Payment Inquiry
The following form is designed for Affiliate Providers who would like to know the status of payment on an invoice.

Prior to submitting this form please take the following steps

1. Confirm you have pressed the submit button in the portal

(many providers hit 'SAVE' but do not actually submit their invoice)

2. Payment works on the "Net 15" Process. Providers can determine the date payment will be made by taking the following steps:
a. Note the date the Invoice was submitted
b. Add 1 Business day ( for receipt of invoice)
c. Add 15 days (for processing with accounts payable)
d. Round the date up to either the 1st or 15th of the month (Payroll dates)
This will be the date of remittance by either direct deposit or mailing of check.
** NOTE: If you receive direct deposit, it typically take 24-48 business hours for payment to register in your account
If you receive checks, it typically takes 7 business days for a check to be received by mail.

a. An invoice was submitted on December 6th.
b. LifeWorks received by December 7th
c. The invoice is processed by December 22nd.
d. Round up to January 1st, when my check/ direct deposit is issued by LifeWorks

You can verify Remittance Dates for the current year, by logging in to portal resources section.

Once you have reviewed the 'Net 15 Process' if you still have questions regarding payment of your invoice, please complete the form below

The Provider Services Billing Team will respond by e-mail in 5 Business days.

If there is an issue requiring clarification, LifeWorks may also call to request additional information

What is your First and Last name *
Your answer
What is the name of your agency (or indicate private practice) *
Your answer
E-mail address *
Your answer
Phone Number *
Your answer
I UNDERSTAND THE FOLLOWING: I may not add any identifying client information to this form. *
Billing Inquiry Type *
What is your Billing Inquiry? *
Your answer
What is the LifeWorks Case Number associated with this Billing Inquiry? *
Your answer
What specific session date(s) are you inquiring about? *
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms