Blue Cross Blue Shield insurance plans are among the most recognized health plans in the country. Each of the 39 Blue Cross Blue Shield companies is independently owned and operated. The process to join the insurance panel to become a network provider varies by company, so you will need to follow the specific process for contracting and credentialing. Benefits to joining the panels include inclusion on the online provider search, referrals from the insurance company, easy claims submission, fast claims payment, online tools and research articles.
Find out the Blue Cross Blue Shield that covers your practice area. Some states such as Maryland only have one Blue Cross Blue Shield company, Carefirst. Other states such as Pennsylvania have five regional carriers. Visit the Blue Cross Blue Shield Association's website to search for the company in your region.
Go to the website of your regional Blue Cross Blue Shield and click the section for providers. You should be able to find information about joining their network on the provider portal. If not, locate the Contact Us page and find a phone number for the provider relations department. You can either find an application online or request one from Provider Relations.
Complete the panel application with your name, provider type, tax ID number, hospital affiliations, practice address, phone number, professional license number and state of issue, type of degree, national provider identifier and birthdate. Submit the application per the instructions with any required supporting documentation such as a Form I-9.
Register online with the Council for Affordable Quality Healthcare's Universal Provider Datasource (CAQH), if you are not already. Once registered, provide the Blue company with authorization to access your credentialing information through CAQH. This is the central repository of credentialing information which many of the independent Blues utilize to verify your credentials.
Sign and return the contract you are sent. This will contain reimbursement rates and rules to follow as a participating panel provider. Once the contracting and credentialing process is complete, you are officially in the network panel.