Use this form to file a claim when your doctor doesn’t file the claim for you. You should send this completed claim form as soon as possible after you get care. Check your certificate of …

Visit BlueCrossNC.com/Claims for prescription drug, dental and international claim forms, or call the toll-free number on your ID card. Type or use blue or black ink to complete. Complete a …

View the links below to find member forms you can download, making it quicker to take action on claims, reimbursements and more. If you can’t find the form or document you’re looking for …

Whether you're a Humana Medicare member or you get insurance from your employer, you have easy access to documents and forms. Choose the category that best describes your coverage. …

Claim Forms. Download a claim form for medical services, pharmacy services or overseas care.

Please submit this form and all documentation to: Ambetter from Coordinated Care • Claims Department-Member Reimbursement • P.O. Box 5010 • Farmington, MO 63640-5010

This form is for out-of-network claims ONLY, to ask for payment for eligible health care you have received. To ensure faster processing of your claim, be sure to do the following: If you write on …

Find the insurance documents you need, including claims, tax, reimbursement and other health care forms. Also learn how to find forms customized specifically for your Aetna benefits as well …

Browse commonly requested Anthem forms to find and download the one you need for various topics including pharmacy, enrollment, claims and more.

Use this form to file a claim for any eligible medical expense when your physician or other provider does not file a claim. Please print clearly with black ink, completing all required fields.