Our representatives will respond within one business day. If you need an immediate response, please call us at the number on your member card.
If you have coverage through an employer group, the majority of demographic changes (e.g., name, date of birth, Social Security number, and address) must be completed through your group.
If you enrolled through the NY State of Health Marketplace, please visit their website https://nystateofhealth.ny.gov/ to update your policy.
For Medical Plans:
For Dental Plans:
Excellus BlueCross BlueShield is committed to service excellence when it comes to interactions with external customers. Our Customer Service employees have a role in helping the organization achieve a superior level of customer satisfaction.
We'd like to hear from you!
If you would like to recognize an Excellus BlueCross BlueShield Customer Service employee that has performed above and beyond expectations, resulting in an exceptional customer experience, please click on the 'Recognize an Employee' button below.
Step 1: Select a Claim Form:
- Medical ClaimOpen a PDF
- Prescription Drug ClaimOpen a PDF
- Compound Prescription Drug ClaimOpen a PDF
- Dental ClaimOpen a PDF
- Vision ClaimOpen a PDF
- International Claim FormOpen a PDF | In SpanishOpen a PDF | European A4 Paper SizeOpen a PDF
- Surprise Bill Certification FormOpen a PDF (If you didn't expect to receive a bill from the provider.)
Step 2: Fill Out the Form & Save it to Your Computer
At this time, electronic methods are preferred over mail.
- Please utilize the appropriate form. Refer to the Print FormsPrint Forms page for a downloadable PDF.
- Fill out the form, sign it if necessary, then scan the form and save the file (e.g. PDF, DOCX, JPG) to your computer
- Electronically submit your correspondenceElectronically submit your correspondence (Login Required), such as:
- HIPAA Authorization
- Medical Records
- Membership/Enrollment Application or Documentation
- Other Letter/Correspondence
- Please limit submissions to common file types: PDF, Word, TIFF, JPG, PNG.
- Please allow up to 72 hours for a reply. Note: The 72-hour time-frame does not include the time required to process your document.
If you are unable to submit your documentation electronically, you may continue to submit your documentation via mail to the address on the back of your member card. Please note, there may be significant delays with the processing of documents received by mail at this time.