Claim Forms

Filing Claims

If the services you receive were provided by a BCBSNC participating provider, they will file a claim for you! Please check our online directory or with your provider to verify their participation before filing your claim. Claims received from members for participating provider services cannot be processed.

What types of services will you be filing?

Prescription Drugs

Dental

Medical, Vision and Diabetic Supplies
Use this new, interactive form to complete your claims for medical, vision, and medical supplies expense reimbursement. You may enter your information directly on to the form, print it and mail it to us as usual. Tips for using the form:

• Edits and calendars will help you enter accurate information.
• When you click the new Print Form button on the claim, a message will be displayed if required information is missing.
• Hover your mouse over the text fields for helpful information.
• If you save the form to your PC, only the blank form will be saved, not the text you entered.
  

Remember, participating providers will file claims for you

If you need to file a claim for services received while outside of the United States, please visit the BlueCard Worldwide^® page in order to download the BlueCard Worldwide Claim Form.