We’re so sorry for your accident. But with XSI, there’s no need to worry!
First, if you’ve been in an accident seek medical treatment within 72 hours of your accident. Filing a claim is the next step. You can either enter your basic information here and a claims rep will contact you or print out the claim form attached (linked to claims forms) and send it in to us by fax or email.
Either way, we will make sure you get the payment you deserve. Thank you for being a member of XSI and get well soon!
Signature and Platinum Plan Claims Forms
Claims Guidelines
Hippa Authorization Form
XSI Signature and Platinum Plan Claims Form
No Limits Claims Forms
Accident Reporting Form
XSI and claims direct access HIPPA
Attending Physicians Statement
For claims assistance call: 801.331.8503 Monday- Friday MT or email: <mailto:cs@xsinow.com> 24 hours a day. We are happy to help!
