Blue Cross BlueShield of Tennessee Credentialing Services

To represent our network as a new provider, you must first complete an enrollment form. Then we check the submitted data for accuracy. Depending on your provider type, we ask for your license, education, insurance, and other credentials. Credentialing is the verification process.

Our online provider enrollment is divided into two sections: hospitals and facilities and physicians and practitioners. Here’s the lowdown on each section’s certification.

For Physicians and Doctors

The information required for credentialing is gathered and coordinated by the Council for Affordable Quality Healthcare®, or CAQH. In addition to completing our enrollment form, you must create a profile on CAQH ProView. We can’t finish credentialing without it.

Keep these pointers in mind when you fill out our enrollment form and use CAQH ProView.

• You must finish your CAQH ProView application within 14 calendar days of submitting your enrollment form to us.

• Have you already created a CAQH ProView profile? Check that your attestation is up to date. Within 14 calendar days of submitting your registration form to us, you must complete the attestation process.

• Up to 60 days before the end of training, new graduates can submit an enrollment form to us.

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

Why do we Credential?

Credentials are assessed in accordance with our policy criteria to ensure the ability and conduct of healthcare workers serving customers in our network. We accredit licensed health care practitioners with whom the company plans to enter into contracts and promote to our members.

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.

Credentialing Process required

• Register with CAQH

• Authorized

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 Tennessee Phone Number

We’re here to help you find the answers to your inquiries. Please choose from the options below to reach the appropriate team: 1-800-565-9140

BlueCross BlueShield of Tennessee Enrollment Form