Becoming a contracted provider with BCBSAZ requires credentialing and starts by completing and submitting the appropriate form:
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) – Medical
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.
