Connect with Us. Choose a state to see how Blue Cross Blue Shield is working in your community. I give permission to Blue Cross and Blue Shield of Florida and its affiliates to contact any and all persons or entities to verify these facts. Prior to becoming a member of our network, a provider must first successfully complete the credentialing process. Box 64560 St. Paul, MN 55164-0560. Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. Please be sure your application is correct and complete so we can process it promptly. Box 64560 St. Paul, MN 55164-0560. Box 65067 Dallas, TX 75265-0267. The credentialing process requires a new Practitioner/Provider to submit an application. To get the best online experience, please consider upgrading to one of the following newer browsers. Generally, the pronouns "our," "we" and "us" used throughout this website are intended to refer collectively to Blue Cross and Blue Shield of Florida, Inc. and its subsidiaries and affiliates. Generally, the pronouns "our," "we" and "us" used throughout this website are intended to refer collectively to Blue Cross and Blue Shield of Florida, Inc. and its subsidiaries and affiliates. M. members covered. HMO coverage is offered by Health Options Inc., an HMO subsidiary of Blue Cross and Blue Shield of Florida. Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. © 2018 Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue. The Credentialing Delegation Program is an extension of Blue Cross and Blue Shield of Louisiana’s URAC-accredited credentialing program. The majority of our providers complete the credentialing process within 60 days or less. Blue Cross Blue Shield of Massachusetts (Blue Cross*) credentials all primary care providers (PCPs), specialty care physicians (SCPs), oral and maxillofacial surgeons, and licensed clinicians (together, “Practitioners”) who have applied for enrollment in our networks and … Claims. To ensure Blue Shield receives all current required documentation, agreements submitted prior to or at the same time as the initial credentialing application will be returned. marks of Horizon Blue Cross Blue Shield of New Jersey. Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or sex. Blue Cross Blue Shield of Massachusetts (Blue Cross*) credentials all primary care providers (PCPs), specialty care physicians (SCPs), oral and maxillofacial surgeons, and licensed clinicians (together, “Practitioners”) who have applied for enrollment in our networks and who have met all contractual requirements. Technologies we offer (for providers) Tips for providers who use billing agencies. Health insurance is offered by Blue Cross and Blue Shield of Florida, Inc., DBA Florida Blue. Update on Credentialing and Recredentialing Process. 800-955-5692 Option # 5. marks of Horizon Blue Cross Blue Shield of New Jersey. In some cases, a site visit will be required. Credentialing Policy Manual. In addition, the national Blue Cross Blue Shield Association has published the program as an example of a successful credentialing program. Credentialing applications and corresponding information are reviewed and formally approved or denied by Blue Shield’s Credentialing Committee. © 2018 Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue. Blue Cross NC will make every effort to credential providers who are physicians and physician's assistants within three business days from the date Blue Cross NC receives a However, where appropriate, the content may identify a particular company; … Effective Oct. 1, 2020, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will begin using Verifide, a credentialing verification organization, to conduct primary source verification. Language assistance available:Español, Kreyol Ayisien, Tiếng Việt, Português, 中文, français, Tagalog, русский, العربية, italiano, Deutsche , 한국어, Polskie, Gujarati, ไทย, 日本語, فارسی. You may access the Nondiscrimination and Accessibility notice. Nondiscrimination and Accessibility notice. Credentialing and recredentialing . The protection of your privacy will be governed by the privacy policy of that site. Register for Provider Central. Screen, validate and process providers information GuideWell, formally GuideWell Mutual Holding Corporation (holding company for Florida Blue), is a mutual insurance holding company primarily focused on health insurance in Florida.It was created in 2013 by a reorganization initiated by Florida Blue, a member company of the Blue Cross Blue Shield Association. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. This program allows you to expedite your credentialing experience to complete the credentialing process with fewer steps. Claims. Box 45190 Jacksonville, FL 32232-5190. www.floridablue.com. However, where appropriate, the content may identify a particular company; … All online. When you apply for network participation, BCBSTX will add you to its roster with CAQH. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. The Credentialing Delegation Program is an extension of Blue Cross and Blue Shield of Louisiana’s URAC-accredited credentialing program. Effective Oct. 1, 2020, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will begin using Verifide, a credentialing verification organization, to conduct primary source verification. Providers who use CAQH ProView ® to self-report credentialing information eliminate the need to complete multiple, lengthy paper forms. Blue Cross Blue Shield of Wyoming has received Health Plan with Health Insurance Marketplace Accreditation from URAC. Language assistance available:Español, Kreyol Ayisien, Tiếng Việt, Português, 中文, français, Tagalog, русский, العربية, italiano, Deutsche , 한국어, Polskie, Gujarati, ไทย, 日本語, فارسی. Provider Enrollment Credentialing Specialist Blue Cross and Blue Shield April 2013 – Present 6 years 6 months. Florida Blue is a PPO, RPPO and Rx (PDP) Plan with a Medicare contract. Box 1798 Jacksonville, FL 32231-0014. Purpose of Credentialing: Blue Cross NC credentials all practitioners of care, ancillary and facility providers applying for membership in the network(s) and re-credentials the applicable contracted practitioner, ancillary and facility providers every three years. Verify eligibility and benefits, submit claims, and more. However, where appropriate, the content may identify a particular company; there, any pronouns refer to that specific entity. 800-955-5692 Option # 2. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. There you'll receive the NPI number you need for enrollment. Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. M+. Generally, the pronouns "our," "we" and "us" used throughout this website are intended to refer collectively to Blue Cross and Blue Shield of Florida, Inc. and its subsidiaries and affiliates. Related Content. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. Blue Cross Blue Shield of Michigan doesn't directly handle credentialing for providers. Florida Blue. You may be contacted by . Thank you for your interest in joining our networks. Credentialing Process Overview . URAC accreditation requires that all providers be fully credentialed if they participate in our network(s). Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. $ 382. Professional Credentialing and Recredentialing Guidelines (for physicians and other professionally licensed practitioners) ... Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Upon receipt, the application will be reviewed for completeness and returned if incomplete. The 36 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico. However, where appropriate, the content may identify a particular company; there, any pronouns refer to that specific entity. The Blue Cross Blue Shield (BCBS) system is made up of 36 independent and locally operated companies. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. About credentialing. Practitioners must submit a completed, signed and dated California Participating Practitioner Application, along with other supporting documents identified on the Blue Shield Credentialing Checklist included with the application. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. When credentialing is complete, we’ll notify you of your status. What You Need to Know about Credentialing. Getting started. We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or sex. You will receive the credentialing application from BCBSWY via email. M+. Dental, Life and Disability are offered by Florida Combined Life Insurance Company, Inc., an affiliate of Blue Cross and Blue Shield of Florida. The 36 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico. 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