Welcome to Blue Cross and Blue Shield of Illinois! We’re so glad you’ve chosen to join us as a participating provider.
Stop here if you haven’t completed all the steps on our Join Our Network page.
Steps for Success
We know it can seem like a lot to take in at first. Here’s a to-do list to help you start to settle in. Contact information is included at the bottom if you have questions.
Note: There may be differences for government programs (Medicaid/Medicare Advantage) and/or HMO members. Refer to your participating provider agreement for more information.
Step 1 – Sign Up for Introductory Training
We offer free training, including on demand orientation modules for new providers. Visit our Webinars and Workshops page for links, dates, times and online registration.
Step 2 – Use Electronic Options
We want to make it easy for you to do business with us.
- See our Electronic Commerce page for an overview of electronic transactions and how to get started.
- Register with Availity® Essentials to establish a secure connection with BCBSIL.
- Sign up for Electronic Funds Transfer – With EFT, claim payments can be deposited directly into your bank account.
- Always check eligibility and benefits first – This step confirms membership, prior authorization requirements and other important information.
- Refer to our Provider Tools page for a menu of online options, with links to helpful user guides.
Step 3 – Follow Required Processes
Below are just a few examples and reminders.
- Get familiar with the Provider Manual – Provider Manuals list detailed policies, procedures and requirements necessary to participate in BCBSIL’s networks. The Provider Manual page also includes a BCBSIL Networks and Benefit Plan guide.
- Check your listing on our Provider Finder® – If changes are needed, you’re required to notify us. For details, instructions and online forms, see the Verify and Update Your Information page.
Step 4 – Request a fee schedule
Fee schedules are a key component of your contractual relationship with BCBSIL.
- To request a PPO and/or Blue Choice PPOSM fee schedule, refer to our Fee Schedule page for information on how to obtain reimbursement rates for specific procedure codes/services.
- To locate the Medicaid fee schedule (professional), you can visit the HFS website.
- To locate the Medicare fee schedule (professional), you can visit the CMS website.
Step 5 – Stay Informed
- Sign up to receive our Blue Review provider newsletter via email each month. Also view current and past issues on our Blue Review page.
- Watch for News and Updates – Check our website often for alerts and announcements.
- Webinars and Workshops – Our schedule of online training sessions changes frequently. Be sure to watch our Webinars and Workshops page often for new and enhanced webinars on a variety of topics, such as new provider resources to help make it easier to do business with us.
Step 6 – Remember, We’re Here To Help
- If you have a commercial claim-related question, call our Provider Telecommunication Center at 800-972-8088. Follow the prompts to speak with a Customer Advocate.
- For government programs claim inquiries, contact customer service: Blue Cross Community Health PlansSM (BCCHPSM) – 877-860-2837; Blue Cross Community MMAI (Medicare-Medicaid Plan)SM – 877-723-7702; Blue Cross Medicare AdvantageSM – 877-774-8592.
- For help with electronic transactions, such as EFT (direct deposit) enrollment, email our Electronic Commerce Services team.
- If you have questions on Availity tools and resources or if you’d like to request customized training, email our Provider Education Consultant team.
- For more complex issues, our Provider Network Consultant teams can help. To identify your PNC team, refer to the PNC assignments listing. The PNC team also hosts monthly Provider Hot Topics webinars.
Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's ID card.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.