Reimbursement Policy Feedback Form

Comments from physicians and other health care professionals regarding Regence reimbursement policies are welcome. Please complete the following information.

Note: Reimbursement Policy staff cannot answer or forward questions regarding pricing, benefits, claims, EOB statements or contract issues. Please contact the Provider Contact Center if you have questions regarding these issues.


First name*:
Last name*:
Specialty*:
City:
State*:
Your email address*:
Your phone number:
Mailing address:
Zip code:
Policy name*:
Policy section*:
Policy number:

Reimbursement policy feedback*:


*If you have additional resources and findings to attach, please email Reimbursement Policy feedback.


I am a provider and I would like to be contacted on a regular basis to review and comment on reimbursement policies in my specialty.