All practitioners participating in the Blue Shield of California network are required to complete an application to renew their credentialing every three years. Completing and submitting the recredentialing application with supporting documentation is a requirement for continued network participation.
Please complete every field of the application as applicable to your provider type, and return it to Blue Shield as soon as possible (within thirty (30) days from the date of receiving your recredentialing notice).
Recredentialing Application (PDF, 661 KB)
When you submit your application please be sure to include the following:
- Complete, signed and dated California Participating Practitioner Application.
- Information about any malpractice actions that may have been taken against you, including settlement amounts and/or explanation of any dismissed or pending claims with pertinent dates included (see Addendum B).
- Evidence of hospital privileges including any additional information as applicable.
- Current Malpractice Liability Insurance Certificate – current Blue Shield of California requirements are $1 million per occurrence and $3 million aggregate. Allied Health and non-physician behavioral health requirements are $1/$1 million. (We cannot accept proof of payment, i.e., check copies or other receipts, as sufficient documentation.)
- Copy of your Drug Enforcement Administration (DEA) certification, if applicable.
- Copy of your current medical license.
Note: Failure to submit the completed, signed and dated application and supporting documents timely will result in termination from the Blue Shield of California network. Incomplete applications cannot be processed, therefore please include all of the required documents.
Where to send your application
Please send your completed recredentialing application and all required documents to the Credentialing Department via either email or mail to:
Mail: Blue Shield of California
Attn: Credentialing Department
P.O. Box 7168
San Francisco, CA 94105
If you have credentialing questions, call our Credentialing Department:
If you have contracting questions, call Provider Information & Enrollment: