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Get CA Blue Shield RA-01 2018-2024

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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  3. Submit all of the requested boxes (these are yellow-colored).
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  5. Insert the date.
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Send your new CA Blue Shield RA-01 in a digital form as soon as you finish completing it. Your information is securely protected, since we adhere to the latest security standards. Become one of numerous happy clients who are already filling in legal documents right from their apartments.

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