Contact your Network Development Representative
at the Office Location nearest you for assistance.
Use these forms for Arkansas Blue Cross metallic and non-metallic medical plans members only.
Use these forms for Medi-Pak Advantage and Medi-Pak Rx plan members only.
For more information about Medicare Part D plan formularies, utilization management criteria, and coverage determination requests:
Use these forms for all members who have dental plans.
Arkansas Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association and is licensed to offer health plans in all 75 counties of Arkansas.
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