Blue Benefit MA Medical and Dental Document Submission Portal

Blue Benefit MA 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 bluebenefitma.com

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

Medical Claims: For medical 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.
Participant's Name*

First NameLast Name
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
Should be Empty: