Home
Forms Library
Solo Provider Enrollment Form - Blue Cross and Blue Shield

Solo Provider Enrollment Form - Blue Cross and Blue Shield 2025

Solo Provider Enrollment Form - Blue Cross and Blue Shield Preview on Page 1

Show details

4.8 out of 5

203 votes

The document is a Solo Provider Enrollment Form for Blue Cross and Blue Shield of Oklahoma, requiring detailed information from healthcare providers wishing to enroll. It includes sections for submitter and practitioner information, office location details, practice information, and various compliance checks. Providers must complete all sections accurately to avoid rejection of the form.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to quickly redact Solo Provider Enrollment Form - Blue Cross and Blue Shield online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Dochub is the greatest editor for changing your documents online. Follow this straightforward guideline edit Solo Provider Enrollment Form - Blue Cross and Blue Shield in PDF format online at no cost:

Sign up and log in. Register for a free account, set a secure password, and proceed with email verification to start managing your templates.
Add a document. Click on New Document and select the form importing option: add Solo Provider Enrollment Form - Blue Cross and Blue Shield from your device, the cloud, or a secure link.
Make changes to the template. Utilize the top and left-side panel tools to redact Solo Provider Enrollment Form - Blue Cross and Blue Shield. Insert and customize text, images, and fillable fields, whiteout unneeded details, highlight the important ones, and provide comments on your updates.
Get your paperwork done. Send the form to other people via email, generate a link for quicker file sharing, export the template to the cloud, or save it on your device in the current version or with Audit Trail added.

Discover all the benefits of our editor today!

See more Solo Provider Enrollment Form - Blue Cross and Blue Shield versions

We've got more versions of the Solo Provider Enrollment Form - Blue Cross and Blue Shield form. Select the right Solo Provider Enrollment Form - Blue Cross and Blue Shield version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (203 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I fill out and sign my [KEY] online?

Yes, and it’s really straightforward! DocHub is a web-based PDF editor with advanced document processing capabilities that allow you promptly edit your forms, fill out empty fields and drop new ones for other people to fill out, and create electronic signatures in several ways. Add your [KEY], provide information as requested, and decide how you want to eSign your document - by typing your name, drawing your signature, uploading its picture, or using a QR code.

How do you get [KEY]?

You can find the latest and most relevant version of the [KEY] in our DocHub forms library. Search it by categories or utilize the search field to get the exact template that suits your situation. You can open this form for editing once you find it.

What is the phone number for CareFirst administrators provider relations?

Please call CareFirst Provider Information and Credentialing at 410-872-3500 or 877-269-9593.

What is the phone number for BCBS of Illinois provider enrollment?

Providers with general questions about IMPACT or provider enrollment may email IMPACT Help or call 877-782-5565 (select option #1).

Is CareFirst BlueChoice the same as Blue Cross Blue Shield?

CareFirst BlueCross BlueShield is the local BCBS plan that performs claims processing and customer service for the PPO in the Maryland, DC and Northern Virginia area. CareFirst BlueCross BlueShield also offers an HMO in the FEHB, called BlueChoice.

How do I become a Florida Blue provider?

You must have a Health and Life license type to offer our products. We will determine if you are properly licensed when we receive your application. Please check with Florida Department of Financial Services (FLDFS) to ensure your license is in good standing prior to submitting your application.

How do I check my carefirst credentialing status?

Providers have the right, upon request, to review the information used in credentialing decisions to correct inaccurate information and to obtain the status of the credentialing process. To request this information, call 877-269-9593 or 410-872-3500.

Why cant I log into my CareFirst account?

If your password is not working correctly, please use the Forgot Password function or contact your Office Manager for assistance. If your password has expired, please contact your Office Manager for assistance. Our Help Desk can be docHubed at 1-877-526-8390.

How do I become a BCBS provider in Oklahoma?

Required for all Providers: Current Oklahoma State Healthcare License - Provider Must be Located and/or Performing Services in the State of Oklahoma. Malpractice Liability Insurance. Provider Disclosure of Ownership and Control Interest Form. Valid W-9.

What is the phone number for CareFirst provider portal?

For technical support, call the CareFirst Help Desk at (877) 526 8390. Below is a list that may assist you with your CareFirst provider-related questions.

Solo Provider Enrollment Form - Blue Cross and Blue Shield 2025

Here's how it works

How to quickly redact Solo Provider Enrollment Form - Blue Cross and Blue Shield online