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Thank you for registering with Blue Cross of Idaho

If you are an Individual or Family Member, please register here.

If you are a Medicare Advantage or Medicare Supplement member, please register here.

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
  • W-9
  • 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.

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Fax:  208-387-6818