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  • Regence Provider Eftach Form

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AUTOMATIC DEPOSIT (EFT/ACH CREDITS) AUTHORIZATION AGREEMENT AND CONTACT INFORMATION All fields are required Date: Provider Organization Name: Tax Identification (ID): Please set-up ALL National Provider.

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You can submit claims electronically or use the the direct claims entry link on our provider portal at providers.bcidaho.com....It is important your submission contain the following information: Member name date of birth, ID number. Provider name, address and provider number. Information about other insurance coverage.

Submitting claims to RGA Electronically: Submit claims directly to Availity with Payer Identification Code ID RGA01.

1 (888) 675-6570.

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

Submitting claims to RGA Mail: Regence Group Administrators, P.O. Box 52890, Bellevue, WA 98015-2890. The claim should include the prefix and the subscriber number listed on the member's ID card. Do not submit RGA claims to Regence.

The payer name is Blue Cross of Idaho; payer ID is BLUEC.

Grievances must be filed within 60 days of the event or incident. You may send a complaint to us in writing or by calling Customer Service.

IVR is available 24 hours a day, seven days a week. When calling our Provider Contact Center at 1 (800) 253-0838, use the phone prompts below to access IVR: If your patient is a Regence member, press 1 and select: For questions regarding dental.

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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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