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Pacific Blue Cross

Medical Supplies & Equipment Provider

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New Medical Supplies & Equipment Provider


  Email Address Guidelines

  • Since a Primary Administrator has full access to view and change banking information, we discourage using a multi-user or communal email address, e.g. admin@ProviderClinic.ca.
  • Pacific Blue Cross Assumes or takes no responsibility for any consequences, directly or indirectly, that may arise from registering with a clinic/communal email address
  • Emails must be unique in PROVIDERnet

Role of PROVIDERnet Primary Administrator:

  • The Primary Administrator is usually the business owner or director
  • Self-serve access to set-up, change, view banking information for direct deposit for the business owner
  • Can view pre-authorizations, submit eligible claims, electronic statements

Role of PROVIDERnet Standard Administrator:

  • Can view pre-authorizations, submit eligible claims, view claims history
This is your PBC-assigned ID
License Information
Upload a copy (.pdf, .png, .gif, .jpg) of your business operating license. Max 1.5MB.
Business Information
Used for PROVIDERnet Access as Primary Administrator
Updated Business Information
Types of Medical Supplies and Equipment provided
Additional Comments
Signature

Person filling in this application