www.bcbsprovidersettlement.com Open in urlscan Pro
45.60.32.174  Public Scan

Form analysis
2 forms found in the DOM

POST /

<form id="fmLoginOptions" method="post" action="/">
  <h4><button type="submit" aria-label="Close" class="btn-custom-close" formaction="/?handler=LoginOptionsClose"><span class="bi bi-x-square-fill"></span></button></h4>
  <input name="__RequestVerificationToken" type="hidden" value="CfDJ8K-6hGB14jpOjsXKdiz1-01N9A22M7he6IE7_07ga7guzhyOfwhCCLPCFrJryaFUsZ_nE4jgyzq_A5gfBHJrg4Rj62ukJ76Dip8HOEHmr6K8ZYapFbZVBkvGkvDew7P1zWGoACakS8uRLZiegE7y1SY">
</form>

POST /

<form id="fmLogin" method="post" action="/"><button type="submit" id="btnLogin" class="btn btn-lg btn-success  default" formaction="/?handler=Login" style="position: absolute; left: -999px; top: -999px; height: 0px; width: 0px;">Log In</button>
  <div class="row">
    <div class="col-md-12">
      <p class="public-page-instructions login-text">Enter your BCBS Provider Settlement Login ID and Password. If you do not have access credentials, click the Request Access button and follow the on-screen instructions to create your Maui Portal
        account.</p>
    </div>
    <div class="col-md-12 mb-3">
      <label for="txt_LoginID" class="form-label public-form-label required-label-before" card-instructions-text="">Username</label>
      <button type="submit" id="btnForgotLoginID" tabindex="-1" class="btn btn-link btn-custom-link float-end py-0" formaction="/?handler=ForgotLoginIDFromLogin">Forgot Username?</button>
      <input type="text" id="txt_LoginID" class="form-control form-control-lg" placeholder="" data-val="true" data-val-required="Login ID is required." name="txt_LoginID" value="">
      <span class="text-danger text-center field-validation-valid" data-valmsg-for="Username" data-valmsg-replace="true"></span>
      <span class="text-danger field-validation-valid" data-valmsg-for="txt_LoginID" data-valmsg-replace="true"></span>
    </div>
    <div class="col-md-12 mb-3">
      <label for="txt_Password" class="form-label public-form-label required-label-before" card-instructions-text="">Password</label>
      <button type="submit" id="btnForgotPassword" tabindex="-1" class="btn btn-link btn-custom-link float-end py-0" formaction="/?handler=ForgotPasswordFromLogin">Forgot Password?</button>
      <input type="password" id="txt_Password" class="form-control form-control-lg" placeholder="" data-val="true" data-val-required="Password is required." name="txt_Password">
      <span class="text-danger text-center field-validation-valid" data-valmsg-for="Password" data-valmsg-replace="true"></span>
      <span class="text-danger field-validation-valid" data-valmsg-for="txt_Password" data-valmsg-replace="true"></span>
    </div>
    <div class="col-md-12 mb-3 d-grid">
      <button type="submit" id="btnLogin" class="btn btn-lg btn-success  default" formaction="/?handler=Login">Log In</button>
    </div>
    <div class="col-md-12 mb-3 d-grid">
      <button type="submit" id="btnRequestAccess" class="btn btn-lg  btn-light button-custom" formaction="/?handler=RequestAccess">Request Access</button>
    </div>
  </div>
  <input name="__RequestVerificationToken" type="hidden" value="CfDJ8K-6hGB14jpOjsXKdiz1-01N9A22M7he6IE7_07ga7guzhyOfwhCCLPCFrJryaFUsZ_nE4jgyzq_A5gfBHJrg4Rj62ukJ76Dip8HOEHmr6K8ZYapFbZVBkvGkvDew7P1zWGoACakS8uRLZiegE7y1SY">
</form>

Text Content

Blue Cross Blue Shield Provider Settlement Website
 * Home

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COMING SOON

The BCBS Provider Settlement Website will open later this year. Check back in
periodically to monitor our progress. For news and updates regarding the
settlement visit www.WhatleyKallas.com/BCBS-Settlement.



Log In Options



Log In

Enter your BCBS Provider Settlement Login ID and Password. If you do not have
access credentials, click the Request Access button and follow the on-screen
instructions to create your Maui Portal account.

Username Forgot Username?
Password Forgot Password?
Log In
Request Access
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