BlueCross BlueShield of Michigan Credentialing Services

To become a new provider in our network, you must first fill out an enrollment form. The submitted data is then checked for accuracy. Depending on the type of provider, we may need your license, education, insurance, and other credentials. The verification process is known as credentialing.

Our online provider enrollment is split into two categories: hospitals and facilities and physicians and practitioners. Here’s an overview of each section’s certification.

For Medical doctors

The Council for Affordable Quality Healthcare®, or CAQH, collects and coordinates the information needed for credentialing. You must create a profile on CAQH ProView in addition to completing our enrollment form. We won’t be able to conclude credentialing without it.

• After submitting your membership form, you must complete your CAQH ProView application within 14 calendar days.

• Have you created a CAQH ProView profile yet? Make sure your attestation is up to date. You must complete the attestation process within 14 calendar days of submitting your registration form to us.

• New graduates can submit an enrollment form to us up to 60 days before the completion of training.

• If you are relocating from out of state, please submit your registration form to us 30 days before to your start date.

What is the purpose of Credentialing?

To verify the competency and conduct of healthcare workers servicing clients in our network, credentials are evaluated in compliance with our policy requirements. We accredit qualified health care practitioners with whom the company intends to form contracts and advertise to its members.

Our Specialist will help you get credentialed right away!

We will primarily evaluate your educational history, career experience, certificates, and registration to practice in a healthcare sector during the credentialing process. We will track your progress throughout the credentialing test in order to determine your education, training, credentials, and registration to practice in a health care context. We will check all of your paperwork to ensure that you are certified by one of the world’s most prestigious healthcare specialists. As a team, we are committed to long-term development. We will assist you in obtaining the services you require. This is how we show our thanks for our consumers and our commitment to their satisfaction.

Credentialing Requirements

• Register with CAQH

• Accredited

Checklist for credentialing

• New Practitioner Enrollment Form -or- Practitioner Change Form

• BCBSM Practitioner Combined Signature Document

• Active Michigan practice location required

• State of Michigan professional license

• Type 1 National Provider Identifier

• Social Security Number

• Tax Identification Number and Internal Revenue Service document

• identifying TIN and associated payee name (BCBSM/BCN does not accept W-9s)

• Council for Affordable Quality Healthcare (CAQH) number (if available)

Application Requirements for Credentialing

• A comprehensive application has the following components:

• Your signature and the date of your application

• “Initial Application Complete” or “Reattestation” CAQH status

• Each state where services are supplied requires a current license to practice.

• Education/Training in the requested specialty(ies) (or documentation that provider will complete training within 60 days of application)

• Up-to-date Hospital Privilege information

• In each state where services are delivered, a current DEA or CDS certificate is required.

• Answers to application-related questions

• Work history for the last five years, in month/year format

• Professional Liability Insurance is up to date.

• If applicable, the applicant must also allow for a site review within 30 days of our request.

Re-credentialing

CAQH ProView® will be used to re-credential, commonly known as re-attestation. It is the process of logging into CAQH ProView, changing your information as necessary, and then attesting, or certifying, that all of the information is correct. Retesting is required every 120 days.

BlueCross BlueShield of Michigan Phone Number

Consumers can also call a Blue Cross health plan advisor at 1-855-237-3501.

BlueCross BlueShield of Michigan Enrollment Form

Clicking at below link; you’ll get to know all minor to major details about BCBS Michigan
https://www.bcbsm.com/amslibs/content/dam/public/employers/documents/enrollment-change-of-status-form.pdf

House of Outsourcing Billing Services

House of Outsourcing is an end-to-end revenue cycle management company provides medical billing services to more than 30 specialties. House of Outsourcing proficient staff handle your entire hospital medical billing operation, from claim creation, accurate claim submission, on time follow up, denial management, appeals, payment posting, reporting as well as consistently guiding practice staff to get you paid 20% more and 50% faster. House of Outsourcing team uses A.I based practice management software to submit billing claims, tracks claims, reporting, scheduling, and patient notifications.