Blue Shield Promise name change and data migration FAQs
Read answers to frequently asked questions about the data migration and name change from Care1st Health Plan to Blue Shield of California Promise Health Plan.
No, all the Blue Shield Promise contracted networks of primary care physicians (PCPs), specialists, and hospitals remain separate after January 1, 2019. Members will not have access to see Blue Shield Promise providers unless those providers are directly contracted with Blue Shield Promise.
No, they do NOT need to contract with Blue Shield of California to continue providing services for Blue Shield Promise Medicare Advantage HMO members. Providers previously participating in the Care1st network have received an amendment notice reflecting the name change.
Yes, members can continue to see their PCP and specialists as participating providers. All the Care1st contracted networks, including hospitals, are available to our members through Blue Shield Promise.
On January 1, 2019, the newly renamed Blue Shield of California Promise Health Plan moved member and provider data into Blue Shield of California’s systems as part of our infrastructure improvements to better support our members and providers.
Key changes include:
- New provider identification numbers
- New member identification numbers
- New member ID cards
- Changes to submission processes for encounter data
Providers received a new agreement from trading partners because they have been identified by the trading partner as participating in Blue Shield of California Promise Heath Plan’s network. The trading partners already had an agreement in place with Blue Shield of California for ERAs. Due to the data migration on January 1, 2019, Blue Shield Promise was added as lines of business to the existing trading partners’ agreement with Blue Shield of California. Providers are required to sign and return the existing agreement to Blue Shield of California.
No, providers will continue to receive separate ERAs for Blue Shield of California and Blue Shield of California Promise Health Plan after January 1, 2019. Providers can either continue to receive remittances from Office Ally as they do today, or they can choose the clearinghouse they are currently using for Blue Shield of California. The option they choose will apply to both Blue Shield of California and Blue Shield of California Promise Health Plan.
No, a provider must either continue to receive ERAs from Office Ally as they do today, or they can choose the clearinghouse they are currently using for Blue Shield of California. The option they choose will apply to both Blue Shield of California and Blue Shield of California Promise Health Plan.
Yes. Although we migrated systems, our claims processing units are intact and remain the same as they were before the migration. Blue Shield Promise providers can continue to contact our existing claims-processing staff.
No. Blue Shield of California Promise Health Plan membership, eligibility, and claims are not accessible from Provider Connection. You can view claims and verify membership and eligibility on the Blue Shield Promise Provider portal. If a provider is contracted with both Blue Shield of California and Blue Shield of California Promise Health Plan, they will need to access separate portals.
Although there is no formal training required, contracted providers can expect to receive ongoing communication about any necessary changes resulting from data migration and related impacts.
They can send an email to Provider_ Relations@blueshieldca.com.
Our phone number is (800) 468-9935. The menu options allow providers to choose the department they need to reach. See our Blue Shield Promise quick phone reference guide (PDF, 129 KB)