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Forms
Electronic Commerce Documents
Document Name File Size
Assignment of New Account 15 KB
Billing Service Price List 15 KB
Billing Service Profile 24 KB
Blue Cross Blue Shield of IL Electronic Remittance Advice 11 KB
Business Associate Addendum 16 KB
Business Associate Cover Letter 17 KB
Commercial Payer List (Institutional) 76 KB
Commercial Payer List (Professional) 97 KB
Electronic Funds Transfer Rider 66 KB
Electronic Funds Transfer Rider Instructions 18 KB
Institutional Billing Service List 15 KB
Institutional Vendor List 15 KB
Professional Billing Service List 41 KB
Professional Vendor List 46 KB
Provider Enrollment Form 18 KB
THIN Online Enrollment 45 KB
THIN (IL) Submitter Enrollment Packet 528 KB
Vendor Profile 25 KB
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