Forms and Documentation
Get the forms you need in one convenient place.
Ambulance Trip Notes Form (pdf)
Record your notes from ambulance trips.
Blue e Account Maintenance
Add Users or Providers to Your Blue e Account
Blue e Interactive Network Agreement
Signing up for Blue e
Credentialing
Apply for credentialing.
Demographic Information (pdf)
Complete this form for demographic changes to your practice.
EFT Sign-up
Sign up for electronic fund transfers.
Electronic Solutions
Agreements, Forms and Instructions
Email Registry Sign-up
Join our email registry for the latest news from BCBSNC.
E-Visit Attestation (pdf)
Document your E-Visits for reimbursement.
E-Visit Vendor Change (pdf)
Notify BCBSNC of a change in your secured electronic channel vendor.
IPP Coordination of Benefits Questionnaire (pdf)
Streamline claims processing by completing this for Blue Card members.
Level I Appeals (pdf)
Complete this form to begin the provider appeal process.
Medicare Level I Appeals (pdf)
Use this form to begin the appeals process for Medicare providers.
Provider Enrollment Applications
Sign up to become a BCBSNC network provider.
Provider Refund Return Form (pdf)
Include this form when returning overpayments to BCBSNC.
Provider Toolkits
Access patient assessment and patient educational materials.