- If you cannot complete your eligibility/benefits inquiry online, please contact us at 800-842-5975.
Paper Claims
If you are still submitting paper claims, use the following forms to submit your claims:
Professional Claims
Professional claims must be submitted using the current version of the CMS-1500 form (version 02/12) on original red-ink-on-white-paper. To order a supply of forms, please use your normal process.
Institutional Claims
Institutional claims must be submitted using the current version of the UB-04 form. Visit the NUBC website to find details for using and ordering the new form.