BlueShield Provider Credentialing Instructions
This document outlines the credentialing and recredentialing processes for healthcare providers with BlueShield. It includes essential steps, required documents, and contact information. Follow the guidelines carefully to ensure a smooth application process.
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How do I fill this out?
To fill out this form, start by gathering all required documents and completing the credentialing application accurately. Make sure to indicate 'UCB SHIP - Special Handling' in the subject line of your email. Submit your application electronically to the designated email address for review.
How to fill out the BlueShield Provider Credentialing Instructions?
1
Gather all required documents for credentialing.
2
Complete the credentialing application form accurately.
3
Email the completed form and documents to the specified addresses.
4
Ensure the subject line states 'UCB SHIP - Special Handling'.
5
Await confirmation and further instructions via email.
Who needs the BlueShield Provider Credentialing Instructions?
1
Healthcare providers applying for BlueShield participation.
2
Physicians seeking network inclusion through UCB SHIP.
3
Doctors requiring updates or changes to their credentials.
4
Providers wanting to ensure compliance with BlueShield guidelines.
5
Practitioners involved in the recredentialing process every 36 months.
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Email or share the document as needed.
What are the instructions for submitting this form?
Submit the completed credentialing paperwork along with required documents to BSCInitialApp@blueshieldca.com and copy BSCProviderInfo@blueshieldca.com. Additionally, indicate 'UCB SHIP - Special Handling' in the subject line of your email. Ensure that all documentation is complete to avoid delays in processing.
What are the important dates for this form in 2024 and 2025?
Credentialing decisions will be communicated via email, and recredentialing occurs every 36 months. Prepare your documents proactively to avoid lapses in coverage.
What is the purpose of this form?
The purpose of this form is to facilitate the credentialing and recredentialing process for healthcare providers wishing to join the BlueShield network. It ensures that all necessary qualifications are verified and documented properly. Providers must complete this form in order to maintain active status within the network.
Tell me about this form and its components and fields line-by-line.
- 1. Professional Malpractice Liability Insurance Certificate: Proof of current liability insurance.
- 2. Medical License: Valid medical practice license.
- 3. Curriculum Vitae: A summary of your professional history.
- 4. Board Eligibility/Certification: Documentation of board certification status.
- 5. DEA Registration: Drug Enforcement Administration registration certificate if applicable.
What happens if I fail to submit this form?
If the form is not submitted, the provider risks termination from the Blue Shield network. All credentials will expire, and the provider will need to reapply from scratch.
- Termination Risk: Not submitting may lead to being removed from the BlueShield network.
- Document Validity: Credentials must be updated to ensure they are valid and compliant.
- Application Delays: Failure to submit on time can cause delays in the application process.
How do I know when to use this form?
- 1. Initial Credentialing: For new providers applying to join BlueShield.
- 2. Recredentialing: For existing providers due for credential renewal.
- 3. Document Updates: To submit updates or changes to existing credentials.
Frequently Asked Question
What documents do I need to submit?
You will need to provide your Professional Malpractice Liability Insurance Certificate, Medical License, Curriculum Vitae, Board Eligibility/Certification, and DEA registration if applicable.
How long does the credentialing process take?
The credentialing process typically takes about 90 to 120 days.
Can I submit my application electronically?
Yes, please submit your completed application and required documents via email.
What if I don't have email?
If email is not available, you can send the documents via postal mail.
How can I check my application status?
You can follow up on your application status by calling the Provider Information and Enrollment Team.
What happens if I miss the recredentialing deadline?
Failing to submit the recredentialing documents timely may result in termination from the network.
Is CAQH registration necessary?
While it's encouraged, it is not mandatory to register with CAQH to apply for credentialing.
Can I update my credentials after submission?
Yes, it's important to keep your credentials up to date, especially during the recredentialing cycle.
How do I contact BlueShield for assistance?
You can reach the Provider Information and Enrollment Team at (800) 258-3091 option 3.
Where can I find additional resources?
Visit the Resources For Prospective Providers section for more information.
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