How to Become a Provider With Blue Cross Blue Shield

by Maggie Gebremichael - Updated September 26, 2017
Portrait of smiling doctors

Blue Cross Blue Shield is a health insurance company that operates throughout the United States. The process for receiving insurance credentials differs. There are many providers who accept Blue Cross Blue Shield patients, such as doctors, dentists, physician assistants, social workers and certified nurse specialists. Facilities like home health agencies and diagnostic testing centers also can become providers.

Satisfy local and state regulations, as you must be able to legally work in the area. For example, you might be a registered nurse and licensed in California, but you cannot work in Florida until the state board of nursing issues a license.

Contact the Blue Cross Blue Shield division in your state. The insurance company maintains a separate website in each state. For example, visit bcbsil.com/provider if you are based in Illinois, bcbsga.com/home-providers.html in Georgia or bcbsm.com/provider in Michigan.

Obtain the appropriate form, such as sole versus group provider. Although you can attach a resume, you must complete the credentialing application and describe your educational and employment history.

Submit proof of professional liability insurance either by mail or by fax. Licensed Dieticians Nutritionist in North Carolina need a policy of at least $1 million per incident and $3 million total. Applications for nursing homes must demonstrate evidence of accreditation or Medicaid/Medicare certification.

Request professional references or evaluations. For example, you might include evaluations from a past supervisor, a physician, or a colleague. Most states Blue Cross Blue Shield agencies accept references that were written recently, such as within six months or one year.

Tips

  • Be prepared to resubmit information over time since Blue Cross Blue Shied periodically reviews credentials.

About the Author

Maggie Gebremichael has been a freelance writer since 2002. She speaks Spanish fluently and resides in Texas. When she is not writing articles for eHow.com, Gebremichael loves to travel internationally and learn about different cultures. She obtained an undergraduate degree with a focus on anthropology and business from the University of Texas and enjoys writing about her various interests.

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