Get Premera Blue Cross Form 020008 2012-2025

Filling out the Premera Blue Cross Form 020008 online can be straightforward when you follow the proper steps. This guide will provide you with detailed instructions to help ensure your form is completed accurately and efficiently.

Follow the steps to complete the form correctly.

1. Click ‘Get Form’ button to access and open the document in the appropriate online editor.
2. In Section A, enter the patient's information. Fill in the patient's full name, date of birth in mm/dd/yyyy format, and Premera member identification number. Ensure all fields are accurately filled out.
3. Proceed to Section B to provide the prescribing and submitting provider's information. Include the name and phone number of the prescribing provider. If known, also add the massage therapist's name and phone number.
4. Move to Section C for the prescription information. Attach the prescription to the form. Make sure it includes the patient's name, date of birth, Premera member identification number, prescription date, prescribing physician's name, signature, and phone number, diagnosis, and the frequency or duration of visits.
5. Select your preferred method of submission—either fax or mail. Do not use both to avoid duplication in processing. Remember, your prescription must cover the date of service for your claims.
6. Once all sections are completed, review your entries to ensure accuracy. After verification, save your changes, and you can download, print, or share the form as needed.

Complete your documents online to ensure a smooth submission process.