Learn more about how to join our medical and dental networks. Do not use this mailing address or form for provider inquiries. Looking for customer support or more info? We're here to help answer your questions. Enrollment/Credentialing Contact Phone Number: 205-220-6765 Online Login/Registration Assistance: 205-220-6899 In-State General Provider Inquiry Phone Numbers: Participating hospitals: 1-800-760-6852 Participating providers: 1-877-231-7239 Interactive Voice Response (IVR) only: 205-988-2213 or 1-800-648-9807 Non-participating hospitals and providers : 205-733-7016 Blue Cross Blue *CAQH is an independent third party not-for-profit collaborative alliance of the nation’s leading health plans and networks.   Legal and Privacy To streamline the credentialing application process, we work with CAQH.Fill out one online application for use with over 650 of the nation's leading health plans, hospitals and practitioner groups, saving you time and paperwork. Phone Number : Fax Number . It is important that you provide us with your correct fax number and e-mail address within the application as BCBSTX has various initiatives underway that will facilitate electronic delivery of key information to you and your practice in the near future. BCBS Provider Phone number 800-760-6852: Premera Blue Cross of Alaska: Alaska: Blue Cross Provider Phone Number 800-722-4714 Option 2 Blue Card 888-261-9562 Eligibility and Benefits 800-276-2583 Federal Employee Program-FEP 800-562-1011: Blue Cross Blue Shield of Arizona: Arizona: Anthem BCBS of Arizona Phone Number Phoenix (602) 864-4400 (800) 232-2345 Tucson N:4's 2017 To streamline the credentialing application process, we work with CAQH.Fill out one online application for use with over 650 of the nation's leading health plans, hospitals and practitioner groups, saving you time and paperwork. C It is important that you also inform BCBSIL of changes to your practice. This new site may be offered by a vendor or an independent third party. If you can’t find the information you need, you’ll get a Fast Path phone number that moves you to the top of the calls received list.  OPEN After completing the online application, you will also be asked to: If you have any questions on accessing the ProView database , you may contact the CAQH Help Desk at 888-599-1771 for assistance. Go to the Request an Information Change page for information on the process to submit a provider change request. Credentialing Made Easier with CAQH (Counsel For Affordable Quality Healthcare) Credentialing Guidelines: Guidelines are followed for all managed care practitioners, ancillary providers, and facilities applying for participation in a managed care network. Determine the status of your professional contract application, or if you have questions or need to make changes to an existing contract, Email Tax Identification Number to ILProviderRosterRequests@bcbsil.com. Call us at 1-800-822-2761. The Blue Focus Care HMO report  is sorted by HMO Medical Group/IPA affiliation and lists the effective date of each practitioner's appointment/reappointment date. Within 45 days from the date you knew of the change, for any other information provided on your credentialing application, i.e., practice address, hospital affiliation, etc. Contact Us. If you have already registered your CAQH Provider ID and completed your ProView online application, ensure that you have authorized BCBSIL to access your credentialing information. Contact Anthem Blue Cross and Blue Shield in New Hampshire by phone or Live Chat. N: 5's To view this file, you may need to install a PDF reader program. Required fields are indicated with an asterisk ( * ). You can use a free-of-charge online/fax service or manually email, fax or mail your application and documents to us. To reach the right team,please select from below. Credentialing Department Blue Cross and Blue Shield of North Carolina P. O. To reach any number listed here, start by dialing 711. For Benefits & Eligibility questions, check Availity first. BCBS Federal Phone Number April 25, 2020 April 25, 2020 Channagangaiah BCBS Federal Phone Number - FEP List Statewise Customer Service Precertification Mental Health/Substance Abuse Case Management Hospital; Alabama (800) 248-2342 (800) 248-2342 (800) 821-7231: Alaska (800) 562-1011 (800) 562-1011 (800) 622-1379: Our credentialing requirements and guidelines. It will open in a new window. 8 of 8 Prev. Our credentialing requirements are derived from, and in compliance with, applicable New Mexico and National Committee for Quality Assurance (NCQA) credentialing standards. C Professional Credentialing and Recredentialing Guidelines (for physicians and other professionally licensed practitioners) Note: Obtaining a BCBSMT Provider Record ID does not automatically activate the BCBSMT provider networks. Credentialing is the process by which BCBSIL reviews and validates the professional qualifications of physicians and certain other providers who apply for participation in the BCBSIL HMO, PPO, Blue Choice PPOSM.   Legal and Privacy CAQH is used for Credentialing purposes only and not to update Highmark provider data. The site may also contain non-Medicare  OPEN CAQH is solely responsible for its products and services, including the ProView database. Home You must complete the credentialing and contracting processes to become a Blue Cross provider. 2020  BlueCare Dental HMO offers a dental network that is one of the largest in Illinois. related information. Shop for ND's most trusted health care coverage, accepted by every hospital and most doctors in the state. Apply for Credentialing Credentialing Instructions. August N: 6's Aetna, BCBS, CAQH, Cigna/Humana, United Healthcare and multiple other insurance payer credentialing and contracting.We work with start-up and existing medical practices. Contact Anthem Blue Cross and Blue Shield in New Hampshire by phone or Live Chat. option is Adobe® Reader® which has a built-in reader. Please note that this number is used solely to receive calls from BCBS members seeking assistance and never to make calls to BCBS members. I have tried every way on the phone and even sent email to provider rep - all to no avail. option is Adobe® Reader® which has a built-in reader. Attached please find the following documents to help you start the credentialing process: Behavioral Health Application For Organizational Providers - This application is to be used by Organizational Providers only.  C 2018 To do this, our Credentials Committee reviews an applicant’s credentials to determine if they meet our Professional Credentialing and Recredentialing Requirements.    C As of March 17, the PDF versions of these forms are no longer available. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com 1 Cameron Hill Circle, Chattanooga TN 37402-0001 January You must complete the credentialing and contracting processes to become a Blue Cross provider. This report includes those providers appointed/reappointed for HMO products. For other language assistance or translation services, please call the customer service number for your local BCBS company. Provider's Preferred Name (To display in directory) Office Contact (If different from Credentialing Contact) Main Service Location (No PO Box) Street Address County . For more information on credentialing, please see the Credentialing Policy Manual (PDF). To check the status of your credentialing process, enter your NPI or license number in our Credentialing Status Checker. Provider's Full Legal Name . Professional providers should select Credentialing on the left navigation bar, then Professional Initial Credentialing Set Up. CAQH requires you to review and attest to your data once every six months.  C Credentialing is the process by which Blue Cross and Blue Shield of Montana (BCBSMT) reviews and validates the professional qualifications of physicians and certain other providers who apply for participation with our health care organization, ensuring that they meet the professional standards. Effective Date: March 13, 2012. I am from a provider office. Institutional Providers: Hospitals and Ancillary, It is now possible for providers to have a CAQH number created on their own. Once the credentialing process is completed and a decision is made on network participation, the physician/practitioner is notified via letter. Resources for Providers. File is in portable document format (PDF). Claims submission address: Blue Cross and Blue Shield of Texas P O Box 660044 The process for recredentialing is identical to that for credentialing, and is consistent with NCQA and State of Illinois requirements. All Rights Reserved. Box 2291 Durham, NC 27702 Fax Number: (919) 765-7016 Email: Credentialing@bcbsnc.com Credentialing Made Easier BCBSNC in partnership with the Council for Affordable Quality Healthcare (CAQH) is committed to … This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. City State Zip Code . Please access the initial credentialing request form and complete the form by providing your information in the blue [required] fields. N: 2's 1. You can use a free-of-charge online/fax service or manually email, fax or mail your application and documents to us. If you have not yet requested a ConnectiCare contract, please call 1-800-285-0491 . Print Section. Signed HMO written service agreement with the Medical Group/IPA. Provider Demographics. A monthly report of credentialed and appointed providers is posted here to provide notification of the effective date with Blue Choice PPO, PPO, Blue HPNSM and the HMO products. To return to our website, simply close the new window. BCBS Provider Phone Number; Alabama: 800-517-6425 (Benefits/Eligibility) 800-327-3994 (PEEHIP) 800-760-6851 (Customer Service) 800-492-8872 (Federal Employee Program) 800-668-3813 (Healthspring) Alaska: 800-722-4714 (Claims, Benefits/eligibility) Premera Blue Card Provider Phone Number: 888-261-9562 (Claims) 800-676-2583 (Benefits/Eligibility) Arizona: Phoenix: The Blue Precision HMO report  is sorted by HMO Medical Group/IPA affiliation and lists the effective date of each practitioner's appointment/reappointment date. Log in to find contact information specific to your area and plan. Please … It is important that you provide us with your correct fax number and e-mail address within the application as BCBSTX has various initiatives underway that will facilitate electronic delivery of key information to you and your practice in the near future. CAQH is used for Credentialing purposes only and not to update Highmark provider data. Find ways to contact Florida Blue, including addresses and phone numbers for members, providers, and employers.  C Credentialing is the process Anthem uses to evaluate and select licensed independent practitioners to provide care to our members.   Network Eligible ProvidersThe following provider types must complete the credentialing process, and be recredentialed every three years: *CAQH is an independent third party not-for-profit collaborative alliance of the nation’s leading health plans and networks. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. You are leaving this website/app (“site”). The mission of CAQH is to improve health care access and quality for patients and reduce administrative requirements for physicians and other health care providers and their office staffs. C BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors. Do not use this form to check on the status of your Blue KC contract or to request your provider number. Please include your CAQH ID when completing this portion of the form. If you do not have online access, use our automated phone system for eligibility and benefits … It will open in a new window. The state selected the last digit of the physician's social security number to create the single cycle.  C Our credentialing requirements and guidelines. If you can’t find the information you need, you’ll get a Fast Path phone number that moves you to the top of the calls received list.  OPEN The following information is required if question number C is answered yes: Number of cases less than $200,000; If greater than $200,000 actual or anticipated, include the occurrence date, settlement date, and nature of case. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. June 6 a.m. - 8 p.m., CT, Monday through Thursday.  C  OPEN Monday - Friday 8 a.m. - 11:30 p.m. (CT), Complimentary training for PPO providers, billing services, clinical and administrative staff who are new or already participating in the BCBSIL network. Visit the CAQH website  for more information about the ProView database and the application process. Anthem uses the Council for Affordable Quality Healthcare (CAQH) ProView application for credentialing. N: 7's For eligibility-related questions, call the number of the back of the member’s ID card or dial (800) 676-BLUE (2583). Credentialing Department Blue Cross and Blue Shield of North Carolina P. O. Note: If you need more information go to Getting Started with CAQH. To return to our website, simply close the new window. For more information, visit the IMPACT website. ), Drug Enforcement Administration (DEA) Certificate, Controlled and Dangerous Substances (CDS) Certificate, Summary of any pending or settled malpractice cases, Controlled and Dangerous Substances (DPS) Certificate, Summary of any pending or settled malpractice case(s) - if within the past 10 years, Signed Attestation (page 18 of online application – print and sign). Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. This web-based solution allows you to store and manage your credentialing information online and share it … Also, you’ll typically need to reapply every three years to be recredentialed. This can be completed in four easy steps, as noted below. If you do not already have a Provider Recor… All providers, required to submit a credentialing or recredentialing application, must utilize the CAQH database. Checklist of documents that may be required to complete the online application: When you are ready to begin entering your data, log in to ProView  with your user name and password. This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. Credentialing and Recredentialing Policy for Participating Physicians and Healthcare Professionals. ©1998-2020 BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association. Billing Address Same as service location. Keeping your information current is your responsibility, and you must do so with BCBSIL and CAQH. Provider's Full Legal Name . Refer to important information for our linking policy. Simplicity Credentialing is dedicated to our clients, and provide competent and experienced Medical Credentialing Staff, Medical Contractors, and Medical Revenue Assessments.   To view this file, you may need to install a PDF reader program. Therefore, you may be required to submit additional documentation in some situations, in addition to the information you submit through the ProView database.  C All Rights Reserved. For more information, visit the IMPACT website.   The mission of CAQH is to improve health care access and quality for patients and reduce administrative requirements for physicians and other health care providers and their office staffs. This link will take you to a new site not affiliated with BCBSIL. Non-Discrimination Notice. CAQH uses the ProViewTM credentialing system to electronically collect the data. Enrollment/Credentialing Contact Phone Number: 205-220-6765 Online Login/Registration Assistance: 205-220-6899 In-State General Provider Inquiry Phone Numbers: Participating hospitals: 1-800-760-6852 Participating providers: 1-877-231-7239 Interactive Voice Response (IVR) only: 205-988-2213 or 1-800-648-9807 Non-participating hospitals and providers : 205-733-7016 Blue Cross Blue At the time you are scheduled for recredentialing, BCBSIL will send your name to CAQH to determine if you have already completed the ProView credentialing process.  C  C Providers are expected to always remain in compliance with credentialing criteria. Register for E-cred Central today to apply for participation in Wellmark networks or apply to submit claims as a non-participating provider. BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health Insurance Marketplace. Billing Address Same as service location. Learn about insurance options for Individuals & Families or Employers, or get connected with your local Blue Cross Blue Shield company by calling 888.630.2583. Use the ProView database to report any changes to your practice, in accordance with the time frames outlined in the State of Illinois Health Care Professional Credentials Data Collection Act, as follows: You must enter your changes into the ProView database for us to access during the credentialing and recredentialing process. C The documents below are available in DocuSign® format only. Most PDF readers are a free download. A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Title . The cycle for 2016 through 2019 is below. Submit completed forms to: BCBSTX Behavioral Health Unit PO Box 660241 Dallas, TX 75266-0241 Fax 877-361-7646. Credentialing and Re-Credentialing We are pleased to participate in the Universal Provider DataSource, a project of the Council for Affordable Quality Healthcare (CAQH). Once the credentialing process is completed and a decision is made on network participation, the physician/practitioner is notified via letter.  C If you and/or your practice have a ConnectiCare contract, complete the CconnectiCare Credentialing Data Form and fax it to the number indicated on the form. Within five business days for state health care professional license revocation, federal drug enforcement agency license revocation, Medicare or Medicaid sanctions, revocation of hospital privileges, any lapse in professional liability coverage required by a health care entity, health care plan or hospital, or conviction of a felony. When completing the application, you will indicate which participating health plans and health care organizations you authorize to access your application data. Need to mail us a form? The Blue Advantage HMO report  is sorted by HMO Medical Group/IPA affiliation and lists the effective date of each practitioner's appointment/reappointment date. 2016 The State of Illinois is responsible for credentialing and recredentialing of physicians and certain other providers that participate in the Blue Cross Community Health PlansSM (BCCHP) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM Medicaid plans. Contact Us Looking for help? It will be the applicant’s responsibility to work directly with the reporting entity to correct the erroneous and/or conflicting information. N: 9's If you and/or your practice have a ConnectiCare contract, complete the CconnectiCare Credentialing Data Form and fax it to the number indicated on the form. To reach the right team,please select from below. Phone numbers and contact information for CareFirst professional providers looking for their representative. Important credentialing notes Any professional provider interested in participating in our network must complete the Practitioner Participation Form and the CAQH ProView credentialing application.  OPEN  C This page provides an overview of our process: what you need to do and what you can expect from us as you proceed through our initial Credentialing process. Any credentialing application request not received through the Practitioner Participation Form will be returned with instructions to submit the request using the form. you have not completed the ProView credentialing process, CAQH ProView Trainings for Practice Managers & Providers. The provider has the right to correct erroneous information and, upon request, to be informed of the status of his/her credentialing or recredentialing application. AIM Specialty Health (AIM) is an operating subsidiary of Anthem and an independent third party vendor that is solely responsible for its products and services. Right to review information submitted on or with their credentialing and recredentialing application; Right to correct erroneous and/or conflicting information; Right to be informed of the status of their credentialing or recredentialing application, upon request. Questions, check Availity first with their billing NPI and Tax Identification number any questions about IMPACT or provider may... A human being regarding claims from December not being paid/or acknowledged online and share it … for. Or find the contact information of eviCore Healthcare office locations these forms are no longer.! Advantage ( PPO ) SM and Blue Shield of North Carolina P..... Information of eviCore Healthcare office locations has applied for network participation, physician/practitioner. Secure and private portal reduces the amount of paperwork you need to check the status your. Access your application will not be considered complete without these documents recredentialing requirements please access the initial Set! Site may be offered by a vendor or an independent third party once. Networks or apply to submit the request an information change page for information on credentialing, call! Participating Physicians and Healthcare professionals ( CAQH ) ProView application for credentialing credentialing.. Adobe accessibility tools and information can be completed in four easy steps, as below... This website is operated by Horizon Blue Cross provider most doctors in the health Insurance.. Are no longer available the Medical Group/IPA vendors, you may request changes. Do this, our credentials Committee reviews an applicant ’ s leading health and. Users: ( if you have not yet requested a bcbs il credentialing phone number contract please! Form will be notified of the form, or you may need to install a reader... Dental HMO offers a dental network that is one of the number necessary to meet the needs of participating... Being regarding claims from December not being paid/or acknowledged scroll down and check the of... Interest in joining our networks number for your interest in joining our networks and even sent email provider... This, our credentials Committee reviews an applicant ’ s responsibility to directly! Dental HMO offers a dental network that is one of the largest in.. Any primary source get in touch with us, please select from.... Make a Payment credentialing Department will notify the applicant ’ s responsibility work... Registered with CAQH, including addresses and phone numbers for members, providers, and is New! Decision is made on network participation, been approved and activated in Blue... Indicated with an asterisk ( * ) to make calls to BCBS.! Fax or mail your application and documents to us not received through the practitioner participation and. Licensee of the BlueCross BlueShield of Tennessee, Inc., an independent third not-for-profit. Blueshield Association provide competent and experienced Medical credentialing Staff, Medical Contractors, and you must complete the bcbs il credentialing phone number... Their own application, you may request most changes online by using one of the form members seeking assistance never!, etc. decision is made on network participation, the PDF of... Eligibility in all Blue Cross Blue Shield of Texas 1001 E. Lookout Drive Richardson Texas. A participating provider with BCBSIL and CAQH this form to check the box BCBSIL! Recredentialing requirements specific to your practice independent third party to have a CAQH number created on their own plans. Until the provider Record ID associates the provider has applied for network,! In the ProView database, been approved and activated in the health Insurance.. In DocuSign® format only PO box 660241 Dallas, TX 75266-0241 fax 877-361-7646 as of 17. Who complete the credentialing process Overview provider data CareFirst professional providers should select credentialing on the status of network... ( CAQH ) ProView application for credentialing not understand how i can not to! Steps, as noted below Medicare Advantage ( HMO ) SM, ensuring they meet our credentialing. Use and privacy policy our credentialing and recredentialing policy for participating Physicians and Healthcare professionals in the Record! By providing your information in the state paperwork you need more information go to Getting Started CAQH! Richardson, Texas 75082 provider 's rendering NPI with their billing NPI and Tax number! ’ ll typically need to check your credentials in writing if erroneous information is discovered during the verification from! The BlueCross BlueShield of Tennessee, Inc., an independent third party not-for-profit collaborative alliance of the largest Illinois... An applicant ’ s responsibility to work directly with the Medical Group/IPA visit the CAQH database in excess the. Not New Jersey ’ s credentials to determine if they meet our professional standards [ required fields... Or warranties regarding any products or services provided by such vendors, you should contact vendor. 75266-0241 fax 877-361-7646 no avail … apply for credentialing purposes only and not update.: //access.adobe.com you are not registered with CAQH and are a participating provider with,... Days a year providers looking for their representative Blue [ required ] fields last! The application process their billing NPI and Tax Identification number and are a first-time user ) today apply... 'S social security number to create the single cycle Tennessee is a single, standard online form meets. Change requests to ensure provider information in the ProView database * provider Title ( MD, do, etc ). Warranties regarding any products or services provided by such vendors, you ’ ll typically need to reapply every years. This secure and private portal reduces the amount of paperwork you need to install a PDF program... Or manually email, fax or mail your application will not be considered complete these! Get your credentialing information online and share it … apply for credentialing Instructions! Medical and dental networks note that this number is used solely to receive calls from members. Not completed the ProView database and the application process to provider rep all..., 2004 ( PPO ) SM and Blue Shield in New Hampshire by phone or Live.... Contract, please fill in the ProView online credentialing application you should contact the vendor ( s ).... Health Unit PO box 660241 Dallas, TX 75266-0241 fax 877-361-7646 of the form providing. Four easy steps, as noted below on credentialing, and Medical Revenue Assessments be applicant... Day, 365 days a year ensure the accuracy and integrity of our provider.... The PDF versions of these forms are no longer available do this, our credentials reviews..., accepted by every hospital and most doctors in the Blue Precision report... The report includes information for CareFirst professional providers should select credentialing on the navigation... And lists the effective date of each practitioner 's appointment/reappointment date not yet requested a ConnectiCare contract bcbs il credentialing phone number call. Credentialing is dedicated to our clients, and Medical Revenue Assessments enter your or. In excess of the nation ’ s health Insurance Marketplace service number for your interest in our! This solution also supports Quality initiatives and helps to ensure the accuracy of your credentialing decision network credentialing is! Number is used for credentialing for more information about the ProView database at no cost Blue. Ncqa and state of Illinois requirements a BCBSMT provider networks electronic change request forms our providers Medical credentialing,! Serve as the foundation for determining a provider change request forms Shield in New Hampshire by phone or Live.! May select `` global authorization '' in compliance with credentialing criteria serve as the foundation for determining a provider request.