Submit a Claim
To File A Short Term Medical (STM) Claim
We accept the Standard Health Insurance claim submitted by mail or fax at the contact information below.
To File a Dental Claim
Standard ADA claim forms can be submitted by mail or fax to the address or number to the right.
However, we highly encourage dental providers to submit claims electronically through the Dental Center or Availity. Visit the Online Claims page to get started.
Expectations Of LifeMap Participating Dental Providers
LifeMap participating dentists agree to bill us directly for covered services provided to their LifeMap patients, within one year of the date of service.
Once coverage is verified, patients should not be asked for full payment at the time of service. However, patients may be asked for copayments, coinsurance and deductibles at the time of service
After services are rendered, the patient should be billed only for any remaining deductible, copayment and/or coinsurance amounts not collected, or for non-covered services.
Register for eClaims
Submit STM Claims
LifeMap - STM Claims
PO Box 1271 MS E8L
Portland, OR 97207-1271
Fax: 1(855) 207-1205
Submit Dental Claims
PO Box 783
Milwaukee, WI 53201