Have you made any changes to your key provider information? It is important
that you notify us of any changes to the following:
- your mailing address
- your phone number
- your office hours
- name of your practice
- your acceptance of new patients
- your plan to dissolve your practice
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 contact your Network Coordinator and notify them of any changes to
your information.
Facility and ancillary providers
Per your contract, 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, Provider Networks and Value-Based
Solutions
- 1901 Market Street, 27th Floor
- Philadelphia, PA 19103
- Independence Blue Cross
- Attn: Legal Department
- 1901 Market Street, 43rd Floor
- Philadelphia, PA 19103
Sixty days? advance notice is required for processing.
Note: This information does not apply to providers contracted with
Magellan Healthcare, Inc., an independent company. Please contact your Magellan
Network Coordinator, if you have any questions.