We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • Social Forms
  • Washington Social Forms
  • Premera 017316 2007

Get Premera 017316 2007-2025

On about other health coverage you may have — thank you for your cooperation! Please either review this form and call Customer Service at 1-800-722-1471 with the information or complete the form and mail to the address above. Subscriber Name and Address Date Member ID Group Number Group Name If you or your dependents have other health coverage, the information requested below will enable us to coordinate payment of your claim(s) with your other carrier(s). Please refer to the back of this fo.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the Premera 017316 online

Filling out the Premera 017316 form online is an important step in providing accurate information about your healthcare coverage. This guide will walk you through each section of the form to ensure a smooth submission process.

Follow the steps to complete the Premera 017316 form accurately

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering your subscriber name and address in the designated fields. Ensure that all information is accurate to avoid delays.
  3. Next, fill in the date, member ID, group number, and group name as prompted. These identifiers are crucial for processing your information.
  4. Proceed to the 'Other Insurance Information' section. Indicate whether you or any family members have other coverage by selecting ‘Yes’ or ‘No’.
  5. If applicable, provide details for any coverage you have with Premera by filling out the subscriber's name, date of birth, and subscriber ID number.
  6. For individuals with Medicare coverage, select 'Yes' and complete the fields for the family member with Medicare, including their Medicare ID and effective date of coverage.
  7. If you have other medical, dental, or vision coverage, select 'Yes' and fill in the details of the policyholder and the insurer's information.
  8. For parents who are divorced or separated, provide the necessary details regarding custody and financial responsibility to determine primary and secondary coverages.
  9. Before submitting the form, review all provided information for accuracy, and make any necessary corrections.
  10. Finally, save your changes. You can download, print, or share the completed form based on your preference for submission.

Complete your Premera 017316 form online today to ensure your healthcare claims are processed efficiently.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

FASE III: PLAN FINAL - Junta de Planificación
Oct 3, 2024 — Este documento se conoce como el Memorial del Plan Final, y representa la...
Learn more
TRABAJO FINAL DE CARRERA
by J Baños Lloredo · 2011 — A mis directores, Dr. Sergio Oller, Dr. Alex Barbat y...
Learn more

Related links form

PRE- APPLICATION FOR INTERMENT - Virginia Department Of ... - Dvs Virginia 2018 Mvdb 22 2016 Virginia Scientific Collecting T&e Permit Form Hellgrammites For Sale Form

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

The payer ID for Premera Blue Cross is 87726. This ID is essential for healthcare providers when submitting claims for reimbursement. If you’re a provider needing additional resources or assistance with this ID and how it relates to Premera 017316, our platform, USLegalForms, can provide valuable guidance and support.

No, Premera Blue Cross and Regence Blue Cross are separate entities that operate under the Blue Cross Blue Shield banner. They each provide health insurance services in different regions and have distinct plans and networks. If you are interested in comparing these options, you may want to explore both offerings in relation to Premera 017316.

To reach the Blue Cross of Washington Premera provider, you can call their customer service at 1-800-722-1471. This number connects you with representatives who can assist with various inquiries including claims, benefits, and policy details. If you are considering enrollment or have questions regarding Premera 017316, this is a helpful contact point.

Yes, Premera Blue Cross is a specific regional entity within the Blue Cross Blue Shield Association. While both names share the same foundational principles of providing health coverage, Premera focuses mainly on the Washington and Alaska markets. By searching for Premera 017316, you can uncover specific plan details and benefits offered by this provider.

No, Blue Cross Blue Shield and Regence are not the same entity. Regence operates under the Blue Cross Blue Shield umbrella but functions as an independent company, which may cause confusion. Understanding the distinctions between these organizations can help you make informed decisions about your healthcare coverage.

The birthday rule for Premera 017316 determines which parent's insurance coverage is primary for dependent children. Under this rule, the coverage of the parent whose birthday occurs first in the calendar year is considered primary. This guideline helps clarify benefit coordination and ensures families receive appropriate coverage.

Another name you will find for Premera 017316 is Premera Blue Cross. This dual naming reflects its partnership with the Blue Cross Blue Shield Association, enhancing its credibility. Knowing this can help you navigate healthcare plans by understanding that both names refer to the same insurance provider.

In Washington, Blue Cross Blue Shield is referred to as Premera 017316. This company provides essential health insurance coverage in the region, allowing residents to access a wide range of healthcare services. When you see Premera in Washington, it is synonymous with Blue Cross Blue Shield.

Premera 017316 is part of the Blue Cross Blue Shield system but operates independently. Customers should understand that while they share the Blue Cross Blue Shield brand, Premera has its own specific services and coverage options. This independence allows Premera to tailor its offerings to better serve local needs.

No, Regence Blue Cross Blue Shield and Premera 017316 are not the same organization. While both offer health insurance, they are separate entities with distinct networks and plans. Each company operates under different guidelines, and it is important to recognize these differences when choosing a health plan.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Premera 017316
Get form
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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