How to Become a Provider for Blue Cross & Blue Shield of Ohio

Anthem Blue Cross and Blue Shield has streamlined the process of becoming credentialed to become a plan provider in Ohio. Credentialing used to be a cumbersome process because insurance companies and hospitals used different formats and asked for different kinds of supporting documents.

Anthem now participates in the Universal Provider Datasource, which allows a provider to fill out a single application with data that can be viewed by all the organizations the provider wants to join. This cuts down on time and hassle for the physician and is an effective cost-cutting concept for the organizations.

Things You'll Need

• Liability insurance with a coverage minimum of $1 million per claim and $3 million aggregate
• Hospital visiting privileges at an Anthem-participating hospital
• Unrestricted Ohio medical license
• Board certification or eligibility
• Completed up-to-date CAQH application
• Anthem Physician Data Sheet Form
• IRS form W-9
• Fax Machine

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Instructions

• 1

  Verify that you have granted Anthem permission to access your CAQH (Council for Affordable Quality Healthcare) application. If Anthem does not have permission to access your CAQH Universal Provider Datasource, contact CAQH through its website or call 888-599-1771. The add Anthem as an organization with permission to access the data.

• 2

  Download parts 1 and 2 of Anthem's Physician's Data Sheet Form and an IRS form W-9. Both forms can be downloaded directly from the Anthem Blue Cross Blue Shield's website section on "Medical Professional Providers."

• 3

  Faxing the required forms to Anthem begins the provider application process.

  Complete both parts of the Physician Data Sheet and IRS form W-9. Fax the completed forms to Anthem's provider contracting department at 303-831-5833.

• 4

  Wait up to 90 days for application processing, according to Anthem. You may check your application status by calling Anthem Blue Cross and Blue Shield's credentialing department at 800-516-7587.