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Adjustment & Reconciliation Forms (Excel Files)
The forms below are La Cruz Azul Provider adjustment forms. If you are interested in becoming a La Cruz Azul Provider, click the Provider Application Form link. Complete, sign and fax to La Cruz Azul.
Physicians
Facility
Providers
Testimonials
Application Forms
Adjustment Forms
HIPAA Companion Guides
Inmediata
Provider Search | Puerto Rico
Provider Search | United States
Provider Search | Worldwide
Medical Publications
Medicare Advantage PFFS terms and Conditions Finder
Important Notice
© 2005-2007 La Cruz Azul de Puerto Rico, Inc.
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® Registered Marks Blue Cross and Blue Shield Association.
La Cruz Azul de Puerto Rico, Inc.
serving the area of the Commonwealth of Puerto Rico.
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