Before you start
If your California practice uses Thrizer for out-of-network BCBS claims, register separately with Blue Shield of California and Anthem Blue Cross. These are different plans. This guide covers Blue Shield; use the Anthem California guide for the other registration. Completing one does not complete both. Blue Shield uses provider-record applications to collect the information needed for claims processing. An incomplete registration can delay claims. The record application is not an agreement to join the network. The practice coordinates registration and includes its clinicians. Have the practice’s tax information, applicable billing NPI, each clinician’s individual NPI, service locations, and supporting documents ready.Choose the correct form
Blue Shield’s website also describes network contracting. For this record-only process, follow the instructions inside the linked PDF. Do not add the website’s separate Letter of Intent or use its contracting submission address unless you intend to request network participation.
Complete your record application
1
Download the applicable PDF
Open the form above and read page 1. Blue Shield says the form can be completed electronically. Use the current form linked from its official application page if the download changes.
2
Enter the individual or group information
Individual (RA-01): complete the practitioner information on page 2. Use the clinician’s individual business email, not a billing-company or group email, as the form instructs. Complete service and billing information on page 3; copy that page for additional locations.Group (RA-02): complete the group information and service location on page 2. List the clinicians and their individual NPIs on page 3. Copy page 3 for more clinicians at that location. Submit one group application per service location.
3
Attach the required documents
Follow the form’s Required Documentation list. It calls for applicable license or certification evidence, an approved legal-entity filing when used, and a signed W-9 or IRS tax document when using an EIN. The group form also explains the evidence required for your legal or Doing Business As (DBA) name.Check names, tax information, NPIs, and addresses against your documents before proceeding.
4
Check the remittance section before authorizing anything
Both forms include Paperless remittance advice (replaces paper EOB). This section authorizes a vendor or clearinghouse to receive electronic remittance information; it is not just a contact-information field.If you do not have a confirmed arrangement, ask Blue Shield how to complete this section. Do not guess a vendor or enter Thrizer as the recipient without confirmed instructions. This section does not enable Thrizer Pay or BCBS direct-deposit reimbursement through Thrizer.
5
Review and send the record application
Review all applicable fields and attachments. Submitting the form certifies that its information is accurate and complete.Email the completed application and required documents to BSCProviderInfo@blueshieldca.com, the record-application address printed in both PDFs. Keep a copy and watch for Blue Shield’s response. If a field or submission requirement is unclear, confirm it with Blue Shield before sending sensitive information.