Blue Cross Forms - Faculty

Health Care Claim Form

This form is used to submit claims for products or services offered through the core plan such as prescription drugs, private or semi-private hospital accommodation, ambulance, wheelchairs, and hearing aids.

Dental Claim Form

This form is used to submit all dental claims including accidental dental services.

Direct Deposit Form

This form is used to set up direct deposit of any payments received from Alberta Blue Cross.

Out of Country Form 

This form is used to submit emergency out of Province/Country claims.