If you are already contracted with Blue Shield of California Promise Health Plan and would like to report a change to your practice, contact the Provider Services Department via phone, email, or fax:
Here are examples of changes you can submit to us:
- Change of address
- Phone or fax number updates
- Location closures
- Moving to a new location
- No longer contracting with Blue Shield of California Promise Health Plan
- Copy of W-9 form
Blue Shield Promise requires providers to notify us or the participating provider group under which they are contracted within five (5) business days when either of the following occurs:
- The provider had previously accepted new patients and the provider is not currently accepting new patients.
- The provider had previously not accepted new patients and the provider is currently accepting new patients.
Send all other contract changes or updates in writing to:
Blue Shield of California Promise Health Plan
Attention: Contracting Department
601 Potrero Grande Drive
Monterey Park, CA 91755
Please include a current signed W-9 form with your request.