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Imagine360 fax number

(972) 470-5450

Claims

Used for: Medical claims submission

Fax destination details

Department
Claims
Purpose
Medical claims submission
Form
Medical Claim Form — Imagine360 Medical Claim Form
Address
1550 Liberty Ridge Dr #330, Wayne, PA 19087
Voice phone
800-827-7223

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Submit an itemized bill for medical, dental, vision or prescription claims, including employee name, patient name, provider name and address, date of service, CPT code, diagnosis code, and charges. Send by mail to P.O. Box 749075, Dallas, TX 75374-9075 or fax to 972-470-5450, or email to memberservices@imagine360.com.

Official form instructions are published as a downloadable file on the organization's website.

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