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  • Il Provider Information Change Request Form 2013

Get Il Provider Information Change Request Form 2013-2025

Cord. This step helps ensure that members utilizing our Provider Finder have access to accurate contact information for your practice. Who can use this change request form? This option applies to participating providers only. If you are not yet a participating provider and wish to contract with BCBSIL, you will need to Request a Contract Application. What changes can be requested using this form? Use this form to request changes to your existing demographic information on file with BCBSIL – Pr.

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The Centers for Medicare & Medicaid Services (CMS) and the State of Illinois have contracted with Blue Cross and Blue Shield of Illinois (BCBSIL) along with other Managed Care Organizations (MCO) to implement Medicaid to all counties in Illinois.

The Illinois Department of Healthcare and Family Services (HFS) is committed to improving the health of Illinois' families by providing access to quality healthcare.

An individual must call the Client Enrollment Broker Call Center at 1-877-912-8880 (TTY: 1-866-565-8576) or go online to the Enrollment Portal at .enrollhfs.illinois.gov to get more information about their HealthChoice Illinois plan choices and to make a plan switch.

Blue Cross and Blue Shield of Illinois (BCBSIL) is a customer-owned health insurance company serving Illinois residents. The company offers individuals and families healthcare and prescription drug coverage through its Blue Choice Preferred PPO, Blue Precision HMO, and BlueCare Direct HMO plans.

Five Easy Steps To Join! STEP 1 – Complete an application. ... Attention Commercial HMO Network Applicants: ... Attention Out-of-State Providers: ... STEP 2 – Submit a signed contract. ... STEP 3 – Become credentialed, if required. ... STEP 4 – Wait for final notification of acceptance. ... STEP 5 – Get connected.

Claims may be submitted electronically or on paper and must have TPL fields completed.

The Centers for Medicare & Medicaid Services (CMS) and the State of Illinois have contracted with Blue Cross and Blue Shield of Illinois (BCBSIL) along with other Managed Care Organizations (MCO) to implement Medicaid to all counties in Illinois.

HealthChoice Illinois is the statewide Medicaid managed care program. Most Medicaid customers are required to choose a primary care provider (PCP) and health plan.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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