Approval Email received from : TXFPS@bcbstx.com  Sub : RE: Enrollment Query - Best Health Urgent Care & Clinic - BCBS Case 02900124  Hello, Ahmed:  We already have professional record 00ND43 setup for your group effective 4/21/2019. If you are wanting a Facility/Ancillary record setup as well please send in the completed attached Request Form. Attached is the form to apply for a facility/ancillary record with BCBSTX.  It can be faxed or emailed back with a signed W-9 and a copy of the facility's license to the contact information on the form.  Once your request is completed, any out-of-network claims rejected before this Provider ID was established can be resubmitted, and you can set up electronic billing by contacting Availity at (800) 282-4548.  If you wish to apply for network participation, you can contact your network representative once the record has been created to begin that process.  If you are applying for a provider record as Long Term Support Services (LTSS) provided by the state, a different form is required.  Please call (855) 212-1615 or email TexasMedicaidNetworkDepartment@bcbstx.com for that information.  If you are applying for a provider record as a Pharmacy, a different department is responsible for establishing those records.  Please contact Pharmacy Programs at (888) 277-5510.  Thank you,     Facility Provider Services  BlueCross BlueShield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company  Fax: 972-766-7315 | Email: TXFPS@bcbstx.com  Eff date is 4/21/2019   Please see the attachment.