Document 6534990

RUN_DATE
DATA_SEQ_NO
CLIENT_NUMBER
UHG_TYPE
DOC_ID
DOC_SEQ_ID
NAME
MAILSET_NUMBER
BARRETT
9452809/000001-00
9452809/000001-01
9452809/000001-02
DIG2CARD
20110607
0000001
0000001
003113
0000001
10:53:48
,WILLIAM
003113
This card is recognized wherever you go and entitles the card holder to the
benefits specified in the agreement pursuant to which this card is issued.
While other independent Blue Cross and Blue Shield Plans who belong to the
Blue Cross and Blue Shield Association may assist the card holder in
obtaining benefits, the card holder recognizes that the agreement which
controls the use of this card and which specifies the card holder's benefits is
solely between the parties to such agreement and Blue Cross and Blue Shield
of Illinois, an independent company operating under a license from the Blue
Cross and Blue Shield Association to use the familiar Blue Cross and Blue
Shield names and service marks in the State of Illinois.
001
BlueCross BlueShield of Illinois
P.O. Box 7344
Chicago, IL 60680-7344
9452809
Attached are your new ID cards. Please discard any previously
issued card(s). Always present your most current ID card to the
hospital or provider when you or your covered dependents seek
health care.
>000001
TEST
=221014215228=
www.bcbsil.com
Subscriber Name:
ABC SAMPLE
Identification Number:
123456789
Group Number:
123456
Pre-notification: Call one day before inpatient or
skilled nursing facility admission, receiving
home health care or private duty nursing
services; and within two days of an emergency,
maternity or for a mental health/substance
abuse admission.
Provider: File medical claims with your local
BCBS Plan.
Customer Service
Pre-Notify Med
Pre-Notify MH/SA
Provider Locator
24/7 Nurseline
1-800-828-3116
1-800-635-1928
1-800-851-7498
1-800-810-2583
1-800-299-0274
BlueCross BlueShield of Illinois, an independent
licensee of the BlueCross BlueShield
Association, provides claims processing only
and assumes no financial risk for claims.
0311394528090000000000100000011534 117
www.bcbsil.com
Subscriber Name:
ABC SAMPLE
Identification Number:
123456789
Group Number:
123456
Shipper ID: 00000000
Shipping Method: DIRECT
CARRIER: USPS
Address:
Pre-notification: Call one day before inpatient or
skilled nursing facility admission, receiving
home health care or private duty nursing
services; and within two days of an emergency,
maternity or for a mental health/substance
abuse admission.
Provider: File medical claims with your local
BCBS Plan.
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Customer Service
Pre-Notify Med
Pre-Notify MH/SA
Provider Locator
24/7 Nurseline
1-800-828-3116
1-800-635-1928
1-800-851-7498
1-800-810-2583
1-800-299-0274
BlueCross BlueShield of Illinois, an independent
licensee of the BlueCross BlueShield
Association, provides claims processing only
and assumes no financial risk for claims.
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Insert
Insert
Insert
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Cycle Date: 20110602
PDF Date: Tue Jun 07, 2011 @ 10:53:48
MaxMover: N
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