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Blue Benefit Administrators of Massachusetts fax number

(877) 596-2583

HIPAA/Privacy Officer

Used for: Submitting Health Reimbursement Account (HRA/Section 105) expense claims and handling confidential HIPAA communications

Fax destination details

Department
HIPAA/Privacy Officer
Purpose
Submitting Health Reimbursement Account (HRA/Section 105) expense claims and handling confidential HIPAA communications
Form
Health Reimbursement Account (HRA/Section 105) – Expense Claim Form — Health Reimbursement Account (HRA/Section 105) – Expense Claim Form
Address
P.O. Box 55917, Boston, MA 02205-5917
Voice phone
877-707-2583

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How to file a claim: complete all sections; use separate forms for different plan years; attach supporting documentation (EOBs, itemized provider statements, pharmacy receipts); do not submit cancelled checks or credit card receipts alone

Official form instructions are published as a downloadable file on the organization's website.

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