Report Requests

Please complete the Report Request form for new report requests and submit to Health Endeavors via a Submit a Request (SAR) ticket.

We have included an example Completed Form, Excel template and Claims Manual for your reference below.

Report Request Example.pdf

Emergency_Visit_Example.csv

ClaimsManual.pdf

**Filling out a Report Request does not guarantee that a report will be built. Health Endeavors has an internal process to determine whether a report will be built and you will be updated on the Submit a Request ticket when a decision has been made on the report**