We partner with the providers who care for our members

Blue KC is committed to the health of our members. That starts with partnering with dedicated healthcare providers like you. We value and appreciate you as your partner in providing quality healthcare. Here, you’ll find a variety of provider-specific information including resources, policies and procedures, claims support and much more.

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Make sure your information is correct

Blue KC in-network providers are required to verify demographic data every 90 days and attest to your information through your CAQH portal.

CACQ provider data portal

Provider resources

Credentialing status

Provide initial credentialing status for new providers.

Prior authorization

Determine what needs a prior authorization and how to submit the request.

Find patient care

Help patients find medical care in their specific network.

Provider resources

Quick tips and resources, including communications, to assist you as you care for our members.

Claims

Learn how to submit and check claim status.

Prescription drug list

Review the drug formulary, as well as the policies and forms for pharmacy.

Provider policies

Understand Blue KC medical policies, payment policies, and BlueCard policies.

Provider portal 101

Learn about our portal features and how to make the most of your account.

Find a form

Access forms for change of address, EDI, utilization management, missing checks and more. Make sure you are using the latest web browser version in order to submit electronic forms. The online form submission is not available to iOS devices. If you are using an incompatible device, please complete your form using the (PDF) link option where noted.

Member complaint/grievance form

Member authorization form

Out-of-area members: medical necessity appeals form

Claims inquiry form (PDF)

FEP member reimbursement claim form

Itemized bill submission form

Medical/dental claim form

Pharmacy claim form (PDF)

BlueCard worldwide international claim form

Provider electronic funds transfer application form (EFT)

Little Stars® physician referral form

Submit or review a prior authorization

Federal employee advance medical review forms

Provider out of network form

Concurrent review for post-acute form

Inpatient reviews

Looking for another form?

Provider portal
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Stay up to date with the latest information for healthcare professionals. You can join the BlueSpeak email distribution list by sending a request to BlueSpeak@BlueKC.com.

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Provider news

Get the latest news regarding topics and issues relevant to healthcare providers.

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