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Get AZ Provider Contracting Request and Information Form 2013

Cross Blue Shield of Arizona (BCBSAZ) you must successfully complete the credentialing process. Please complete the enclosed application. 1) If you utilize CAQH, the Council for Affordable Quality Healthcare, BCBSAZ will accept that application. Please indicate your CAQH ID# in lieu of completing this entire application. CAQH ID#:______________ Then complete pages 1-3 in full. 2) If you do not have CAQH, Please complete the entire enclosed application and provide the supporting documentation a.

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