Regence Uniform Medical Plan (Washington state employees)

Source: https://www.hca.wa.gov/assets/pebb/ump-regence-medical-claim-form.pdf

Read date: 10-09-2026

Research steps

1. Confirm the applicable UMP plan and coverage. Use the UMP Medical Claim Form, PD001-UMP1, for non-network provider reimbursement. https://www.hca.wa.gov/assets/pebb/ump-regence-medical-claim-form.pdf
2. Complete and sign the form. Attach itemized bills with the member name and ID, procedure and diagnosis information, date and type of service, provider name and contact information, NPI or tax ID, and itemized charges. Include the other plan's EOB when UMP is secondary. https://www.hca.wa.gov/assets/pebb/54-0017-ump-select-coc-2026.pdf
3. Sign in and open Submit a claim. The public certificate identifies regence.com/member/submit-claim/; authenticated controls are UNREADABLE. https://www.hca.wa.gov/assets/pebb/54-0017-ump-select-coc-2026.pdf
4. Submit within 12 months after the service date. UMP may pay the member, provider, or both jointly; proof of payment may be required when the member paid before filing. https://www.hca.wa.gov/assets/pebb/54-0017-ump-select-coc-2026.pdf
5. Check Claims in the Regence UMP member account. NOT PUBLISHED: file constraints, confirmation, electronic-signature acceptance, CMS-1500 treatment, or processing time. https://ump.regence.com/pebb/forms/common-forms

Filing facts

• Portal upload: YES
• Portal: Regence UMP member account
• Portal path: Sign in > Submit a claim; public certificate identifies regence.com/member/submit-claim/
• Mail address: Regence BlueShield, Attn: UMP Claims, PO Box 1106, Lewiston, ID 83501-1106
• Fax: 1-877-357-3418
• Attach: Member name; UMP member ID including alpha prefix; procedure code and diagnosis code or description; date and type of service; provider name, address, telephone, NPI or tax identification number; itemized charges; other-plan EOB when UMP is secondary
• File types: NOT PUBLISHED
• File size limit: NOT PUBLISHED
• Maximum files: NOT PUBLISHED
• One file or separate files: NOT PUBLISHED
• Confirmation: NOT PUBLISHED
• Status check: Regence UMP member account > Claims
• Processing time: NOT PUBLISHED
• Member deadline: Within 12 months after date of service
• Deadline basis: NO for cited 2026 UMP Select certificate
• Mental health route: UMP uses the same medical claim route for covered outpatient psychotherapy; no separate mental-health member portal is published

Confirm the address, fax number or portal path on the insurer's own claims page before you send; read on 10-09-2026.