Non-Contracting Free Standing Dialysis
Submit the following to Blue Cross of Idaho if you wish to be a non-contracting provider vs. a contracting provider with Blue Cross of Idaho. To be considered a "Non-contracting" provider with Blue Cross of Idaho, the following documentation must be submitted for review. Any missing items may result in the return of incomplete documents or a delay in processing.
- Provider Information Sheet
- Current state license (attach copy)
- Medicare Certification or Joint Commission accreditation or operated by a contracting licensed hospital (attach 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.