Credentialing Process For Hospitals And Ancillary Providers

Credentialing is the process by which Blue Cross and Blue Shield of Montana (BCBSMT) reviews and validates the professional qualifications of physicians and certain other providers who apply for participation with our health care organization, ensuring that they meet the professional standards.

All physicians and professional providers must successfully complete the credentialing process prior to participation in the BCBSMT provider networks as outlined in the Provider Network Participation Policy.

After the BCBSMT Provider Record ID is set up, BCBSMT will forward you a contract and a credentialing application. Forward the completed contract and credentialing application along with the requested attachments to BCBSMT via:

  • Email: MTContracting@bcbsmt.com (preferred method)
    or
  • Mail to:
    Blue Cross and Blue Shield of Montana
    Network Management Dept.
    3645 Alice Street
    Helena, MT 59601-8656

After a completed application is received, BCBSMT verifies the data. Then, the Credentialing Committee evaluates the credentials.

When the process is complete, the applicant receives written notification of his/her credentialing status with BCBSMT.

The applicant then receives a second written notification indicating his/her professional status with BCBSMT, the effective date of the contract/agreement and a copy of the executed agreement.

Note: The effective date of the agreement is the credentialing approval date. Effective dates are not backdated.

If you need to check on the status of a previously submitted provider record or have questions regarding the completion of the packet, contact BCBSMT Network Management.

If you do not have an NPI, go to the NPPES website to apply for one.