Reminder: Submitting completed facility provider application required for recredentialing process

Blue Cross Blue Shield of Michigan and Blue Care Network recredentials our participating health care facilities to ensure continued compliance with Blue Cross and BCN qualification standards.

As part of this process, participating facilities are required to complete and submit a facility provider application. We’ll also use data collected from the recredentialing application to verify and update facility demographic information that’s stored in our provider payment database and in our directories.

Click here for the recredentialing form for freestanding radiology centers, clinical independent laboratories, durable medical equipment suppliers, retail health centers and urgent care centers recredentialing.

Completion of the application is a Blue Cross and BCN program requirement. Failure to complete and return this application will result in termination of your participation agreement with Blue Cross and BCN.

After receiving and completing the application, submit it within 30 days:

• By mail:
  Corporate Credentialing and Program Support
  Mail Code H201
  Blue Care Network
  20500 Civic Center
  Southfield, MI 48076

• By fax:
  1-866-900-0250 (When faxing, please attach the Blue Cross cover letter as the first page.)

If you have any questions about this process, call Corporate Credentialing and Program Support at 248-226-5274 or 248-327-5023 from 8 a.m. to 4 p.m. Monday through Friday, send an email to profcredentialing@bcbsm.com or click here.