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Regence uniform medical claim form 2025

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The document is a Medical Claim Form for submitting reimbursement requests for services received from non-network providers under the PEBB and SEBB Uniform Medical Plans. It outlines the necessary steps to complete the form, including attaching itemized bills, retaining copies, and submitting the form to Regence BlueShield. The form requires personal information about the patient and subscriber, details about other insurance coverage, and certifies that all provided information is accurate.

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Versions	Form popularity	Fillable & printable
2022	4.8 Satisfied (208 Votes)
2020	4.4 Satisfied (60 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the medical claim form?

Regence participating providers and facilities and any non-participating provider or facility located in our service area must submit their claims electronically.

What is Regence Uniform medical Plan?

In simpler terms, a medical claim form is a formal written request that a healthcare provider submits to an insurance company, Medicare or Medicaid, or another affiliated entity seeking compensation for the healthcare services provided to a patient.

Does Novitas accept paper claims?

Listed below are the exceptions Novitas Solutions can accept as a hardcopy claim submission. All other claims must be submitted via Direct Date Entry (DDE) or electronically. Note: ASCA prohibits payment of paper submitted claims except in limited situations such as small providers, etc.

Does Regence accept paper claims?

Your UMP health plan is a valuable benefit that includes medical and prescription drug coverage to help you stay healthy and pay for the cost of an illness or injury. When you see a network provider for covered preventive care servicesincluding routine annual physical exams and certain immunizationsyou pay $0.

What is the timely filing limit for Regence Blue Shield of Washington claims?

Please complete a separate form for each family member. The time limit for filing claims is one year from the date of service/purchase.

regence uniform medical

Regence uniform medical claim form pdf Ump regence uniform medical claim form Regence uniform medical claim form online Regence claims mailing address Uniform medical plan prior authorization form Regence claims phone number What is Regence timely filing limit PO Box 1106 Lewiston, ID 83501

What is the difference between paper claims and electronic claims?

Slow Processing: Paper claims take longer to process than electronic claims due to manual handling, mailing times, and potential errors in handwritten forms. Higher Costs: Printing, postage, and manual processing can incur higher costs over time, especially for large volumes of claims.

Are Regence and Blue Shield the same?

Regence is the name given to Blue Cross and Blue Shield plans in four northwestern states. Serving 2.2 million members, Regence offers health insurance plans under the following names.