Get Qualification Form Instructions - Bcbsm.com

Completing the Qualification Form effectively is an important step towards maintaining your health and ensuring your health plan's compliance. This guide provides detailed instructions to help you fill out the form accurately and submit it within the required timeframe.

Follow the steps to complete the Qualification Form successfully.

1. Press ‘Get Form’ button to access the Qualification Form and open it in your preferred editor.
2. Fill out the Member Information section using either a blue or black pen. Ensure that all fields are legible and complete, as any illegible entry or missing information can invalidate your form.
3. Schedule an appointment with your doctor well before the compliance deadline to have them fill out their section of the form. It is essential that your physician signs the form for it to be processed.
4. After completing all required information on the Qualification Form, fax it to the designated number, 1-866-392-6496, before the compliance deadline. Retain a copy of the form and your fax confirmation for your records.
5. Once your form is submitted, you may access additional health and wellness resources by logging into Member Secured Services. Here you can complete a health assessment and participate in health-coaching programs.
6. If your physician requires further discussion regarding your health measures, they may schedule a follow-up appointment to ensure you are on track with your health goals.

Complete your Qualification Form online now for a healthier future!