Learn about Blue Cross Blue Shield culture, salaries, benefits, work-life balance, management, job security, and more. Federal Employee Program® (FEP) members should visit the FEP website. Credentialing committee decision. 800-337-2204. Blue Cross Blue Shield of Michigan doesn't directly handle credentialing for providers. Visit Premera Facebook page Visit Premera Twitter page Visit Premera Youtube page Visit Premera LinkedIn page Box 64560 St. Paul, MN 55164-0560. Update on Credentialing and Recredentialing Process. Outside the United States. Credentialing and recredentialing . Blue Cross Blue Shield of Wyoming has received Health Plan with Health Insurance Marketplace Accreditation from URAC. Box 1798 Jacksonville, FL 32231-0014. You will receive the credentialing application from BCBSWY via email. Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. ... ©1996-Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. The credentialing process requires a new Practitioner/Provider to submit an application. In the United States, Puerto Rico and U.S. Virgin Islands. M. members covered. Health insurance is offered by Blue Cross and Blue Shield of Florida, Inc., DBA Florida Blue. $ 382. The Premera Blue Cross credentialing program has won high ratings from the National Committee for Quality Assurance (NCQA) and has been continuously accredited since 1996. Internet Privacy Statement  |  Terms of Use. Credentialing Policy Manual. ©2020 Horizon Blue Cross Blue Shield of New Jersey Three Penn Plaza East, Newark, New Jersey 07105. Outside the United States. ... You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Generally, the pronouns "our," "we" and "us" used throughout this website are intended to refer collectively to Blue Cross and Blue Shield of Florida, Inc. and its subsidiaries and affiliates. This program allows you to expedite your credentialing experience to complete the credentialing process with fewer steps. It seems you're using a browser version we no longer support. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Dental, Life and Disability are offered by Florida Combined Life Insurance Company, Inc., DBA Florida Combined Life. Enrollment in Florida Blue or Florida Blue HMO depends on contract renewal. Blue Cross and Blue Shield of North Carolina (Blue Cross NC), working with the Council for Affordable Quality Healthcare (CAQH), is committed to streamlining the administrative process for physicians and other health care providers. Language assistance available:Español, Kreyol Ayisien, Tiếng Việt, Português, 中文, français, Tagalog, русский, العربية, italiano, Deutsche , 한국어, Polskie, Gujarati, ไทย, 日本語, فارسی. ® Registered Marks of Blue Cross Blue Shield of Massachusetts. Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. © 2018 Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue. Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. However, where appropriate, the content may identify a particular company; … There you'll receive the NPI number you need for enrollment. Claims. M. members covered. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. Blue Cross and Blue Shield of Texas Attn: Provider Administration P.O. Credentialing Q & As. Care Coordination. Providers will receive notification when the Credentialing Committee review has been completed. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. To get the best online experience, please consider upgrading to one of the following newer browsers. Requirements for Blue Shield of California network providers. Dental, Life and Disability are offered by Florida Combined Life Insurance Company, Inc., an affiliate of Blue Cross and Blue Shield of Florida. Please read the application thoroughly and … Blue Cross has more than … Claims. Box 45190 Jacksonville, FL 32232-5190. www.floridablue.com. Please be sure your application is correct and complete so we can process it promptly. Providers who use CAQH ProView ® to self-report credentialing information eliminate the need to complete multiple, lengthy paper forms. Outside the United States. Call Network Management and Credentialing Services at 1-800-316-BLUE (2583). Healthcare professionals who sign a direct contract with Blue Shield to join our network will be subject to credentialing by Blue Shield. About credentialing. The Council for Affordable Quality Healthcare (CAQH), an alliance of the nation’s leading health plans and networks working to simplify healthcare administration, announced today that Blue Cross and Blue Shield of Florida (BCBSF) will now use the CAQH Universal Credentialing DataSource® (UCD) service to streamline credentialing for its 36,000 participating providers. Visit Member Services . However, where appropriate, the content may identify a particular company; there, any pronouns refer to that specific entity. 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 streamlining the administrative Working with The National Center for Accessible Media at WGBH (NCAM), we're striving for the highest level of accessibility for people with disabilities. In order to complete the process, visit CAQH.org. However, where appropriate, the content may identify a particular company; there, any pronouns refer to that specific entity. Blue Cross and Blue Shield of Nebraska is an independent licensee of the Blue Cross and Blue Shield Association. Precertification. In addition, the national Blue Cross Blue Shield Association has published the program as an example of a successful credentialing program. invested in community health initiatives . on behalf of Blue Cross Blue Shield of Florida to obtain any information that is missing or incomplete on your application. Dental, Life and Disability are offered by Florida Combined Life Insurance Company, Inc., DBA Florida Combined Life, an affiliate of Blue Cross and Blue Shield of Florida, Inc. When you apply for network participation, BCBSTX will add you to its roster with CAQH. Box 64560 St. Paul, MN 55164-0560. next Hospitals and Facilities . The Credentialing Delegation Program is an extension of Blue Cross and Blue Shield of Louisiana’s URAC-accredited credentialing program. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. The Blue Cross Blue Shield (BCBS) system is made up of 36 independent and locally operated companies. Providers who are contracted with Anthem Blue Cross and Blue Shield to serve Hoosier Healthwise, Healthy Indiana Plan and Hoosier Care Connect through an accountable care organization (ACO), participating medical group (PMG) or Independent Physician Association (IPA) are to follow guidelines and practices of the group. Connect with Us. The following steps can be used as a guideline: Register with CAQH ProView ® Obtain a CAQH ID; Complete and attest to your profile; Upload the required documents; Save CAQH ProView authorization settings to reflect the desired organization access. NOTE: Advantage65 Select contracts include restricted network provisions. Health Care Administrative Solutions, Inc. (HCAS) Learn more about Provider Central. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. To ensure Blue Shield receives all current required documentation, agreements submitted prior to or at the same time as the initial credentialing application will be returned. Choose a state to see how Blue Cross Blue Shield is working in your community. Register, login, manage your plan, renew. 800-955-5692 Option # 5. P.O. Learn How. However, where appropriate, the content may identify a particular company; … Florida Blue. Thank you for your interest in joining our networks. Site visits. HMO coverage is offered by Health Options Inc., DBA Florida Blue HMO, an HMO affiliate of Blue Cross and Blue Shield of Florida, Inc. The Premera Blue Cross credentialing program has won high ratings from the National Committee for Quality Assurance (NCQA) and has been continuously accredited since 1996. Forms for Facility Provider Enrollment Tutorial - Facilities can learn how to join the Blue Cross provider networks by viewing this web-based training.. We will communicate all credentialing decisions in writing. Generally, the pronouns "our," "we" and "us" used throughout this website are intended to refer collectively to Blue Cross and Blue Shield of Florida, Inc. and its subsidiaries and affiliates. You must use providers who participate in a network program to receive full Medicare supplemental benefits. Box 64560St. To submit a new enrollment or make changes to your existing information, select your classification type below. Blue Cross and Blue Shield of Minnesota uses a credentialing process to provide members with a selection of physicians and other health care professionals who have demonstrated backgrounds consistent with the delivery of high quality, cost-effective health care. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Generally, the pronouns "our," "we" and "us" used throughout this website are intended to refer collectively to Blue Cross and Blue Shield of Florida, Inc. and its subsidiaries and affiliates. GuideWell, formally GuideWell Mutual Holding Corporation (holding company for Florida Blue), is a mutual insurance holding company primarily focused on health insurance in Florida.It was created in 2013 by a reorganization initiated by Florida Blue, a member company of the Blue Cross Blue Shield Association. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists:. This program allows you to expedite your credentialing experience to complete the credentialing process with fewer steps. To ensure adequate access to members in North Carolina, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will expedite the credentialing of providers with a temporary license due to COVID-19. The majority of our providers complete the credentialing process within 60 days or less. Related Content. The Blue Cross and Blue Shield Association licenses Blue Cross and Blue Shield of Nebraska to offer certain products and services under the Blue Cross® and Blue Shield® brand names within the state of Nebraska. Mental Health/Substance Abuse. Blue Cross Blue Shield of Massachusetts (Blue Cross), Inc. is expediting access to care for members who may be affected. When credentialing is complete, we’ll notify you of your status. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Professional Credentialing and Recredentialing Guidelines (for physicians and other professionally licensed practitioners) ... Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Blue Cross Blue Shield Association (BCBSA) is a federation of 36 separate United States health insurance companies that provide health insurance in the United States to more than 106 million people. The 36 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico. Effective Oct. 1, 2020, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will begin using Verifide, a credentialing verification organization, to conduct primary source verification. Register for Provider Central. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Practitioners must submit a completed, signed and dated California Participating Practitioner Application, along with other supporting documents identified on the Blue Shield Credentialing Checklist included with the application. Credentialing Process Overview . It seems you're using a browser version we no longer support. Blue Cross Blue Shield of Massachusetts (Blue Cross*) credentials all primary care providers (PCPs), specialty care physicians (SCPs), oral and maxillofacial surgeons, and licensed clinicians (together, “Practitioners”) who have applied for enrollment in our networks and … However, where appropriate, the content may identify a particular company; … We're always here to help with your health care needs. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. The Medical Director and/or the Credentialing Committee review credentialing applications regularly. P.O. We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or sex. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists:. Whether you have 50 or 50,000 employees, Blue Cross and Blue Shield companies can provide a comprehensive healthcare solution that's strategically aligned to meet your business goals and the needs of your employees. In some cases, a site visit will be required. Prior to becoming a member of our network, a provider must first successfully complete the credentialing process. The Blue Cross Blue Shield (BCBS) system is made up of 36 independent and locally operated companies. HMO coverage is offered by Health Options Inc., DBA Florida Blue HMO, an HMO affiliate of Blue Cross and Blue Shield of Florida, Inc. marks of Horizon Blue Cross Blue Shield of New Jersey. Verify eligibility and benefits, submit claims, and more. Field Service P.O. Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. P.O. Medical & Pharmacy Policies and Guidelines, Marketplace Health Plans (myBlue, BlueCare HMO, BlueOptions, BlueSelect), Risk Adjustment / Quality Revenue Program Management, Medicare Clinical Care Programs Referral Form (PDF), Florida Blue Care Management Referral Form (PDF), 835 Health Care Electronic Remittance Advice Request Form (PDF), Accredo Prescription Enrollment Form (PDF), Billing Authorization for Professional Associations, Clinical Care Programs Referral Form (PDF), CVS Caremark Hemophilia Enrollment Form (PDF), CVS Caremark Specialty Pharmacy Enrollment Form (PDF), Electronic Funds Transfer Registration Form (PDF), Express Scripts (ESI) Home Delivery Order Form, Healthy Addition Prenatal Program High-Risk Member Log (PDF), Hospital, Ancillary Facility and Supplier Business Application, Medicare Advantage Waiver of Liability Form for Non-Contracted Providers (PDF), Member Discharge from PCP Practice (HMO and BlueMedicare HMO only), National Provider Identifier (NPI) Notification Form, Non-Par Medicare Advantage Appeal form (PDF), Notice of Medicare Non Coverage Form (PDF), Notice of Medicare Non Coverage Form Instructions (PDF), Physician and Group Request to Participate Form, Preservice Fax Cover Sheet for Medical Records (PDF), Provider Reconsideration/Administrative Appeal Form (PDF), Skilled Nursing Facility Select Medication Program Order Form (PDF), Nondiscrimination and Accessibility notice. Credentialing Process Overview . Providers who use CAQH ProView ® to self-report credentialing information eliminate the need to complete multiple, lengthy paper forms. We share with all physicians and providers who participate in our networks a commitment to quality care and service as well as to the standards set by regulatory and accrediting organizations. Otherwise, you will need to sign a direct contract with Blue Shield. Box 45190 Jacksonville, FL 32232-5190. www.floridablue.com. Practitioners requesting participation in Arkansas Blue Cross and Blue Shield’s Preferred Payment Plan, Medi-Pak® Advantage PFFS and LPPO networks must agree to follow the network Policies and Procedures and Terms and Conditions and meet the network Credentialing Standards. Purpose of Credentialing: Blue Cross NC credentials all practitioners of care, ancillary and facility providers applying for membership in the network(s) and re-credentials the applicable contracted practitioner, ancillary and facility providers every three years. Florida Blue. P.O. Box 65067 Dallas, TX 75265-0267. The protection of your privacy will be governed by the privacy policy of that site. Blue Cross and Blue Shield of Minnesota Credentialing Department R315 P.O. Jacksonville, Florida Area. You can simplify this process by using the Council for Affordable Quality Healthcare’s (CAQH) online credentialing … See Step 2 details below. For questions about your health insurance coverage, benefits or treatment, please call the toll-free number on the back of your member ID card or find your BCBS company. Internet Privacy Statement  |  Terms of Use. Choose a state to see how Blue Cross Blue Shield is working in your community. M+. Visit Premera Facebook page Visit Premera Twitter page Visit Premera Youtube page Visit Premera LinkedIn page What does this mean? FEP Blue Focus We'd suggest starting in one of these areas: ... You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Paul, MN 55164-0560Blue Cross uses the credentialing process to evaluate each practitioner’s qualifications and performance. Blue Cross Blue Shield of Massachusetts (Blue Cross*) credentials all primary care providers (PCPs), specialty care physicians (SCPs), oral and maxillofacial surgeons, and licensed clinicians (together, “Practitioners”) who have applied for enrollment in our networks and who have met all contractual requirements. GuideWell, formally GuideWell Mutual Holding Corporation (holding company for Florida Blue), is a mutual insurance holding company primarily focused on health insurance in Florida.It was created in 2013 by a reorganization initiated by Florida Blue, a member company of the Blue Cross Blue Shield Association. $ 382. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. Blue Cross & Blue Shield of Mississippi does not control such third party websites and is not responsible for the content, advice, products or services offered therein. The Blue Cross and Blue Shield Association licenses Blue Cross and Blue Shield of Nebraska to offer certain products and services under the Blue Cross® and Blue Shield® brand names within the state of Nebraska. Blue Cross Blue Shield of Massachusetts is committed to improving the accessibility of our websites and electronic communications. 800-333-2227. Language assistance available:Español, Kreyol Ayisien, Tiếng Việt, Português, 中文, français, Tagalog, русский, العربية, italiano, Deutsche , 한국어, Polskie, Gujarati, ไทย, 日本語, فارسی. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. To learn more about why contracting with Blue Shield is the right decision for your practice, view these documents. The Credentialing Delegation Program is an extension of Blue Cross and Blue Shield of Louisiana’s URAC-accredited credentialing program. Florida Blue. Our credentialing requirements and guidelines. Related Content. © 2018 Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue. Provider Enrollment Credentialing Specialist Blue Cross and Blue Shield April 2013 – Present 6 years 6 months. Florida Blue has an agreement with Medversant to perform the data collection and validation of the required credentialing elements. Upon receipt, the application will be reviewed for completeness and returned if incomplete. For questions about your health insurance coverage, benefits or treatment, please call the toll-free number on the back of your member ID card or find your BCBS company. However, where appropriate, the content may identify a particular company; there, any pronouns refer to that specific entity. Florida Blue HMO is an HMO plan with a Medicare contract. Helpful tips. Generally, the pronouns "our," "we" and "us" used throughout this website are intended to refer collectively to Blue Cross and Blue Shield of Florida, Inc. and its subsidiaries and affiliates. However, where appropriate, the content may identify a particular company; there, any pronouns refer to that specific entity. Shop for Insurance. ® Registered Marks are property of their respective owners. 107. Credentialing Department Blue Cross and Blue Shield of North Carolina P. O. ® Registered Marks of the Blue Cross and Blue Shield Association. Box 1798 Jacksonville, FL 32231-0014. The 36 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico. All online. Blue Cross and Blue Shield of Minnesota Credentialing Department R315 P.O. You may access the Nondiscrimination and Accessibility notice. Information current and approximate as of December 31, 2018. Thank you for your interest in joining our networks. M+. I have been told I must be rostered in order to input my information into the CAQH ProView. Medversant . Technologies we offer (for providers) Tips for providers who use billing agencies. We provide health insurance in Michigan. Blue Cross and Blue Shield of Florida, Inc., can only raise your premium if we raise the premium for all contracts like yours in this State. Field Service P.O. Generally, the pronouns "our," "we" and "us" used throughout this website are intended to refer collectively to Blue Cross and Blue Shield of Florida, Inc. and its subsidiaries and affiliates. marks of Horizon Blue Cross Blue Shield of New Jersey. Download and complete the Minnesota Uniform Initial Credentialing Application (PDF).Fax to (651) 662-2905, or mail to:Blue Cross and Blue Shield of MinnesotaCredentialing Department R315P.O. Generally, the pronouns "our," "we" and "us" used throughout this website are intended to refer collectively to Blue Cross and Blue Shield of Florida, Inc. and its subsidiaries and affiliates. We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or sex. Getting started. URAC accreditation requires that all providers be fully credentialed if they participate in our network(s). The protection of your privacy will be governed by the privacy policy of that site. Generally, the pronouns "our," "we" and "us" used throughout this website are intended to refer collectively to Blue Cross and Blue Shield of Florida, Inc. and its subsidiaries and affiliates. Generally, the pronouns "our," "we" and "us" used throughout this website are intended to refer collectively to Blue Cross and Blue Shield of Florida, Inc. and its subsidiaries and affiliates. All rights reserved. Any professional provider interested in participating in our network must complete and return a credentialing application kit. All rights reserved. I agree there shall be no liability on the part of, and no action for damages shall arise against, Blue Cross and Blue Shield of Florida or its affiliates, its representatives, or … In the United States, Puerto Rico and U.S. Virgin Islands. ©2020 Horizon Blue Cross Blue Shield of New Jersey Three Penn Plaza East, Newark, New Jersey 07105. HMO coverage is offered by Health Options Inc., DBA Florida Blue HMO. You may access the Nondiscrimination and Accessibility notice. Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. CAQH - ProView. What You Need to Know about Credentialing. It will not meet eligibility criteria for participation and will be returned to you if it's incomplete. However, where appropriate, the content may identify a particular company; there, any pronouns refer to that specific entity. 800-955-5692 Option # 2. Credentialing and recredentialing made easier. You may be contacted by . Under all our plans, physicians and other providers applying for a contract … Health insurance is offered by Blue Cross and Blue Shield of Florida, Inc., DBA Florida Blue. HMO coverage is offered by Health Options Inc., an HMO subsidiary of Blue Cross and Blue Shield of Florida. Credentialing applications and corresponding information are reviewed and formally approved or denied by Blue Shield’s Credentialing Committee. Care Management Programs. Information current and approximate as of December 31, 2018. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. The Health of America. To join our networks, you will need to be affiliated with an Independent Practice Association (IPA) or medical group that is contracted with Blue Shield. Health insurance is offered by Blue Cross and Blue Shield of Florida, Inc., D/B/A Florida Blue. Screen, validate and process providers information Florida Blue is a PPO, RPPO and Rx (PDP) Plan with a Medicare contract. Dental, Life and Disability are offered by Florida Combined Life Insurance Company, Inc., DBA Florida Combined Life, an affiliate of Blue Cross and Blue Shield of Florida, Inc. 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