Tel: 800-922-4966
Transparency in Coverage
Consolidated Appropriations Act, 2021
HOME
ABOUT
ABOUT US
TCR CAA 2021
PRIVACY POLICY
SERVICES
MEMBER SERVICES
EMPLOYER SERVICES
BROKER SERVICES
ID CARD REQUEST FORM
DOWNLOAD FORMS
MEMBER LOGIN
MEMBER LOGIN
STUDENT LOGIN
PROVIDER LOGIN
TESTIMONIALS
CONTACT US
CONTACT CUSTOMER SERVICE
OFFICE LOCATIONS
More
Use tab to navigate through the menu items.
MENU
FORMS TO DOWNLOAD
Medical Claim Form
Medical Claim Reimbursement Form
Dental Claim Reimbursement Form
Member Portal Instructions
Provider Portal Inst
ructions
Provider Update Form
Request for Predetermination Form
Request for Review of Benefit Denial Form
HIPAA Privacy Authorization Form
Appointment of Authorized Representative
