This document shows the general flow a customer will go through when submitting a claim for reimbursement.

Key Terms

• Service Start Date → The date care was received
• Service End Date (optional) → Do Not Enter
• Vendor/Provider → Merchant Name

Initial Screen

Enter Claim Item

The first step involves selecting a provider previously utilized or adding a new provider. Additionally, the “Service Start Date” should match the date on the receipt that will be submitted as part of the claim. This step is critical to avoid a claim being denied.

Select Service

There are two dropdown sections that you can utilize to select a service category. Please select an “LMN Needed” option under the “Other Services” category.

• Common Services → Do Not Select
• Other Services → Select LMN Needed

Other Services

When selecting a category, please select one of the categories that has “LMN Needed” in the title.

Submit Receipt

Next up, select “Submit Receipt Online NOW.” For a receipt to qualify for reimbursement, please ensure that it has the five information points required. If a receipt is missing any of these points, we recommend reaching out to the company you purchased your product/service from to obtain an updated receipt.

1. Date of service or purchase