Member Self Submit Claims

Most of the time, your doctor or hospital handles the billing for you. However, if you see an out of network provider or receive care while traveling abroad, you may need to pay upfront and ask us for reimbursement.

2025 Dates of Service:

Please complete and submit this form to shcr@ascension.org. If you have any questions, please call our customer service department at 888-492-6811.

2026 Dates of Service:

Please complete and submit this form to Anthem via mail at:

Anthem Blue Cross and Blue Shield
P.O. Box 105187
Atlanta, GA 30348-5187