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Third-Party Credentialing Requests

If you are a third-party hospital or credentialing organization requesting certificates of insurance or claims history, please email your request to certificates@omic.com. Ensure you include the following information:

  • The name of the insured
  • Policy number or Client ID number
  • A signed and dated release letter from the insured authorizing our company to provide this information
  • Your mailing address to be displayed on the certificate

Alternatively, you can submit your request and attach the signed release using the form below.

Note: Please allow 5-7 business days for processing and mailing.

COI and Claims History Request Form

Requestor's Information

Mailing Address(Required)
(This address will be printed on the COI)

Insured's Information

Insured's Information(Required)
Full Name
Policy Number
Client ID Number
 

Release Forms

Drop files here or
Max. file size: 100 MB.
    Please attach a signed and dated release form for each insured entered above.