Common use of Claim Reimbursement Request Form Clause in Contracts

Claim Reimbursement Request Form. When you elect to have Blue Cross and Blue Shield work with your designated vendor for your Account-Based Offerings, you will provide Blue Cross and Blue Shield with a completed Claim Reimbursement Request Form that designates certain aspects of the Account-Based Offerings that you will make available to your eligible employees.

Claim Reimbursement Request Form. When you elect to have Blue Cross and Blue Shield work with your designated vendor for your Account-Based Offerings, you will provide Blue Cross and Blue Shield with a completed Claim Reimbursement Request Form that designates certain aspects of the Account-Based Offerings that you will make available to your eligible employees.  Cooperation. You will cooperate with Blue Cross and Blue Shield to the extent reasonably necessary to enable Blue Cross and Blue Shield to provide services in accordance with this Account-Based Offerings Administrative Services Agreement and will provide any information reasonably necessary for Blue Cross and Blue Shield’s provision of services.