Directions for accessing the Blue Cross Blue Shield of ...
Directions for accessing the Blue Cross Blue Shield of Michigan (BCBSM) enrollment documents for the Traditional and TRUST PPO Networks
New Providers (new practitioners not currently registered with BCBSM or BCN)
1. Go to and click the hyperlink for “Provider area”.
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2. Choose “Enrollment and Changes” under Provider Services on the left side of the page.
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3. Choose “Physicians and Professionals” and click NEXT.
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4. Choose “Enroll a new provider” and click NEXT.
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5. Choose “Licensed Master Social Worker” under Behavioral Health and click NEXT.
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6. Answer the question “Is the Licensed Master Social Worker an incorporated individual?”
a. If you choose YES, click NEXT.
b. If you choose NO, a second question is shown. Please answer the question “Do you wish to add the new Licensed Master Social Worker to an existing Professional Group?”
i. Click NEXT when you have answered this question.
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7. Click “New Mental Health Practitioner Enrollment Form”. This form will open in a new tab or window. All new providers must complete and submit this enrollment form.
a. If you are adding a Licensed Master Social Worker to an existing Professional Group, you must also complete and submit the “Group Change Form” and “Group Practice Agency Authorization and Acknowledgement”.
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8. Click on “[ + ] BCBSM agreements and signature documents”. This category will expand and several documents will be listed.
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9. The last four documents are the Participation Agreements and Signature Documents for the Traditional network (first two documents) and TRUST PPO network (last two documents). Any document you click will be opened in a new tab or window.
a. The signature document for all networks you are requesting to enroll in must be completed and submitted along with the forms completed in Step 6.
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If you have any questions regarding enrollment, requirements, or BCBSM policy, please contact Provider Enrollment at 1-800-822-2761 or providerenroll@
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