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To make it easier to find the forms you use regularly, we’ve put them all in one place. Some forms can be submitted online, and others can be printed and then faxed or mailed to us. (There are specific instructions on each form.)

Become a Participating Provider 
Use this online form to apply for participation in our network.

Website Registration
To register as a participating provider and access our secure Provider site, you’ll need to request a provider personal identification number (PIN).

  • By taking part in this survey, you’re helping ensure that our members have the most up-to-date information about your practice.

  • Please complete this form to refer a member for case management services.

  • To process claims timely and accurately, it’s important that we know if a patient has any health insurance coverage other than Blue Cross & Blue Shield of Rhode Island. If your patient has other coverage, please complete this form. You can fax it to (401) 459-1137 or mail it to:
    Attn: Provider COB – 00043
    Blue Cross & Blue Shield of Rhode Island

BlueCHiP Checklists

Provider Access / Administrative