Please complete all information requested on the form. Missing information may delay the process of the claim. If you have any questions, contact Patient Claims at (504)592-1533
<br> <br>
The Blood Center will review the form, then process the claim for payment. Payments will be made directly to the patient and will be generated on a monthly basis. Claims must be submitted within 6 months from the date of blood component usage.
<br><br>
Alternatively, you can also print out and submit a paper form: <a href="https://cms.thebloodcenter.org/sites/default/files/2020-08/BloodReplacementClaimForm.pdf">Click here to download the form.</a>


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