Submit a claim. Type at least three letters and we’ll start finding suggestions for you.This is a library of the forms most frequently used by health care professionals. (For example, if you paid your 2019 Medicare Part B premiums, you have until December 31, 2020 to submit your claim). Fax to 877-353-9236; Mail to P.O. Non-Discrimination Statement and Foreign Language Access * These forms can be found at https://www.scdhhs.gov > For Providers > Provider Manuals > Physicians, Laboratories, and Other Medical Professional Providers Manual > Forms.We look forward to working with you to provide quality services to our members.Copyright 2019 BlueCross BlueShield of South CarolinaBlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association.BlueChoice HealthPlan has contracted with Amerigroup Partnership Plan, LLC, an independent company, for services to support administration of Healthy Connections.Availity is an independent company that provides a secure portal on behalf of BlueChoice HealthPlan.This link leads to a third-party website. Please 

There are 4 ways to submit your claim. (You can fill the form in electronically or complete it by hand.) There’s a lot more to health care than just paperwork. Box 14053, Lexington, KY 40512 BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. You have until December 31 of the following benefit year to submit your claim for reimbursement. BlueCross BlueShield of South Carolina Consumer Products AF-525 P.O. BlueChoice HealthPlan has contracted with Amerigroup Partnership Plan, LLC, an independent company, for services to support administration of Healthy Connections. BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Non-Discrimination Statement and Foreign Language Access Include itemized bills for covered services or supplies. Headquartered in Columbia and operating in South Carolina for more than 70 years, BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Would you like to continue? Certification and Authorization (This form must be signed and dated below.) Download the health benefits claim form: English Español; Complete the form following the instructions on the back.

BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. Forms Authorize Release of Protected Health Information (PHI) Request Continuation of Care from a Non-Network Provider Update Your Tobacco Usage Information Request Reimbursement from an HRA or FSA Earn BlueEssentials Blue Rewards Submit Information Related to an Accident Arrange Auto Payments for Your Policy Mail-Order Prescription Drugs BlueEssentials Change Request Form … Health care providers, clearinghouses, billing services, and practice management vendors wishing to exchange data electronically with Blue Cross NC need to sign and submit a Blue Cross and Blue Shield of North Carolina Trading Partner Agreement and an Electronic Connectivity Request Form, or a Blue e Interactive Network Agreement. Reimbursement may be considered taxable income, so consult your tax advisor. Reimbursement is sent to the member's address on file with Blue Cross.

Looking for a form but don’t see it here? That company is solely responsible for the privacy policies and content on its site. Box 100133 Columbia, SC 29202-3133 If a member's policy has prescription drug coverage (Plans H and I), he or she should send us copies of drug receipts or a printout from the pharmacy. But when you do need an insurance form or document, we make it easy for you to find the right one.Find policy and coverage information for members who purchase their own insurance, and those who are covered by small business plans.Access forms and instructions for submitting medical, dental, vision, prescription drug or Medicare Supplement claims. Blue Cross Blue Shield of Massachusetts will make a reimbursement decision within 30 calendar days of receiving a completed : request form. The member should include his or her BlueCross BlueShield ID number and mail all of the documentation to us at the above address.