BCBS of Louisiana
Southern Regional Medical Corporation

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Benefits Documents for Southern Regional Medical Center

These summaries of your benefit plan include coverage information and your deductible, copayment and coinsurance amounts.

In-Area and Out-of-Area (OOA)
Employer Preferred Option (EPO)/
Preferred Care (PPO)
Benefits Plan
In-Area and Out-of-Area (OOA)
Employer Preferred Option (EPO)/
High Deductible Health Plan (HDHP)
Benefits Plan


Other Customer Forms

Our forms are updated regularly. Please use the most current form to avoid delays in processing. Read each form carefully for special instructions and/or submission information.

Authorized Delegate Form

Other Coverage Questionnaire

Health Insurance Claim Form

Continuity of Care Request

BlueCard International Claim

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