How to Fill Out and Submit a MyChart Settlement Claim Form

To collect your share of a MyChart privacy settlement, you file the claim form on your specific provider’s settlement website before that settlement’s deadline. Each health system’s case is separate, with its own portal, ID number, and payout, so the first task is matching your notice to the right settlement. The form itself is short and usually takes about five minutes online.

Find the Settlement That Covers You

There is no single nationwide MyChart settlement. Each lawsuit names one health system, and you can only file against the provider whose portal you actually used during the covered period. If a notice arrived by mail or email, it names the case and includes a unique ID that ties you to the administrator’s database.

The settlements announced so far include:

  • Duke University Health System: claims filed at duhssettlement.com, deadline August 16, 2026. Approved claimants receive a pro rata share of the net fund.1Williams v. Duke University Health Settlement. Williams v. Duke University Health – Home
  • Novant Health: $6.66 million fund covering up to 1,362,296 patients who used Novant MyChart between May 2020 and August 2022, divided equally after fees and costs.2Novant Health. Novant Health Reaches Preliminary Settlement Resolving Meta Pixel Class Action Claims
  • WakeMed: $2.45 million fund for portal users between March 2018 and May 2022; final approval landed in November 2025 and payments of $26.75 began in February 2026.
  • SSM Health: $31.50 per claimant plus a 12-month digital privacy monitoring membership for portal logins between July 2020 and February 2023. Deadline passed November 25, 2025.3SSM Health Data Settlement. SSM Health Data Settlement – Frequently Asked Questions
  • Loyola University Medical Center: $2.67 million fund; deadline passed August 5, 2025.
  • LCMC Health: $15 per claimant for portal use between January 2019 and November 2022; deadline passed November 2025.

If your provider is not on this list, search its name together with “pixel settlement” or “MyChart settlement.” New cases continue to surface as more hospital systems face the same allegations.

Confirm Your Eligibility

Two things decide eligibility: which portal you used and when. You needed to actually log in and use MyChart during the settlement’s date window, not just hold an account. Scheduling an appointment, reading test results, or messaging a provider during that window would have triggered the data transmission at issue. A date range that qualifies you for one settlement does not carry over to another.

You do not have to prove identity theft, financial loss, or any other concrete harm. The settlements pay for the alleged privacy violation itself. Patients who already opted out of the class or resolved their claims separately are excluded.

If you never received a notice but believe you used the portal during the covered period, most settlement sites still let you submit a claim by entering your name, provider, and approximate dates of use. The administrator checks that information against the provider’s access logs.3SSM Health Data Settlement. SSM Health Data Settlement – Frequently Asked Questions

What to Have Ready Before You Start

The claim forms across these cases ask for the same short list of information. Gather it before you open the site so you can finish in one sitting.

Your Personal Information

Every form requires your full legal name and current mailing address. Email is standard; phone is usually optional. Use the address where you actually want a paper check delivered, because the administrator sends it to whatever address you type on the form, not the one your provider has on file.4Loyola University Medical Center Settlement Administrator. Smith, et al. v. Loyola University Medical Center Settlement Claim Form

Your Notice ID

If a notice reached you, it contains a code that speeds up verification. The label depends on the case: Novant Health calls it a Settlement Claim ID on the postcard, SSM Health emailed a Unique ID and PIN, and Loyola uses a Claim ID Number.5U.S. District Court for the Middle District of North Carolina. Exhibit 1 – Settlement Agreement and Claim Form3SSM Health Data Settlement. SSM Health Data Settlement – Frequently Asked Questions Entering the code on the settlement site pre-fills some fields and confirms you are already in the database. Lost the notice? Check your email trash for the original message, or call the administrator using the number on the settlement website and ask them to resend your credentials or verify you another way.

Your Payment Method

Some settlements only issue paper checks. Others offer a choice between a check and an electronic option such as PayPal, Venmo, Zelle, or ACH direct deposit. SSM Health offered all four electronic methods, while Loyola paid by check only.3SSM Health Data Settlement. SSM Health Data Settlement – Frequently Asked Questions4Loyola University Medical Center Settlement Administrator. Smith, et al. v. Loyola University Medical Center Settlement Claim Form Electronic payment is only offered on the online form, not on the paper version. If you pick a check and later move, contact the administrator to update your address before distribution starts; a returned check can take months to reissue. Checks typically expire 180 days after they are issued.

Your Signature

The last section asks you to sign and date the form, affirming that everything you entered is true and correct to the best of your knowledge. This is a legal declaration. Filing a claim you know you do not qualify for can constitute fraud. Notarization is not required.

Submit Online or by Mail

Online is faster. Go to the settlement website named in your notice, enter your ID code, complete the remaining fields, clear the CAPTCHA, and submit. The site issues a confirmation number. Save it or print the confirmation page before closing the browser, because that number is your proof of timely filing if anything is disputed later. Most administrators also send an email confirmation to the address you provided.

If you prefer paper, download the form from the settlement website or ask the administrator to mail you one. Fill it in, sign it, and send it to the address printed on the form. The envelope must be postmarked by the claim deadline; when the administrator opens it does not matter as long as the postmark is timely. Certified mail with a return receipt costs a few dollars and gives you a delivery record.

If you leave a field blank or make a mistake, the administrator will notify you and give you a window, typically 20 days, to fix it before the claim is rejected.5U.S. District Court for the Middle District of North Carolina. Exhibit 1 – Settlement Agreement and Claim Form Treat that as a safety net, not a plan. Check every field before you submit.

What Happens After You File

Filing does not trigger immediate payment. The court first holds a Final Fairness Hearing to decide whether the settlement is fair, reasonable, and adequate. Once the judge grants final approval, an appeal period follows, usually 30 days. When that window closes and no appeal is pending, the administrator calculates each claimant’s share and starts sending payments.

Under normal timelines, expect payment about two to three months after final approval becomes effective. The WakeMed settlement, for example, was finally approved in mid-November 2025 and started paying in late February 2026. An appeal can push distribution back by six months to a year or more.

How much you receive depends on the settlement. Some pay a fixed amount per person, like SSM Health’s $31.50.3SSM Health Data Settlement. SSM Health Data Settlement – Frequently Asked Questions Others divide the remaining fund equally among approved claimants after fees and costs, so the payout moves with the claim count. Individual payments across the announced settlements have ranged from $15 to roughly $32. Attorney fees come out of the fund before distribution rather than out of your check, and courts commonly award about one-third of the fund to class counsel.

If You’d Rather Opt Out or Object

Filing a claim is not your only option. If you think your damages are larger than the settlement offers, for example if you can tie actual identity theft or financial harm to the data disclosure, you can opt out of the class and pursue your own lawsuit. Opting out preserves your individual rights but forfeits any payment from the fund. To opt out, send a written exclusion request to the settlement administrator before the opt-out deadline in your notice. The letter should include your full name, address, the case name and number, and a clear statement that you want to be excluded. The opt-out deadline always falls before the claim filing deadline, so read the notice carefully.

If you want to stay in the class but think the terms are inadequate, you can file a written objection with the court. Objections are heard at the Final Fairness Hearing and can address the payment amount, the attorney fee request, or how the fund is split. Objecting does not stop you from also submitting a claim; you can do both.

Taxes on Your Payment

Privacy settlement payments like these are generally taxable income. The IRC Section 104 exclusion covers settlements for physical injury or physical sickness, and pixel-tracking claims do not qualify.6Internal Revenue Service. Tax Implications of Settlements and Judgments In practice, the payouts are small enough that you probably will not get a 1099-MISC. Starting in 2026, the IRS reporting threshold for such payments is $2,000 per payee per calendar year, and a $15 or $30 payment sits well under that. You are still technically required to report the income, but the amounts do not warrant tax planning.