We continually update as well as develop educational documents to assist our network providers with their Blue Cross needs.

Plus sign that becomes an "X" when the accordion collapses to show more content Forms

The documents below are available in DocuSign® format only. The PDF versions of these forms are no longer available. Submitting these forms in the DocuSign format allows the Provider Credentialing & Data Management staff to efficiently process your requests. For details on completing DocuSign forms, view this guide. When submitting DocuSign documents, please do not separately email them to Blue Cross. We automatically receive your submission from the DocuSign application. Double submissions (submitting through DocuSign and also sending an email of the completed form) could delay the processing time for your request.

Your request can take up to 90 days to process once all required information has been received. Providers will remain non-participating in our networks until their credentialing application has been approved by the credentialing committee and an executed contract is in place.

DocuSign Format
iLinkBlue Agreement Packet

Provider Update Request Form

Professional Initial Credentialing Packet
(now includes LCSA Attachment A)

Facility Credentialing Packet
(now includes all HDO Attachments)