Please select the member's health plan
If you do not recall the name, please provide any informative and/or descriptive details in the Description box below
Please provide the agent's name if you recall
In order to process your trip rescue, we will need either a screenshot of the trip in RideView, or the open trip card with ALL member/trip details and upload the screenshot in the attachments portion (add or drop files here) below. If you do not have a screenshot, please fill out as much detail below to assist us with your trip rescue. Please be sure to include your email so we can respond quickly to your urgent request. Note: Only one form per member, this will allow an agent to work on your request quickly.
Please enter the details of your request. A member of our support staff will respond as soon as possible.