Local Blue Cross Claims Address



  • * Louisiana Medicaid Department Address
  • * Louisiana Medicare Secondary Claim Address
  • * Locate IP Address
  • Local Blue Cross Claims Address

    PDF download:

    customer claim form – Anthem

    Insured's Street Address (❏ check if new address) … Daytime Phone Number …
    Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of
     …

    Filing a Health Insurance Claim

    participating provider, you will need to file your claim yourself. Before … Then,
    you must complete the Blue Cross & Blue Shield Medical Claim Form. Be sure to
    … Mail the claim form to the correct address or fax claims to 601-664-5342. A
    great …

    NJ DIRECT Claim Form – State of New Jersey

    ITEMS 20 – 26 … participated in care and treatment to release to Horizon Blue Cross Blue Shield …
    I agree to reimburse Horizon BCBSNJ should this claim be incorrectly paid. …
    NAME & ADDRESS of person or institution rendering the service or …

    SUBSCRIBER'S CLAIM FORM *Non-Participating Provider – – –

    NOTE: Rx Drugs must be submitted on Prescription Drug Claim Form 8009 (12-
    21-10) … An itemized bill that includes the provider's complete name and address
    , dates of service, charges and any … Blue Cross and Blue Shield ID Card.

    List of Automatic Crossover Trading Partner – CMS

    Apr 30, 2013 … Do Not Include Number Shown Below on Incoming Claims. Coordination of …
    BLUE CROSS AND BLUE OF MISSISSIPPI – SUPPLEMENTAL. 00067.
    Customer ….. 877-423-9117. TIC – IBEW LOCAL 461 WELFARE FUND.

    Traditional Plan Claim Form – Horizon Blue Cross Blue Shield

    I the undersigned, authorize and request Horizon Blue Cross Blue Shield of New
    … For claim adjudication, analysis, and administration, I agree that New Jersey
    State … NAME & ADDRESS of Health Care Professional rendering the service or
     …

    Name Address Change Form

    Name/Address Change. Change Anthem Blue Cross and Blue Shield records for:
    … The name shown on my Anthem Blue Cross and Blue Shield … Address (
    complete section #2). 1. Complete to … The Local Choice Program c/o Anthem
    Blue …

    Member Claim Form – Blue Cross of Idaho

    Member Claim Form. This form must be filled out for all claims submitted by a
    member. 1. … Enrollee's Address (Street, City, State, Zip Code). Was this
    condition …

    GHI-COMPREHENSIVE BENEFITS PLAN/EMPIRE BLUECROSS …

    Payment for services will be made directly to the provider – you will not have to
    file a claim form when you use a GHI participating provider. Empire BlueCross …

    Section 11 – Payer Fact Sheets – Wisconsin Department of Health …

    In Wisconsin, Anthem Blue Cross and Blue Shield is the trade name used by
    Blue Cross … HMO license under CompCare – 611 Stock Insurance Corporation,
    Mixed Model HMO … How will payer contract with Local Public Health Depts. …..
    Notes: Appeal address: Care Wisconsin, ATTN Appeals, PO Box 14017, Madison
    , …

    Anthem Claim Form

    (Street) (❏ check if new address) … Anthem Blue Cross and Blue Shield is the
    trade name of Anthem Health Plans of Virginia, Inc. … This claim form is designed
    to help you, the insured, file itemized health care related bills for you or an
    enrolled family … For Hospital Services — local Blue Cross, Hospital, or UB92
    Form.

    billing resource manual – Georgia Department of Community Health

    BCBS of GA: PPO-Federal Employees Plan (FEP); Open Access HMO; Open
    Access Point …. The business of Public Health begins with clients seeking
    services at local county ….. The Claim address is on the back of the member's ID
    card.

    Prescription Claim Form

    Prescription Drug Reimbursement / Coordination of Benefits Claim Form … Street
    Address … injure, or deceive any insurance company submits a claim.

    835 Billing Guide – Pennsylvania Department of Human Services

    Jul 9, 2015 … 005010X221A1 Health Care Claim Payment/Advice (835) transaction records ….
    Address. 200. Independence Blue Cross 1901 Market Street.

    appendix 2 carrier codes – SC DHHS

    Feb 1, 2017 … ADDRESS LINE. CITY …. ALLEN MEDICAL CLAIMS ADMINISTRATORS. PO
    BOX 978 …. X0YDN ANTHEM BLUE CROSS AND BLUE SHIELD.

    Direct Reimbursement Claim Form – Davis Vision – CareFirst

    CareFirst BlueCross BlueShield is the shared business name of CareFirst of …
    Mail completed claim form to: Vision Care Processing Unit, P.O. Box 1525,
    Latham, NY …. Members should call the phone number on the back of their
    member …

    TPL Insurance Carrier ID List by Carrier ID – the Montana Healthcare …

    Before April 1st after April 1st Primara Blue cross …. Claims no longer processed
    at this address DO NOT USE. 157 ….. call the local BCBS to match your State.

    UnitedHealthcare Claim Form

    HEALTH INSURANCE CLAIM FORM. OTHER. 1. … RESERVED FOR LOCAL
    USE. 21. … PHYSICIAN'S, SUPPLIER'S BILLING NAME, ADDRESS, ZIP CODE.

    front cover – Los Alamos National Laboratory

    should be sent to the address given above. … Website—For provider network
    information, BCBSNM Drug List, claim forms, and other information, or to e-mail …
    Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service ……
    Out-of-state providers that contract with their local Blue Cross and/or Blue Shield
     …

    CMS 1500 Billing Instructions – Maryland Medicaid – Maryland.gov

    Oct 1, 2015 … Paper Claims Submission & Claims Address … code sets and forms, Maryland
    Medicaid has replaced all local procedure codes to ….. Cross/Blue Shield, the
    provider must first bill the other insurance company before Medical.