Blue Cross and Blue Shield of Louisiana has a collection of forms online to help you manage your account needs. You can download various forms you need from our Forms page and submit them by mail or fax. *Forms

Most Commonly Used Forms:
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​1. Authorized Delegate: This form is used to give Blue Cross permission to share your protected health information with another person or company.

2. Other Coverage Questionnaire: This form provides us with who you may have other medical coverage with or confirms that you do not have another medical policy with another carrier.

Other Coverage Questionnaire Note: This information should be updated every two calendar years for us to process your claims.

3. Medical Appeal Form: This form is used to appeal a medical benefit decision.

4. Medical Claim Form: This form is used to file claims for medical services.

Note: If you receive services from a participating provider, your provider will file the claim for you.

Link to all *Forms

*Refer to the selected form for the appropriate mailing address and fax number.

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