BlueCross BlueShield of Massachusetts Credentialing Services

Except for clinic physicians, we accredit all providers who seek to join our networks. Of becoming a Blue Cross provider, you must first fulfill the credentialing and contract procedures.

How our Specialist will assist you with getting credentialed immediately?

Mostly during credentialing process, we will assess your educational background, career experience, certifications, and registration to practice in a healthcare area. We will monitor your progress all through the credentialing test to find your education, training, credentials, and registration to practice in a health care setting. We will review all of your papers to guarantee that you are accredited by one of the world’s most prominent healthcare professionals. We are devoted to long-term growth as a team. We will help you in acquiring the services you desire. This is how we express our appreciation to our customers and our dedication to satisfying the customers.

How to get credentialed?

Credentialing

Documents (including completed contracts) sent to P.O. Box 55350 can now be emailed to Provider-Enrollment@bcbsma.com. We will send you an automated confirmation email if you use email.

Documents with fax instructions should still be faxed.

Start the contracting application and credentials verification processes.
Here’s how:

• Check our credentialing guidelines to make sure you meet our requirements.

• Follow the credentialing steps we outline so we can review and approve your credentials as part of your enrollment with us.
Physicians and licensed practitioners use CAQH ProView, the universal provider data source for credentialing. We’ll need you to authorize our access to your profile in CAQH ProView.

• Submit a contracting form. Be sure to select the right one for your provider type.

Obtain a contract. One copy must be read, signed, and returned. One copy will be kept for your records.
Receive your credentialing decision as well as your welcome letter.
Your welcome letter will inform you of the following: the effective date of your participation with us; the products in which you are enrolled; and how to set up direct deposit with Pay Span, the vendor we employ for electronic payments and remittances.

Advantages of Participation

Through our Provider Central website, we provide participating providers with a variety of electronic self-service solutions that streamline your business processes and provide you with the information you require 24 hours a day, seven days a week. This includes the following:
Verification of eligibility and benefits.
Options for electronic claim submission: Direct connection; Online Services, a free service available through this website (needs logging in); existing arrangements with numerous clearinghouses.

Online payments and remittances, as well as direct deposit. We require that providers be paid via direct transfer using Pay span. You will also receive online Provider Payment and Provider Detail Advisories once you have registered for Pay span.

How we assist providers

We’re here to help you provide high-quality health care to your patients.

• Website for a certain service

• You should register on our website as a participating supplier in order to:

• Receive contractual notifications as well as other essential news and updates.

• Use our self-service technologies to conduct business with us. 24/7

• Learn about the procedures and policies of the plan.

Step 1

Navigate to the CAQH ProView website.
• You must either: update your information and authorize Blue Cross to access it, or

• Register, fill out the Integrated Massachusetts Application (IMA), and send in your documentation.

Here’s how to do it:

• Navigate to the CAQH ProView website.

• Make a password for yourself (if you don’t already have one).

• Click the Complete/Update application button.

• Enter your details here.

• Select the option to allow all healthcare organisation access to your information.

Please provide the requested supporting documentation. A hospital letter from your primary hospital is required if you are linked with one. Before the application can be deemed complete, the hospital letter must be received. This is one of the most typical reasons for credentialing delays.

Step 2

Blue Cross Blue Shield of Massachusetts makes its own certification determinations. To do this, our Credentials Committee examines an applicant’s credentials to see if they meet our Professional Credentialing and Re-credentialing Requirements. The initial credentialing decision will be communicated to you. If you are credentialed, we will give you a welcome letter outlining the date of your contractual engagement with us.

Re-credentialing
View your data through the CAQH ProView.

Every two years, around your birthday, you must re-credential. The cycle of re-credentialing is determined by whether you were born in an odd or even year. For example, if your birthday is May 15, 1980 (an even year) and you were initially credentialed in May of 2015, your re-credentialing is required in May of 2016 because 2016 is also an even year. Your next re-credentialing application is due in May 2018, and then every two years after that.To re-credential, go over your data in CAQH ProView and re-attest to its accuracy. Make sure that all expired information in your CAQH ProView application is up to date.

The information you supply to CAQH ProView is reviewed by our Credentials Committee. We will contact you if we have any questions regarding your credentials. Otherwise, you will not receive any further correspondence from us regarding your re-credentialing.The absence of updated malpractice insurance information is one of the primary causes of incomplete re-credentialing applications; make sure to review this information while re-attesting.

Reminder:
The CAQH will send you a reminder every 120 days to examine your data, amend any expired information, and re-attest to your information. When health insurers access data for credentialing purposes, this ensures that your data is current and up to date.

BlueCross BlueShield of Massachusetts Phone Number

From 8 a.m. to 8 p.m., seven days a week, dial 1-800-678-2265 (TTY: 1-800-522-1254).

BlueCross BlueShield of Massachusetts Email Address

Please send your queries at ebr@bcbsma.com.

BlueCross BlueShield of Massachusetts Enrollment Form

By clicking here you’ll be directed to your desired form;
https://provider.bluecrossma.com/ProviderHome/portal/home/forms/forms/forms-library/