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  • Provider Demographic Change Form - Bluecross Blueshield Of ...

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PROVIDER DEMOGRAPHIC CHANGE FORM BlueCross BlueShield of Western New York PROVIDER ENROLLMENT DEPARTMENT 257 West Genesee Street Buffalo, NY 14202 CONFIDENTIAL Please complete all sections of this.

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We typically see the credentials verification process completed in 60 90 days and the contracting phase complete in another 30 days for a total of 90 120 days from the time an insurance company receives the providers credentialing application.

To join our network as a new provider, the first thing you'll do is fill out an enrollment form. Then we verify that the information submitted is accurate. Depending on the type of provider you are, we want to know you have the appropriate license, education, insurance and other qualifications.

Get your NPI number. ... Know how you are billing for your services. ... Obtain malpractice insurance. ... Complete the CAQH application. ... Register with Medicare. ... Contact each insurance company with which you want to be in-network.

Blue Cross and Blue Shield is the oldest and largest payer group in the U.S., consisting of 36 independent, locally operated franchises that collectively make up the Blue Cross Blue Shield Association.

To join our network as a new provider, the first thing you'll do is fill out an enrollment form. Then we verify that the information submitted is accurate. Depending on the type of provider you are, we want to know you have the appropriate license, education, insurance and other qualifications.

On the home screen, tap "Find a Doctor." Tap "My Primary Care Physician." Choose the family member whose primary care physician you want to change. Then, confirm your selection. Select "Get Started." Tap "Select PCP" underneath the primary care physician you'd like to choose.

The application must be complete and accurate, dated with a current date, signed, and accompanied by all Blue Shield-required supporting documentation. The standard turnaround time for processing a complete initial CPPA is between 90 and 120 days.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232