How to file a claim online

We encourage you to use this electronic option, you can review the status of your claim with the number assigned. This is the easiest and most convenient way to file a claim and monitor your process.
Follow these simple steps: 
1. Visit your LyncOne Portal
  • Log in to your LyncOne Member Portal 
  • Click “Claims” under the “Operations” drop down menu
  • Click “Enter a New Claim” button and complete all the required information
2. Compile all the necessary documentation

All your documentation must be legible and submitted in PDF format including receipts, invoices, laboratory results, diagnostic testing and medical records. We encourage you to keep copies, for your records, of all documents provided with your claim form. All invoices must be official and altered documents will not be accepted. 

 

When submitting relevant documents:
  • Separate receipts and itemized bills if more than one (1) claimant
    • If you are filing a claim from a medical provider in Mexico, you must submit a “Factura Electrónica” also referred to as a “Comprobante Fiscal Digital (CFDI)” or “Factura Fiscal”, which is an electronic invoice that serves as an electronic tax receipt (required by Mexican authorities)
  • Completed a separate Claim Form for each claimant with appropriate receipts and itemized bills attached
  • Doctor’s invoices/bills must include:
    • Medical providers name, address, and signature
    • Claimant’s name
    • Doctor’s specialty (obstetrics, pediatrics, neurology, etc.)
    • Detailed description of service rendered (office visit, surgery, etc.)
    • Date(s) of service
    • Diagnosis
    • Charge for service / Total amount billed (with proper currency)
  • Pharmacy receipts must include:
    • Claimant’s name
    • Name of prescribing physician
    • Name of prescription
    • Date(s) of prescription
    • Charge for medication
    • Pharmacy name, telephone number, and address
  • Hospital invoices/bills must include:

    • Claimant’s name
    • Referring/treating physician
    • Date of admission and discharge
    • Diagnosis/reason for hospitalization
    • Itemized hospital bill
    • (Note: tax and patient convenience items such as telephone and television are non-covered items)
  • If a medical laboratory test or diagnostic exam is performed, the results should be included

     

     

3. Check your reimbursement method

We recommend you to review or update your payment method for claim reimbursement via the member portal in LyncOne.

  • Log in to your LyncOne Member Portal
  • Click “Profile” and scroll down to the “Claims Reimbursement Method” section
  • Select your payment method and complete the required information:
    • Check (only available to a mailing address in the U.S.)
    • Wire
4. Review your explanation of benefits

Once your claim has been processed, you can review your Explanation of Benefits. The EOB describes the policyholder’s claims reimbursement including allowable charges, amount applied to the deductible, percentage of reimbursement, and any refused charges. You can view and download the Explanation of Benefits via the member portal in LyncOne.

  • Log in to your LyncOne Member Portal
  • Click “Claims” under the “Operations” drop down menu
  • In the same line as the “Date of Service”, select the appropriate “From” and “To” dates related to the claim you submitted
  • Once the dates have been selected your claim will appear in the table
  • Click the icon under the column titled “EOB”
  • Your EOB will appear, feel free to save to your computer or print and keep for your records

Ready to file a claim?

Questions?

We are here to assist, guide and support you every step of the way.  Please feel free to contact our office at +1 (800) 222-3002 within the U.S. at  +1 (305) 405-8929, outside the U.S.  or via email at claims@lyncpay.com with any questions you may have regarding your claim submission.