Login or Enroll Online

Fundamental Care Employer ResourcesFundamental Care - Health insurance for employers on a tight budget.

Fundamental Care>Member Resources>File a claim

    Medical Claims Form

    Most providers bill Fundametal Care directly. If your provider does not bill insurance, here is the information we need to consider your claim. Please take the form to your doctor's office and he/she can help you complete it.

    1. Complete the Claim Identification Form

    Note: claim forms may be photocopied

    2. Attach original bills (bills must be originals, not photocopies).

        3. Attach copy of "Certificate of Creditable Coverage" from your prior
        insurer, if applicable.

        4. Mail (Facsimile documents can not be accepted) to:

        IMPORTANT!

        If you are submitting a claim with a Date of Service before 03/01/2007 please use the following address:

        CIGNA HealthCare
        P.O. Box 30870
        Phoenix, AZ 85046

        If the Date of Service is after 03/01/2007, SEE THE BACK OF YOUR INSURANCE ID CARD FOR CLAIMS SUBMITION ADDRESS. Thank you.

        IMPORTANT: Please submit your claim within 90 days of the date of service

      Adobe Acrobat Reader Download Click here to download Adobe Acrobat Reader.

Privacy Statements | Disclaimer Phone: 1-800-258-9260

CIGNA HealthCare
“CIGNA” and “CIGNA HealthCare” refer to various operating subsidiaries of CIGNA Corporation. Products and services are provided by these operating subsidiaries and not by CIGNA Corporation. These operating subsidiaries include Connecticut General Life Insurance Company, Tel-Drug, Inc. and its affiliates, CIGNA Behavioral Health, Inc., Intracorp, and HMO or service company subsidiaries of CIGNA Health Corporation and CIGNA Dental Health, Inc.