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Blue Shield of California fax number

(844) 742-1153

Continuity of Care Team

Used for: Filing/processing Continuity of Care request via a faxed Continuity of Care Application

Fax destination details

Department
Continuity of Care Team
Purpose
Filing/processing Continuity of Care request via a faxed Continuity of Care Application
Form
Continuity of Care Application (C13095-MEM-FF-XLB-SP-0126-REF3354350) — Continuity of Care Application
Address
Blue Shield of California, Attn: Continuity of Care Team, P.O. Box 272580, Chico, CA 95927-2580

Before you send

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  • Check the organization website or call its main line for the current fax number.
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Complete Part 1 (eligibility); Part 2 (provider and treatments); Part 3 (attach progress notes and treatment plan); Part 4 (certification/authorization). Fax the completed form to (844) 742-1153 or mail to Blue Shield of California, Attn: Continuity of Care Team, P.O. Box 272580, Chico, CA 95927-2580. Customer Service numbers are on page 3 of the form.

Official form instructions are published as a downloadable file on the organization's website.

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