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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
  • Claims
    • Overview
    • Real-time claims
    • How to submit claims
    • Prescreen claims
    • Claims-Routing Tool
    • Check claim status
    • Manage electronic transactions
    • Fee schedule
    • Claim issues & disputesNEW
      New

      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
    • Policies & guidelines
  • Guidelines & resources
    • Overview
    • Forms
    • Drugs & pharmacy resources
    • Guidelines & standards
    • Provider manuals
    • Patient care resources
    • Prospective providers
  • News & education
    • Overview
    • Register for webinars
    • AuthAccel online authorization training
    • Learning resources
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  • Guidelines and resources contacts

Guidelines and resources contacts

Blue Shield of California Provider Services:

Download phone quick reference guide (PDF, 145 KB)
Phone: (800) 541-6652, 24 hours a day, seven days a week

Blue Shield of California Promise Health Plan Provider Services:

Download phone quick reference guide (PDF, 129 KB)
Phone: (800) 468-9935, 8 a.m. to 5 p.m., Monday through Friday

  • Compliance hotlines

    Compliance & Ethics

    Call to report Code of Conduct, compliance or ethics issues.
    Helpline: (888) 800-2062
    Hotline: (855) 296-9083

            Online Reporting: Compliance & Ethics Web Hotline

            Email: corporate-compliance@blueshieldca.com

    Special Investigations Unit

    Call to report fraud-related issues.
    Helpline: (800) 221-2367
    Hotline: (855) 296-9092

            Online Reporting: Special Investigations Web Hotline

            Email: stopfraud@blueshieldca.com

    Privacy

    Call to report privacy or confidentiality issues (mishandling or unauthorized disclosure of IIPI or PHI).
    Helpline: (888) 266-8080
    Hotline: (855) 296-9086

            Online Reporting: Privacy Web Hotline

            Email: privacy@blueshieldca.com

    Medicare Compliance

    Call to report Medicare-related legal or compliance issues.
    Helpline: (800) 445-2517
    Hotline: (855) 296-9084

            Online Reporting: Medicare Compliance Web Hotline

            Email: Medicare.Compliance@blueshieldca.com

  • Disease management and wellness programs

    Call for information on preventive health, wellness, and disease management programs.

    Disease management referrals for Blue Shield of California members

    To obtain a copy of the referral form, email Blue Shield of California:
    Email:center.hw@blueshieldca.com

    Submit a referral form using secure email or fax:
    Email: bscliaison@alere.com
    Fax: (877) 280-0179

    Population Health Management program for Blue Shield Promise members

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

    LifeReferrals 24/7SM

    (doesn't apply to Blue Shield 65 Plus)
    Phone;(800) 985-2405

    Case management referrals for Blue Shield of California members

    Using secure email, submit patient name, member ID number, and reason for referral:
    Email:edhccmr@blueshieldca.com
    Phone:(877) 455-6777

    Complex Case Management referrals for Blue Shield Promise members

      Provider Services:(800) 468-9935
    Fax: (323) 889-6575

    NurseHelp 24/7SM for Blue Shield of California members

    Blue Shield of California
          Center for Health & Wellness
          P.O. Box 7168
          San Francisco, CA 94120-7168

    Phone:(877) 304-0504
    Email: center.hw@blueshieldca.com

    24/7 Nurse Advice Line for Blue Shield Promise members

    Phone:(800) 609-4166 [TYY: 711]

    Blue Shield Promise Transitional Care Management program

    Phone:(877) 702-5566, 8 a.m. to 6 p.m., Monday through Friday

    Behavioral Health Services for Blue Shield Promise members

    Find information and contacts

  • Member Services - Blue Shield of California

    HMO and PPO

    Blue Shield of California
          Appeals and Grievances
          P.O. Box 5588
          El Dorado Hills, CA 95762-0011

    Members should call the first number on the back of their member ID card for appeals inquiries.

    Blue Shield 65 Plus (HMO)

    Blue Shield of California
          Grievance Resolution Department
          6300 Canoga Avenue
          Woodland Hills, CA 91367-2555

    Medicare Member Services phone:(800) 776-4466, TTY 711

    Standard and expedited appeal fax: (916) 350-6510

  • Member Services - Blue Shield Promise

    Blue Shield of California Promise Health Plan
    Member Services
    601 Potrero Grande Dr.
    Monterey Park, CA 91755

    Blue Shield Promise Medicare

    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

     Send us an email
    Find contact information by service area

    Blue Shield Promise Cal MediConnect

    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

  • 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

  • Provider Services - Blue Shield of California

    Call for questions about:

    • Member eligibility
    • Blue Shield Express Line
    • Claims/billing questions
    • Plan benefits
    • Billing address/forms
    • Assistance with language other than English
    • Locating network providers-provider directories

     

    HMO and PPO:

    Blue Shield of California
    Customer Services
    P.O. Box 272540
    Chico, CA 95927
    Phone: (800) 541-6652, Monday - Friday, 8 a.m. – 5 p.m.

    Blue Shield 65 Plus (HMO):

    Blue Shield of California&
    P.O. Box 272640
    Chico, CA 95927-2640
    Phone: (800) 541-6652, TTY 711, Monday – Friday, 8 a.m. – 5 p.m.
    Fax: (818) 228-5137 or (818) 228-5130

  • Provider Services - Blue Shield Promise

    Call for questions about:

    • Member eligibility
    • Plan benefits
    • Claims/billing questions
    • Member authorizations


    Blue Shield of California Promise Health Plan
    601 Potrero Grande Drive,
    Monterey Park, CA 91755-7430

    Phone: (800) 468-9935 [TTY 711], 8 a.m. to 5 p.m., Monday through Friday

  • 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 & Enrollment
           P.O. Box 629017
           El Dorado Hills, CA 95762

    Phone:(800) 258-3091

    Fax: (916) 350-8860, Monday - Friday, 6:00 a.m. - 6:30 p.m.

  • Provider information and enrollment - Blue Shield Promise

    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
           601 Potrero Grande Dr.
           Monterey Park, CA 91755

  • Credentialing Department - Blue Shield of California

    Phone:(888) 398-2250

    Email:BSC_Credentialing@blueshieldca.com

  • Technical services

    For technical issues with the Provider Connection website including password resets and problems logging in, please contact our Provider Services support desk.

    Phone:(800) 541-6652

    Online form:Technical support request

  • Other Blue plan members information

    BlueCard provider customer services:

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

    BlueCard resources

    BlueCard program information

    Policies and authorizations for out-of-state members

    Claims routing tool

  • Federal Employee Program members information

    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.

Get contact information

Eligibility and benefits contacts

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

Get contact information

Authorization contacts

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

Get authorizations contact information

Claims contacts

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

Get claims contact information

Technical support request form

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

Request tech support

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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