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Get CA Blue Shield RA-01 2018

Shield) and/or Blue Shield of California Promise Health Plan (Blue Shield Promise) to establish an individual practitioner record for the purpose of supporting claims processing. Once the application process is complete, Blue Shield and/or Blue Shield Promise will confirm eligibility of the applicant for claims submission, using the contact information provided. Instructions Identify the individual practitioner requiring a billing record and complete all fields with the practitioner information..

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