Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (2024)

Phone

Mail

Corporate headquarters

Shared Advantage Customer Service

Contact us with questions about:

• Instate BlueCard benefits/eligibility information
• Instate claim status
• Pricing information on instate claims
• Appeal Status on instate claims
• Written Correspondence Status on instate claims
• Status of payment (check information, paid information, etc.) information for instate claims
• Provide EOB copies on instate claims
• Authorization Inquiries
  

Phone:(800) 219-0030
Monday through Friday, 6 a.m. to 6:30 p.m.

Provider Connection Customer Service

For issues related to the following functions on the Provider Connection website:

• Password resets and logging in
• Accessing member eligibility and benefits, claims information, or Clear Claim Connection (C3) claims prescreening simulation tool
• Submitting prior authorization

Phone:(800) 541-6652, 24 hours a day, seven days a week
Please have your Provider NPI or Tax ID number available when speaking with a representative.

Contact technical support

Provider information and enrollment– Blue Shield of California network

Contact us with questions about:

• Provider network inquiries and applications
• Address, phone, fax, and practice changes
• Group additions/deletions
• Credentials
• Provider directory updates
• Provider education
• Contractual obligations
• PPO related requests

Blue Shield of California
Provider Information and Enrollment
P.O. Box 629017
El Dorado Hills, CA 95762

Phone:(800) 258-3091

Fax: (916) 350-8860
Monday through Friday,6 a.m. to 6:30 p.m.

Provider information and enrollment– Blue Shield of California Promise Health Plan

If you are an Ancillary provider who is interested in joining our network, you can submit a Letter of Interest by the following methods:

By email:PromiseLOI@blueshieldca.com

By mail: Blue Shield of California Promise Health Plan
Attention: Provider Contracting
3840 Kilroy Airport Way
Long Beach, CA 90806

Credentialing department – Blue Shield of California

Email:BSC_Credentialing@blueshieldca.com

EDI related issues

Contact us with questions about:

• EDI setup inquiries (270/271, 276/277, 278, 837, 835)
• ERA setup inquiries
• EFT setup inquiries
• Member benefit enrollment setup inquiries (820/834)

Call the EDI Help Desk at(800) 480-1221

Pharmacy services

Contact us for drug formulary information and to request prior authorization for outpatient prescription drugs and home self-administered injectables.

For Blue Shield providers

Blue Shield of California
Pharmacy Services
P.O. Box 7168
San Francisco, CA 94120-7168

Phone:(800) 535-9481

Fax: (888) 697-8122

For Blue Shield Promise providers

Phone:(800) 468-9935

BlueCard program

BlueCard provider customer services:
(800) 676-25836 a.m. to 9 p.m., Monday through Friday

BlueCard resources

BlueCard program information

Verify BlueCard member's eligibility

Claims routing tool

Federal Employee Program customer services:

(800) 824-8839, Monday through Friday,8:30 a.m. to 4:30 p.m.

Eligibility and benefits contacts

Find phone and fax numbers for Blue Shield eligibility and benefits contacts.

Authorization contacts

Contact Medical Care Solutions for questions about authorization requests, preauthorization, medical policy, and more.

Claims contacts

Find phone numbers and addresses for claims, the EDI help desk, and member appeals and grievances.

Guidelines and resources contacts

Find phone and fax numbers for compliance and ethics, disease management, wellness prevention, and more.

Technical support request form

Request help with your log in, registration or other technical problems.

Provider Connection Reference Guide

Find detailed instructions for activities like checking eligibility, making a referral, determining if prior authorization is necessary, prescreening claims, checking claims status, and other tools and information you need to serve our members.

About Provider Connection

Learn about the range of information and tools available to Blue Shield of California providers on this website

Company holidays

Operation centers will be closed in observance of Blue Shield of California’s holiday schedule, with the exception of Medicare Member Services.