Bcbs Credentialing Status Checker: A Guide to Understanding Your Status

Understanding your BCBS credentialing status can be a daunting task, but it doesn't have to be.

BCBS credentialing status is determined by the Blue Cross Blue Shield Association, which is the umbrella organization for the 36 independent Blue Cross and Blue Shield companies across the United States.

Your credentialing status is a crucial factor in getting paid by BCBS, as it ensures that you meet their standards for quality and safety.

To check your credentialing status, you can use the BCBS credentialing status checker, which is a free online tool that provides instant access to your credentialing information.

The credentialing status checker is accessible 24/7, making it convenient for you to check your status at any time.

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To check your BCBS credentialing status, you'll need to go through the credentialing process, which starts with registering for a CAQH account if you don't already have one.

The CAQH Provider Data Portal allows providers to self-report professional and practice information to BCBSIL, making it a crucial step in the credentialing process. The portal is user-friendly and guides you through the application process.

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To complete the application, follow these steps:

BCBSIL may contact you to supplement, clarify or confirm certain responses on your application, so be prepared to provide additional information if needed.

To check your credentialing status, simply enter your NPI or license number in the Credentialing Status Checker.

You'll need to have submitted the Provider Onboarding Form to get credentialed first.

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To check the status of your credentialing process, you can enter your NPI or license number in our Credentialing Status Checker. This is a convenient way to stay on top of your application.

You can find the Credentialing Status Checker after submitting the Provider Onboarding Form to get credentialed. This form is a necessary step in the credentialing process.

The Credentialing Status Checker is easy to use and allows you to track the progress of your application. Simply enter your NPI or license number and you'll be able to see the current status of your credentialing process.

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If you're a provider who participates in our networks, you're required to complete a process to verify information and/or credential your process prior to acceptance. This process varies depending on your type of provider.

Here are the different types of providers and where to learn more about their specific requirements:

Remember, creating and/or updating your CAQH profile is an important part of the credentialing process. You have 45 days to finalize your CAQH application, or the BCBSTX credentialing process will be discontinued and you'll need to start over.

You'll want to stay on top of updates to your information to avoid any issues with credentialing. You're responsible for keeping your information current with both CAQH and BCBSIL.

CAQH will send you automatic reminders to review and attest to the accuracy of your data. You must use the CAQH Provider Data Portal to report any changes to your practice, as outlined in the state of Illinois Health Care Professional Credentials Data Collection Act.

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You have a tight deadline to report certain changes, such as a state health care professional license revocation, which must be done within five business days. Any other changes, like a practice address or hospital affiliation, should be reported within 45 days from the date you knew of the change.

Here are the specific time frames to keep in mind:

Don't forget to also inform BCBSIL of any changes to your practice or demographic information. You can find more information on how to do this on their Verify and Update Your Information page.

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To verify your credential status, it's best to call the insurance company directly. Make a list of insurance companies you think you may be credentialed with based on submitted applications or previous work.

Have all your important identifiers handy, such as NPI and tax ID numbers, as you may have multiple possibilities. Create a cheat sheet with your NPI, tax ID, addresses, names, and other relevant information to reference while on the phone.

Call each insurance company on your list to verify your credential status.

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Provisional status is a new process that BCBSMT is introducing, effective July 15, 2023. This process allows providers to have a provisional network participation status if they meet certain requirements.

To be eligible for provisional status, providers must have a valid BCBSMT Provider Record ID for claim payment, complete the CAQH ProView database online application with "global" or "plan specific" authorization to BCBSMT, and have a valid license to practice in Montana.

The review process takes an average of 8-10 calendar days, and providers will be notified once the CAQH credentialing applications are reviewed for completeness. If the applicant does not meet the provisional network participation requirements, they must be fully credentialed and approved prior to being made effective.

Here are the key requirements for provisional status:

It's worth noting that credentialing can be a lengthy process, so be sure to allow sufficient time for the full credentialing process to be completed before checking your status.

Re-enrollment can be a bit of a process, but it's essential to stay on top of it. CAQH requires you to review and attest to your data once every six months.

You'll receive recredentialing notices from BCBSIL every three years, which is in accordance with state of Illinois requirements. This is because the state uses the last digit of your Social Security number to determine your recredentialing cycle.

BCBSIL will add you to the CAQH roster to receive your application when it's time for recredentialing. This ensures that your information is up to date and accurate.

Verisys, a company that BCBSIL works with, may contact you to verify credentialing and recredentialing data. They'll ask you to re-attest to your data accuracy, which is a quick and easy process.

Once the recredentialing process is completed, you'll be considered approved unless otherwise notified. If not approved, a letter with details will be mailed to you within 10 business days.

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Provisional status is a temporary arrangement that allows providers to participate in the network while their credentialing process is being reviewed. This status is only available to providers who meet specific requirements.

To be eligible for provisional status, a provider must have a valid BCBSMT Provider Record ID for claim payment, complete the CAQH ProView database online application with "global" or "plan specific" authorization to BCBSMT, and hold a valid license to practice in Montana.

The review process typically takes 8-10 calendar days, after which the provider will be notified of the outcome. If the applicant does not meet the requirements, they must be fully credentialed and approved before being made effective.

Here are the key requirements for provisional network participation:

Keep in mind that credentialing can be a lengthy process, so it's essential to allow sufficient time for completion before checking your status.