Start here
For clinicians and practice administrators in Capital Blue Cross’s Pennsylvania service area. First confirm the Blue Plan for your practice or claim-service location. Use the location used for billing, not your client’s home plan. If you need a new practice record, confirm the first-time registration process with the payer. The public resources below do not establish a complete application for every out-of-network practice.Where are you in the process?
- Starting for the first time or unsure? Check with the payer whether your practice already has a record under the same tax ID and service location, then follow the steps below for the record you need.
- Adding a clinician to an existing practice? Ask the payer how to add the clinician, complete any required individual enrollment, and link them to the existing practice. Do not create a new practice just to add a clinician.
- Already submitted, waiting for approval? Check your pending registration using the submission reference. Do not send a duplicate application unless the payer asks you to.
- Practice and required clinician affiliations confirmed active? Notify Thrizer Support.
Before you start
Have your practice’s legal name, tax ID (EIN/TIN), service address, and each clinician’s rendering NPI and license information ready. Use details that match Thrizer. The practice coordinates registration; group clinicians do not need to create separate practices. The payer may require individual enrollment and group affiliations.1
Contact the payer
Use Capital Blue Cross provider information and call 866-688-2242, the listed nonparticipating-provider support number. Ask whether Capital serves your practice or claim-service location and how to create a first-time nonparticipating record.
2
Confirm the route for your practice
Confirm which practice and clinician records are needed, the current application and attachments, and how to check activation. Capital, Highmark, and Independence are different companies; use the location guide to identify other plans serving your location.Capital’s provider-information page describes updates to existing records. Its update form and update-processing timeline do not establish the first-time enrollment process or its timing. A Pennsylvania address alone does not establish that Capital is your only required Blue Plan.
3
Complete and submit the confirmed request
Once the payer confirms the right new-record, addition, or update process, complete and submit the application or request through that channel with the documents it requires for your practice. Ask the payer about unclear fields or attestations before submitting; do not guess.Keep a copy, the submission confirmation, and any case number. Then follow the pending-registration guidance until the payer confirms activation. A receipt does not mean your record is active.
4
Confirm activation, then notify Thrizer
Ask the payer to confirm that the practice record and all required clinician affiliations are active. Keep the approval confirmation and related documents; a submission receipt or portal login does not establish activation.Send the confirmation to Thrizer Support and review the next steps. Support identifies affected claims and reviews which are eligible for resubmission. Do not duplicate pending claims solely because registration became active.