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  • Coordination Of Benefits Questionnaire - Bcbstx

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Coordination of Benefits Questionnaire BCBS POLICYHOLDER NAME: BCBS GROUP #: BCBS MEMBER ID #: Your Blue Cross Blue Shield contract contains a Coordination of Benefits (COB) provision. If there is.

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This Coordination of Benefits (COB) Questionnaire contains questions about other forms of medical insurance you have. COB helps to ensure that members covered by more than one plan will receive the benefits they are entitled to while avoiding overpayment by either plan.

Coordination of Benefits (COB) is a provision in most health plans that allow families with two wage earners covered by health benefit plans to receive up to 100% coverage for medical services. COB rules determine which plan is primary for you, your spouse and your dependent children.

Non-duplication coordination of benefits method In this case, if you incur a $100 doctor office visit expense and the primary payor pays $80, the secondary payor with a $25 office visit copay pays nothing because the primary plan paid more than what the secondary payor would have paid on its own.

Complaints and Appeals. If you have a complaint about a service or care you received from Blue Cross and Blue Shield of Texas (BCBSTX) or one of our providers, please call a Customer Advocate at 1-888-657-6061 (TTY: 711). You can file a complaint by phone or ask for a complaint form to be mailed to you.

If you have questions regarding a specific claim, please contact Provider Customer Service at 1-800-451-0287 to speak with a Customer Advocate.

An Explanation of Benefits (EOB) is a notification provided to members when a health care benefits claim is processed by Blue Cross and Blue Shield of Texas (BCBSTX). The EOB shows how the claim was processed. The EOB is not a bill. Your provider may bill you separately.

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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