Before you start
Use this guide when Blue Cross of Idaho is a required Local / Host Plan for your practice or claim-service location. It has a non-contracting enrollment packet for creating provider records without signing a network contract. This is separate from Regence BlueShield of Idaho registration. If registration is incomplete, claims can be delayed. Not sure which plan applies? First identify your required Local / Host Plan. Registration is separate from joining a network.Prepare and submit the packet
1
Open the non-contracting enrollment page
Open Non-contracting Provider Enrollment. For professional therapy claims, use the Medical professionals section and its behavioral-health requirements, not the facility packet.
2
Complete the Provider Information Sheet
Download the current sheet linked on that page. In Section A, select Non-Contracting and enter the practice and location information.Complete Section B when adding an individual clinician, using that clinician’s individual NPI. Complete Section C with the requester’s contact information.
3
Include each required affiliation
The sheet calls for a separate form for each organizational NPI to which a clinician is being added. Your practice coordinates these records; clinicians are not creating separate practices.If you are a solo practitioner without an organizational NPI, ask Blue Cross of Idaho how to complete that field. Do not substitute an unrelated NPI.
4
Attach the documents and send
Include your W-9 and, for a behavioral-health professional, a copy of the current Idaho license. Selecting Mental health on the sheet also requires the Behavioral Health Practitioner Area of Expertise Questionnaire. Select and attest only to expertise that applies.Send the packet to PR2PI@bcidaho.com or fax 208-387-6818. Keep a copy and ask the payer to confirm the practice and clinician records.