Provider Onboarding Process

We contract with physicians, facilities and other health care professionals to form our provider networks. Our networks give our members access to quality, accessible and cost-effective health care services. We welcome you to apply to join us. See the process below.

To join our networks or submit claims electronically as an out-of-network provider, obtain a provider record ID with Blue Cross and Blue Shield of Texas for each tax identification number under which you bill.

Before you’re contracted, approved and activated in a network, your claims will be processed as out-of-network. Obtaining a provider record ID doesn’t automatically enroll you in our networks.

If you already have a provider record ID and only need to update your demographics: Use the Demographic Change Form.

Inactive provider record IDs: We may automatically cancel a provider record ID if claims aren’t filed under it within a 24-month time period. Complete the Provider Onboarding Form to apply to reinstate a canceled provider record ID.

  • Physicians, Professional Providers and Hospital/Facility-Based Providers

    Complete the Provider Onboarding Form. In the form, you can choose to participate in-network or out-of-network. 

    Medical school and residency information is required from physicians (MD and DO) who participate in our networks.

    If you indicate on the onboarding form that you want to be a participating provider, your record ID is assigned, and we’ll send you the appropriate contracts to complete. View requirements for providers to obtain a provider record below and be in-network:

    Solo provider requirements:
    • Valid Texas medical or professional license in good standing with the appropriate Texas professional licensing board
    • Physical practice address in Texas or a contiguous county
    • A complete, signed and dated W9 and a copy of each provider’s licensefor all new group and solo practitioner submissions
    • Completed Provider Onboarding Form with the solo provider’s information
    Group provider requirements:
    • Valid Texas medical or professional license in good standing with the appropriate Texas professional licensing board
    • Physical practice address in Texas or a contiguous county
    • Completed Provider Onboarding Form using the group information
    • Completed roster for providers affiliated with your group tax ID and billing NPI

    Roster process: As of May 1, 2025, we don’t accept rosters on templates older than version 25.01.28. The version number is in the A1 cell on the TX tab of the roster. Existing groups only need to send new providers and not a full roster.  Starting Sept. 1, 2025, we will not accept rosters on templates older than version 25.06.23

    To submit a roster:

    • Download the required provider roster template from the roster section of the Provider Onboarding Form
    • Submit with one tax ID per onboarding request
    Hospital/facility-based professional providers requirements:
    • New individual providers must list the name of each facility that they service in the comments section of the Provider Onboarding Form.
    • Group providers should submit using the provider roster template. Enter a Y in the Hospital/Facility Based Provider column and enter the facility the provider is servicing in the “Hospital/Facility Name or NPI” section.
    • Existing contracted groups should only include the providers they are adding using the provider roster template.

     

    Once your provider record is set up, we’ll send you the appropriate contracts to complete. Complete and submit the contracts according to the enclosed instructions.

  • Ancillary Providers 

    Complete the Ancillary Provider ID Request Form and email the completed form and required supporting documents to the address on the form.

    Once you are notified that your provider record ID has been created, refer to the Credentialing and Contracting Process for Ancillary Providers.

  • Facilities

    Submit your information to the appropriate Network Management Office location.

  • Case Status Checker

    If you completed a Provider Onboarding Form, check the status of your application by entering the case number you received in your confirmation email in our Case Status Checker.

  • ParPlan

    Complete the ParPlan contract.

    About ParPlan: The ParPlan program is open to contracted and non-contracted providers and is designed for the protection of members, providers and our company. ParPlan providers:

    • Do not have to complete credentialing
    • Do file members’ claims
    • Are included in the directory of ParPlan providers
    • Do accept our allowable amounts and don’t bill the member over the allowable amount
    • Do limit members’ out-of-pocket expenses to the deductible and cost share amounts

    When completing the Provider Onboarding Form, professional providers and hospital/facility based providers can sign and submit a ParPlan contract.

    • The ParPlan contract must be signed by the authorized signatory for group providers or by the solo provider.
    • Return the signed ParPlan contract with your Provider Onboarding Form or submit by email to the Standard Contracting Team or to your local Network Management Office.
    • By signing a ParPlan contract, the provider is only active in ParPlan if they are contracted and credentialed in other networks.

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