Regence Uniform Medical Vision Claim Form

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Forms and documents for members - Regence

https://www.regence.com/member/resources/forms-documents

Forms and documents for members Sign in × Find a doctor Contact us Loading... Forms and Documents for Individuals and Families Access all the forms and documents you …

Forms and documents - Regence

https://www.regence.com/provider/forms-documents

Forms & documents for providers. Access all the forms and documents you need to support your Regence patients, manage your claims payments and more. Search by …

Uniform Medical Plan - Regence

https://www.regence.com/provider/products/large-groups-administrators/ump

Uniform Medical Plan (UMP) Uniform Medical Plan (UMP) is a health plan offered through the Washington State Health Care Authority’s (HCA) Public Employees Benefits Board …

Claims - PEBB - Regence

https://ump.regence.com/pebb/benefits/claims-appeals

To submit a claim by mail download and complete the VSP Request for Reimbursement form and mail it to the address below. If you have questions on how to fill out this claim …

Commonly used forms - PEBB - ump.regence.com

https://ump.regence.com/pebb/forms/common-forms

Vision form VSP Request for Reimbursement form: for services from an out-of-network provider or for the purchase of prescription contact lenses and eyeglasses. If you have …

Vision - Regence

https://www.regence.com/provider/products/vision

We partner with Vision Service Plan® (VSP) for routine vision examinations and eye wear for our group, individual and Medicare Advantage products, including the pediatric vision …

Your new UMP vision benefits - hca.wa.gov

https://www.hca.wa.gov/assets/pebb/ump-vision-service-plan-2021.pdf

To submit a claim by mail, contact VSP Member Services at 1 (800) 877-7195 to request a VSP Member Reimbursement Form. The form can be sent to a preferred address or …

Uniform Medical Plan (UMP) - Washington

https://www.hca.wa.gov/about-hca/programs-and-initiatives/uniform-medical-plan-ump

Uniform Medical Plan (UMP) is a self-insured health plan offered through the Washington State Health Care Authority’s (HCA) Public Employees Benefits Board (PEBB) Program …

MEDICAL CLAIM FORM - Washington

https://www.hca.wa.gov/assets/pebb/ump-regence-medical-claim-form.pdf

Sign the completed form where indicated at the bottom of this page and submit the completed claim form to:Regence BlueShieldAttn: UMP ClaimsPO Box 1106Lewiston, …

Get Regence Uniform Vision Claim Form - US Legal Forms

https://www.uslegalforms.com/form-library/308042-regence-uniform-vision-claim-form

Select the orange Get Form button to begin editing and enhancing. Switch on the Wizard mode in the top toolbar to have more pieces of advice. Fill every fillable area. Be sure the …

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