Provider Submit a Claim

First Name *

Last Name *

Phone *

A salesperson will call.

Claims must be submitted electronically by using the form below or mailed to the following address:

GlobalHealth, Inc.
ATTN: Claims
P.O. Box 2328
Oklahoma City, OK 73101-2328

GlobalHealth Payer ID # - GHOKC

Name of billing provider: *

TIN: *

Organizational NPI: *

Provider NPI: *

Contact name: *

Contact phone number: *

Contact email: *

Other:

Contact or account manager: *

Phone: *

Email:

* Denotes required field.

I am not a robot: