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  • Bcbsri Member Waiver Form

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Blue Cross & Blue Shield of Rhode Island Small Employer Waiver Form/Certification EMPLOYER NAME GROUP ID. NO. EMPLOYEE NAME DATE NAME OF EMPLOYEE S SPOUSE AND/OR CHILDREN (IF APPLICABLE) Note:.

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Related content

Medical Coverage - Office of Employee Benefits...
Coverage Information; Eligibility; Enrollment/Waiver; Premium Rates; Claims ... All three...
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Just call Customer Service at (401) 459-5000 or 1-800-639-2227 (outside RI).

Monday through Friday 8:00 a.m. to 4:30 p.m. Please contact your account executive or call our main number at (401) 459-1000 or 1-800-637-3718 outside Rhode Island.

If you have questions about whether or not your claims meet all conditions of a “clean claim,” you may contact the Physician and Provider Service Center at (401)-274-4848 or 1-800-230-9050. 1.

Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association. Blue Cross & Blue Shield of Rhode Island (BCBSRI) is a non-profit, community-focused health plan established in 1939 to help Rhode Islanders finance their healthcare needs.

Prime Therapeutics LLC is an independent pharmacy benefit management company, contracted by Blue Cross & Blue Shield of Rhode Island (BCBSRI) to provide pharmacy benefit management services.

In the ANSI file, the Carrier Reference (Payer ID) for BCBSRI must be 00870 for Blue Shield/ Blue Chip and 00370 for Blue Cross/Blue Chip. Any other Payer id will not be recognized by our system.

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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
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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