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BlueCard Worldwide International Claim Form Blue Cross and Blue Shield Plans are independent licensees of the Blue Cross and Blue Shield Association. Please see the instructions on the reverse side of this form before completing. Signature of subscriber or patient Date General Information The BlueCard Worldwide International Claim Form is to be used to submit institutional and professional claims for benefits for covered services received outside the United States Puerto Rico and the U.S....
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How to fill out worldwide claim form

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How to fill out BlueCard Worldwide N-12-420

01
Start by downloading the BlueCard Worldwide N-12-420 form from the official website.
02
Read the instructions carefully before filling out the form.
03
Fill in your personal information in the designated fields, including your name, address, and contact information.
04
Provide your BlueCard identification number if applicable.
05
Specify the type of service required and the date of service.
06
Include any additional details that may be required by the insurance provider.
07
Review the form for accuracy and completeness.
08
Sign and date the form where indicated.
09
Submit the completed form to the appropriate address or electronically as instructed.

Who needs BlueCard Worldwide N-12-420?

01
Individuals who are traveling abroad and require medical assistance.
02
Members of health insurance plans that include international coverage.
03
Those seeking treatment outside their home country under the BlueCard program.

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Instructions and Help about international claim online

[Music] hi I'm Stephanie Piccalilli Hansen and I work for booby International and Brighton today I will guide you through the simple process of claiming for your medical expenses there are a few things you need to do and there are few things you can do to help speed up the process of evaluating your claims by a fair deal let's start with the essentials first gather your medical bills standard physician bills medicine bills etc should be paid by you if you have been to the doctors they should specify a diagnosis a service a date of service and an amount paid if you have purchased prescription medicine the bill should contain a name date and amount paid it is important that we know that the bills are paid so make sure you either have receipts or that you notify us of how you have paid the bills for example if you paid by internet banking for some policies a claim form is required if this is true in your case make sure to fill it out if you've been treated for something out of the ordinary we need a medical statement from your doctor going more in depth with your diagnosis and treatment that's it for the essentials now let's look at what you can do to have the claims' evaluation when even smoother and quicker the best way is to simply think of us as humans like you which means if you can treat the doctors written letters chances are we can't either if you take the time to write the context of your treatment we'll be able to evaluate your claim faster a few lines will do and if your documents are in physical order or according to diagnosis and family member we don't have to link documents on different pages thereby speeding up the process by a great deal in short if a few notes in a bit of order would help you understand the bills better the same goes for s ultimately leading to faster claims handling and finally let us know you preferred currency and method of reimbursement when everything is ready you can post your original documents — we were international wrestle house Brussels mousse Brighton be in one — and our United Kingdom please remember to take copies of everything we send and to specify your policy number worldwide help option plan holders can also claim online be a members world if you stick to this guide you should be good and your reimbursement documents ought to be on your members won't account shortly let's recap gather your documents make sure they make sense send them to us [Music]

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BlueCard Worldwide N-12-420 is a healthcare program that allows members to access medical services while traveling or residing outside their home country, ensuring they receive care as per their health insurance coverage.
Providers and health care facilities who offer services to BlueCard Worldwide members are required to file BlueCard Worldwide N-12-420 to ensure proper billing and reimbursement.
To fill out BlueCard Worldwide N-12-420, providers must complete the form with accurate patient information, service details, billing codes, and any supporting documentation required for the services rendered.
The purpose of BlueCard Worldwide N-12-420 is to facilitate the billing and reimbursement process for healthcare services provided to BlueCard members outside their home country, ensuring that they receive necessary care.
The information that must be reported on BlueCard Worldwide N-12-420 includes the patient's personal details, provider information, service dates, treatment descriptions, billing codes, and any applicable authorizations or referrals.
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