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Non-contracting Durable Medical Equipment


To be considered a "Non-contracting" provider with Blue Cross of Idaho, please submit the following documentation for review. Any missing items may result in the return of incomplete documents or a delay in processing.

  • Provider information sheet
  • W-9
  • Medicare supplier #, PTAN or legacy (DMERC#)
  • Current Idaho DME, Limited Service or Community Pharmacy licensure where required (attach a copy)


NOTE:  Non-contracting providers must meet Blue Cross of Idaho licensing and/or accreditation standards but are not required to sign a contract with Blue Cross of Idaho. Blue Cross of Idaho pays our members directly for covered services provided by non-contracting providers.

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Fax:  208-387-6818


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