How to Become a Health Care Provider With Blue Cross

There are many different state Blue Cross health plans. Below are the general procedures for becoming a Blue Cross provider. There may be some differences in requirements from state to state. By becoming a provider with Blue Cross you will be listed in the providers directory for your state and city, thus giving you more exposure to new patients, and more patients who carry your Blue Cross plan will be able to use your services.

Things You'll Need

• Provider ID number
• Application for credentialing
• Resume
• W-9 form
• Malpractice insurance fact sheet
• Medical license
• Copy of DEA certification
• Summary of any pending malpractice suits
• List of previous locations where you have practiced

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Instructions

Becoming a Blue Cross Provider

• 1

  Go to http://www.CAQH.org, click on "Universal Provider Data Source" and then click on "Participating Organizations." There you will see a list of all insurance companies and other organizations that are part of this network. If your insurance company is listed, then you can proceed in applying to be a provider for Blue Cross. The CAQH is the main company that handles all the credentialing of providers.

• 2

  Call the Blue Cross division of your state and ask if you already have a provider number. If you don't, proceed to step 3. If you do, proceed to step 4 and download an application from CAQH.

• 3

  To obtain a provider ID number, call CAQH at [phone] and tell them that you want to become a provider and be added to their roster. Wait to receive a Welcome Kit; it will include your provider ID number and welcome information.

• 4

  Go to the CAQH website, create a password, enter your user ID number and download the CAQH credentialing application.

• 5

  You will need the following items to complete your application: your curriculum vitae (resume), medical license, DEA certification (if applicable), Internal Revenue Service W-9 Form, malpractice insurance fact sheet, a summary of any pending malpractice suits and a list of all previous places you have practiced. Fill out the application and send it along with the above requirements by fax or mail.

• 6

  A contract will be sent to you by the Blue Cross health plan you are working with once the application has been accepted. You then need to sign it and send it back in to them.