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  • Provider forms | Blue Shield of CA Promise Health Plan
    Download and print commonly requested forms for prior authorizations, coverage determination requests, referrals, screenings, enrollment for electronic claims submission and remittance advices, and more
  • Network and procedure forms - Blue Shield of California
    Download and submit Blue Shield network and procedure forms that help you and your office meet credentialling requirements and other procedures
  • Prior authorization forms and templates - Blue Shield of CA Provider
    The most commonly requested prior authorization fax forms for procedures, injectable drugs (office administered and home self-administered) and oral topical drugs, including templates to be used for authorization notices to Blue Shield TotalDual (HMO D-SNP) and Inspire (HMO D-SNP) members
  • Patient care forms - Blue Shield of CA Provider
    Patient care forms related to coordinating benefits, member grievances, and more Forms include acknowledgment of financial responsibility, home care referral, language assistance request, out of network referral request, and palliative care eligibility screening tool
  • Provider Connection home page | Blue Shield of CA Provider
    When an out-of-area Blue plan member seeks medical care from your office, use our tools to simplify claims submission to Blue Shield of California Explore the BlueCard Program Need help with Provider Connection? See Provider Connection training or the Provider Connection Reference Guide (PDF, 3 MB)
  • Special Guidelines for Claim Forms - Blue Shield of CA Provider
    Please use original red claim forms for all paper claims Blue Shield of California and Blue Shield Promise use Optical Character Recognition (OCR) to scan paper claims Claims submitted on photocopied claim forms prevent the OCR process from working properly, necessitating manual data entry of the claim, which can slow down processing and payment
  • Forms - Blue Cross and Blue Shield of Illinois
    The forms in this online library are updated frequently— check often to ensure you are using the most current versions Some of these documents are available as PDF files
  • Authorizations - Blue Shield of CA Provider
    Authorization tools Blue Shield providers can submit medical and pharmacy authorizations online in AuthAccel Blue Shield Promise providers can submit medical authorizations online, but pharmacy requests must be faxed




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