1. Blue cross blue shield of Arizona
ON LINE SUBMISSION TOOL

2. Chose One Option

3. Select

4. Please begin your application

5. Please click on Find a provider here
Click on the blue words

7. Enter doctor, hospital or specialty in the box
Select your county
Enter doctor, hospital or specialty in the box
click

8. Continue with enrollment process
to Step 4
Please click on the appropriate circle and complete your broker data here

9. Once complete, you will be given a confirmation number
Step 5 is reviewing your applicants information
If you find you need to correct information click on the orange Edit button
If all is correct; please click on the orange Submit button
Once complete, you will be given a confirmation number
Congratulations to you for using the electronic application process!