To request multiple changes of one or more billing NPI numbers (Type 2), or rendering providers NPI (Type 1), send a request to firstname.lastname@example.org. BCBSIL will review and send a letter to the group once complete. It is extremely important that you verify the accuracy of the data we have on file and provide exact service locations and affiliated providers to be added to the BCBSIL files.
Due to the credentialing requirements, Changes are not immediate upon submission of this form. The provider being added to the group will not be considered in network until they are appointed into the network. Processing can take 30-120 days. BCBSIL will review and send a letter to the group once complete.
Note: CAQH Credentialing Application must be complete prior to completing this form. Credentialing is required for Professional Provider Types: MD, DO, PSYD, DC, CNM, LCSW, LCPC, LMFT, DPM, PA, APN and CNP.