Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (2024)

Welcome to Provider Connection at Blue Shield of California. We are here to help, whether you're already a network participant or just want to know more about us.

Live chat

Use live chat for questions about:

  • Claims
  • Benefits
  • Member elibility
  • How to use Provider Connection
  • Contracts
  • Credentialing
  • Demographics
  • Electronic Data Interchange (EDI)
  • Recoveries

Live chat is available:
Monday through Friday, 6 a.m. to 6:30 p.m.

LogintoProviderConnectiontostartachat

Phone

Call us for questions about:

  • Authorizations
  • Pharmacy advice
  • Claims
  • Benefits
  • Member eligibility
  • How to use Provider Connection
  • Contracts
  • Credentialing
  • Demographics
  • Electronic Data Interchange (EDI)
  • Recoveries

Simply speak your request and our voice-activated system will direct your call to the appropriate representative.

Blue Shield of California Provider Services:
Monday through Friday, 6 a.m. to 6:30 p.m.

Phone:

(800) 541-6652

Blue Shield of Promise Health Plan Provider Services:
Monday through Friday, 6 a.m. to 6:30 p.m.
Available 24/7 for hospital admissions.

Phone

(800) 468-9935

Mail

For all other Provider Services inquiries:

Blue Shield of California
P.O. Box 272540
Chico, CA 95927-2540

Blue Shield of California BlueCard Program
P.O. Box 272630
Chico, CA 95927-2630

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

Corporate headquarters

Corporate Headquarters

Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (1)Blue Shield of California
601 12th Street
Oakland, CA 94607
Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (2) Phone:(510) 607-2000

Southern Region Main Office
Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (3)Blue Shield of California
100 North Sepulveda Blvd.
El Segundo, CA 90245
Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (4) Phone:(310) 744-2580

Medicare Main Office
Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (5)Blue Shield of California
6300 Canoga Ave.
Woodland Hills, CA 91367
Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (6) Phone:(818) 598-8000

Blue Shield of California Promise Health Plan
Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (7) 3840 Kilroy Airport Way
Long Beach, CA 90806
Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (8)Phone:(800) 468-9935

Live chat is available:
Monday through Friday, 6 a.m. to 6:30 p.m.

LogintoProviderConnectiontostartachat

Shared Advantage Customer Service

Contact us with questions about:

  • Instate BlueCard benefits/eligibility information
  • Instate claim status
  • Pricing information on instate claims
  • Appeal Status on instate claims
  • Written Correspondence Status on instate claims
  • Status of payment (check information, paid information, etc.) information for instate claims
  • Provide EOB copies on instate claims
  • Authorization Inquiries

Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (9)Phone:(800) 219-0030
Monday through Friday, 6 a.m. to 6:30 p.m.

Provider Connection Customer Service

For issues related to the following functions on the Provider Connection website:

  • Password resets and logging in
  • Accessing member eligibility and benefits, claims information, or Clear Claim Connection (C3) claims prescreening simulation tool
  • Submitting prior authorization

Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (10)Phone:(800) 541-6652, 24 hours a day, seven days a week
Please have your Provider NPI or Tax ID number available when speaking with a representative.

Contact technical support

Provider information and enrollment– Blue Shield of California network

Contact us with questions about:

  • Provider network inquiries and applications
  • Address, phone, fax, and practice changes
  • Group additions/deletions
  • Credentials
  • Provider directory updates
  • Provider education
  • Contractual obligations
  • PPO related requests

Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (11)Blue Shield of California
Provider Information and Enrollment
P.O. Box 629017
El Dorado Hills, CA 95762

Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (12)Phone:(800) 258-3091

Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (13) Fax: (916) 350-8860
Monday through Friday,6 a.m. to 6:30 p.m.

Provider information and enrollment– Blue Shield of California Promise Health Plan

If you are an Ancillary provider who is interested in joining our network, you can submit a Letter of Interest by the following methods:

Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (14) By email:PromiseLOI@blueshieldca.com

Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (15) By mail: Blue Shield of California Promise Health Plan
Attention: Provider Contracting
3840 Kilroy Airport Way
Long Beach, CA 90806

    Credentialing department – Blue Shield of California

    Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (16) Email:BSC_Credentialing@blueshieldca.com

    EDI related issues

    Contact us with questions about:

    • EDI setup inquiries (270/271, 276/277, 278, 837, 835)
    • ERA setup inquiries
    • EFT setup inquiries
    • Member benefit enrollment setup inquiries (820/834)

    Call the EDI Help Desk atContact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (17)(800) 480-1221

    Pharmacy services

    Contact us for drug formulary information and to request prior authorization for outpatient prescription drugs and home self-administered injectables.

    For Blue Shield providers

    Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (18)Blue Shield of California
    Pharmacy Services
    P.O. Box 7168
    San Francisco, CA 94120-7168

    Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (19)Phone:(800) 535-9481

    Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (20)Fax: (888) 697-8122


    For Blue Shield Promise providers

    Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (21)Phone:(800) 468-9935

    BlueCard program

    BlueCard provider customer services:
    Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (22)(800) 676-25836 a.m. to 9 p.m., Monday through Friday


    BlueCard resources

    Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (23)BlueCard program information

    Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (24) Verify BlueCard member's eligibility

    Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (25) Claims routing tool

    Federal Employee Program customer services:

    Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (26) (800) 824-8839, Monday through Friday,8:30 a.m. to 4:30 p.m.

    Eligibility and benefits contacts

    Find phone and fax numbers for Blue Shield eligibility and benefits contacts.

    Get contact information

    Authorization contacts

    Contact Medical Care Solutions for questions about authorization requests, preauthorization, medical policy, and more.

    Get authorizations contact information

    Claims contacts

    Find phone numbers and addresses for claims, the EDI help desk, and member appeals and grievances.

    Get claims contact information

    Guidelines and resources contacts

    Find phone and fax numbers for compliance and ethics, disease management, wellness prevention, and more.

    Get contact information

    Technical support request form

    Request help with your log in, registration or other technical problems.

    Request tech support

    Provider Connection Reference Guide

    Find detailed instructions for activities like checking eligibility, making a referral, determining if prior authorization is necessary, prescreening claims, checking claims status, and other tools and information you need to serve our members.

    Provider Connection Reference Guide (PDF, 4.4 MB)

    About Provider Connection

    Learn about the range of information and tools available to Blue Shield of California providers on this website

    Learn more about Provider Connection

    Company holidays

    Operation centers will be closed in observance of Blue Shield of California’s holiday schedule, with the exception of Medicare Member Services.

    View holiday schedule

    Contact Provider Connection at Blue Shield of California | Blue Shield of CA Provider (2024)

    FAQs

    What is the phone number for Blue Shield of California PPO provider? ›

    If you have any questions about our plan benefits, procedures and other topics, call Provider Services at (800) 468-9935 (TTY 711), 6 a.m. to 6:30 p.m., Monday through Friday. To notify us of hospital admissions, call Provider Services at 800-468-9935 (TTY 711).

    Is Blue Shield of California the same as Blue Shield? ›

    Blue Shield of California, an independent member of the Blue Shield Association, is a nonprofit health plan dedicated to providing Californians with access to high-quality health care at an affordable price.

    How do I contact Blue Shield Covered California? ›

    Contact Covered California at (800) 300-1506 or visit CoveredCA.com if you need to: Update your address and contact information.

    What is the email address for Blue Shield of California? ›

    Effective immediately, all email inquiries for servicing issues should be sent to Producer.Services@blueshieldca.com. All appointment inquiries should go to ProducerServiceAppointments@blueshieldca.com.

    Is Blue Shield Covered California a PPO? ›

    You have access to our Exclusive PPO Network, which is the only statewide PPO network and includes more than 50,000 doctors and 350 hospitals across California.

    Is hmo or PPO better? ›

    HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

    Can you use Blue Cross Blue Shield of California in any state? ›

    Most Blue Cross Blue Shield members can rest easy since Blue Cross Blue Shield coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists.

    Does Blue Shield California only work in California? ›

    For companies headquartered in California, we provide a single national coverage solution – wherever your workforce is located. With our extensive Blues network, 97% of claims are in-network.

    Is Blue Shield of California good insurance? ›

    Blue Shield of California gets good marks as an all-around health insurance provider. Its customers say they would highly recommend it to others and 94% said they'll renew their policies with the insurer.

    Why is Covered Ca so expensive? ›

    Healthcare Inflation

    Medical advancements, prescription drug costs, and the general inflation of healthcare services all contribute to the overall expense of providing comprehensive coverage.

    What is the income limit for Covered California? ›

    According to Covered California income guidelines and salary restrictions, if an individual makes less than $47,520 per year or if a family of four earns wages less than $97,200 per year, then they qualify for government assistance based on their income.

    Why don't doctors take Covered California? ›

    This could be for various reasons. In some cases, medical insurance carriers payout less for the California Health Exchange plans, so physicians don't want to accept them. In other cases, it's just that doctors have heard they might get paid less.

    What is the address for Blue Shield of California? ›

    Blue Shield of California, 601 12th St, Oakland, CA - MapQuest.

    Is Blue Cross Blue Shield the same as Blue Shield of California? ›

    Blue Shield of California is a Registered® mark of the BlueCross BlueShield Association, an association of independent Blue Cross and Blue Shield plans. Blue Shield of California and Mylifepath are service marks of Blue Shield of California.

    How do I contact Anthem Blue Cross Blue Shield California? ›

    Case Management for Anthem Blue Cross Cal MediConnect Plan

    Case Management support is available 24/7 through Anthem Blue Cross Cal MediConnect Plan Customer Care at 1-855-817-5786.

    What is PPO insurance in California? ›

    Preferred Provider Organizations (PPOs)

    You pay less if you go to these providers. Preferred providers are also called in-network providers. With a PPO, you can go to a doctor or hospital that is not on the preferred provider list. This is called going out-of-network. However, you pay more to go out-of-network.

    What is the phone number for the California Department of Health Care providers? ›

    Providers: Telephone Service Center: (800) 541-5555. Provider-Telecommunications Network (PTN): (800) 786-4346. Out-of-State Provider Support: (916) 636-1960.

    What is the phone number for Anthem Blue Cross California PPO? ›

    Customer Care Centers

    Call 888-831-2246 Option 4 and ask to speak with Dr.

    References

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