Coordination of Benefits Questionnaire Form - Empire Blue Cross Blue Shield

The Coordination of Benefits Questionnaire Form is used by Empire Blue Cross Blue Shield to determine the primary insurance coverage for an individual who has multiple health insurance plans.

The Coordination of Benefits Questionnaire form is typically filled out by the insured individual or the policyholder when dealing with Empire Blue Cross Blue Shield.

FAQ

Q: What is the Coordination of Benefits Questionnaire Form?
A: The Coordination of Benefits Questionnaire Form is a form used by Empire Blue Cross Blue Shield to gather information about an individual's other health insurance coverage.

Q: Why do I need to fill out the Coordination of Benefits Questionnaire Form?
A: You need to fill out the Coordination of Benefits Questionnaire Form to help Empire Blue Cross Blue Shield determine the order in which your health insurance plans will pay for your medical expenses.

Q: How do I fill out the Coordination of Benefits Questionnaire Form?
A: You need to provide accurate and complete information about your other health insurance coverage, including the name of the insurance company and policy number.

Q: What happens after I submit the Coordination of Benefits Questionnaire Form?
A: After you submit the Coordination of Benefits Questionnaire Form, Empire Blue Cross Blue Shield will review the information and determine the order of payment for your medical expenses based on the coordination of benefits rules.

Q: Can I update my information on the Coordination of Benefits Questionnaire Form?
A: Yes, if there are any changes to your other health insurance coverage, you should contact Empire Blue Cross Blue Shield and provide them with the updated information.

Q: Do I need to fill out the Coordination of Benefits Questionnaire Form every year?
A: It is recommended to review and update the Coordination of Benefits Questionnaire Form if there are any changes to your other health insurance coverage, so it may need to be filled out on an annual basis.

Q: Is the Coordination of Benefits Questionnaire Form mandatory?
A: The Coordination of Benefits Questionnaire Form may be required by Empire Blue Cross Blue Shield to accurately determine the order of payment for your medical expenses, so it is recommended to fill it out if requested.

Q: Can I have multiple health insurance plans?
A: Yes, it is possible to have multiple health insurance plans, and the Coordination of Benefits Questionnaire Form helps determine the order in which they will pay for your medical expenses.

Q: Can I use insurance from another company with Empire Blue Cross Blue Shield?
A: Yes, you can use insurance from another company along with your Empire Blue Cross Blue Shield coverage. The Coordination of Benefits Questionnaire Form helps determine the order of payment between the two insurance plans.