Network and procedure forms

Download and submit Blue Shield forms that help you and your office meet credentialling requirements and other procedures. You'll need Adobe Reader to view the forms.

 

  Behavioral health facility application (PDF, 486 KB)

  Behavioral health practitioner application (PDF, 1,170 KB)

  Health delivery organization application (PDF, 97 KB)

  Individual practitioner information change form (PDF, 998 KB)

  Individual practitioner record application (PDF, 741 KB)

  Provider credentialing application (PDF, 757 KB)

  Provider dispute resolution – facility (PDF, 72 KB)

  Provider dispute resolution – professional (PDF, 72 KB)

  Provider group/facility information change form (PDF, 1.1 MB)

  Provider group/facility record application (PDF, 788 KB)

  Provider recredentialing application (PDF, 744 KB)

Patient care forms

Submit these forms when delivering patient care, including forms related to coordinating benefits, member grievances, and more.

Find patient care forms for Blue Shield of California members Find forms for Blue Shield Promise members

Resources for providers continuing participation in Blue Shield network

Find out how to continue participation in our network, including a recredentialing application and mailing instructions.

Find resources

Policies and standards

Find medication policies information and standards for HIPAA transactions, medical records and more.

Read about our policies and standards

Join our network

Learn about joining our provider network and find resources to apply.

Learn more

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