Member Services

Claim Reimbursement

First, you need to obtain a copy of your Major Medical EOB (Explanation of Benefit) and Itemized Statement from your healthcare provider, showing procedures performed.

1. The EOB can be found online via your primary insurance carrier’s portal or you will receive it via mail.
2. The Itemized Statement (or HCFA) can be obtained from your physician’s office/hospital of care.
3. You will also need to complete an Covenant Administrators Claim Form; download by clicking the button below.

Covenant Administrators Claim Form

Once you have obtained these items and completed the Claim Form, you may file the claim to Covenant Administrators via fax or mail:

Member Customer Service