{"id":68,"date":"2026-07-24T15:02:36","date_gmt":"2026-07-24T15:02:36","guid":{"rendered":"https:\/\/uhcmedicalrecordsovercharge.com\/?page_id=68"},"modified":"2026-07-30T21:49:18","modified_gmt":"2026-07-30T21:49:18","slug":"claim-form","status":"publish","type":"page","link":"https:\/\/uhcmedicalrecordsovercharge.com\/?page_id=68","title":{"rendered":"Claim Form"},"content":{"rendered":"\n<h2 class=\"wp-block-heading has-text-align-center\">How Do I File a Claim?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">If you wish to participate in this settlement and receive either a $100.00 flat award or if you wish to produce actual documentary evidence or payments in excess of $100.00 and be awarded that amount minus $2.08, then YOU MUST FILL OUT A CLAIM FORM BY MAY 3, 2027.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">On your Claim Form submittal, you must provide your Date of Birth, last 4 digits of your Social Security Number, and your unique identifier found on your Notice Postcard. This information will be used to verify you are a Class Member who requested in writing and paid for medical records from the Defendant between September 10, 2008 and June 5, 2014.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You may access and submit the Claim Form as outlined below.  <strong>When submitting your documentary evidence, if applicable, you must include your name, unique id and telephone number.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"\">Electronic Submittal via Settlement Website:<ul><li>You may fill out, sign and submit the Claim Form electronically by clicking on the following link: \u201c<a href=\"https:\/\/na4.documents.adobe.com\/public\/esignWidget?wid=CBFCIBAA3AAABLblqZhA1OdVJGeChsd9obAxezeuLsd4hZf5IPAs-NkP1kUGL9gbMfd3Qs0giSxw2Gksv6w4*\" target=\"_blank\" rel=\"noreferrer noopener\">Electronic Claim Form Submittal<\/a>\u201d.\u00a0<\/li><\/ul>\n<ul class=\"wp-block-list\">\n<li class=\"\">For claims in excess of $100, submit your documentary evidence by email to <a href=\"mailto:ClaimsAdmin@UHCMedicalRecordsOvercharge.com\">ClaimsAdmin@UHCMedicalRecordsOvercharge.com<\/a>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"\">Printing of Hard Copy Forms for Submittal:\n<ul class=\"wp-block-list\">\n<li class=\"\">You may download and print a PDF of the Claim Form by clicking the following link: \u201c<a href=\"https:\/\/uhcmedicalrecordsovercharge.com\/wp-content\/uploads\/2026\/07\/Patient-Claim-Form-7-23-2026-Final-Version.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Printable Claim Form<\/a>\u201d.<\/li>\n\n\n\n<li class=\"\">The <strong>completed, signed<\/strong> Claim Form and documentary evidence, if applicable, should be submitted to the Claims Administrator via email (preferred), fax or mail using the following:\n<ul class=\"wp-block-list\">\n<li class=\"\">email to <a href=\"mailto:ClaimsAdmin@UHCMedicalRecordsOvercharge.com\">ClaimsAdmin@UHCMedicalRecordsOvercharge.com<\/a> <\/li>\n\n\n\n<li class=\"\">fax to (205) 716-2364<\/li>\n\n\n\n<li class=\"\">mail to 501 Riverchase Pkwy E, Suite 100, Hoover, AL 35244<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li class=\"\">When sending your Claim via email or fax, please reference <strong>Overcharge Claim Submittal<\/strong> in the email subject line or on the fax cover page. When sending your Claim via mail, include \u201c<strong>Attn: Overcharge Claim Submittal<\/strong>\u201d on the envelope.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The Deadline to Submit a Claim Form may be extended without further direct notice to you so please consult this Settlement Website at <a href=\"http:\/\/www.uhcmedicalrecordsovercharge.com\/\">www.UHCMedicalRecordsOvercharge.com<\/a>&nbsp;to be aware of any updates in this case. They will be easily found on the home page of this Settlement Website.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>How Do I File a Claim? If you wish to participate in this settlement and receive either a $100.00 flat award or if you wish to produce actual documentary evidence or payments in excess of $100.00 and be awarded that amount minus $2.08, then YOU MUST FILL OUT A CLAIM FORM BY MAY 3, 2027.&nbsp; [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-68","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/uhcmedicalrecordsovercharge.com\/index.php?rest_route=\/wp\/v2\/pages\/68","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/uhcmedicalrecordsovercharge.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/uhcmedicalrecordsovercharge.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/uhcmedicalrecordsovercharge.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/uhcmedicalrecordsovercharge.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=68"}],"version-history":[{"count":7,"href":"https:\/\/uhcmedicalrecordsovercharge.com\/index.php?rest_route=\/wp\/v2\/pages\/68\/revisions"}],"predecessor-version":[{"id":119,"href":"https:\/\/uhcmedicalrecordsovercharge.com\/index.php?rest_route=\/wp\/v2\/pages\/68\/revisions\/119"}],"wp:attachment":[{"href":"https:\/\/uhcmedicalrecordsovercharge.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=68"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}