Follow the steps below to register as an out-of-network practitioner with BCBS of North Carolina:
You will need:
W-9 Form (only for solo practitioners not part of a group)
Scroll down and select “Non-participating enrollment request status"
Complete the non-participating enrollment form and submit
Email the completed W-9 form to ProvRequests@bcbsnc.com
Download the W-9 Form and complete it in its entirety.
Email completed W-9 Form to ProvRequests@bcbsnc.com
Scroll down and select “I want to remain out-of-network"
Complete the non-participating enrollment form and submit.