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Document Upload Portal for Providers
Note to Providers: If you have received an Explanation of Benefits (EOB),
please complete the information below and upload the needed information via this
SECURE
portal.
1. Member Last Name:
*
Member First Name:
*
2. Insurance ID Number:
*
3. Group Number:
*
4. Claim Number (as shown on EOB):
5. Provider Name:
*
6. Provider TIN:
*
7. Upload documents here.
*
HealthSmart
PO Box 94468| Lubbock, TX 79493-4468 | 833-782-5090 (phone) | 806-473-3136 (fax)