Get Mebaplans

Filing a Major Medical Claim through Mebaplans can be straightforward if you follow the essential steps outlined in this guide. This comprehensive resource is designed to help users complete the form accurately, ensuring that all necessary information is provided for a successful claim.

Follow the steps to fill out the Mebaplans effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the subscriber’s legal name, patient’s legal name, and membership number in the corresponding fields. Ensure that you also provide the patient’s date of birth and sex.
3. Fill in the subscriber’s address, including street, city, state, and zip code. If you have a new address, check the appropriate box.
4. Indicate the patient’s relationship to the subscriber by selecting the correct option (self, spouse, or child).
5. In the illnesses section, list all relevant illnesses or conditions for which you are submitting bills. Include the date of first symptoms for each illness.
6. Answer whether the treatment was a result of an accidental injury. If yes, provide the date and a description of the accident.
7. State whether the illness or injury was work-related and provide information on where the accident occurred if applicable.
8. Complete the Medicare section accurately by indicating if the patient has Medicare and provide effective dates for Parts A and B if applicable.
9. If the patient is covered under any other health insurance, answer yes, and provide the name of the policyholder, their relationship to the patient, insurance company details, and effective date of coverage.
10. Review the authorization section, sign, and date the form to confirm that the information provided is accurate and complete.
11. Once all fields are filled out, save your changes. You can download, print, or share the completed form as necessary.

Complete your Mebaplans online today to ensure efficient processing of your Major Medical Claim.