NC BCBS Form BE236 1999 free printable template
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MEMBER CLAIM FORM
Do not file for prescription drugs on this form.
TIPS FOR FILING:
I Claim must be filed within 18 months from the date services were received, or they will be denied for late filing.
I
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How to fill out NC BCBS Form BE236
How to fill out NC BCBS Form BE236
01
Obtain the NC BCBS Form BE236 from the official website or authorized distributor.
02
Read the instructions provided with the form carefully to ensure proper completion.
03
Fill in your personal information at the top, including your name, address, and contact details.
04
Provide your insurance information, such as your Blue Cross Blue Shield member ID number.
05
Enter relevant medical information as requested, including details about the service or treatment.
06
Attach any required documentation, such as medical records or provider statements.
07
Review the completed form for accuracy and completeness.
08
Sign and date the form to attest to the information provided.
09
Submit the form via the specified method (mail or online), according to the instructions provided.
Who needs NC BCBS Form BE236?
01
Individuals seeking reimbursement for medical expenses from Blue Cross Blue Shield of North Carolina.
02
Patients who have received services from healthcare providers that require the submission of this specific form for claims processing.
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People Also Ask about
Can you use Blue Cross Blue Shield NC in another state?
Your ID card gives you access to participating providers outside the state of North Carolina through the Blue Card® Program, and benefits are provided at the in-network benefit level.
What is Healthy Blue NC claims number?
844-594-5070 (TTY 711) Monday through Saturday, 7 a.m. to 6 p.m. Eastern time.
What is the timely filing limit for BCBS NC claims?
Claims not received within 18 months from the date the service was provided will not be covered, except in the absence of legal capacity of the member.
What is the timely filing limit for BCBS NC?
Claims not received within 18 months from the date the service was provided will not be covered, except in the absence of legal capacity of the member.
What is the phone number for BCBS of North Carolina member services?
How and when can I contact my health plan? Blue Cross NC's Customer Service representatives are available to answer calls at 1-877-258-3334, Monday through Friday from 8:00 a.m. to 7:00 p.m.
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What is NC BCBS Form BE236?
NC BCBS Form BE236 is a form required by Blue Cross and Blue Shield of North Carolina for reporting specific health coverage and claims information.
Who is required to file NC BCBS Form BE236?
Entities such as healthcare providers and insurance companies that participate in or provide coverage through Blue Cross and Blue Shield of North Carolina are required to file this form.
How to fill out NC BCBS Form BE236?
To fill out NC BCBS Form BE236, individuals or entities must provide accurate information related to member coverage, claims submitted, and other necessary data as specified in the instructions provided with the form.
What is the purpose of NC BCBS Form BE236?
The purpose of NC BCBS Form BE236 is to collect relevant data for reporting purposes, ensuring compliance with state and federal regulations while assisting in administrative processes.
What information must be reported on NC BCBS Form BE236?
The information that must be reported on NC BCBS Form BE236 includes details such as subscriber identification, coverage types, claims data, dates of service, and any other information as required by Blue Cross and Blue Shield of North Carolina.
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