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Contracting Applications

Please email ProviderApplicationStatus@bcbsma.com with your inquiries regarding credentialing and provider enrollment. If you need to call us, you can reach us at 1-800-316-BLUE.

Acupuncturist Contracting Application

Behavioral Health Clinical Profile

Behavioral Health Nurse and Physician Assistant Contracting Application

Birth Center Contracting Application

Certified Nurse-Midwife (CNM) Contracting Application

Certified Registered Nurse Anesthetist (CRNA) Contracting Application

Clinical Roster for Provider Application

Contracting Application for Audiologists, Chiropractors, Optometrists, and Licensed Dietitian Nutritionists

Dental Network Application

Licensed Applied Behavioral Analyst

MD Group Contracting Application

NP Contracting Application

Opioid Treatment Program Application

PA Contracting Application

PA-PCP and NP-PCP Contracting Application

Physical Therapist, Occupational Therapist, and Speech Language Pathologist Contracting Application

Podiatrist (DPM) Contracting Application

Provider Application (for Ancillary Institutional Providers)

For help completing this eForm, refer to our Contracting Applications area for Ancillary Institutional Providers.

Psychiatrist, Psychologist, Licensed Alcohol and Drug Counselor (LADC-I), LICSW, LMFT, and LMHC Contracting Application

Provider Central

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