Submitting Claims

Regence participating physicians, dentists, other health care and dental professionals and facilities agree to bill us directly for covered services provided to their Regence patients within one year of the date of service.

Once coverage is verified patients should not be asked for full payment at the time of service.

• Patients may be asked for copayments, coinsurance and deductibles at the time of service.
• After services are rendered, the patient should only be billed for any remaining deductible, copayment and/or coinsurance amounts not collected and non-covered services.

Electronic claims submission
Regence strongly recommends submitting claims electronically. Electronic billing is available for all Regence and BlueCard^® out-of-area patients and offers the following advantages:

• Decreased data errors
• Reduced administrative costs
• Improved cash flow by providing:
  • Reduced paperwork
  • Expedited claims processing and account reconciliations
  • Confirmation reports for submitted, received and denied claims

Find out more about submitting claims electronically.

Paper claims submission
Claims must be submitted on appropriate claim forms (CMS-1500, UB-04, J-400 through J-404).

Claims are generally processed within 30 days after receipt. However some claims requiring investigation can take longer.

• If you do not receive notification of a processing action on a claim within 30 days please verify status using the Provider Center.
• If no record is found on Provider Center, please resubmit the claim.