Get Blue Cross Claim Form Alberta

This guide provides clear and supportive instructions on filling out the Blue Cross Claim Form Alberta online. By following these steps, you can efficiently complete and submit your claim for benefits.

Follow the steps to successfully complete your claim form.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. Begin by filling out the patient information section. Include the patient’s name as it appears on the Blue Cross identification card, their date of birth, and their sex. Specify the patient's relationship to the subscriber.
3. In the following section, provide details about any other health insurance coverage the patient may have. Answer ‘Yes’ or ‘No’ and fill in the required fields, including the name of the insuring company and the policy or identification number.
4. Describe the diagnosis in detail. Include the nature of the illness, injury, or symptoms requiring treatment, and answer whether the treatment was due to a work-related accident.
5. List all charges for services rendered in the charges section. Use a separate line for each service, noting the provider's name, type, description of the service, dates of service/purchase, and the corresponding charges.
6. Select a payment option in the payee section. Decide whether the payment should be made to the subscriber or directly to the provider, and fill out the necessary information.
7. Complete and sign the form at the signature section. Ensure that the signature belongs to the subscriber or the patient and date the form.
8. Review all entries for completeness and accuracy. Save any changes made. Once satisfied, download, print, or share the completed form as required.

Complete your documents online to ensure a smooth claim process.