CBABLUEVT Medical and Dental Document Submission Portal

CBA Blue Medical and Dental Document Submission Portal
Submission Guidelines:

Required Forms: Please ensure the appropriate form is completed. If a form is required, you can find it under the Member Forms section on cbabluevt.com.

One Document Type per Submission: Each submission should include only one document type per member.

Medical and Dental Claims: For medical and dental claims, submit only one claim per member at a time. Be sure to include proof of payment along with the completed claim form.

Membership Information: Use the Member ID number and Group number found on the front of your membership card.
Member's Name*

First NameLast Name
Member ID*
XXX000000000
Group Number*
50XXX
Email Address*
example@example.com
Phone Number
Please enter a valid phone number.
Group/Employer's Name*
Document Type*
File Upload*

(Limit of 5 Files)
Cancelof
Please note:

The uploaded file must be DOC, DOCX, PDF, GIF, JPG, PNG, TIFF or TIF in format. The uploaded file must be less than 28MB in size.

Renaming a non-supported file type to a supported file types will not be accepted. EXAMPLE: myreceipt.png to myreceipt.pdf
Please visit https://ebpa.wealthcareportal.com/Page/Home
Should be Empty:

CBA Blue Medical and Dental Document Submission Portal