Get Blue Cross Of Illinois Claim Form Fillable

Filing a claim with Blue Cross Of Illinois can be straightforward when you have the right guidance. This user-friendly guide will help you navigate the Blue Cross Of Illinois Claim Form Fillable online, ensuring that all necessary information is accurately provided for efficient processing.

Follow the steps to fill out your claim form accurately

1. Click ‘Get Form’ button to access the form and open it in the editor, allowing you to begin filling it out.
2. Begin by entering your identification number, which can be found on your Blue Cross and Blue Shield identification card. Be sure to copy it accurately to avoid any processing delays.
3. Complete the patient information section by providing the full legal name of the patient, their date of birth, and indicate their gender using the options provided.
4. In the member information section, enter the name of the member or policyholder as it appears on the Blue Cross and Blue Shield ID card, along with their date of birth and current address.
5. Indicate whether the claim is for an accidental injury or a workers' compensation claim by selecting 'Yes' or 'No' accordingly. If applicable, provide the date of the accident.
6. Briefly describe the condition or injury for which the patient received services. You can reference the diagnosis from the itemized bill provided by the healthcare provider.
7. Attach the original itemized bills that align with the required details mentioned in the form. If your claim is the result of a service first billed to Medicare, ensure you include a copy of the explanation of benefits from Medicare.
8. Review all sections to ensure completeness and accuracy, as incomplete forms can lead to delays.
9. Sign and date the form to certify that the provided information is correct. Missing the signature can also cause problems in processing your claim.
10. Once completed, you can save changes, download, print, or share the form as needed before submitting it to the designated address.

Complete your Blue Cross Of Illinois Claim Form Fillable online today for efficient claim processing.