Use these forms to "get on file" to process claims or to provide us with updated information.
You can complete the forms by downloading them and then clicking in each form field and typing your information. You can also save the forms to your computer. To complete your application, please print the forms, then sign and fax them to 803-264-4795. We will receive the information in a secure electronic inbox. If you have any questions about the forms, please email us at firstname.lastname@example.org.
Use these forms to file claims for these BlueCross BlueShield of South Carolina plans: Preferred Blue®, State Health Plan, Federal Employee Program (FEP) and the Preferred Dental Network.
These forms are not applications to join any of the networks. They simply allow you to file claims to BlueCross. Submitting these forms is not a guarantee that we will pay the claims you file.
If you are interested in joining either our health plan or mental health networks, please visit the Credentialing page.
Who should complete this packet? Health care professionals or entities who want to file claims to us or make changes in the information that we have on file about them. Download the File Application Packet. This packet contains:
Use these forms to notify us of any changes in demographic information or any additions/deletions of providers to your staff. We use this information for claims processing and in our directories.