Provider Login Assignment Form
You will have the ability to access Member Eligibility, Claims and Authorizations online with the login and password provided upon completion of the form. Understand that HIPAA requirements and guidelines should be adhered to and any discovery of mishap will be reported.
Bulletins & Newsletters, Toolkit and Toolkit Updates, Companion Guides (Effective January 1, 2020), Forms, Reports and Templates (Fax Cover Sheets, Authorization Request Forms), Contact Information and Phone Guide, Presentations.
All content included on this site, such as text, graphics, logos, button icons, images, data compilations, and software, is the property of Blue Shield Promise Health Plan ("Blue Shield Promise") or its content suppliers and protected by United States and international copyright laws. The compilation of all content on this site is the exclusive property of Blue Shield Promise Health Plan and protected by U.S. and international copyright laws. All software used on this site is the property of Blue Shield Promise Health Plan or its software suppliers and protected by United States and international copyright laws.
Blue Shield Promise Health Plan website and other Blue Shield Promise Health Plan website graphics, logos, page headers, button icons, scripts, and service names are trademarks of Blue Shield Promise Health Plan. Blue Shield Promise Health Plan´s trademarks may not be used in connection with any product or service that is not Blue Shield Promise Health Plan´s, in any manner that is likely to cause confusion among customers, or in any manner that disparages or discredits Blue Shield Promise Health Plan All other trademarks not owned by Blue Shield Promise Health Plan that appear on this site are the property of their respective owners, who may or may not be affiliated with, connected to, or sponsored by Blue Shield Promise Health Plan.
License and Site Access
Blue Shield Promise Health Plan grants you a limited license to access and make personal use of this site and not to download (other than page caching) or modify it, or any portion of it, except with express written consent of Blue Shield Promise Health Plan. This license does not include any resale or commercial use of this site or its contents; any collection and use of any product listings, descriptions, any derivative use of this site or its contents; any downloading or copying of account information for the benefit of another; or any use of data mining, robots, or similar data gathering and extraction tools. This site or any portion of this site may not be reproduced, duplicated, copied, sold, resold, visited, or otherwise exploited for any commercial purpose without express consent of Blue Shield Promise Health Plan. You may not frame or utilize framing techniques to enclose any trademark, logo, or other proprietary information (including images, text, page layout, or form) of Blue Shield Promise Health Plan without express written consent of Blue Shield Promise Health Plan. You may not use any meta-tags or any other hidden text utilizing Blue Shield Promise Health Plan´s name or trademarks without the express written consent of Blue Shield Promise Health Plan. Any unauthorized use terminates the permission or license granted by Blue Shield Promise Health Plan. You are granted a limited, revocable, and nonexclusive right to create a hyperlink to the home page of Blue Shield Promise Health Plan website so long as the link does not portray Blue Shield Promise Health Plan or its affiliates in a false, misleading, derogatory, or otherwise offensive matter. You may not use any logo or other proprietary graphic or trademark as part of the link without express written permission.
DISCLAIMER OF WARRANTIES AND LIMITATION OF LIABILITY
THE SITE IS PROVIDED BY BLUE SHIELD PROMISE HEALTH PLAN WEBSITE ON AN "AS IS" AND "AS AVAILABLE" BASIS. BLUE SHIELD PROMISE HEALTH PLAN MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, AS TO THE OPERATION OF THIS SITE AND THE INFORMATION, CONTENT, MATERIALS, OR PRODUCTS INCLUDED ON THIS SITE. YOU EXPRESSLY AGREE THAT YOUR USE OF THIS SITE IS AT YOUR SOLE RISK. THE INFORMATION CONTAINED IN THIS WEB SITE IS GENERAL IN NATURE AND NOT INTENDED TO PROVIDE PROFESSIONAL HEALTH CARE OR ADVICE. IF YOU HAVE A SPECIFIC HEALTH RELATED QUESTION, PLEASE SEE A DOCTOR OR LICENSED HEALTH CARE PROVIDER. TO THE FULL EXTENT PERMISSIBLE BY APPLICABLE LAW, Blue Shield Promise Health Plan website DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. BLUE SHIELD PROMISE HEALTH PLAN DOES NOT WARRANT THAT THIS SITE, ITS SERVERS, OR E-MAIL SENT FROM HERE ARE FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS. BLUE SHIELD PROMISE HEALTH PLAN WILL NOT BE LIABLE FOR ANY DAMAGES OF ANY KIND ARISING FROM THE USE OF THIS SITE, INCLUDING, BUT NOT LIMITED TO DIRECT, INDIRECT, INCIDENTAL, PUNITIVE, AND CONSEQUENTIAL DAMAGES. ALL LINKS TO OTHER WEB SITES ARE SOLELY FOR YOUR CONVENIENCE IN OBTAINING RELATED INFORMATION. SUCH INCLUSION DOES NOT CONSTITUTE OR IMPLY A RECOMMENDATION OR ENDORSEMENT BY BLUE SHIELD PROMISE HEALTH PLAN. BLUE SHIELD PROMISE HEALTH PLAN DOES NOT CONTROL THE CONTENTS OF THESE WEB SITES AND DOES NOT GUARANTEE THE ACCURACY OR COMPLETENESWS OF ANY SUCH INFORMATION. THESE WEB SITES MAY CONTAIN MATERIAL WHICH MAY BE OFFENSIVE TO YOU. YOU ACCESS THESE WEB SITES AT YOUR OWN RISK. CERTAIN STATE LAWS DO NOT ALLOW LIMITATIONS ON IMPLIED WARRANTIES OR THE EXCLUSION OR LIMITATION OF CERTAIN DAMAGES. IF THESE LAWS APPLY TO YOU, SOME OR ALL OF THE ABOVE DISCLAIMER, EXCLUSIONS, OR LIMITATION MAY NOT APPLY TO YOU, AND YOU MIGHT HAVE ADDITIONAL RIGHTS.
By visiting Blue Shield Promise Health Plan website, you agree that the laws of the State of California, without regard to principles of conflict of laws, will govern these Conditions of Use and any dispute of any sort that might arise between you and Blue Shield Promise Health Plan.
SITE POLICIES, MODIFICATION, AND SEVERABILITY
Please review our other policies posted on this site. These policies also govern your visit to Blue Shield Promise Health Plan website. We reserve the right to make changes to our site, policies, and these Conditions of Use at any time without notice. If any of these conditions shall be deemed invalid, void, or for any reason unenforceable, that condition shall be deemed severable and shall not affect the validity and enforceability of any remaining condition.
When you access our web site, we may automatically count your access within our statistics on how many persons accessed a particular topic in our web site. We will not request and you do not have to provide personal information to access general topics on this web site. If you send us an email, we will use your email address to reply to you. We may also use it to send you, from time to time, informational or educational material. If you do not want us to send such material to you, you can inform us by email, regular mail or phone. We will not collect personal information about you through this web site unless you provide us that information voluntarily. If you do so, we wil1 not rent, sell, license or transmit that information outside of Blue Shield Promise Health Plan and those affiliated companies providing services for us to conduct our health care management operations. In all cases, we will fully comply with federal and state laws and regulations governing confidentiality of health and personal information. To access certain sections of this web site, we may require authorized users to use a unique identifier.
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Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association