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 continue 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 in one of the following ways:
- On the NaviNet? web portal, select Provider Change Form from the Plan Transactions
menu and submit your changes electronically.
- 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, 36th Floor
Philadelphia, PA 19103
Note: Thirty days' advance
notice is required for processing.
NaviNet? is a registered trademark of NaviNet,
Inc., an independent company.