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 checklist and group 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
The name of the contact person
The name of the contact person
The email of the contact person
The contact phone number
Enter all 0s if there is no group NPI






We can best serve you when you give as much detailed information as possible. Please do not provide your tax ID or other sensitive information.