Secure Online Customer Inquiry Form

With our secure online customer inquiry form, you can submit your questions to Customer Service securely and conveniently.

  • Claims. Choose this category to submit questions about your claim(s). You can enter up to 10 claims per form. This category is for past services. For current or future needs, select "benefits" or "other."
  • Benefits. Choose this category to ask a question about your benefits. If you have a medical emergency or need authorization for a medical procedure scheduled in the very near future, please call the Medical Authorization number on your ID card.
  • Other. Choose this category to ask us anything about your coverage.

Our goal is to respond to your email no later than 48 business hours after receipt.

Member Information
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Who are you?





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For your spouse or any child age 18 and older, an Authorized Delegate Form giving you permission to act on this person’s behalf must be on file in order for BCBSLA to process your request. Please provide the additional identifier that was included on the Authorized Delegate Form (your date of birth, your driver’s license number or tax ID number)

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What are you asking about?


Question about a claim #1


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How may we help you?


Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.


Question about a claim #2


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How may we help you?


Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.


Question about a claim #3


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How may we help you?


Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.


Question about a claim #4


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How may we help you?


Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.


Question about a claim #5


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Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.


Question about a claim #6


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How may we help you?


Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.


Question about a claim #7


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How may we help you?


Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.


Question about a claim #8


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How may we help you?


Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.


Question about a claim #9


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How may we help you?


Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.


Question about a claim #10


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How may we help you?


Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.


Other Question


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How may we help you?


Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.
Question about benefits for a specific service




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How may we help you?

Acceptable file formats: pdf, doc, docx, gif, tif, png, rtf, csv, msg, jpg, txt, xls, xlsx.
Submit Your Inquiry
Please review your information before submitting.

NOTE: If you have a medical emergency or need authorization for a medical procedure scheduled in the very near future, please call the Medical Authorization number on your ID card.