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BLUE CROSS AND BLUE SHIELD MEDICARE PART D PRESCRIPTION DRUG REIMBURSEMENT FORM (To be used for Secondary Reimbursement under an American Airlines Group Health Plan) BLUE CROSS AND BLUE SHIELD GROUP
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Sign and date the form before sending it to the appropriate Blue Cross and Blue Shield office or claims address.
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Blue Cross Blue Shield is a health insurance company that offers a variety of plans for individuals and families.
Individuals or families who are enrolled in a Blue Cross Blue Shield health insurance plan may be required to file claims for medical services.
To fill out a Blue Cross Blue Shield claim, you will need to provide information about the medical service received, the provider, and any other relevant details.
The purpose of Blue Cross Blue Shield is to help individuals and families afford the cost of medical services by providing insurance coverage.
Information such as the date of service, the name of the provider, the cost of the service, and any other relevant details must be reported on a Blue Cross Blue Shield claim.
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