Filing A Claim:

Electronic payer ID: 59231

Mail: PO Box 10269 Jacksonville, FL 32247

Customer Service: (855) 292-9526 option 1

Claims Fax: (877) 596-2244

Inquiring About An Existing Claim:

Please complete the form below To be contacted by our team.

Provider Name

Provider Tax ID #

Inmate ID #

Patient Name

First Name

Last Name

Patient/Inmate DOB

Date Of Service From

Date Of Service To

Charge Amount

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