Claim Status Request

Quality Health Management, LLC ("QHM")

7600 Corporate Center Drive, Suite 502
Miami, Florida 33126 USA
Telephone: (305) 821-8430
Toll-Free: (877) 688-8821
Fax: (305) 820-4033

If you are a provider requesting claims status, please complete the information below. We will provide you with an answer within 48 hours.

* Provider Name: 
* Email Address: 
Phone Number: 
Patient First Name: 
Patient Last Name: 
Date of Birth: 
Date of Service: 
Total Charges: 
Your Comments: