content_box title=”OPTION 2″ backgroundcolor=”” icon=”fa-stethoscope” iconflip=”” iconrotate=”” iconspin=”” iconcolor=”” circlecolor=”” circlebordersize=”” circlebordercolor=”” outercirclebordersize=”” outercirclebordercolor=”” image=”” image_width=”” image_height=”” link=”” linktext=”” link_target=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]

Fax Claims to:
888-506-6228

[/fusion_content_box][/fusion_content_boxes][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]