Get the free premera member submitted claim form

P.O. Box 91059 Seattle, WA 98111-9159 Member Submitted Claim Form This form is to be used for medical and dental claims where you incurred expenses from a provider who did not bill the plan directly.

How to fill out premera member submitted claim

How to fill out premera member submitted claim:

1. Gather all necessary information: Before starting the claim, make sure you have all the required information. This includes the member's personal details, such as name and address, as well as their Premera insurance policy number.
2. Identify the reason for the claim: Determine why the member is submitting the claim. It could be for medical services, prescription drugs, or any other covered expenses. This information will help you properly categorize the claim.
3. Obtain the necessary documentation: Collect all the relevant documents to support the claim. This may include medical bills, invoices, receipts, or any other documentation that proves the expenses or services being claimed.
4. Complete the claim form: Use the Premera member submitted claim form provided by the insurance company. Fill out the form accurately and completely, ensuring that all required fields are properly filled.
5. Attach supporting documents: Attach all the supporting documents you gathered earlier to the claim form. Make sure they are organized and easily understandable for efficient processing.
6. Review and double-check: Before submitting the claim, review all the information, ensuring it is accurate and complete. Double-check that all required documents are attached and that there are no errors or omissions in the form.
7. Submit the claim: Submit the complete claim package to Premera using the appropriate submission method. This can usually be done online through the member portal or by mail. Follow the instructions provided by Premera to ensure the claim is successfully submitted.

Who needs premera member submitted claim:

1. Premera insurance policyholders: Any individual who holds a Premera insurance policy and has incurred covered expenses or services can submit a member claim for reimbursement.
2. Patients seeking reimbursement: If a Premera policyholder has paid for medical services or products out-of-pocket, they can submit a member claim to request reimbursement for eligible expenses.
3. Individuals with eligible expenses: Anyone who has incurred eligible expenses covered by their Premera insurance policy can submit a member claim to receive reimbursement for those expenses.

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What is premera member submitted claim?

Premera member submitted claim is a claim filed by a member of the Premera insurance company to request reimbursement for medical expenses paid out-of-pocket.

Who is required to file premera member submitted claim?

Any Premera insurance member who has paid for eligible medical expenses out-of-pocket and wants to be reimbursed is required to file a premera member submitted claim.

How to fill out premera member submitted claim?

To fill out a Premera member submitted claim, you need to obtain a claim form from Premera or their website, provide your personal information, details of the treatment/service received, attach any necessary supporting documents (such as receipts or medical records), and submit the completed form to Premera via mail or online.

What is the purpose of premera member submitted claim?

The purpose of a premera member submitted claim is to seek reimbursement for eligible medical expenses that were paid out-of-pocket by the Premera insurance member.

What information must be reported on premera member submitted claim?

The information that must be reported on a Premera member submitted claim includes the member's personal details (such as name, address, and insurance ID), details of the treatment/service received (including codes, dates, and costs), any supporting documentation, and any other information specifically requested by Premera.