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November 2013

CCPS now processes credentialing for all Blues hospital, non-hospital facilities

The Corporate Credentialing and Program Support department now manages the credentialing process for all hospital and non-hospital facilities applying to join the Blues’ network. This change, which took effect July 1, 2013, includes all managed care and Traditional networks.

The minimum credentialing requirements include:

  • Completed and signed credentialing and recredentialing application
  • Medical director (an M.D., D.O. or physical therapist for occupational physical therapy) with a valid state license and in good standing
  • Valid facility state license
  • Valid pharmacy license (for ambulatory infusion centers)
  • Both general and professional liability malpractice insurance (BCN only)
  • Accreditation or a current Centers for Medicare & Medicaid Services survey

Failure to meet these requirements could result in affiliation denial or termination from all networks.

For questions about re-credentialing only, please email profcredentialing@bcbsm.com.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2012 American Medical Association. All rights reserved.
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