Have you made any changes to your key provider information, such as your
mailing address or the name of your practice? If so, please be sure to notify
us.
We value your help in keeping our data files current. Accurate data files allow
us to provide you with important information on billing, claims, changes or
additions to policies, and announcements of administrative processes.
Professional providers
Please notify us of any changes to your information in one of the following
ways:
Complete the Provider Change Form, and fax or mail it to us using the
instructions at the bottom of the form.
Contact your Network Coordinator.
Facility and ancillary providers
You are required to submit any changes to your information in writing. This
request should be sent directly to the Senior Vice President of Contracting and
the Legal Department at the addresses below:
Independence Blue Cross
Attn: Senior Vice President, Contracting and Provider Networks
1901 Market Street, 27th Floor
Philadelphia, PA 19103
Independence Blue Cross
Attn: Legal Department
1901 Market Street, 43rd Floor
Philadelphia, PA 19103
Thirty days' advance notice is required for processing.
Note: This information does not apply to providers contracted with Magellan
Behavioral Health, Inc., an independent company. Please contact your Magellan
Network Coordinator, if you have any questions.