• Agent • Agent • Agent • Agent
• Employer • Employer • Employer • Employer
• Provider • Provider • Provider • Provider
Home Contact Provider Customer Service Site Map Search
Regence Blue Cross Blue Shield of Oregon
Oregon state health insurance For Physicians, Other Health Care Professionals and Facilities
Behavioral Health »
BlueCard Program »
Care Management »
Claims & Billing
Contact Us »
Contracts/Credentialing »
Cost & Quality »
Dental Professionals »
Educational Tools »
Products »
Secured Site
 Provider Center »
Provider Directory »
Provider Library »
RegenceRx Pharmacy »
TriWest »
Claim Form Instructions

CMS 1500 (08/05) Claim Forms for Professional Services

Regence requires claims to be submitted electronically or on an original standard CMS-1500 (08/05) claim form for professional services. The mailing address for filing claims can vary by product. View the claims mailing address.

Interactive Regence CMS 1500 (08/05) Claim Form Instructions

Place your mouse over colored areas to view detailed information for that form field.

View detailed claim form instructions (PDF)

 

Note: To print a PDF document, you need Adobe® Reader®. Download it now for free. 
Regence BlueCross BlueShield of Oregon. All rights reserved. Regence BlueCross BlueShield of Oregon is an Independent Licensee of the Blue Cross and Blue Shield Association.
Regence Ethics  Privacy Policy  Fraud and Abuse  Site Feedback