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If this information is not submitted with the claim(s), services will be denied until the information is received. Do not use this form unless you have. This form is only used to update existing provider group or facility records. If you are submitting additional information due to receiving a letter from bcbstx requesting it, it should be submitted using the.
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Review each form to determine the appropriate form to use. Do not use this form unless you have received a request for. This form is only used to update existing provider group or facility records. If you are submitting additional information due to receiving a letter from bcbstx requesting it, it should be submitted using the letter received or the additional.
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