CLAIM FORMP.O. Box 8069 Little Rock, Arkansas 722038069A SEPARATE CLAIM FORM CLAIM MUST BE SUBMITTED EACH PATIENT WHEN SENDING BILLS TO A SEPARATE FORM MUST BEFOR SUBMITTED FOR EACH PATIENT ARKANSAS BLUE CROSS AND.
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How to fill out the AR Health Advantage BCBS HA72-01 online
Filling out the AR Health Advantage BCBS HA72-01 form online is a straightforward process that ensures your claims are submitted correctly. This guide provides step-by-step instructions to help users complete the form efficiently and accurately.
Follow the steps to fill out the AR Health Advantage BCBS HA72-01 form correctly.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Enter the health advantage identification number. This number is located on your identification card and includes the three-digit prefix.
- Complete the patient's information section. Include the patient's last name, first name, initial, date of birth, and sex. Specify their relationship to the policyholder.
- Describe the illness or injury requiring treatment by including the date the illness began and indicating if it was an accident. Provide the accident's date if applicable.
- Indicate whether the patient is a full-time student and whether the illness or injury relates to an employment situation.
- Complete the other insurance section if applicable, including the Medicare coverage status and any other medical insurance details.
- Provide additional information regarding other insurance, including the policyholder's details and other relevant coverage information.
- Ensure all items on the claim form are filled out completely to support the processing of your claim.
- Certify that all provided information is complete and accurate by signing and dating the form.
- After completing the form, you can save changes, download, print, or share the completed claim form as needed.
Ensure your claims are processed efficiently by filling out your documents online.
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Is Blue Advantage of Arkansas the same as Blue Cross Blue Shield?
Health Advantage and Arkansas Blue Cross are independent licensees of the Blue Cross and Blue Shield Association.
What is the claims address for BCBS of Arkansas?
Where and how do I submit BlueCard claims? If you are an Arkansas provider, always submit BlueCard claims electronically through Availity or mail to Arkansas Blue Cross and Blue Shield, P.O. Box 2181, Little Rock, AR 72203-2181.
How do I file a claim with Blue Cross Blue Shield of Arkansas?
For more information, contact customer service at 800-800-4298.
How do I contact Blue Cross Blue Shield Arkansas?
Member Service Lines ServiceNumberCustomer Service (main line)800-238-8379Metallic Plan Members (Gold, Silver, Bronze and Catastrophic)800-800-4298 (TDD 501-502-1458)Dental - Benefits and Billing questions888-224-5213Dental - Claim questions888-223-499915 more rows
What is the explanation of benefits for Arkansas Blue Cross Blue Shield?
The Explanation of Benefits (EOB) shows you the details of your medical and pharmacy expenses and how health insurance covers each. It is a summary of your claims activity that includes: Total charge: The total amount a provider charged for services. Member discount: We negotiate discounts with providers for you.
How do I submit a claim to Blue Advantage Arkansas?
Where and how do I submit BlueCard claims? If you are an Arkansas provider or contract with BlueAdvantage and are located in a contiguous area, always submit BlueCard claims electronically through Availity or mail to BlueAdvantage, P.O. Box 2181, Little Rock, AR 72203-2181.
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