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Enrollment Form (?) Fax completed form to: Blue Cross and Blue Shield of Texas. Fax number: 1-855-879-7170 Utilization Management: Phone number: 1-855-879-7178 Part I Patient Information Patient’s
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How to fill out enrollment form - bcbstxcom
How to fill out enrollment form - bcbstxcom:
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Visit the bcbstxcom website.
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Click on the enrollment form link to open it.
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Provide the required personal information, such as your full name, address, and contact details.
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Fill in any additional information that is specifically requested, such as your social security number or date of birth.
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Depending on the form, you may need to indicate your preferred plan, coverage options, or any other specific choices.
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