Forms
Ensure you are using the latest web browser version in order to submit electronic forms. The online form submission is not available to iOS devices (an operating system used for mobile devices manufactured by Apple). If you are using one of these devices please use the PDF to complete your form.
Appeals
- Member Complaint/Grievance Form
- Member Authorization Form
- Out-of-Area Members: Medical Necessity Appeals Form
Claim Forms
- Claims Inquiry Form (PDF)
- FEP Member Reimbursement Claim Form
- Itemized Bill Submission Form
- Medical/Dental Claim Form (PDF)
- Pharmacy Claim Form (PDF)
- BlueCard Worldwide International Claim Form
EFT/ERA Enrollment Forms
Little Stars Program Referral
Prior Authorization
Provider Services
Skilled Nursing Facility Concurrent Review
Utilization Management
An independent licensee of the Blue Cross and Blue Shield Association
© Blue Cross and Blue Shield of Kansas City. All rights reserved.