Before you can get contracted in the BCBSMT Provider Networks or send claims electronically as an out-of-network provider, you will need to be assigned a BCBSMT Provider Record ID. The provider record associates the provider's rendering National Provider Identifier (NPI) with their billing NPI and tax identification number (TIN). Learn More
Note: Dental Providers Participating in the Dental PPO Network should contact Dental Network Provider Administration (DNOA) at 800-972-7565 for all updates.
Easy Steps to Join the BCBSMT Provider Network
You can join the BCBSMT provider network in six easy steps. Start now.
Case Status Checker
If you have completed the Provider Onboarding Form, Demographic Update Form or sent a General Email Inquiry and would like to check the status, enter the case number you received in your confirmation email in our Case Status Checker
Credentialing and Recredentialing
All providers who participate in our networks are required to complete a credentialing process prior to acceptance. Recredentialing is performed every three years. Refer to the following for additional information:
- If you previously chose not to be listed in Provider Finder, your directory information will be displayed starting in February 2022. Directory information includes name, location and hours, contact information, specialties, languages spoken, credentials, affiliations and whether you are accepting new patients. The address you’ve provided to us will be displayed.
- Hospital and Ancillary Providers Learn More
- Physician and Professional Providers Learn More
Note: The requirements of creating and/or updating your CAQH profile is important. Failure to finalize your CAQH application within 45 days will cause the BCBSMT credentialing process to be discontinued and you will be required to start the process over.
- Recredentialing Learn More
The Council for Affordable Quality Healthcare, Inc. (CAQH) will collect the data required for our credentialing and recredentialing process. CAQH uses an electronic database, entitled ProView, to collect the data. This online credentialing application process supports our administrative simplification and paper reduction efforts. This solution also supports quality initiatives and helps to ensure the accuracy and integrity of our provider database.
- First Time Users can follow these five easy steps to register with CAQH. Learn More
- CAQH Contact Information
- CAQH Professional Provider Credentialing Checklist (pdf link)
CAQH VeriFide may contact you on behalf of BCBSMT and request that you:
- Reattest to your data’s accuracy, or
- Complete your credentialing application by entering or attaching missing information in CAQH ProView
Please respond as soon as possible to help complete the credentialing process.
Verify information for the provider directory separately: Entering and attesting to data in CAQH ProView doesn’t verify the information needed for the federal Consolidated Appropriations Act (CAA). The CAA requires that certain directory information be verified every 90 days, even if your data hasn’t changed since you last verified it. We recommend that professional providers use Availity® Essentials Provider Data Management tool to quickly verify their directory information with us and other insurers every 90 days. Facilities must use the Demographic Change Form to verify their data. Learn more on our Verify and Update Your Information page.
Completing the Application Process
The CAQH standardized application is an online form that meets the needs of all participating health care organizations. When completing the application, you will need to indicate which participating health plans and health care organizations you authorize to access your application data. Learn More
Keeping your information current with CAQH and BCBSMT is your responsibility. Learn More
Credentialing Status Checker
After you submit the Provider Onboarding Form to get credentialed, check the status of your credentialing process by entering your NPI or license number in our Credentialing Status Checker