Provider Enrollment Assistance Form

Provider Enrollment Assistance Form

If you need help with the provider enrollment process, please fill out this form. Someone will be with you within two business days.

To see which forms are needed for provider enrollment, please see the individual checklistgroup checklist or in state, out of network checklist.

If you're checking on the status of an application, please note we will contact you at these points in the application process:

  1. When we receive your entire application 
  2. If we need any additional documentation 
  3. When your application is moving to the onboarding process 
  4. When your enrollment is complete and you are enrolled with BlueCross BlueShield of South Carolina and BlueChoice HealthPlan