Becoming a contracted provider with BCBSAZ requires credentialing and starts by completing and submitting the appropriate form (see below). If you are already contracted with BCBSAZ and would like to add a line of business, please contact your provider liaison.

     Contract Request/Information Form - Medical (Requires a CAQH Proview number and complete provider profile)

    • Chiropractors must apply through American Specialty Health (ASH) at 1 (888) 511-2743
    • Providers with concierge practices must meet specific requirements and sign a Concierge Practice Contract Addendum.

     Contract Request/Information Form - Facility/Ancillary

     Contract Request/Information Form - Dental

     TriWest CCN network (for Veterans) – Facility

There are several steps in the BCBSAZ contracting process. To learn more, including how to avoid delays, please download the overview.