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  • Medical Waiver Follow-up Form (pdf) - Blue Cross Blue Shield Of ...

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Medical Waiver Follow-up Form Member Instructions: If your physician has verified that it is either medically inadvisable or unreasonable for you to meet one or more of the health criteria required.

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Frequency code 8: • Must be used to fully void a claim. Must represent the entire claim—not just the line or item that you are retracting.

Filing claims Use payor ID 03036 to submit claims electronically. Call your clearinghouse or Change Healthcare at 1-800-266-2206 for help submitting claims.

Mailing Address (claims and correspondence): Blue Benefit Administrators of Massachusetts. PO BOX 55917. Boston, MA 02205-5917.

Common Re-Submission Codes Include: 6-Corrected. 7-Replacement. 8-Void.

Blue Cross Blue Shield of Massachusetts serves nearly three million members....Get to Know Us. CompanyBlue Cross and Blue Shield of Massachusetts, Inc.Headquarters101 Huntington Avenue, Suite 1300 Boston, MA 02199-761111 more rows

Call 1-800-200-4255(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
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