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Shorter Security Application BlueKC.com One Pershing Square, 2301 Main, P.O. Box 419169, Kansas City, MO 641416169 8163952222 REQUESTED EFFECTIVE DATE: You may request an Effective Date of the 1st
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To fill out bcbskc-sts-0117 - 12 mosindd, follow these steps:
02
Open the form in a PDF editor or print it out if you prefer to fill it out manually.
03
Start by entering the date of the form at the top.
04
Fill in your personal information, including your name, address, and contact details.
05
Provide your BCBSKC member ID and group number, if applicable.
06
If you are filling out this form for a dependent, include their information as well.
07
Indicate the coverage period for which you are reporting, usually 12 months.
08
Provide details of any changes or updates to your insurance coverage during the reporting period.
09
Sign and date the form to certify the accuracy of the information provided.
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Submit the completed form to the appropriate department or address as specified.
Who needs bcbskc-sts-0117 - 12 mosindd?
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BCBSKC-STC-0117 - 12 mosindd is needed by individuals who have Blue Cross Blue Shield Kansas City insurance and are required to report any changes or updates to their insurance coverage for a 12-month period.
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This form is typically used by policyholders or their dependents to provide accurate and up-to-date information regarding their insurance coverage.
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What is bcbskc-sts-0117 - 12 mosindd?
bcbskc-sts-0117 - 12 mosindd is a specific form required for reporting certain information to Blue Cross Blue Shield of Kansas City.
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Providers and entities providing services to Blue Cross Blue Shield of Kansas City are required to file bcbskc-sts-0117 - 12 mosindd.
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The purpose of bcbskc-sts-0117 - 12 mosindd is to ensure transparency and accurate reporting of services provided to Blue Cross Blue Shield of Kansas City.
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