How to make updates
If your question is not answered here, call provider service at (651) 662-5200 or 1-800-262-0820.
Add, remove or update electronic funds transfer (EFT)
Please note: All entities that share the same NPI must have the same EFT information.
The form to request EFT (Electronic Funds Transfer) changes is only accessible on the Availity Essentials portal.
To access it, log in or register at Availity.com/Essentials and see the Resources tab in Blue Cross Blue Shield Minnesota Payer Spaces. The form is called "NEW-Electronic Funds Transfer (EFT) Form." User must have access to the Minnesota Region on Availity Essentials in order to use the EFT form.
For more details, please see QuickPoint QP112-20 Changes to Electronic Funds Transfer Processes
Please allow up to 90 days for completion of this process.
Add a location as result of a merger/buyout
Complete the Tax ID Change form.
Email the form to: Provider.Data@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 90 days for completion of this process.
Add a new/additional location
Note: If you are not already contracted with Blue Cross Blue Shield of Minnesota under the Tax ID for the new location and are interested in joining our network, visit the Join our Network page.
If you are a behavioral health or substance use disorder provider: Complete the Behavioral Health Contract Request form. Under “Type of Request” check the box for “New location, NPI, or specialty (choose if the Tax ID for the group or location has a contract with Blue Cross).”
If you are a healthcare provider: complete a Contract Request form. Under “Type of Request” check the box for “New location, NPI, or specialty (choose if the Tax ID for the group or location has a contract with Blue Cross).”
How many practitioners do you have?
Practitioners must be submitted with the Contract Request for specialties that require individual practitioners for billing. Forms sent in separate emails will not be processed.
Five or fewer practitioners: When requesting to add new location, submit the MN Uniform Practitioner Change form for each practitioner.
Six or more practitioners: If six or more need to be affiliated with the new location or contract, fill out the Multiple practitioner add sheet (xlsx).
Where to send your forms:
Email the forms to: provider.enrollment.and.credentialing@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 90 days for the completion of this process.
Add an additional NPI/UMPI to your practice/facility
Note: If you are not already contracted with Blue Cross Blue Shield of Minnesota under the Tax ID for the new location and are interested in joining our network, visit the Join our Network page
If requesting to change the existing contracted NPI to a new NPI/UMPI, see "Update NPI" lower on this page.
If you are a behavioral health or substance use disorder provider: Complete the Behavioral Health Contract Request form. Under “Type of Request” check the box for “New location, NPI, or specialty (choose if the Tax ID for the group or location has a contract with Blue Cross).”
If you are a healthcare provider: Complete a Contract Request form. Under “Type of Request” check the box for “New location, NPI, or specialty (choose if the Tax ID for the group or location has a contract with Blue Cross).”
How many practitioners do you have?
Practitioners must be submitted with the Contract Request for specialties that require individual practitioners for billing. Forms sent in separate emails will not be processed.
Five or fewer practitioners: When requesting to add new location, submit the MN Uniform Practitioner Change form for each practitioner.
Six or more practitioners: If six or more need to be affiliated with the new location or contract, fill out the Multiple practitioner add sheet (xlsx).
Where to send your forms:
Email the forms to: provider.enrollment.and.credentialing@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 90 days for the completion of this process.
Add a new/additional specialty to your existing contracted location
Note: If you are not already contracted with Blue Cross Blue Shield of Minnesota under the Tax ID for the new location and are interested in joining our network, visit the Join our Network page.
If you are a behavioral health or substance use disorder provider: Complete the Behavioral Health Contract Request form. Under “Type of Request” check the box for “New location, NPI, or specialty (choose if the Tax ID for the group or location has a contract with Blue Cross).”
If you are a healthcare provider: Complete a Contract Request form. Under “Type of Request” check the box for “New location, NPI, or specialty (choose if the Tax ID for the group or location has a contract with Blue Cross).”
How many practitioners do you have?
Practitioners must be submitted with the Contract Request for specialties that require individual practitioners for billing. Forms sent in separate emails will not be processed.
Five or fewer practitioners: When requesting to add new location, submit the MN Uniform Practitioner Change form for each practitioner.
Six or more practitioners: If six or more need to be affiliated with the new location or contract, fill out the Multiple practitioner add sheet (xlsx).
Where to send your forms:
Email the forms to: provider.enrollment.and.credentialing@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 90 days for the completion of this process.
Add a practitioner to your group
How many practitioners do you have?
Five or fewer practitioners: When requesting a contract or new location, please submit the MN Uniform Practitioner Change form for each practitioner.
Six or more practitioners: If six or more need to be affiliated with the new location or contract, please fill out the Multiple practitioner add sheet (xlsx).
Where to send your forms?
Email the form to: provider.enrollment.and.credentialing@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 45 days for completion of this process.
Add or remove an individual PCA or PCA supervisor to my group
Complete an Individual PCA Data Sheet (Excel).
Email the form to: Provider.Data@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 45 days for completion of this process.
Change tax ID
Complete the Tax ID Change form.
Email the form to: Provider.Data@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 90 days for completion of this process.
Directory suppress a practitioner or remove a directory suppression
Complete and submit the MN Uniform Practitioner Change form.
Email the form to: provider.enrollment.and.credentialing@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 45 days for completion of this process.
Non-participating setup request form
The Non-participating Setup Request form is only to be used when requesting to be set up as a non-participating provider. This form is not to be used by contracted providers who are looking to become non participating. Please contact 651-662-5200 or 1-800-262-0820 if you have any questions.
Email the form to: Provider.Data@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 90 days for completion of this process.
Opt back in to Medicare
Please complete this form when a practitioner opts back into Medicare.
Email the form to: Provider.Data@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 90 days for completion of this process.
Remove a practitioner from your group
Complete and submit the MN Uniform Practitioner Change form.
Email the form to: provider.enrollment.and.credentialing@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Report a clinic name change
For clinics changing their name, please fill out the Provider Demographic Change form
Email the form to: Provider.Data@bluecrossmn.com
Or mail to:
Provider Data Operations
P.O. Box 982809
El Paso, TX 79998-2809
Please allow up to 45 days for completion of this process.
Report a clinic or location closing
Complete a Provider Clinic/Branch Closure form. To ensure proper transition of care for impacted members, please provide at least a 60-day notice of a planned closure.
Email the form to: Provider.Data@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please note that if your clinic is changing your tax ID as a result of a merger/buyout, please see the answer to the question: “Add a location as a result of a merger/buyout.”
Report a practitioner name change
Complete and submit the MN Uniform Practitioner Change form.
Email the form to: provider.enrollment.and.credentialing@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Report a practitioner's race or ethnicity
Complete and submit the MN Uniform Practitioner Change form.
Email the form to: provider.enrollment.and.credentialing@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Update address or phone number
Please complete the Provider Demographic Change form.
Email the form to: Provider.Data@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 45 days for completion of the change process.
Update NPI
An updated NPI can be submitted by completing a Provider Demographic Change form for any contracting provider/facility or practitioner already set up on our system. (For new contracting providers/facilities or practitioners, the NPI should be entered on the initial request forms.)
Email the form to: Provider.Data@bluecrossmn.com
Or mail to:
Provider Data Operations
PO Box 982809
El Paso, TX 79998-2809
Please allow up to 90 days for completion of this process.