Blue Shield of California Promise Health Plan invites you to consider becoming part of our network. Blue Shield Promise contracts with independent physician associations (IPAs) and medical groups on a capitated basis. Under the IPA/medical group arrangements, operational functions are delegated, with Blue Shield Promise providing oversight.

Our health plan also offers an opportunity for independent physicians and other provider types to contract directly with Blue Shield Promise under flexible reimbursement arrangements. 

Credentialing is determined by line of business - Commercial/Medicare and Medi-Cal. Individual practitioners that are joining provider groups with existing Blue Shield of California (Blue Shield) Commercial, Medicare and/or Blue Shield Promise Medi-Cal contracts, please utilize the Provider Credentialing Intake Form. 

The Council for Affordable Quality Healthcare (CAQH) allows insurance companies to use a single, uniform application for credentialing across health plans. Blue Shield leverages CAQH as a preferred partner to streamline the credentialing process.

If you are a CAQH participant, please complete the Provider Credentialing Intake Form and submit the form to BSCInitialApp@blueshieldca.com.

Or

If you are not a CAQH participant but would like to become one, please complete the CAQH ProView profile. Once you have registered, complete the Provider Credentialing Intake Form and submit the form to BSCInitialApp@blueshieldca.com.

Or

If you are not interested in becoming a CAQH participant, please complete the California participating practitioner application (CPPA) and Checklist (PDF, 757 KB). Email or mail the application and all supporting documentation outlined in the checklist to:

 Email: BSCInitialApp@blueshieldca.com

 Blue Shield of California
 Attn: Credentialing Department
 601 12th Street, 21st Floor
 Oakland, CA 94607

If the required supporting documents are missing or the documents with signature pages are dated more than three months prior to the receipt of the completed application, the Credentialing Department will contact the applicant for the missing information. Failure to submit the information within the third attempt of the Credentialing Department contacting you will be considered a voluntary withdrawal of the application.

If you have previously completed a CPPA for another health plan or medical group, you may submit it for this process. 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 CAQH or CPPA is between 90 and 120 days. For general inquiries related to the application including status updates, email BSCCredentialingInquiry@blueshieldca.com.

Welcoming new Medi-Cal providers

Medi-Cal sometimes adds benefits that are provided by healthcare professionals who haven’t worked with us before. If you are new to the process of enrolling as a network provider, we are here to assist you. Contact us and we will connect you to the right team that can help you understand everything you need to do.

 Provider Services phone: (800) 468-9935

Interested in becoming part of the Blue Shield Promise provider network?

For new solo practitioners and provider groups wanting to join the Blue Shield of California Promise Health Plan (Blue Shield Promise) line of business which is exclusively in Los Angeles and San Diego counties, you can submit a Letter of Interest in the following ways:

 For ABA Therapy Clinicians, email the letter to: PromiseLOI@blueshieldca.com

 For Behavioral Health individual providers/provider groups (MD, NP, Psychologist, LMFT, LCSW, and LPCC), complete the Individual provider/Provider group application              

 For all other providers, email the letter to: PromiseLOI@blueshieldca.com


By mail:

 Blue Shield of California Promise Health Plan
      3840 Kilroy Airport Way,
      Long Beach, CA 90806-2452
      Attention: Provider Contracting

 

Please include the following information with your Letter of Interest:

  • Preprinted tax documents: Social Security-4 form or letter from IRS and a W/9 Form
  • National Provider Identifier (NPI): Include a printout from the National Plan and Provider Enumeration System (NPPES) Registry
  • Service area by city and county
  • Specialty services (e.g., equipment, bariatric, languages)
  • Proof of enrollment with Medi-Cal (within 12 months for new providers)
  • Professional Liability Insurance Certificate (Minimum requirement is $1M per occurrence/3M in aggregate)

 

There is a 90-day minimum turnaround for review of complete submissions. If you would like to obtain information regarding your submission, please contact Blue Shield Promise’s Provider Contracting department at (800) 468-9935.

 

We are available to assist you

We encourage you to find what you need on this website, at your convenience. When you can't find what you need online, our dedicated Provider Services phone line is available:

  Phone: (800) 468-9935, 6 a.m. to 6:30 p.m., Monday through Friday. Available 24/7 for hospital admissions.

We also have additional specialists to help with member customer care, enrollment and retention, interpreters, transportation, health education, and more.

 View provider resources (PDF, 67 KB)

 

Blue Shield Promise Medi-Cal Provider orientation

In addition to completing the contracting and credentialing process, the Department of Health Care Services’ (DHCS) contract with Blue Shield Promise requires that all new providers participating in our network complete orientation training within 10 business days of active status. Training includes Medi-Cal Managed Care services, policies, and procedures.

To meet this training requirement, click the link below, complete the course, and sign the attestation at the end of the module.

 2024 Blue Shield Promise Medi-Cal Provider orientation (10 min)

 

Access information and resources

As a Blue Shield Promise network provider, you can access member eligibility, claims, and authorizations information online. You will need to register and create an account on our Provider Connection website to access these resources.

 Create a Provider Connection account