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Learn moreProfessional Provider Credentialing
MDs, DOs, DPMs, DCs, DDS/DMDs (Oral Surgeon),
Psychologists (fully licensed) and IPTs
If you're an MD, DO, DPM, DC, DDS/DMD (oral surgeon), fully licensed psychologist or independent physical therapist (IPT), you can submit information online using the Council for Affordable Quality Healthcare (CAQH) Universal Credentialing Datasource (UCD) system. Blue Cross Blue Shield of Michigan and Blue Care Network will use the information you submit to enroll and credential you, reducing the time and hassle of paperwork.
To begin the process, you must submit the BCBSM/BCN Physician/Professional Enrollment and Change Form, which is included in the Enrollment Kit below.
BCN Credentialing Updates
Blue Care Network and Blue Choice POS products
BCN practitioners currently being credentialed or re-credentialed may request the status of their application by contacting the BCN Credentialing department at 248-455-3560.
Enrollment Kit
The following documents are provided to assist you in enrolling as a Blues provider and beginning the process of registering in the CAQH UCD.
- Introductory Letter (PDF)
- BCBSM/BCN Physician/Professional Enrollment and Change Form (formerly PEQ) (PDF)
- Requirements for BCN Participation — PCG Endorsement form (PDF)
- Enrollment FAQs (PDF)
- CAQH FAQs (PDF)
- For information about the Traditional and TRUST (PPO) agreements, go to the enrollment page and choose your classification.
- Group Enrollment Form (PDF)
- Group Practice Agency Authorization Form (PDF)
Independent Physical Therapy providers: New to the TRUST PPO Network? Make sure you've completed all the enrollment steps.
