Request Claims History

Credentialing, Coverage, & Claims History Request Center

We're committed to ensuring access to the essential information you need.

Our reports provide coverage verification and claims histories for any Positive policies in effect during the requested time period.

Please complete the form on the right to request verification.

Our dedicated team is here to help you with any questions or concerns you may have. For any inquiries or assistance regarding your requests, please feel free to contact us.

credentialing@positivephysicians.com

888.335.5335

Request a Coverage Verification or
Claims History Online

Request Type(Required)

Coverage Verification & Claims History

COI (Certificate of Insurance)

Requestor Information

Full Name(Required)

First Last

Organization Name(Required)

Email Address(Required)

Phone Number(Required)

Insured Information

Full Name of Insured(Required)

First Middle Last

Policy Number

Policyholder (Group) Name

Policy State

Attach Release Form

All credentialing requests require a handwritten signed authorization from the provider prior to the release of their claims history report. If you do not have a standard release form, download this sample form.

Please attach your completed release form here(Required)

Max. file size: 300 MB.

Credentialing, Coverage, & Claims History Request Center

Request a Coverage Verification or Claims History Online

Requestor Information

Insured Information

Attach Release Form

Request a Coverage Verification or
Claims History Online