Claims

  • Claims are requests for payment. Often your doctor's office will submit the claim on your behalf, but you can also submit a claim. Each time you visit a healthcare provider and file a claim, you receive an Explanation of Benefits statement, which explains how your claim was processed. Instead of getting paper statements, you can get them online in your secure LifeWise account. This way you can access them anytime without cluttering your home.

    To view your explanations of benefits online you'll need to register. After registering you'll be able to:

    • View your most recent claims
    • Check your current deductible and benefits limits
    • View your current plans and benefit details
    • Search claims up to two years prior
  • How to Submit a Non-Preferred Provider Claim

    When you see a provider or use a pharmacy outside of the network, you have to submit the claim yourself after paying for the service up front (preferred providers submit the claim for you).

    To File a Claim

    1. Complete a claim form (Available at lifewiseor.com in the "Member Forms" section).
    2. Attach an itemized bill from the provider for the covered service.
    3. Make a copy for your records.
    4. Mail your claim to the address on the claim form.
  • Understanding claims payments

    After a claim is submitted you’ll receive a breakdown of the charges submitted to LifeWise. This is your Explanation of Benefits and it shows what we pay for and the portion, if any, you are responsible for.

  • Request a Claim Review

    If you would like a review of your claim, just call Customer Service at 800-596-3440. You must make your request within 180 days after you receive your EOB. You can also submit a request in writing.

    Include a copy of the EOB in question and any other documentation that may support your inquiry. Please send the request to:
    LifeWise Health Plan of Oregon
    PO Box 91059
    Seattle, WA 98111-9159

    Once we receive your request, we’ll send you more details about the review process.