We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Multi-State Forms
  • Regence Uniform Medical Claim Form 2020

Get Regence Uniform Medical Claim Form 2020-2025

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the Regence Uniform Medical Claim Form online

Filing a claim for reimbursement can be a streamlined process if you know how to correctly fill out the Regence Uniform Medical Claim Form. This guide provides step-by-step instructions to assist you in completing the form efficiently.

Follow the steps to complete the Regence Uniform Medical Claim Form.

  1. Click ‘Get Form’ button to obtain the necessary document and open it in your preferred editor.
  2. Begin with Section 1, where you will input the employee or retiree information. This includes the UMP identification number, patient's last and first name, date of birth, sex, and relationship to the subscriber. Ensure to provide a daytime phone number and the subscriber's details.
  3. Move to Section 2, which requires patient information. Fill in the same details pertaining to the patient, including their relation to the subscriber.
  4. In Section 3, provide the examining physician or optometrist information. Enter the date of service, services rendered, physician's name, address, and phone number. Include specific diagnosis and procedure codes and confirm whether refraction is included.
  5. Acknowledge Section 4 by filling in the supplier information. This section may require the provider's input or an attached prescription to ensure all information is complete for processing the claim.
  6. Finally, before submission, review all sections for accuracy. When satisfied, sign the completed form in the designated area, indicating your authorization for releasing medical information necessary for processing the claim.
  7. Submit the claim form to Regence BlueShield using the provided address or by fax. Retain copies of the completed form and all attached itemized bills for your records.

Complete your Regence Uniform Medical Claim Form online today for efficient claim processing.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

UMP (Regence) Medical Claim Form
The time limit for filing claims is one year from the date of service/purchase. Note: This...
Learn more
Uniform Medical Plan - Benefits
Uniform Medical Plan. Table of Contents. Provider networks. Cost overview. Coverage...
Learn more

Related links form

Form B250a Medicare Secondary Payer Form Bill Me Later Dispute Form Mi 1040 Fillable Form

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

School employees in Washington state enjoy various benefits, including health insurance through plans like UMP. These benefits often cover medical, dental, and vision care, contributing to the overall well-being of employees and their families. For any medical claims, including UMP services, using the Regence Uniform Medical Claim Form will ensure your claims are properly filed.

A UMP account typically refers to an insurance account related to the Uniform Medical Plan. This account manages your health benefits, allowing you to track claims, coverage details, and payment histories. When you need to submit a claim, the Regence Uniform Medical Claim Form is generally the document that you will complete.

UMP insurance in Washington state refers to the Uniform Medical Plan that provides comprehensive health coverage for state employees. This insurance plan covers a range of medical services, including doctor visits, hospital stays, and preventive care. Utilizing the Regence Uniform Medical Claim Form can help streamline the claims process for these services.

To claim a medical expense, start by completing the Regence Uniform Medical Claim Form with accurate details about your condition and treatment. Attach any required documentation, such as medical bills and statement of services, to validate your claim. Submit the form and documents to your insurance provider through their designated method. This organized approach enhances the likelihood of a timely response and payment.

The procedure for making an insurance claim begins with filling out the Regence Uniform Medical Claim Form. Collect all relevant documents, including receipts and invoices, to support your claim. Once you have completed the form and gathered your documents, send them to your insurance provider. Monitoring the status of your claim can help you stay informed throughout the process.

The best way to make an insurance claim is to provide all required information accurately on the Regence Uniform Medical Claim Form. Double-check your details and documentation before submission to avoid delays. You can submit your claim online or via mail, depending on your preference. Following the correct procedures will lead to smoother processing and quicker reimbursement.

In insurance, UMP stands for Uniform Medical Plan, a product offered by Regence. This plan provides comprehensive healthcare coverage and helps members easily navigate their medical expenses. If you are a UMP member, using the Regence Uniform Medical Claim Form will be crucial for submitting your claims efficiently. Always check your coverage details to maximize your benefits.

To make a medical claim, you must fill out the Regence Uniform Medical Claim Form completely, providing information about the services you received. After completing the form, submit it to your insurance provider, usually through their online portal or by mail. Make sure to gather all necessary documents, such as invoices and receipts, to support your claim. This will help expedite the review process and facilitate payment.

Filling out an expense reimbursement form is similar to using the Regence Uniform Medical Claim Form. Start by clearly stating your name, date, and the nature of the expenses incurred. Include all relevant details such as itemized costs and dates. Submitting accurate information will facilitate a quicker review and approval process.

UMP and Regence are not the same, although they may be associated with overlapping service areas. UMP stands for Uniform Medical Plan, which is a different plan offered in Washington state. Regence, on the other hand, has its own distinct insurance products and services. It's essential to understand the differences when looking for coverage or filing claims using the Regence Uniform Medical Claim Form.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Regence Uniform Medical Claim Form
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232