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  • Oregon Regence Blue Cross Coordination Of Benefits Form

Get Oregon Regence Blue Cross Coordination Of Benefits Form

100 S.W. Market Street P.O. Box 1271 Portland, OR 97207-1271 (503) 225-5336 1 (800) 452-7390 Date Patient Name Group & ID No. Claim No. Adj. Rel. Dear Member: Your health coverage includes a Coordination.

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How to fill out the Oregon Regence Blue Cross Coordination Of Benefits Form online

This guide provides clear and supportive instructions on how to effectively complete the Oregon Regence Blue Cross Coordination Of Benefits Form online. Understanding how to fill out this form correctly will help ensure the timely processing of your health coverage claims.

Follow the steps to complete the form online:

  1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the date at the top of the form, followed by the patient's name, group and ID number, and claim number.
  3. Indicate if you or any family members have other health coverage by selecting 'Yes' or 'No'. If 'Yes,' proceed to fill in the insurance information.
  4. In the insurance information section, provide details of the other insurance including the effective date, cancellation date, name of the insurance company, address, telephone number, and the name of the policyholder.
  5. Fill out the ID number, group number, date of birth, employer's name, and type of coverage (medical, dental, vision, or prescription). Select whether it is a group/employer policy or individual.
  6. Repeat the previous step for any other persons covered by different insurance plans.
  7. If applicable, complete the child custody information regarding the dependents and provide the name of the parent with custody.
  8. If you or any family members are covered by Medicare, fill in the Medicare certification section with the member's name, Medicare number, and effective dates for Part A and Part B.
  9. Certify the accuracy of the information by signing and providing your work and home telephone numbers, along with your email address.
  10. After completing all sections, review the information for accuracy, then save your changes, download, print, or share the form as required.

Complete your documents online to ensure efficient processing.

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The rules for coordination of benefits involve a set of guidelines aimed at determining how multiple insurance policies work together. Typically, the primary insurance pays first, and the secondary insurance covers any remaining eligible costs. By filling out the Oregon Regence Blue Cross Coordination Of Benefits Form accurately, you help clarify your coverage, ensuring providers understand how to submit claims for maximum benefits. Familiarizing yourself with these rules can enhance your experience with insurance claims.

Regence and Blue Cross Blue Shield operate under the same umbrella but are not the same entity. Regence is a licensed member of the Blue Cross Blue Shield Association, providing health insurance in certain states, including Oregon. Therefore, when you use the Oregon Regence Blue Cross Coordination Of Benefits Form, you are interacting with a brand that aligns with Blue Cross Blue Shield standards. Understanding the connection can help you navigate your health coverage options more effectively.

To check your Regence benefits, you can log into the Regence website or mobile app. There, you will find detailed information about your coverage, claims, and available benefits. Additionally, if you require assistance with the Oregon Regence Blue Cross Coordination Of Benefits Form, consider using uslegalforms. They offer forms and guidelines to help simplify your experience.

Coordination of benefits is a process that determines how multiple health insurance plans work together to cover your medical expenses. For instance, if you have two insurance policies, one may cover a portion of your medical bill, while the other fills in the gaps. This concept is essential when filling out the Oregon Regence Blue Cross Coordination Of Benefits Form, as it helps ensure you receive the maximum benefits to which you are entitled.

Regence and Regence Blue Cross Blue Shield refer to the same organization, but they can have different branding based on the services offered. As part of the Blue Cross Blue Shield Association, Regence provides health insurance across several states, including Oregon. If you are looking for information related to the Oregon Regence Blue Cross Coordination Of Benefits Form, you will find it helpful to know that they operate under the same umbrella and can assist with your health insurance needs.

The Oregon Regence Blue Cross Coordination Of Benefits Form is a crucial document used when a person has more than one health insurance plan. This form helps determine how each insurance plan pays for healthcare services, ensuring that you receive maximum coverage without overpaying. By submitting this form, all parties involved can efficiently coordinate payments for your medical bills, making the process smoother for you.

Regence is a member of the Blue Cross Blue Shield network of insurance companies. Regence offers Medicare Advantage plans in four states in the northwestern part of the country. Each plan may offer prescription drug coverage as well as additional benefits not covered by original Medicare.

Anthem and Regence are each independent licensees of the Blue Cross and Blue Shield Association.

Blue Cross Blue Shield is part of the Anthem family of brands, but the two entities each sell health insurance in different areas of the country, and each company provides Medicare health benefits and prescription drug coverage to beneficiaries in those areas.

Visit our Explore plans page to get started or call us directly at 1-888-REGENCE (734-3623) (TTY:711).

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© 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
Help Portal
Legal Resources
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