Have you made any changes to your key provider information, such as your mailing address or the name of your practice? If so, please be sure to notify us. We value your help in keeping our data files current. Accurate data files allow us to provide you with important information on billing, claims, changes or additions to policies, and announcements of administrative processes.

Professional providers Please notify us of any changes to your information in one of the following ways: Complete the Provider Change Form, and fax or mail it to us using the instructions at the bottom of the form. Contact your Network Coordinator.

Facility and ancillary providers

You are required to submit any changes to your information in writing. This request should be sent directly to the Senior Vice President of Contracting and the Legal Department at the addresses below: Independence Blue Cross Attn: Senior Vice President, Contracting and Provider Networks 1901 Market Street, 27th Floor Philadelphia, PA 19103 Independence Blue Cross Attn: Legal Department 1901 Market Street, 43rd Floor Philadelphia, PA 19103 Thirty days' advance notice is required for processing. Note: This information does not apply to providers contracted with Magellan Behavioral Health, Inc., an independent company. Please contact your Magellan Network Coordinator, if you have any questions.