Network Participation
Contract/Credentialing Requests
To update other provider information, please use the Provider Information Change Form (login and go to “Provider Resources > Forms > Provider Information Change”).
To add a line of business or request participation in another AZ Blue network, contact your Provider Relations Contact.
To terminate a contract or end an affiliation with a tax ID, use the Termination Form.
Medical Professionals
This form requires a CAQH profile and number. You can also use this form to add a new tax ID to your contract.
Dental Professionals
This form requires a CAQH dental profile and number. You can also use this form to add a new tax ID to your contract.
Facilities, Professional Groups, & Ancillary Providers
This form may be used to request contracting, credentialing, and to add a new tax ID to your contract.
TriWest Healthcare Alliance Network (for Veterans)
To request a contract for the TriWest Healthcare Alliance Network, visit the TriWest contracting page. After you have a TriWest contract, use the AZ Blue professional or facility form to request credentialing and contract updates.
PT/ST/OT Professionals
If you are a PT/ST/OT professional and are part of a group, your group must have a group contract on file with us before we can complete your credentialing. To request a group contract, see the above facility/group form.
Chiropractors
Chiropractors must request contracting/credentialing American Specialty Health (ASH) at 1-888-511-2743.
Providers with Concierge Practices
Providers with concierge practices must meet specific requirements and sign a Concierge Practice Contract Addendum. For more information, reach out to your Provider Relations Contact.
- See the AZ Blue contracting and credentialing process overview.
Blue Cross Blue Shield of Arizona (AZ Blue) works closely with hospitals and doctors across Arizona to provide quality, affordable healthcare. Here’s how we make a difference:
- We’re a not-for-profit company and an independent licensee of the Blue Cross Blue Shield Association, committed to inspiring health and making it easy.
- Along with 33 other locally operated BCBS companies, we deliver health insurance coverage to one in three Americans in all 50 states, the District of Columbia, and Puerto Rico. In addition, the BCBS Federal Employee Program insures over five million federal employees, retirees, and their families. Our coverage also extends to members who live, work, and travel internationally, and to those who travel to the United States.
- Our national Blue Distinction® program recognizes doctors and hospitals for their expertise and exceptional quality in delivering care, from whole person health to centers of excellence for specialty care.
- We support the health and wellbeing of the larger Arizona community through initiatives and partnerships that address serious population health challenges.
- We offer a wide array of health and wellness programs, as well as a robust care management program to support members when they need that extra level of care.
- Our Provider Relations program keeps you informed and assigns a provider relations contact to answer your questions, respond to concerns, and support your network participation.
- Our online provider directory gives you visibility to members and other contracted physicians and hospitals across Arizona and nationwide.
The AZ Blue Provider Relations team assigns a Provider Relations Contact to support our network providers. Use the Provider Relations Contact search tool to see the contact information for your assigned Provider Relations Contact.