INSURER FILING GUIDE

Select Health Colorado

Use this public information to prepare your packet, then confirm the route on the insurer's own page.

AT A GLANCE

Claim facts

Member form	Claim reimbursement form Number: 4589200 Revision: 2026-05 (printed in month/year order) Open the insurer form
Portal upload	YES
Portal path	Selecthealth.org/claims > Claim Reimbursement
Mail address	Select Health, P.O. Box 30192, Salt Lake City, Utah 84130-0192
Fax	801-442-0204
Attachments	Provider or facility name; provider or facility Tax ID if available; NPI if available; provider phone; provider or facility address; service dates; billed amount; description of services; procedure codes; diagnosis code; proof of payment
Deadline	1 year after the date of service
Outcome and status	Member account or Select Health mobile app > Claims
Processing time	10 to 30 days for reimbursements; 10 to 20 days for typical pending claims
Caveats	Colorado individual plans may not include ordinary out-of-network benefits. Employer and self-funded plan documents may differ. Medicare and Medicaid are outside this read.

STEP BY STEP

Read date: 10-09-2026

Confirm that the plan covers the service and permits member reimbursement. Select Health can reimburse only covered services, procedures, and diagnoses. https://selecthealth.org/transparency-in-coverage/claims-billing
Complete every applicable field on Claim reimbursement form 4589200. Add the provider identifiers, service dates, billed amount, service description, procedure code, and diagnosis code. https://selecthealth.org/content/dam/selecthealth/forms/common/claim-reimbursement-form.pdf
Add a receipt and one of the listed proofs of payment. Use a separate reimbursement form for each receipt. A superbill alone is not the complete package. https://selecthealth.org/content/dam/selecthealth/forms/common/claim-reimbursement-form.pdf
Upload the package at selecthealth.org/claims through Claim Reimbursement. NOT PUBLISHED: file types, size limit, maximum file count, package structure, and confirmation. The web form is public, but its controls are UNREADABLE to this read. https://www.selecthealth.org/forms https://selecthealth.org/content/dam/selecthealth/forms/common/claim-reimbursement-form.pdf
Submit within one year after service unless the controlling plan provides a longer period. Check status in the member account or mobile app under Claims. Typical reimbursement processing is 10 to 30 days. https://selecthealth.org/transparency-in-coverage/claims-billing https://selecthealth.org/resources/claims

Portal upload: YES
Portal: Select Health Claim Reimbursement web form
Portal path: selecthealth.org/claims > Claim Reimbursement
Mail address: Select Health, P.O. Box 30192, Salt Lake City, Utah 84130-0192
Fax: 801-442-0204
Attach: provider or facility name; provider or facility Tax ID if available; NPI if available; provider phone; provider or facility address; service dates; billed amount; description of services; procedure codes; diagnosis code; proof of payment
File types: NOT PUBLISHED
File size limit: NOT PUBLISHED
Maximum files: NOT PUBLISHED
One file or separate files: One reimbursement form per receipt, a receipt, and proof of payment; the public web form's package controls are UNREADABLE
Confirmation: NOT PUBLISHED
Status check: Member account or Select Health mobile app > Claims
Processing time: 10 to 30 days for reimbursements; 10 to 20 days for typical pending claims
Member deadline: 1 year after the date of service
Deadline basis: The current claims page says claims generally must be filed within 1 year; longer limits may apply in stated circumstances
Mental health route: Select Health behavioral health

Confirm the address, fax number or portal path on the insurer's own claims page before you send; read on 10-09-2026.

Read on 10-09-2026 from https://selecthealth.org/content/dam/selecthealth/forms/common/claim-reimbursement-form.pdf. Confirm the address, fax number or portal path on the insurer's own claims page before you send.