Contracting Applications - Provider Central - Blue Cross Blue 2026

1. Click ‘Get Form’ to open the Contracting Applications - Provider Central - Blue Cross Blue in the editor.
2. Begin by filling out the 'Organization Information' section. Enter your provider's legal name, DBA, Tax ID number, and National Provider Identifier (NPI). If applicable, include your Blue Cross non-contracted provider number and Medicare participation status.
3. Complete the 'Authorized Signatories' section by providing the name, title, and email of someone authorized to sign contracts on behalf of your organization. Ensure that this person is set as a trusted sender for electronic signatures.
4. In the 'Product Participation' section, check all relevant Blue Cross products you wish to participate in. This includes options like HMO, PPO, and Medicare Advantage.
5. Fill out the 'Service Information' section detailing hospitals or physician groups that refer to your organization and what makes your organization unique.
6. Review and complete the 'Attestations' section by checking boxes that affirm your organization's ability to submit claims electronically and comply with communication requirements.
7. Finally, sign and date the application in the 'Representations' section before submitting it through our platform along with any required supporting documentation.

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