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Blue Choice New England Consumer Disclosure Notice
We are required by the Rhode Island Department of Health (DOH) to provide you with access to this consumer disclosure notice, which can help answer many common questions about your Blue Choice New England health plan.
Blue Cross Blue Shield Global Core
The Blue Cross Blue Shield Global Core is to be used to submit institutional and professional claims for benefits for covered services received outside the United States, Puerto Rico and the U.S. Virgin Islands.
International Claim Form
A form for submitting a medical claim when the care is received outside of the U.S., Puerto Rico, and the U.S. Virgin Islands.
Continuity of Care Request Form
Complete this form if your doctor is leaving our network and you're receiving treatment for a serious, chronic, or acute medical condition. You may qualify to continue your in-network care for a defined period of time or treatment.
Continuity of Care Form for Plans that Include Tiered-Provider and Limited Provider Networks
Our tiered or limited network plans include a benefit for certain members with a serious health condition, such as cancer or cystic fibrosis.
Dental Claim Form
A form for submitting a dental claim with instructions on how to file a claim.
Enhanced Dental Benefits Enrollment Form
Your dental coverage policy must include Enhanced Dental Benefits in order to be eligible for coverage.
Find a Doctor & Estimate Costs
Our Find a Doctor & Estimate Costs makes it easy for you to find what you need. Search for doctors, dentists, hospitals, and other healthcare providers. Get cost estimates for over 1,600 procedures. Read and write reviews, and compare up to ten doctors at a time.
HMO Blue New England Consumer Disclosure Notice
We are required by the Rhode Island Department of Health (DOH) to provide you with access to this consumer disclosure notice, which can help answer many common questions about your HMO Blue New England health plan.
Medex Subscriber Claim Form
A form for submitting a claim for Medex subscribers with instructions on how to file a claim.
Subscriber Claim Form A form for submitting a medical claim with instructions on how to file a claim
Transition of Care Form for New Members
We understand that it’s difficult to leave doctors you’ve had long-term relationships with. To make this transition easier, complete this form to request temporary transition of care at the in-network level. To understand what conditions may or may not qualify, or to learn more about how the process works, please see our Frequently Asked Questions.
Transition of Care Form - Athem Blue Cross and Blue Shield, Maine
Anthem's Transition of Care form for members with a Maine PCP.
Transition of Care Form - Athem Blue Cross and Blue Shield, New Hampshire
Anthem's Transition of Care form for members with a New Hampshire PCP.
Transition of Care Form - Athem Blue Cross and Blue Shield, Connecticut
Anthem's Transition of Care form for members with a Connecticut PCP.
Vision Claim Form
A form for submitting a vision claim, with instructions on how to file a claim.