Follow these steps to request a contract.
Contract process
Please note that reviewing a contract request does not guarantee that you will be offered a contract.
To have a contract request reviewed, please complete the following steps:
Step 1: Complete a separate Contract Request Form for each type of transportation service your business provides.
For the Provider Specialty on the contract request form, write in one of the following as applicable:
- Special Transportation Services (STS)
- Common Carrier
- Common Carrier - Volunteer Drivers
Step 2: Complete the Provider Information Form
Step 3: Gather and/or complete these forms and information:
- Copy of STS MNDOT Vehicle Certificate for each vehicle (only required for STS)
- Copy of certificate of registration with the Office of the Secretary of State of Minnesota
- Copy of Driver Roster (XLS) (not required for volunteer drivers)
- Proof your employees and drivers have completed and passed the Net Study background check
- Proof of insurance – Send a copy of the Acord Certificate of Liability Insurance (not required for volunteer drivers)
- Blue Cross requires $1 million in auto liability in the combine single limit (each accident) auto insurance liability coverage.
- Name “Blue Cross Blue Shield of Minnesota” as a certificate holder on the document.
Step 4: Save and email the form(s) to provider.enrollment.and.credentialing@bluecrossmn.com
or mail to:
Blue Cross and Blue Shield of Minnesota
Provider - PDO
PO Box 982809
El Paso, TX 79998-2809
The process for approved Transportation contract requests typically takes 60 days to complete.
Contract process
Please note that reviewing a contract request does not guarantee that you will be offered a contract.
To have a contract request reviewed, please complete the following steps:
Step 1: Complete a Contract Request Form
For the Provider Specialty, write in “Interpreter”.
Step 2: Complete the Interpreter Agency Information Update Form.
Step 3: Save and email the form(s) to provider.enrollment.and.credentialing@bluecrossmn.com
or mail to:
Blue Cross and Blue Shield of Minnesota
Provider - PDO
PO Box 982809
El Paso, TX 79998-2809
The process for approved Interpreter contract requests typically takes 60 days to complete.
Contract process
Please note that reviewing a contract request does not guarantee that you will be offered a contract.
To have a contract request reviewed, please complete the following steps:
Step 1: Complete a Contract Request Form
For the Provider Specialty, write in “Personal Care Agency (PCA)”.
Step 2: Complete a PCA Information Form
Step 3: Gather the following proof of insurance:
- Commercial General Liability $1M per occurrence / $3M in aggregate
- Professional Liability coverage of $1M / $3M in aggregate
- Worker’s compensation insurance of $500,000
- Fidelity Bond of $20,000
- Surety Bond of $50,000
Name “Blue Cross Blue Shield of Minnesota” as a certificate holder on the document.
Step 4: Complete an Individual PCA Data Sheet
Step 5: Save and email the form(s) to provider.enrollment.and.credentialing@bluecrossmn.com
or mail to:
Blue Cross and Blue Shield of Minnesota
Provider - PDO
PO Box 982809
El Paso, TX 79998-2809
The process for approved PCA contract requests typically takes 60 days to complete.
Contract process
Please note that reviewing a contract request does not guarantee that you will be offered a contract.
To have a contract application reviewed, please complete the following steps:
Step 1: Complete a Contract Request Form
- For Provider Specialty, write in “Housing Consultation/Care Coordination” or “Housing Transition/Sustaining”
- If you are providing both services, two separate contract requests must be submitted: One for Housing Consultation and one for Housing Transition/Sustaining
Step 2: Save and email the form along with a copy of your DHS Enrollment Letter to provider.enrollment.and.credentialing@bluecrossmn.com
or mail to:
Blue Cross and Blue Shield of Minnesota
Provider - PDO
PO Box 982809
El Paso, TX 79998-2809
The process for approved Housing Stabilization Services contract requests typically takes 60 days to complete.