Welcome Facilities and Hospitals

What credentialing forms are available online for facilities/hospitals?
Louisiana Blue  offers the Facility Initial Credentialing Packet online through DocuSign^®. It can be found on this site under the Network Enrollment >Join Our Networks section.

What documents are included in the Facility Initial Credentialing Packet?
The packet includes the Facility Credentialing Application and attachments, iLinkBlue Service Agreement, Business Associate Addendum Agreement, Electronic Funds Transfer (EFT) Enrollment Form and Administrative Representative Registration Form.

What attachments are included in the Facility Initial Credentialing Packet?
Attachments should be completed, as applicable only:

• Attachment A – Ambulance
• Attachment B – DME Supplier
• Attachment C – ASC, Hospital, IOP, PHP, Psych, CDU, SNF, LTAC, Rehab
• Attachment D – Urgent Care, Walk-in Clinic
• Attachment E – Diagnostic Services
• Attachment F – Retail Health Clinic
• Attachment G – Laboratory
• Attachment H – Outpatient Cath Lab

How will I know if Blue Cross received my application?
Once your application is finalized through DocuSign you will receive a confirmation email to notify you the signing process is complete, and the form is submitted to Blue Cross for processing.

How long does it take to complete the credentialing process?
The process can take up to 90 days for completion once Louisiana Blue receives all required information.

Do I need to complete the entire credentialing packet?
Facilities that are NOT credentialed with Louisiana Blue must complete and submit the full Facility Initial Credentialing Packet.

What credentialing criteria are required specifically for my facility type?
Our Facility Type Requirements document lists the criteria required for the different facilities to help you determine what criteria are needed. It is available under Network Enrollment >Join Our Networks >Facilities and Hospitals, then look under the “Credentialing Process” tab.

I have submitted documents to Blue Cross for processing by the PCDM Department. How can I get an update on the status of my request?
The preferred method of status updates is through email. Please wait 30 days from submission before checking status, then send an email to PCDMstatus@bcbsla.com. Using email creates a record of your inquiry allowing for easy reference. In your email, please include the facility name, Tax ID, facility NPI, type of form submitted and the date it was emailed. Most emails are answered within 24-48 hours.
Note: For Louisiana Blue to give information to your billing or management company instead, you must have a Business Associate Addendum Agreement on file.

Do I have to be fully credentialed before a provider agreement is put in place?
Yes. Once your credentialing application is completed, accepted by Blue Cross and approved by our Credentialing Committee, you must then work with your Provider Contracting Representative to complete the provider agreement process.

When will I become a PARTICIPATING facility?
Once you are approved by the Louisiana Blue Credentialing Committee and all necessary provider agreements are signed and executed with Louisiana Blue, you will be included as “participating” in the agreed upon provider networks. Your effective date will be outlined in the “Welcome to the Network” letter and will include a copy of your executed provider agreement.

How do I complete my recredentialing?
Louisiana Blue  and/or a delegate will contact you six (6) months prior to the expiration of your credentials. If you have not heard from Louisiana Blue, please email recredentialing@vhpla.com for your recredentialing application.

As a non-participating provider, how do I submit a record-only request?

• Non-participating providers, who only need a Louisiana Blue record, must complete the Facility Initial Credentialing Application through DocuSign.

How do I update the information that Louisiana Blue has on file about my facility?
Please complete the Provider Update Request Form to submit changes to the information Louisiana Blue has on file about you. It is important to keep your information updated with Blue Cross. This allows us to maintain current directories, contact you as needed and have accurate payment information on file.

Do I need to complete the entire Provider Update Request Form?
No. It is not necessary to complete the entire form. Choose only the options that apply for your needed change. DocuSign will prompt you to the pages based on your selection to make only those “types of change.” The selection/pages that need to be completed will appear in red text throughout the form.

What options are included on the Provider Update Request Form?
This is a comprehensive DocuSign form that allows you to select the needed area(s) for update then submit it electronically. The Provider Update Request Form includes the following request options:

• Demographic Information – To update contact information such as addresses, phone numbers or email addresses.
• Existing Providers Joining a New Provider group – If you are joining an existing provider group or clinic or adding new providers to your group.
• Add or Remove Practice Location – To add a practice location(s) or to remove a practice location(s).
• Change Tax ID Number – To file a change in your Tax ID number. Supporting documentation will be required, as outlined on this page.
• Terminate Network Participation – To terminate existing network participation or an entire provider record.
• Change EFT Information – To change your electronic funds transfer (EFT) information, or to cancel receiving payments via this method.

How do I update my demographic data?
Complete the Demographic Information section of the Provider Update Request Form.

If you are updating group demographic information, such as Correspondence or Billing Address, then select applies to “Provider Group/Clinic” and enter the Group/Clinic name on the form. If the physical location needs updating at the top of the form, select “Provider Group/Clinic.” For the Type of Change, select “Demographic Information.”

When should I submit an Electronic Funds Transfer (EFT) Enrollment Form and when should I instead complete the EFT Termination/Change section of the Provider Update Request Form?

• If you need to initially enroll in EFT, you should complete the EFT Enrollment Form.
• If you are already enrolled in EFT and want to change or terminate your banking information, complete the EFT Termination/Change section of the Provider Update Request Form. At the top of the form, choose “Provider Group/Clinic.” A blank voided check and/or bank letter will need to be attached to the document.

Note: If you are changing your EFT information, the old information you provide must match what is on file at Louisiana Blue.

How do I terminate my entire facility record?
If you have multiple records with Louisiana Blue, then you must separately term each record, based on Tax ID and billing NPI.

When is a Tax ID change request needed?
When an entire facility is moving from one Tax ID to another, complete the “Change Tax ID Number” section of the Provider Update Request Form. Please refer to the section’s checklist for additional required attachments.

To update your Tax ID number, use the Provider Update Request Form, select that the request applies to “Provider Group/Clinic” if there are multiple providers in the group. Then complete the “Change Tax ID Number” section of the form.

How will I know if Louisiana Blue received my Provider Update Request Form submission?
Once your submission is finalized through DocuSign, you will receive a confirmation email from DocuSign to notify you that the form was submitted. After prescreening, an additional email is sent from Blue Cross indicating the form is received and moved to processing. If the form does not pass prescreening, an email will be sent from Louisiana Blue requesting additional information; or in case of a rejection, a rejection letter is sent.

As a credentialed facility, how do I get listed in Louisiana Blue's online directory?
As a network facility, you are automatically listed in our online directory, unless you request not to be listed.

I have never used DocuSign to submit forms. How do I know what to do?
Louisiana Blue's DocuSign Guide includes detailed information and tips on how to navigate the fields throughout.

I was working on an application and had to step away and now the application is blank.
For security purposes, after 30 minutes of inactivity the application will timeout. If you need more time to complete your form, click “Finish Later” to save your work and a link will be sent to your email to access your application later.

Our office is closed on a specific day during the regular work week, but the form is asking me to complete the hours that I work.
For regular workdays that you do not see patients, enter your hours as “12 a.m. – 12 a.m.”

How do I know if my submission was received by Louisiana Blue?
Once your submission is finalized through DocuSign, you will receive a confirmation email to notify you that the form is signed by all parties. The form will then be reviewed by Louisiana Blue.

What happens if my DocuSign link for my recredentialing application expires?
Please send an email to PCDMstatus@bcbsla.com to request a new link for your recredentialing application. Be sure to include your name, email address, provider name and NPI number. Once you receive an updated link, please do not use any old links.

Can I make changes or add something to a document that I have already submitted to Louisiana Blue through DocuSign?
Once you click “Finish” you cannot change or add anything. This is a security feature to ensure that submissions are not altered. You must submit a new request or application to add or change something after you click “Finish.”

Can I submit and sign a form on behalf of the provider?
If you are completing the form and you sign the form, you are attesting that the information you have entered is correct and you are authorized to submit it on behalf of the relevant provider.

The incorrect name is populated on the DocuSign form I received from Louisiana Blue. How can I update that information?

• If the Authorized Representative name is incorrect, you can edit the field by right clicking the signature.
• If the provider name is incorrect, in the signature link go to “other actions” to update.

Who should complete the DocuSign forms sent by Louisiana Blue?

• The person completing the form should be the Authorized Representative for the provider and/or the provider. The final signature should be from the provider.
• If the Authorized Representative is incorrect, go to advanced options in the signature portion of the form to edit.
• Authorized Representative completes set one. The Provider needs to complete and sign part 2.

I have submitted several credentialing applications for multiple providers. How do I know which link is for which provider?
When the link is sent to the email address listed for the provider, it comes from Louisiana Blue via DocuSign and the subject will be “Please DocuSign: Professional Credentialing Packet – PROVIDERS NAME.” The provider name will be prepopulated from the provider portion of the application. Note: It is important you list the correct provider’s name when completing the provider section at the beginning of the application.

Can I print the signature page and sign it manually and upload it?
We do not accept handwritten signatures. One of the benefits of using DocuSign is that it allows us to electronically capture signatures.

I have multiple attachments but only one paperclip. What do I do?
If you need to upload multiple documents, you can upload multiple in each paperclip.

I received a notification I now have a non-par provider record. Can I start submitting claims?
The Record Assignment notification you receive is to let you know the initial application paperwork is complete. You must still complete the full credentialing and contracting processes, as applicable, before you will be given network participation. It is recommended that you not see our members until you receive network participation notification. Providers are considered out of network until they receive the Blue Cross Welcome to the Network notification letter. The Blue Cross Welcome to the Network notification letter will notify you of next steps and your network participation effective date shall be the effective date indicated on the signature page of your provider agreement. Louisiana Blue  does not backdate network participation. Any claims submitted prior to network participation will process as out- of-network. When a claim is processed as out of network, payment for services may go to the member not to the provider.

When can I start seeing Louisiana Blue members and filing claims?
The provider will not be in our network(s) until accepted by the Louisiana Blue Credentialing Committee and an active contract is in place. Louisiana Blue does not back date your network participation. It is based on your network participation contract/acceptance date. Your effective date will be outlined in the Welcome to the Network notification we will send you. Once you receive confirmation that you are participating in our Louisiana Blue network(s) you may begin seeing Blue members and filing claims as an in-network provider. Further, members will have access to you through our online directories and will receive in-network level benefits for your services.