DI Insurance: Claim Enrollment Forms

Learn how to complete enrollment forms to begin submitting claims to carriers

Erika Gardner avatar
Written by Erika Gardner
Updated over a week ago

Prior to submitting claims electronically to carriers in the DI Insurance portal, you must first complete an enrollment form for each carrier. You can quickly access each enrollment form below:


Please follow the submission instructions on the cover sheet for each form. Any questions regarding the completion of a form may be directed to the Vyne Support Department at (866)712-9584.

To access claims enrollment forms in the DI Insurance portal:

  1. Login to the DI Insurance portal

  2. Click on your name in the upper right corner

  3. Then, click on Resources from the dropdown list

  4. Click on the Claim Enrollment Forms section

  5. Click on the name of the carrier to open the form

  6. The enrollment form will open in a new window. Download the form to your computer, then complete it and submit it following the instructions provided on the first page of each form

Did this answer your question?