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GA Anthem Blue Cross And Blue Shield Member Claim Form (WGS Claims) 2007
Get GA Anthem Blue Cross And Blue Shield Member Claim Form (WGS Claims) 2007-2024
IENT INFORMATION - Person who received services: NAME (last, first, MI) SEX MALE FEMALE NUMBER OF ITEMS ATTACHED RELATIONSHIP TO SUBSCRIBER SELF CHILD SPOUSE OTHER Mo. DATE OF BIRTH Day Yr. PRIMARY MEMBER INFORMATION: NAME (last, first, MI) ADDRESS City State Zip Code IMPORTANT Check here if this is a new address OTHER COVERAGE INFORMATION: IS THIS PATIENT COVERED BY ANY OTHER GROUP HEALTH CARE PLAN OR MEDICARE? YES WAS CONDITION RELATED TO AN AUTOMOBILE ACCIDENT? NO YES WAS CONDITION.
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GA FAQ
If you have questions about this form or need additional assistance, contact Provider Services at (844) 396-2330 or contact your local Provider Experience Consultant.
and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (collectively “BCBSGa”) has changed to Anthem Blue Cross and Blue Shield (Anthem), a trusted name that symbolizes quality for millions of consumers across the country. While our trade name and logo have changed, almost everything else will stay the same.
Anthem Blue Cross and Blue Shield | State Health Benefit Plan | Division of Georgia Department of Community Health.
Member Services 855-641-4862.
Blue Cross and Blue Shield of Georgia has been providing quality health benefits for residents of Georgia for more than 70 years. Carry with you the medical ID card that signifies quality health care coverage and receive your healthcare from one of the largest physician networks in the state of Georgia.
The World Geodetic System (WGS) is a standard for use in cartography, geodesy, and satellite navigation including GPS.
By Phone: Call the number on the back of the member's ID card or dial 800-676-BLUE (2583) to speak to a Provider Service representative.
Blue Cross and Blue Shield of Georgia has been providing quality health benefits for residents of Georgia for more than 70 years. Carry with you the medical ID card that signifies quality health care coverage and receive your healthcare from one of the largest physician networks in the state of Georgia.
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