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Provider Credentialing

In conjunction with contracting, individual providers, hospitals, and other facilities must be credentialed prior to participation in BCBSMT provider networks as outlined in the Provider Network Participation Policy.   

Recredentialing

Recredentialing is performed every 3 years.  It involves updating the information you provided during the previous credentialing process and signing new consent and attestation forms.  All information is again verified, and the application is presented to the Credentailing Committee for consideration. Please return the recredentialing application in a timely manner, so your participation in the networks is not jeopardized.

The Process

After a completed application is received, we verify the applicant's data.  Then, the Credentialing Committee evaluates the applicant's professional qualifications, such as training, licensure, certifications, and background as well as professional competence and conduct, as summarized in the standards.  Click on the links below for more information.

When the process is complete, the applicant receives written notification of his/her professional status with BCBSMT.  To be considered a network provider, the credentialing process must be complete.  For the status of a submitted application, call us at 1.800.447.7828, Extension 6100 option 2, or email
HCS-X6100@bcbsmt.com.

 Standards for Individual Providers
 Standards for Facilities Credentialing

Completing Your Application

The credentialing process may begin before you start to practice.  Please submit an application as soon as possible to avoid delay in becoming a participating provider.  The process takes an average of 45 days to complete after an application is received. 

For assistance completing your application, click on the Guideline links below or contact us at 1.800.447.7828, Extension 6100 option 2, or by email at HCS-X6100@bcbsmt.com.

 Guidelines for Individual Provider Form 
 Guidelines for Completing the Facilities Form

Credentialing Tips

To help ensure the completeness of your credentialing application and expedite the process, pay particular attention to the following details.  

             More...

Continuing Medical Education

The completion of 75 Category I CME is required between each credentialing cycle.  The following websites offer free or low-cost continuing medical education credits:

Medscape CME Tracker
CME Web

 
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Provider Credentialing