Get MA BCBS N20-07-371
Ely. Do not hold to submit with the claim. Check here if you will be electronically submitting this to your local BC and/or BS Plan and you have the Policy Holders signature on file. Member: Your Blue Cross and/or Blue Shield contract may contain a Coordination of Benefits (COB) provision. Your Plan depends upon your help in order to process your claims correctly and appreciates your prompt and accurate reply. If any of the information below changes, please contact your Blue Cross and/or Blue S.
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