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Anthem Blue Cross and Blue Shield
P. O. Box 14046
Roanoke, VA 240384046Instructions
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5. Print clearly and complete this application in ink.
For each person to be covered, provide all requested
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How to fill out general notice of pre-existing
How to fill out general notice of pre-existing
01
Begin by gathering all the necessary information and documents relevant to the pre-existing condition. This may include medical records, previous diagnoses, treatment plans, and any other supporting documentation.
02
Read the instructions provided with the general notice of pre-existing form carefully to ensure you understand the requirements and obligations.
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Fill in your personal information in the designated fields, including your name, address, phone number, and email address.
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Specify the details of the pre-existing condition, including the name of the condition, date of diagnosis, and any relevant medical information.
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Provide information about any treatments or medications you have received or are currently receiving for the pre-existing condition.
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If required, attach any supporting documentation that may strengthen your case or provide further evidence of the pre-existing condition.
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Double-check all the information you have provided for accuracy and completeness.
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Sign and date the general notice of pre-existing form in the designated area.
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Keep a copy of the completed form for your records and submit it as instructed by the relevant authorities.
Who needs general notice of pre-existing?
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Anyone who has a pre-existing condition and is required to disclose it to a particular entity or authority may need a general notice of pre-existing. This could include individuals applying for insurance, seeking employment, or participating in activities or programs that require disclosure of health conditions. It is always best to consult with the specific entity or authority to determine if a general notice of pre-existing is necessary.
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