About Provider Connection | Blue Shield of CA Provider

<!DOCTYPE HTML> <html lang="en" data-dir="ltr"> <head> <meta charset="UTF-8"/> <title>About Provider Connection | Blue Shield of CA Provider</title> <link href="/content/dam/bsca/en/bsc-brand/favicon/favicon.png" rel="shortcut icon" type="image/x-icon"/> <meta name="description" content="Provider Connection is your source for detailed member eligibility and benefit information, claims status and payment information, authorization status and submission, Blue Shield policies and guidelines, and more."/> <meta name="keywords" content=""/> <meta name="author" content="Blue Shield CA"/> <meta property="twitter:site" content="@BlueShieldCA"/> <meta property="twitter:creator" content="@BlueShieldCA"/> <meta property="twitter:title" content="About Provider Connection | Blue Shield of CA Provider"/> <meta property="og:image" content="/content/dam/bsca/en/bsc-brand/logos/twitter/pazMGY.png"/> <meta property="twitter:card" content="/content/dam/bsca/en/bsc-brand/logos/twitter/pazMGY.png"/> <meta property="twitter:description" content="Provider Connection is your source for detailed member eligibility and benefit information, claims status and payment information, authorization status and submission, Blue Shield policies and guidelines, and more."/> <meta property="og:type" content="Website"/> <meta property="og:site_name" content="BlueShieldCA"/> <meta property="og:title" content="About Provider Connection | Blue Shield of CA Provider"/> <meta property="og:description" content="Provider Connection is your source for detailed member eligibility and benefit information, claims status and payment information, authorization status and submission, Blue Shield policies and guidelines, and more."/> <meta property="og:url" content="https://www.blueshieldca.com/en/provider/about-pc"/> <meta name="template" content="base-page"/> <meta name="viewport" content="width=device-width, initial-scale=1"/> <link rel="canonical" href="https://www.blueshieldca.com/en/provider/about-pc"/> <link rel="stylesheet" href="/etc.clientlibs/bsca/clientlibs/clientlib-base.lc-1740457970566-lc.min.css" type="text/css"> <script src="/etc.clientlibs/clientlibs/granite/jquery.lc-1740457970566-lc.min.js"></script> <script src="/etc.clientlibs/clientlibs/granite/utils.lc-1740457970566-lc.min.js"></script> <input type="hidden" id="dl-page-name" value="About Provider Connection"/> <input type="hidden" id="dl-gen-site-section" value="Provider"/> <input type="hidden" id="dl-site-section" value="Provider : About Provider Connection"/> <input type="hidden" id="dl-sub-section" value="Provider : About Provider Connection"/> <script> window.dataLayer = window.dataLayer || []; window.dataLayer.push({ devEnvironment: window.location.hostname, 'page': { 'attributes': { 'language': document.getElementsByTagName('html')[0].getAttribute('lang'), 'responsiveDesignBreakpoint': screen.availWidth + ' X ' + screen.availHeight, 'screenOrientation': window.innerHeight > window.innerWidth ? 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gtm-track-click="{'eventCategory': 'Provider', 'eventAction': 'Click - Text Increase', 'eventLabel': 'Increase Text Size', 'eventNonInteracton': 'false', 'event': 'eventTracker'}">Increase Text Size</button> <button class="clickme decrease" data-decreasetext="Decrease Text Size" gtm-track-click="{'eventCategory': 'Provider', 'eventAction': 'Click - Text Decrease', 'eventLabel': 'Decrease Text Size', 'eventNonInteracton': 'false', 'event': 'eventTracker'}">Decrease Text Size</button> </div></div> </div> </li> </ul> <ul class="menu-right"> <li> <div class="cmp-topbar__login"> <div> </div> </div> </li> <li> <div class="cmp-topbar__Hlist"> <div> <div class="cmp-horizontallist custom-pipe-container float-right"> <ul> <li> <a href="/providerwebapp/logOutExternal" onclick='onHorizontalListClick(event);' gtm-track-click="{'eventCategory': 'Provider', 'eventAction': '/providerwebapp/logOutExternal.html', 'eventLabel': 'Log out', 'eventNonInteracton': 'false', 'event': 'eventTracker'}">Log 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class="header-logo__parent"> <div class="cmp-header--logo"> <div> <div class="image"> <div class="cmp-image"> <a href="/en/provider" data-auth-href="/providerwebapp/connect/home"> <img src="/content/dam/bsca/en/shared/logos/Blue-Shield-California-logo.svg" loading="lazy" class="cmp-image__image primarylogo" itemprop="contentUrl" alt="Blue Shield of California, homepage" title="Blue Shield of California, homepage"/> </a> <meta itemprop="caption" content="Blue Shield of California, homepage"/> </div> <div id="isSpoof" class="cmp-image cmp-image-secondary"> <a href="/en/provider" data-auth-href="/providerwebapp/connect/home"> <img src="/content/dam/bsca/en/shared/logos/provider-logo.png" loading="lazy" class="cmp-image__image secondarylogo" itemprop="contentUrl" alt="Provider Connection logo" title="Provider Connection logo"/> </a> <meta itemprop="caption" content="Provider Connection logo"/> </div> </div> </div> </div> </div> <div class="navigation"> <nav aria-label="Main" id="navigation-e10abc050c" class="cmp-navigation" itemscope="" itemtype="http://schema.org/SiteNavigationElement" data-cmp-data-layer="{"navigation-e10abc050c":{"@type":"core-components-examples/components/navigation"}}"> <ul class="cmp-navigation__group"> <li class="cmp-navigation__item cmp-navigation__item--level-0" data-title="Eligibility & benefits"> <a data-cmp-clickable="false" class="cmp-navigation__item-link" data-href="javascript:void(0)" href="javascript:void(0)"> Eligibility & benefits <span class="chevron-icon"></span> </a> <div class="content"> <ul class="single-column"> <li> <div class="heading "> <h4>Eligibility & benefits </h4> <div class="heading_bdr"> </div> </div> <ul> <li data-title="Eligibility & benefits overview"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/eligibility-benefits.html" href="/en/provider/eligibility-benefits" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Eligibility & benefits', 'eventLabel': 'Secondary: Eligibility & benefits', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Eligibility & benefits overview </a> </li> <li data-title="Verify eligibility"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/providerwebapp/verifyEligibility/singleSearch.html" href="/providerwebapp/verifyEligibility/singleSearch" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Eligibility & benefits', 'eventLabel': 'Secondary: Eligibility & benefits', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Verify eligibility </a> </li> </ul> </li> <li> <ul> <li data-title="Member rosters"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/providerwebapp/memberRosters.html" href="/providerwebapp/memberRosters" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Eligibility & benefits', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Member rosters </a> </li> <li data-title="Benefit summaries"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/eligibility-benefits#benefitsum" href="/en/provider/eligibility-benefits#benefitsum" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Eligibility & benefits', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Benefit summaries </a> </li> <li data-title="Preventive health guidelines"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/eligibility-benefits#phg" href="/en/provider/eligibility-benefits#phg" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Eligibility & benefits', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Preventive health guidelines </a> </li> </ul> </li> <li> <div class="heading "> <h4> </h4> </div> </li> </ul> </div> </li> <li class="cmp-navigation__item cmp-navigation__item--level-0" data-title="Authorizations"> <a data-cmp-clickable="false" class="cmp-navigation__item-link" data-href="javascript:void(0)" href="javascript:void(0)"> Authorizations <span class="chevron-icon"></span> </a> <div class="content"> <ul class="single-column"> <li> <div class="heading "> <h4>Authorizations </h4> <div class="heading_bdr"> </div> </div> <ul> <li data-title="Authorizations overview"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/authorizations.html" href="/en/provider/authorizations" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Authorizations', 'eventLabel': 'Secondary: Authorizations', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Authorizations overview </a> </li> <li data-title="Medical authorization"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/providerwebapp/authorization/medicalAuthorization.html" href="/providerwebapp/authorization/medicalAuthorization" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Authorizations', 'eventLabel': 'Secondary: Authorizations', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Medical authorization </a> </li> <li data-title="Medical authorization status"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/providerwebapp/authorization/medicalRequestStatus.html" href="/providerwebapp/authorization/medicalRequestStatus" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Authorizations', 'eventLabel': 'Secondary: Authorizations', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Medical authorization status </a> </li> <li data-title="Pharmacy authorization"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/providerwebapp/authorization/pharmacyAuthorization.html" href="/providerwebapp/authorization/pharmacyAuthorization" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Authorizations', 'eventLabel': 'Secondary: Authorizations', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Pharmacy authorization </a> </li> </ul> </li> <li> <ul> <li data-title="Pharmacy authorization status"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/providerwebapp/authorization/pharmacyRequestStatus.html" href="/providerwebapp/authorization/pharmacyRequestStatus" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Authorizations', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Pharmacy authorization status </a> </li> <li data-title="Out-of-area Blue plan members"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/authorizations#otherblue" href="/en/provider/authorizations#otherblue" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Authorizations', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Out-of-area Blue plan members </a> </li> <li data-title="Policies & guidelines"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/authorizations#policies" href="/en/provider/authorizations#policies" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Authorizations', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Policies & guidelines </a> </li> <li data-title="Authorization forms & list"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/authorizations#forms" href="/en/provider/authorizations#forms" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Authorizations', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Authorization forms & list </a> </li> <li data-title="Authorization log upload"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/providerwebapp/authorization/IPAFileUpload.html" href="/providerwebapp/authorization/IPAFileUpload" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Authorizations', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Authorization log upload </a> </li> </ul> </li> <li> <div class="heading "> <h4> </h4> </div> </li> </ul> </div> </li> <li class="cmp-navigation__item cmp-navigation__item--level-0" data-title="Claims"> <a data-cmp-clickable="false" class="cmp-navigation__item-link" data-href="javascript:void(0)" href="javascript:void(0)"> Claims <span class="chevron-icon"></span> </a> <div class="content"> <ul class="single-column"> <li> <div class="heading "> <h4>Claims </h4> <div class="heading_bdr"> </div> </div> <ul> <li data-title="Claims overview"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/claims.html" href="/en/provider/claims" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Claims', 'eventLabel': 'Secondary: Claims', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Claims overview </a> </li> <li data-title="How to submit claims"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/claims/how-to-submit.html" href="/en/provider/claims/how-to-submit" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Claims', 'eventLabel': 'Secondary: Claims', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> How to submit claims </a> </li> <li data-title="Claims routing tool"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/providerwebapp/connect/claims/claimsRoutingTool.html" href="/providerwebapp/connect/claims/claimsRoutingTool" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Claims', 'eventLabel': 'Secondary: Claims', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Claims routing tool </a> </li> <li data-title="Check claims status"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/providerwebapp/claims/claimStatus.html" href="/providerwebapp/claims/claimStatus" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Claims', 'eventLabel': 'Secondary: Claims', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Check claims status </a> </li> </ul> </li> <li> <ul> <li data-title="Real-time claims"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/providerwebapp/claims/realTimeClaims.html" href="/providerwebapp/claims/realTimeClaims" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Claims', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Real-time claims </a> </li> <li data-title="Manage electronic transactions"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/claims/electronic-transactions.html" href="/en/provider/claims/electronic-transactions" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Claims', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Manage electronic transactions </a> </li> <li data-title="Fee schedule"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/claims#profee" href="/en/provider/claims#profee" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Claims', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Fee schedule </a> </li> <li data-title="Claims issues & disputes"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/claims/disputes.html" href="/en/provider/claims/disputes" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Claims', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Claims issues & disputes </a> </li> <li data-title="Policies & guidelines"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/claims#policies" href="/en/provider/claims#policies" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Claims', 'eventLabel': 'Secondary: ', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Policies & guidelines </a> </li> </ul> </li> <li> <div class="heading "> <h4> </h4> </div> </li> </ul> </div> </li> <li class="cmp-navigation__item cmp-navigation__item--level-0" data-title="Guidelines & resources"> <a data-cmp-clickable="false" class="cmp-navigation__item-link" data-href="javascript:void(0)" href="javascript:void(0)"> Guidelines & resources <span class="chevron-icon"></span> </a> <div class="content"> <ul class="single-column"> <li> <div class="heading "> <h4>Guidelines & resources </h4> <div class="heading_bdr"> </div> </div> <ul> <li data-title="Guidelines & resources overview"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/guidelines-resources.html" href="/en/provider/guidelines-resources" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Guidelines & resources', 'eventLabel': 'Secondary: Guidelines & resources', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Guidelines & resources overview </a> </li> <li data-title="Forms"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/guidelines-resources#forms" href="/en/provider/guidelines-resources#forms" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Guidelines & resources', 'eventLabel': 'Secondary: Guidelines & resources', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Forms </a> </li> <li data-title="Drugs & pharmacy resources"> <a data-cmp-clickable="true" class="cmp-navigation__item-link button arrowleft" data-href="/content/bsca/language-masters/en/provider/guidelines-resources#drugs" href="/en/provider/guidelines-resources#drugs" gtm-track-click="{ 'eventCategory': 'Navigation', 'eventAction': 'Guidelines & resources', 'eventLabel': 'Secondary: Guidelines & resources', 'eventNonInteracton': 'false', 'event': 'eventTracker'}"> Drugs & pharmacy resources 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'/content/bsca/language-masters/en/provider.html', 'eventLabel': 'Home', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" href="/en/provider"> <span itemprop="name">Home</span> </a> <meta itemprop="position" content="1"/> </li> <li class="cmp-breadcrumb__item cmp-breadcrumb__item--active" aria-current="page" itemprop="itemListElement" itemscope itemtype="http://schema.org/ListItem"> <span itemprop="name">About Provider Connection</span> <meta itemprop="position" content="2"/> </li> </ol> </nav> <nav id="breadcrumb-92ea93a3b4-2" class="cmp-breadcrumb cmp-breadcrumb__mobile" aria-label="Breadcrumb"> <ol class="cmp-breadcrumb__list" itemscope itemtype="http://schema.org/BreadcrumbList">   </ol> </nav> </div> <div class="spacer aem-GridColumn aem-GridColumn--default--12"> <div class="cmp-spacer cmp-spacer__desktop cmp-spacer__horizontal cmp-spacer__16"></div> <div class="cmp-spacer cmp-spacer__mobile cmp-spacer__horizontal cmp-spacer__8"></div> </div> <div class="title text-center aem-GridColumn aem-GridColumn--default--12"> <div id="title-c38cdbd503" class="cmp-title"> <h1 class="cmp-text__H1">About Provider Connection</h1> </div> </div> <div class="spacer aem-GridColumn aem-GridColumn--default--12"> <div class="cmp-spacer cmp-spacer__desktop cmp-spacer__horizontal cmp-spacer__32"></div> <div class="cmp-spacer cmp-spacer__mobile cmp-spacer__horizontal cmp-spacer__16"></div> </div> <div class="text narrow-text aem-GridColumn aem-GridColumn--default--12"> <div id="text-fdd90087a1" class="rte-content cmp-text "> <p><span class="cmp-text__bodytext">Provider Connection is your online source for current, detailed member eligibility and benefit information, claims status and payment information, authorization status and submission, Blue Shield policies and guidelines, and more.</span></p> <p><span class="cmp-text__bodytext">Registered users can quickly access a variety of online resources, including:</span></p> <p><span class="cmp-text__bodytextdark">Member eligibility and benefit information</span><span class="cmp-text__bodytext"> in the <a href="/en/provider/eligibility-benefits" title="Eligibility & benefits section">Eligibility and benefits section</a>:</span></p> <ul> <li><span class="cmp-text__bodytext">Query up to 24 months of eligibility, updated daily</span></li> <li><span class="cmp-text__bodytext">View plan coverage information, including benefit limitations and authorization requirements</span></li> <li><span class="cmp-text__bodytext">Determine copayment, co-insurance, deductible and out-of-pocket accumulations</span></li> <li><span class="cmp-text__bodytext">Verify PCP assignment (current and historical)</span></li> <li><span class="cmp-text__bodytext">View claims mailing address</span></li> <li><span class="cmp-text__bodytext">Generate printer-friendly summary of eligibility and benefits</span></li> <li><span class="cmp-text__bodytext">Generate member roster for HMO PCPs</span></li> <li><span class="cmp-text__bodytext">Access HMO Benefit Guidelines and Summary of Benefits for other plans</span></li> </ul> <p><span class="cmp-text__bodytext"> <br> <span class="cmp-text__bodytextdark">Medical authorizations</span> in the <a href="/en/provider/authorizations" title="Authorizations section">Authorizations section</a>:</span></p> <ul> <li><span class="cmp-text__bodytext">Query status information for authorizations submitted via phone, fax, or online</span></li> <li><span class="cmp-text__bodytext">Submit authorization requests for most services (inpatient, outpatient, durable medical equipment or hospice/home health care services)</span></li> <li><span class="cmp-text__bodytext">Determine if authorization is required</span></li> <li><span class="cmp-text__bodytext">Search medical and medication policies</span></li> <li><span class="cmp-text__bodytext">Search drug database and formulary</span></li> </ul> <p><span class="cmp-text__bodytext"> <br> </span><span class="cmp-text__bodytextdark">Claim status and payment information</span><span class="cmp-text__bodytext"> in the <a href="/en/provider/claims" title="Claims section">Claims section</a>:</span></p> <ul> <li><span class="cmp-text__bodytext">Query up to 24 months of your pending and finalized claims, updated daily</span></li> <li><span class="cmp-text__bodytext">View/print/download copies of your Explanation of Benefits</span></li> <li><span class="cmp-text__bodytext">View/print/download payment reports for reconciling both checks and electronic deposits</span></li> <li><span class="cmp-text__bodytext">View/print/download claims activity reports for accounts-receivable management</span></li> <li><span class="cmp-text__bodytext">Look up PPO professional fee schedule allowances, and payment policies</span></li> <li><span class="cmp-text__bodytext">Review special guidelines for claim forms for billing and electronic claims information</span></li> <li><span class="cmp-text__bodytext">Learn about how to enroll for electronic remittance advice (ERA) and electronic funds transfer (EFT)</span></li> </ul> <p><span class="cmp-text__bodytext"> <br> </span><span class="cmp-text__bodytextdark">Other resources</span> <span class="cmp-text__bodytext">in the <a href="/en/provider/guidelines-resources" title="Guidelines & resources section">Guidelines and resources section</a>:</span></p> <ul> <li><span class="cmp-text__bodytext">View/print/download provider manuals, and newsletters</span></li> <li><span class="cmp-text__bodytext">Find guidelines, policies, and procedures</span></li> <li><span class="cmp-text__bodytext">Use Find a Provider to assist with referrals</span></li> <li><span class="cmp-text__bodytext">Provide resources for your patients</span></li> </ul> <p><span class="cmp-text__bodytext">Note: Registered providers can access eligibility, authorizations and claims information for most Blue Shield members (does not include Medicare+Choice membership).</span></p> <p><span class="cmp-text__bodytext">Claims or authorizations not processed by Blue Shield of California, which may include pharmacy, behavioral health, or dental benefits, are not available online.<br>  </span></p> <h2>Register for Provider Connection</h2> <p><span class="cmp-text__bodytext">Providers, billing services, and management service organizations may <a href="https://www.blueshieldca.com/providerwebapp/connect/#/connect/register/accountType" title="register online">register online</a> in minutes. In order to register, you must provide your provider organization tax identification number. Begin registration, or to determine if you organization already has an Account Manager by entering your organization's Tax ID.</span></p> <p><span class="cmp-text__bodytext">For security reasons, if someone from your organization has already registered, please contact that Account Manager in order to obtain your own user account. Each user of the Provider portal is required to have their own unique username and password. Sharing of usernames and passwords violates the <a href="/en/home/site-help/terms-of-use" title="Provider Connection portal terms of use">Provider Connection portal terms of use</a> and will result in the account being disabled.</span></p> <p><span class="cmp-text__bodytext">Organizations are also prohibited from using “automated” scrapping programs on our site to mine data. Scrapping programs impact portal performance and will result in the account being disabled.<br>  </span></p> <h2>Join our provider networks</h2> <p><span class="cmp-text__bodytext">To enjoy the full benefits of Provider Connection, including access to your claims information, you must either join our networks, or request a non-participating provider record. This also allows you to exchange electronic claims transactions with us. <a href="/en/provider/guidelines-resources/prospective-providers" title="Learn how to join our provider networks">Learn how to join our provider networks</a></span></p> </div> <script async defer src="/etc.clientlibs/bsca/components/common/text/clientlibs.lc-1740457970566-lc.min.js"></script> </div> <div class="spacer aem-GridColumn aem-GridColumn--default--12"> <div class="cmp-spacer cmp-spacer__desktop cmp-spacer__horizontal cmp-spacer__32"></div> <div class="cmp-spacer cmp-spacer__mobile cmp-spacer__horizontal cmp-spacer__16"></div> </div> <div class="custom__flex customflex_center flex__equalHeight aem-GridColumn aem-GridColumn--default--12"> <div class="cmp-primarycard cmp-primarycard__nobg xl__card" data-component="primary" data-title="Technical support request form"> <h2 class="cmp-primarycard__heading"> Technical support request form </h2> <div class="cmp-primarycard__description"><p><span class="cmp-text__bodytext">Request help with your log in, registration or other technical problems.</span></p> </div> <div class="btn-bottomalign"> <a data-title="Technical support request form" class="button arrowleft arrowxlleft" aria-label="Request tech support" href="/providerwebapp/connect/connect/technicalSupportForm" gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Card-Secondary Link', 'eventLabel': 'Request tech support', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" data-gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Image Card-Secondary Link', 'eventLabel': '', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" target="_self">Request tech support</a> </div> </div> <div class="cmp-primarycard cmp-primarycard__nobg xl__card" data-component="primary" data-title="Provider Connection reference guide"> <h2 class="cmp-primarycard__heading"> Provider Connection reference guide </h2> <div class="cmp-primarycard__description"><p><span class="cmp-text__bodytext">Find detailed instructions for activities like checking eligibility, making a referral, determining if prior authorization is necessary, prescreening claims, checking claims status, and other tools and information you need to serve our members.</span></p> </div> <div class="btn-bottomalign"> <a data-title="Provider Connection reference guide" class="button arrowleft arrowxlleft" aria-label="Provider Connection reference guide (PDF, 3 MB)" href="/content/dam/bsca/en/provider/docs/Provider-Connection-Reference-Guide.pdf" gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Card-Secondary Link', 'eventLabel': 'Provider Connection reference guide (PDF, 3 MB)', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" data-gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Image Card-Secondary Link', 'eventLabel': '', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" target="_blank">Provider Connection reference guide (PDF, 3 MB)</a> </div> </div> <div class="cmp-primarycard cmp-primarycard__nobg xl__card" data-component="primary" data-title="Provider Connection help"> <h2 class="cmp-primarycard__heading"> Provider Connection help </h2> <div class="cmp-primarycard__description"><p><span class="cmp-text__bodytext">Get Provider Connection help for account registration and management, authorizations, claims, member eligibility, and more.</span></p> </div> <div class="btn-bottomalign"> <a data-title="Provider Connection help" class="button arrowleft arrowxlleft" aria-label="Get help" href="/en/provider/about-pc/help" gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Card-Secondary Link', 'eventLabel': 'Get help', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" data-gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Image Card-Secondary Link', 'eventLabel': '', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" target="_self">Get help</a> </div> </div> <div class="cmp-primarycard cmp-primarycard__nobg xl__card" data-component="primary" data-title="Contact us"> <h2 class="cmp-primarycard__heading"> Contact us </h2> <div class="cmp-primarycard__description"><p><span class="cmp-text__bodytext">Find phone and fax numbers for Blue Shield corporate offices, provider and pharmacy services, medical management, EDI program and technical services as well as contact information for Provider Connection specific features.</span></p> </div> <div class="btn-bottomalign"> <a data-title="Contact us" class="button arrowleft arrowxlleft" aria-label="Find contact information" href="/en/provider/about-pc/contact-us" gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Card-Secondary Link', 'eventLabel': 'Find contact information', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" data-gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Image Card-Secondary Link', 'eventLabel': '', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" target="_self">Find contact information</a> </div> </div> <div class="cmp-primarycard cmp-primarycard__nobg xl__card" data-component="primary" data-title="Manage your profile"> <h2 class="cmp-primarycard__heading"> Manage your profile </h2> <div class="cmp-primarycard__description"><p><span class="cmp-text__bodytext">Manage your profile, get help with your username and password, or access Message center.</span></p> </div> <div class="btn-bottomalign"> <a data-title="Manage your profile" class="button arrowleft arrowxlleft" aria-label="Manage profile" href="/providerwebapp/manageMyProfile/profile" gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Card-Secondary Link', 'eventLabel': 'Manage profile', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" data-gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Image Card-Secondary Link', 'eventLabel': '', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" target="_self">Manage profile</a> <a data-title="Manage your profile" class="button arrowleft arrowxlleft" aria-label="Access Message center" href="/providerwebapp/message-center" gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Card-Secondary Link', 'eventLabel': 'Access Message center', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" data-gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Image Card-Secondary Link', 'eventLabel': '', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" target="_self">Access Message center</a> </div> </div> <div class="cmp-primarycard cmp-primarycard__nobg xl__card" data-component="primary" data-title="News and announcements"> <h2 class="cmp-primarycard__heading"> News and announcements </h2> <div class="cmp-primarycard__description"><p><span class="cmp-text__bodytext">Stay informed about programs, policies, and announcements issued by Blue Shield.</span></p> </div> <div class="btn-bottomalign"> <a data-title="News and announcements" class="button arrowleft arrowxlleft" aria-label="News for Blue Shield of California providers" href="/en/provider/news-education/news" gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Card-Secondary Link', 'eventLabel': 'News for Blue Shield of California providers', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" data-gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Image Card-Secondary Link', 'eventLabel': '', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" target="_self">News for Blue Shield of California providers</a> <a data-title="News and announcements" class="button arrowleft arrowxlleft" aria-label="News for Blue Shield Promise providers" href="/en/bsp/providers/working-with-us/news-announcements" gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Card-Secondary Link', 'eventLabel': 'News for Blue Shield Promise providers', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" data-gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Image Card-Secondary Link', 'eventLabel': '', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" target="_self">News for Blue Shield Promise providers</a> </div> </div> <div class="cmp-primarycard cmp-primarycard__nobg xl__card" data-component="primary" data-title="Company holidays"> <h2 class="cmp-primarycard__heading"> Company holidays </h2> <div class="cmp-primarycard__description"><p><span class="cmp-text__bodytext">Operation centers will be closed in observance of Blue Shield of California’s holiday schedule, with the exception of Medicare Member Services.</span></p> </div> <div class="btn-bottomalign"> <a data-title="Company holidays" class="button arrowleft arrowxlleft" aria-label="View holiday schedule" href="/en/home/contact-us/holiday-schedule" gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Card-Secondary Link', 'eventLabel': 'View holiday schedule', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" data-gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Image Card-Secondary Link', 'eventLabel': '', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" target="_self">View holiday schedule</a> </div> </div> <div class="cmp-primarycard cmp-primarycard__nobg xl__card" data-component="primary" data-title="Terms of use and privacy information"> <h2 class="cmp-primarycard__heading"> Terms of use and privacy information </h2> <div class="cmp-primarycard__description"></div> <div class="btn-bottomalign"> <a data-title="Terms of use and privacy information" class="button arrowleft arrowxlleft" aria-label="View Blue Shield of California websites terms of use" href="/en/home/site-help/terms-of-use" gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Card-Secondary Link', 'eventLabel': 'View Blue Shield of California websites terms of use', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" data-gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Image Card-Secondary Link', 'eventLabel': '', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" target="_self">View Blue Shield of California websites terms of use</a> <a data-title="Terms of use and privacy information" class="button arrowleft arrowxlleft" aria-label="View privacy information" href="/en/home/about-blue-shield/privacy-and-security" gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Card-Secondary Link', 'eventLabel': 'View privacy information', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" data-gtm-track-click="{'eventCategory': 'Click', 'eventAction': 'Image Card-Secondary Link', 'eventLabel': '', 'eventNonInteracton': 'false', 'event': 'eventTracker'}" target="_self">View privacy information</a> </div> </div> </div> <div class="spacer aem-GridColumn aem-GridColumn--default--12"> <div class="cmp-spacer cmp-spacer__desktop cmp-spacer__horizontal cmp-spacer__48"></div> <div class="cmp-spacer cmp-spacer__mobile cmp-spacer__horizontal cmp-spacer__24"></div> </div> </div> </div> </div> <div class="footnotes aem-GridColumn aem-GridColumn--default--12"><div> </div></div> <div class="inheritance experiencefragment aem-GridColumn aem-GridColumn--default--12"> <div class="xfpage page basicpage"> <div id="container-08c7ff6d41" class="cmp-container"> <div class="aem-Grid aem-Grid--12 aem-Grid--default--12 "> <div class="listoflinks background-primaryblck aem-GridColumn aem-GridColumn--default--12"> <div id="footer"> <footer class="cmp-footer" data-component="footer"> <div id="container-97c410ebe3" class="cmp-container"> <div class="cmp-footer__content"> <div data-component="footerlinks"> <div class="footer-link-list"> <div class="footer-link-item"> <h3>Provider tools</h3> <ul> <li class="listicons"><a class="listicons" href="/en/provider/guidelines-resources#prospect" target="_self" gtm-track-click="{'eventCategory': 'Provider', 'eventAction': '/content/bsca/language-masters/en/provider/guidelines-resources#prospect', 'eventLabel': 'List: Become a Blue Shield Provider', 'eventNonInteracton': 'false', 'event': 'eventTracker'}">Become a Blue Shield Provider</a></li> <li class="listicons"><a class="listicons" href="/en/provider/news-education/webinars" target="_self" gtm-track-click="{'eventCategory': 'Provider', 'eventAction': '/content/bsca/language-masters/en/provider/news-education/webinars.html', 'eventLabel': 'List: Sign up for webinars', 'eventNonInteracton': 'false', 'event': 'eventTracker'}">Sign up for webinars</a></li> <li class="listicons"><a class="listicons" href="/en/provider/guidelines-resources#manuals" target="_self" gtm-track-click="{'eventCategory': 'Provider', 'eventAction': '/content/bsca/language-masters/en/provider/guidelines-resources#manuals', 'eventLabel': 'List: Provider manuals', 'eventNonInteracton': 'false', 'event': 'eventTracker'}">Provider manuals</a></li> <li class="listicons"><a class="listicons" href="/en/provider/guidelines-resources#resources" target="_self" gtm-track-click="{'eventCategory': 'Provider', 'eventAction': 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