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Changes in Practice

Provider Administrative Policy

Provider Information
Policy Date
April 2007
Revised/September 2012
Provider Type(s)


Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.


Changes in Practice

Contracting providers must notify Blue Cross of Idaho in writing via email, fax or regular mail of any following practice changes:

  • Change in ownership or tax identification number, (please include a copy of the updated W-9).
  • Change of address or additional service location
  • Change in office hours
  • Change in providers who join or leave their practice
  • Change of call-share providers status
  • Change in status when physicians accept new members
  • Change in sponsoring/supervising physician if you are a nurse practitioner, physician assistant or service extender working under the supervision/sponsorship of a physician.

Contact your provider relations representative (see MA PAP 102) to determine the paper work you will need.

Primary care physicians (PCPs) must continue accepting new patients until Blue Cross of Idaho receives 30-day written notification indicating they plan not to accept or to limit acceptance of new patients.

Please let us know if claims with dates of service prior to the tax identification change fall under a previous tax identification number so we can issue new provider numbers.

If your tax identification change represents a change of ownership, your contracts with Blue Cross of Idaho may not be valid. Please contact your provider relations representative (see MA PAP 102) prior to ownership changes to assure your contracting status remains in place.

W-9 Form

Provider Information Sheet

Provider Request for Update Form



Policy History

Date Action Reason
September 2012 Revised Added Provider Request for Update Form
June 2012 Revised Added language to notification requirements for contracting providers
January 2012 Revised Removed mailing address, linked MA PAP 102 Contact Information
October 2011 Revised Contact information
November 2010 Revised Service extender information added
May 2008 Revised Language clarification

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