Wiki BCBS Credentialing

CMBA4

Contributor
Messages
21
Best answers
0
Hi All,

I have been trying to get a hold of BCBS regarding credentialing two Psy. Dr's in the NY area. Every time I call I either get disconnected or transferred to a busy line. I've tried E-mailing the person it provides on the machine and that came back as undeliverable. This has been going on about a month now. Not sure what else to do. I can't find any reps to actually help me get someone in the correct department. Does anyone know the right person to contact or how to go about getting a credentialing application?

Someone please help, it will be greatly appreciated.

CMBA

THANK YOU!!!!
 
Do you know where the network participation tab is? Also the email you supplied is invalid. Do you by chance have an updated one?

Thank you!!
 
Providers Home

Medical Policies and Coverage

News and Information

Forms and Documentation

Electronic Claims and Eligibility

Dental Providers

eManuals

Network Participation

Credentialing Applications

Provider Enrollment Applications

Fee Schedules

EFT Sign-up

Blue e Sign-up

Pharmacy Program

Quality-Based Programs

Resources

Education and Learning Center

Blue Medicare

IPP BlueCard

Apply for Credentialing
Credentialing Instructions
BCBSNC Special Instructions for Licensed Certified Social Worker/Certified Substance Abuse Counselor/Licensed Clinical Addiction Specialist/Licensed Pastoral Counselors/Licensed Marriage and Family Therapist/Licensed Psychological Associate/Psychiatric Nurses, and Certified Nurse Specialists


Dear Health Care Provider:

This application is the "Uniform Application to Participate as a Health Care Practitioner, developed by the North Carolina Department of Insurance pursuant to North Carolina General Statute 58-3-230.

The following instructions will help you to avoid delays associated with an incomplete application. Please review this material carefully before attempting to complete the Uniform Application. Fill in all required information completely and attach all required documents before submitting your application.

Blue Cross and Blue Shield of North Carolina (BCBSNC) will notify you of an incomplete application within 15 days of its receipt requesting the information to complete your application. Your incomplete application will be closed 60 days from receipt if the requested information is not received. Upon completion of the credentialing process, you will be presented to the Credentialing Committee for approval or denial. If denied you will be notified by certified mail. If approved you will be notified by BCBSNC's Network Management informing you of your effective date to see BCBSNC managed care members.

ALL APPLICANTS: Please note all fields must be COMPLETED or indicate NOT APPLICABLE (NA)

Provide education/practice history from beginning of your education in your field of expertise up to your current practice location (must include months/years and account for any gaps greater than three months). This information may be submitted on your Curriculum Vitae (CV) and reference sections B 1-5 of the application as "see attached CV".
Provide the following documents on page three of the Uniform Application:
Copy of CV to include all work history after graduation from appropriate school (CV must account for any gaps of 90 days or more)
Certificate of Insurance of at least $1 million per occurrence and $3 million aggregate
Copy of the face sheet of your current professional liability insurance policy, indicating by name, provider(s) covered, coverage amounts, effective date, expiration date, and policy number.
The original, unaltered Attestation Statement containing the provider's original signature and date must be submitted with your application.
Copy of Masters degree or certified transcript documenting completion of Masters degree (For LCSW and CCAS)
If you have a single medical malpractice judgment case settled for $200,000.00 or more; or if you have multiple malpractice cases settled for any amount two letters of recommendation from physician peers are required.


Reference:
http://www.bcbsnc.com/content/providers/application/certified-counselor.htm
 
Top