Bluecard Worldwide International Claim Form
Core international claim form is to be used to submit institutional and professional claims for benefits for covered services received outside the united states puerto rico and the u s. Then fill out a bluecard worldwide claim form and send it with the bill s to the bluecard worldwide service center the address is on the form.
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For filing instructions for other claim types e g dental.

Bluecard worldwide international claim form. For other claim types e g dental prescription drugs contact your florida blue plan for filing instructions. For outpatient no overnight stay at a hospital and doctor care or inpatient care you did not get through the bluecard worldwide service center you will need to pay the doctor or hospital and send an international claim form. The bluecard worldwide international claim form is to be used to submit institutional and professional claims for benefits for covered services received outside the united states fpuerto rico and the u s.
The bluecard worldwide international claim form is to be used to submit institutional and professional claims for benefits for covered services received outside the united states puerto rico and the u s. Orfiling instructions f other claim types. You will need to pay the hospital for the out of pocket fees you normally pay.
The bluecard worldwide international claim form is to be used to submit institutional and professional claims for benefits for covered services received outside the united states puerto rico and the u s. The bluecard worldwide international claim form is to be used to submit institutional and professional claims for benefits for covered services received outside the united states puerto rico and the u s. The bluecard worldwide international claim form is to be used to submit institutional and professional claims for benefits for covered services received outside the united states puerto rico and the u s.
Easily fill out pdf blank edit and sign them. The bluecard worldwide international claim form is to be used to submit institutional and professional claims for benefits for covered services received outside the united states puerto rico and the u s. For other claim types e g dental prescription drugs contact your blue cross and blue shield company for filing instructions.
For filing instructions for other claim types. Save or instantly send your ready documents. Complete bluecard worldwide international claim form online with us legal forms.
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