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Blue Shield of California Blue Shield of California Provider Connection Homepage
  • Eligibility & benefits
    • Overview
    • Verify eligibility
    • Member rosters
    • Benefit summaries
    • Preventive health guidelines
    • HEDIS reporting
  • Authorizations
    • Overview
    • Medical authorization
    • Medical authorization status
    • Pharmacy authorization
    • Pharmacy authorization status
    • Out-of-area Blue plan members
    • Policies & guidelines
    • Authorization forms & list
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      File disputes online

      You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! Available for commercial, Shared Advantage®, and BlueCard®.

      Learn more
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  • Authorization contacts

Authorization contacts

Blue Shield of California Provider Services:

Phone: (800) 541-6652, 24 hours a day, seven days a week

 

Blue Shield of California Promise Health Plan Provider Services:

Phone: (800) 468-9935, 8 a.m. to 5 p.m., Monday through Friday

 

  • Blue Shield of California member authorizations

    Contact us with questions about:

    • Authorization requests for referrals – Auth logs and tracking numbers 
    • Preauthorization for POS (N/A for Medicare)
    • Blue Shield medical policy
    • Emergency services
    • Denials
    • All admissions – notification to Blue Shield and concurrent review
    • DME/HME & Home Health (if health plan is financially responsible)
    • Clinical trials
    • Nurse triage line
    • General medical management questions pertaining to prior authorization, case management, continuity of care, investigational and experimental, medical policy and clinical issues
    • Transplant requests
    • Second opinions


    Blue Shield of California
           Medical Care Solutions
           P.O. Box 629005
           El Dorado Hills, CA 95762-9005

    HMO and PPO:

      Phone:(800) 541-6652 (Option 6)
    Fax: (844) 295-4637
            Monday – Friday, 8 a.m.– 5 p.m.

    Blue Shield 65 Plus (HMO):

      Phone:(800) 541-6652 (Option 6)
    Fax: (844) 696-0975
            Monday – Friday, 8 a.m.– 5 p.m.

    FEP (PPO):

      Phone:(800) 633-4581 (Option 6)
    Fax: (916) 350-8746

    HMO Direct Contracting and CalPERS EPO:

      Phone:(888) 732-0000
    Fax: (844) 295-4638

    Care Management Response Line / Transplant Line

    Phone:(800) 637-2066, ext. 3507708

    RN Triage Line:

    Phone:(916) 350-6110
          Please listen to greeting in its entirety before leaving a message.

  • Blue Shield Promise member authorizations

    If you have questions related to Blue Shield Promise medical or pharmacy authorizations, contact Provider Services at (800) 468-9935.

    Blue Shield Promise Medicare Member Services

    Contact us 8 a.m. - 8 p.m., seven days a week from October 1 through March 31, and Monday through Friday from April 1 through September 30:
    Phone: (800) 544-0088 [TTY: 711]
    Fax: (866) 712-2731
    Send us an email

    Blue Shield Promise Medi-Cal Member Services

     Send us an email
    Find contact information by service area

    Blue Shield Promise Cal MediConnect Member Services

    Contact us 8 a.m. - 8 p.m., seven days a week:
    Phone: (855) 905-3825 [TTY: 711]
    Fax: (323) 889-5416
    Send us an email

  • Other Blue plan member authorizations

    BlueCard provider customer services:

    (800) 676-2583, 6 a.m. to 9 p.m., Monday through Friday

    BlueCard resources

    BlueCard program information

    Out-of-state member pre-service review

    Policies and authorizations for out-of-state members

    Verify BlueCard member's eligibility

  • Federal Employee Program member authorizations

    Federal Employee Program customer services:

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

General contacts

Find phone and fax numbers for Blue Shield corporate offices, provider and pharmacy services, medical management, EDI program and technical services.

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Eligibility and benefits contacts

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Claims contacts

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

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Guidelines and resources contacts

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

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Technical support request form

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

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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.

View reference guide for Blue Shield providers (PDF, 2.7 MB)

View reference guide for Blue Shield Promise providers (PDF, 2.5 MB)

About Provider Connection

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

Learn more about Provider Connection

Company holidays

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

View holiday schedule

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