To become a provider for Blue Cross Blue Shield of Michigan, you need to be credentialed. This process verifies the licenses and qualifications of a provider and ensures that they meet the state requirements for health care. You may have rights during the credentialing process (PDF)
Blue Cross Blue Shield of Michigan doesn't directly handle credentialing for providers. In order to complete the process, visit CAQH.org. There you'll receive the NPI number you need for enrollment.
We handle the credentialing process for hospitals and facilities. You'll do this in step three. Follow the steps and we’ll let you know when your credentialing is complete.
During the credentialing or recredentialing process, you can ask questions about the status of your application, ask to review information submitted to support your application and correct anything in error by calling us at 1-800-822-2761.
We want to make this process as easy as possible. Use these checklists to make sure you have everything you need before you start.
Now that you have everything on your checklist, you'll answer a series of questions to put together the forms you'll need to enroll. These forms and your required documents make up your enrollment application. Download them, fill out the PDFs electronically, then print them and fax them to us.
It can take us up to 90 days to review your enrollment application. You'll receive a letter to let you know that you have successfully enrolled. If your enrollment application is incomplete, you may receive a letter to let you know why your application has been delayed.
Some professional provider and allied group administrators can make changes using our Provider Enrollment and Change Self-Service tool. Learn more in our self-service FAQ.
Read about CAQH Supplemental Enrollment for our pilot members only who are practicing delegates.
Credentialing is a verification process you'll need to pass before you can join our provider network.
This helps us ensure you meet the state requirements for health care.
To get credentialed, you'll need to visit CAQH.org. There, you'll receive your NPI number, which you'll need to complete enrollment with us.
We offer two ways to find patient eligibility information — by logging into our secured provider portal or by calling our automated response system.
Our automated response system is for registered, nonregistered and out-of-state providers.
You can fax your preauthorization, along with supporting documentation, to 1-866-311-9603. We accept faxes between 8 a.m. and 4:30 p.m. Monday through Friday.
Or, you can mail it to:
Blue Cross Blue Shield of Michigan
P.O. Box 2227
Detroit, MI 48231-2227
Attention: Preauthorization, Provider Inquiry
Service Mail Code: 0450
We respond to nonurgent preauthorizations 15 days after receiving them.
For an urgent request, you must attest with a signature that the patient's condition is unstable and a delay more than 72 hours could jeopardize their life or limb, or subject them to adverse health consequences if they don't get the requested care.
We respond to urgent requests within 72 hours.