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. July 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. File is in portable document format (PDF). option is Adobe® Reader® which has a built-in reader. Also, you’ll typically need to reapply every three years to be recredentialed. The resources below will direct you to the right place. Have these things handy for each provider listed on the enrollment form: NPI; Group tax ID number or the last four digits of each provider's Social Security number; The provider's primary address and phone number Professional Credentialing and Recredentialing Guidelines (for physicians and other professionally licensed practitioners) Title . Our credentialing requirements are derived from, and in compliance with, applicable New Mexico and National Committee for Quality Assurance (NCQA) credentialing standards. Do not use this mailing address or form for provider inquiries. The Provider Record ID associates the provider's rendering NPI with their billing NPI and Tax Identification Number. Get your credentialing decision Blue Cross Blue Shield of Massachusetts makes independent decisions about credentialing. For more information, visit the IMPACT website. 8 of 8 Prev. Contact Anthem Blue Cross and Blue Shield in New Hampshire by phone or Live Chat. Credentialing and Re-Credentialing We are pleased to participate in the Universal Provider DataSource, a project of the Council for Affordable Quality Healthcare (CAQH). This web-based solution allows you to store and manage your credentialing information online and share it … 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. This link will take you to a new site not affiliated with BCBSIL. CAQH is solely responsible for its products and services, including the ProView database. N: 6's You must complete the credentialing and contracting processes to become a Blue Cross provider. 09/01/20 Obtain BCBSIL Patient ID Numbers Online via Availity ® 08/28/20 Illinois Medicaid Claim Filing Tip: Include the Prior Authorization Number; 08/17/20 Physical Therapy Benefits to be Contained Within Automated IVR Phone System as of Sept. 8, 2020 ; 08/14/20 HEDIS MY2020: Key Changes for Medicaid Pay-for-Performance Measures 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. Only the health plans that participate in the ProView database and that you have authorized access will receive any changes. 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. To reach the right team,please select from below. related information. To return to our website, simply close the new window. Provider's Preferred Name (To display in directory) Office Contact (If different from Credentialing Contact) Main Service Location (No PO Box) Street Address County . 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. Therefore, you may be required to submit additional documentation in some situations, in addition to the information you submit through the ProView database. Availity provides administrative services to BCBSIL. Provider's Preferred Name (To display in directory) Office Contact (If different from Credentialing Contact) Main Service Location (No PO Box) Street Address County . Credentialing Contact Information Credentialing Department Commonwealth Care Alliance 2 Avenue de Lafayette Boston, MA 02111 credentialingdepartment@commonwealthcare.org Keep Reading. 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. Effective Date: March 13, 2012. You can use a free-of-charge online/fax service or manually email, fax or mail your application and documents to us. Refer to important information for our linking policy. Please include your CAQH ID when completing this portion of the form. 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.   The data is updated weekly. Once the credentialing process is completed and a decision is made on network participation, the physician/practitioner is notified via letter. Our credentialing requirements and guidelines. C  N: 8's   Most PDF readers are a free download. Professional Credentialing and Recredentialing Guidelines (for physicians and other professionally licensed practitioners) This web-based solution allows you to store and manage your credentialing information online and share it … I do not understand how I can not talk to a human being. It will open in a new window.  C Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com After we review your Provider Onboarding Form, your signed contract and you complete the credentialing process, we will let you know if you are accepted into our networks.  C   Register for E-cred Central today to apply for participation in Wellmark networks or apply to submit claims as a non-participating provider. If you are a participating provider with BCBSIL, you may request most changes online by using one of our electronic change request forms. United States List 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) This report includes those providers appointed/reappointed for HMO products. March   Please access the initial credentialing request form and complete the form by providing your information in the blue [required] fields. 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. Step 4 — Review Process. Month 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. To view this file, you may need to install a PDF reader program. ), 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). 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. Please … All Rights Reserved. Refer to important information for our linking policy. 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. If your credentialing application is not available to BCBSIL because you have not completed the ProView credentialing process, you will be added to our roster and CAQH will send you a Welcome Kit that includes your CAQH Provider ID so that you can complete the ProView credentialing process. June  C  OPEN Keeping your information current is your responsibility, and you must do so with BCBSIL and CAQH.  OPEN  C For Benefits & Eligibility questions, check Availity first.  C C Log in to find contact information specific to your area and plan. The credentialing criteria serve as the foundation for determining a provider’s eligibility and continued eligibility in all Blue Cross networks. We're here to help answer your questions. 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. Submitting these forms in the DocuSign format allows the Provider Credentialing & Data Management staff to continue processing your requests as our employees take precautionary measures to prevent the spread of the novel Coronavirus (COVID-19).