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 Monday through Friday, 8 a.m. to 5 p.m.


Compliance hotlines

Compliance and Ethics

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

       Online Reporting: Compliance and Ethics web hotline

       Email: corpcomp@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.
 

Case management referrals for Blue Shield of California members

The Case Management referral form can be found here.

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

Wellvolution®

Wellvolution® provides access to lifestyle-based tools and support to help members lose weight, treat diabetes, support mental health, and more. These clinically proven programs are available at no additional cost for Blue Shield and Blue Shield Promise members 18 years and older.

 Blue Shield members can go to Wellvolution.com to learn more.
 Blue Shield Promise members can go to Wellvolution.com/Medi-Cal to learn more.
 

Health Education Classes for Blue Shield Promise members

 The Health Education Referral Form can be found on Provider Forms.
  Email: BlueShieldCAHealthEducation@blueshieldca.com


Population Health Management program for Blue Shield Promise members

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

LifeReferrals 24/7SM

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

NurseHelp 24/7SM for Blue Shield of California members

 Phone: (877) 304-0504
 

24/7 Nurse Advice Line for Blue Shield Promise members

 Phone: (800) 609-4166 (TTY: 711)
 

Blue Shield Promise Transitional Care Management program

 Phone: (800) 468-9935 Monday through Friday, 6 a.m. to 6:30 p.m. Available 24/7 for hospital admissions.
 

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
      3840 Kilroy Airport Way
      Long Beach, CA 90806
 

Blue Shield Promise Medi-Cal

 Send us an email
 Find contact information by service area
  
 

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 through Friday, 8 a.m. to 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 through Friday, 8 a.m. to 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
      3840 Kilroy Airport Way
       Long Beach, CA 90806

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

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 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
      3840 Kilroy Airport Way
      Long Beach, CA 90806
 

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.

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.

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.

© California Physicians' Service DBA Blue Shield of California 1999-2024. All rights reserved. California Physicians’ Service DBA Blue Shield of California is an independent member of the Blue Shield Association. Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Health plans are offered by Blue Shield of California.

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