Blue Shield of California Promise Health Plan (Blue Shield Promise) invites you to consider becoming part of our network. Blue Shield Promise contracts with independent physician associations (IPAs) and medical groups on a capitated basis. Under the IPA/medical group arrangements, operational functions are delegated, with Blue Shield Promise providing oversight.

Our health plan also offers an opportunity for independent physicians and other provider types to contract directly with Blue Shield Promise under flexible reimbursement arrangements. 

Individual practitioner participating in IPA with exiting participation agreement

Credentialing is determined by line of business - Commercial, Medicare and Medi-Cal. If you are an individual practitioner that is joining provider groups with existing Blue Shield of California (Blue Shield) Commercial, Medicare and/or Blue Shield Promise Medi-Cal contracts, please use the Provider Credentialing Intake Form.

The Council for Affordable Quality Healthcare (CAQH) allows insurance companies to use a single, uniform application for credentialing across health plans. Blue Shield leverages CAQH as a preferred partner to streamline the credentialing process.

If you are a CAQH participant, please be certain to use this standardized Provider Credentialing Intake Form and submit the form to BSCInitialApp@blueshieldca.com.

Or

If you are not a CAQH participant but would like to register with CAQH, please complete the CAQH ProView profile. Once you have registered, complete the Provider Credentialing Intake Form and submit the form to BSCInitialApp@blueshieldca.com.

Or

If you are not interested in becoming a CAQH participant, please complete the California participating practitioner application (CPPA) and Checklist (PDF, 2.4 MB). Email or mail the application and all supporting documentation outlined in the checklist to:

 Email: BSCInitialApp@blueshieldca.com

 Blue Shield of California
 Attn: Credentialing Department
 601 12th Street, 21st Floor
 Oakland, CA 94607

If the required supporting documents are missing or the documents with signature pages are dated more than three months prior to the receipt of the completed application, the Blue Shield Credentialing Department will contact the applicant for the missing information. Failure to submit the information within the time allocated after the third attempt by the Credentialing Department to contact you will be considered a voluntary withdrawal of the application.

If you have previously completed a CPPA for another health plan or medical group, you may submit that document for this process. The application must be complete and accurate, dated with a current date, signed, and accompanied by all supporting documentation required by Blue Shield.

The standard turnaround time for processing a complete initial CAQH or CPPA is between 90 and 120 days. For general inquiries related to the application including status updates, send an email to the Credentialing Department at BSCCredentialingInquiry@blueshieldca.com.

Welcoming new Medi-Cal providers

Medi-Cal sometimes adds benefits that are provided by healthcare professionals who have not worked with Blue Shield Promise in the past. If you are new to the process of enrolling as a network particpant, we are here to assist you. Contact our Provider Services team at (800) 468-9935, between 6 a.m. and 6:30 p.m. PT, Monday through Friday, and we will connect you to the right team that can help you understand everything you need to do.

 

Solo Practitioners and Provider Groups interested in joining the Blue Shield Promise provider network

Solo practitioners and provider groups who want to join the Blue Shield Promise Medi-Cal network, currently exclusive to Los Angeles and San Diego counties may submit a Letter of Interest in the following ways:

  • ABA Therapy Clinicians may email the letter to: BSCABAContracting@blueshieldca.com
  • Behavioral Health individual providers or provider groups offering the following qualifications may complete the  complete and send the Individual provider/Provider group application (PDF, 517KB) to the same email address: medical doctor, nurse practitioner, psychologist, licensed marriage and family therapist, licensed clinical social worker and licensed professional clinical counselor
  • Medi-Cal Doulas
    Blue Shield Promise will only contract with doulas who have been approved via the Department of Health Care Services (DHCS) Provider Application for Validation and Enrollment (PAVE) portal, have completed the doula-specific credentialing process, and are currently providing services within Los Angeles and/or San Diego County. If you would like to learn more about the credentialing and contracting requirements to become contracted doula provider in Blue Shield Promise’s Medi-Cal network, please email bscpromisedoula@blueshieldca.com.

All other provider may send email the letter to: PromiseLOI@blueshieldca.com.

If you prefer to send the letter by postal mail, please use the address below:

 Blue Shield of California Promise Health Plan
      3840 Kilroy Airport Way,
      Long Beach, CA 90806-2452
      Attention: Provider Contracting

Please include the following information with your Letter of Interest:

  • Preprinted tax documents: Social Security-4 form or letter from the Internal Revenue Service (IRS) and a W/9 Form
  • National Provider Identifier (NPI): Include a printout from the National Plan and Provider Enumeration System (NPPES) Registry
  • Service area by city and county
  • Specialty services (e.g., equipment, bariatric, languages)
  • Proof of enrollment with Medi-Cal (within the past 12 months for new providers)
  • Professional Liability Insurance Certificate (Minimum requirement is $1M per occurrence/3M in aggregate)

There is a 90-day minimum turnaround time for review of complete submissions. If you would like to obtain information about your submission, please contact Blue Shield Promise’s Provider Contracting department via our Provider Customer Service telephone number at (800) 468-9935, 8 a.m. to 5 p.m. PT, Monday through Friday.

We are available to assist you

We encourage you to find the information or services you need on this website, at your convenience. If you cannot find what you need online, our dedicated Provider Customer Service team is available at (800) 468-9935, 6 a.m. to 6:30 p.m. PT, Monday through Friday. Available 24/7 for hospital admissions.

We also have additional specialists to help you with patient care enrollment and retention, interpreters, transportation, health education, and more for Blue Shield Promise plan members.

View resources available to providers (PDF, 67 KB)

 

Blue Shield Promise Medi-Cal Provider Orientation

In addition to completing the contracting and credentialing process, the Department of Health Care Services’ (DHCS) contract with Blue Shield Promise requires that all new providers to participating in our network complete orientation training within 10 business days of active status. Training includes Medi-Cal managed care services, policies, and procedures.

To meet this training requirement, click the link below, complete the course, and sign the attestation at the end of the module.

 2025 Blue Shield Promise Medi-Cal Provider orientation (10 min)

 

Access information and resources

As a Blue Shield Promise network provider, you can access member eligibility, claims, and authorizations information online at our Provicer Connection website, www.blueshieldca.com/provider. If you are not already registered, please register and create an account to access those resources.

 How to create a Provider Connection account