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Click ‘Get Form’ to open the bcbs al enr 431 form in the editor.
Begin by filling in your personal information. Use a black ballpoint pen and ensure you print clearly. Enter your last name, first name, street address, city, state, ZIP code, date of birth, and social security number.
Select your gender and marital status by checking the appropriate boxes. Choose the type of medical coverage you are applying for: individual or family.
List all eligible dependents under this contract. Provide their names, relationship to you, dates of birth, and social security numbers.
Indicate if you are applying for a new contract or making changes due to qualifying events such as marriage or loss of coverage. Fill in the necessary details as prompted.
Complete the coordination of benefits section if applicable. This includes providing information about any other health insurance coverage you or your dependents may have.
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Records must be mailed to the P.O. Box listed on the medical record request. Records can also be faxed. The fax information is listed on the Medical Request Letter. Blue Cross does not prepay for medical records.
How to submit a claim to Blue Cross Blue Shield Alabama?
You can submit a claim a few ways: Behind log in filling out the online claim submission form under the Self Service section of the website. Printing and mailing the appropriate form under the Forms and Materials section of the website.
How to get a BCBS proof of coverage?
How can I request a Certificate of Coverage? To request a Certificate of Coverage, contact your local Blue Cross and Blue Shield company. The phone number can be found on the back of your member ID card or you can visit the Contact Us section of this website.
Is BCBS the same as BCBS of Alabama?
Even though Anthem and Blue Cross and Blue Shield of Alabama are both part of the Blue Cross and Blue Shield System, we are completely separate companies. Anthem is an Indianapolis-based company that operates Blue Cross and Blue Shield plans in 14 states, but not in Alabama.
How do I submit an insurance claim?
Contact your insurance company Whether you file your car insurance claim over the phone, online, through a mobile app, or with an agent, your insurer will likely request the following details: Location, date, and time of accident. Name, address, phone number, and insurance policy number for all involved in the accident.
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