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How to Complete Your Out-of-Network Claim Form

Did you recently see a provider that was not in your plan’s network? Start by checking your benefit book to see if you have out-of-network coverage. If you do, then download the out-of-network claim form.

For your claim to be processed, we need to get key pieces of information from you. We know that filling out insurance forms can get confusing, so we want to help. Check out "How to Complete a Claim Form".

Remember, you must submit your claim within one year of the date of service in order for it to be accepted by BCBSAZ. To get started, download the claim form.