Welcome Providers

Overview

There are two options for obtaining a Blue Cross provider record:

Participating Provider

  • To request network participation as a participating provider, either through a new contract, or by joining an existing group, choose the “I wish to PARTICIPATE in Blue Cross’ network(s)” option on the credentialing packet checklist.
  • Must enter into a contractual agreement with Blue Cross to provide covered services to our members
  • See increased Blue Cross patient volume as members receive higher benefits when using network providers
  • Are listed in our online provider directory

Non-Participating Provider

  • To request a provider record only for filing claims, choose the “I wish to obtain a Blue Cross record only as a NON-PARTICIPATING provider” option on the credentialing packet checklist.
  • Have not signed a network agreement with Blue Cross and are; therefore, not in our networks
  • May not receive payment for some services as some members may not have benefits for services provided by non-participating providers without obtaining prior approval
  • Will not be listed in our online provider directory

Credentialing Process

The credentialing process can take up to 90 days after all required information is received. Providers will remain non-participating in our networks until their application has been approved by the credentialing committee. The committee approves credentialing twice per month.

After 90 days, you may inquire about your credentialing status by contacting our Provider Credentialing & Data Management Department at pcdmstatus@bcbsla.com.

The following professional provider types must meet certain criteria:

  • Applied Behavioral Analysts (ABA)
  • Acupuncturists
  • Audiologist
  • Certified Nurse Midwife (CNM)
  • Certified Registered Nurse Anesthetist (CRNA)
  • Certified Registered Nurse First Assistant (CRNFA)
  • Clinical Nurse Specialist (CNS)
  • Doctor of Chiropractic (DC)
  • Doctor of Osteopathic (DO)
  • Doctor of Medicine (MD)
  • Doctor of Podiatric Medicine (DPM)
  • Doctor of Dental Surgery (DDS)
  • Doctor of Medicine in Dentistry (DMD)
  • Hearing Aid Dealer
  • Licensed Addiction Counselor (LAC)
  • Licensed Clinical Social Worker (LCSW)
  • Licensed Professional Counselor (LPC)
  • Nurse Practitioner (NP)
  • Occupational Therapist (OT)
  • Optometrist (OD)
  • Physician Assistant (PA)
  • Psychologist (PhD)
  • Physical Therapist (PT)
  • Registered Dietician & Nutritionist (RD)
  • Registered Nurse First Assistant (RNFA)
  • Speech-Language Pathologist & Audiologist (SLP)
Learn more about Professional Provider type requirements.

 

Provider Type Requirements

Join Our Networks

Your request can take up to 90 days to process once all required information has been received. The BCBSLA 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. BCBSLA 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.

Applying for network participation has been made easy. Our online applications can now be completed, signed and submitted digitally with DocuSign. Each packet includes a checklist of all required documents. Please follow that checklist to ensure all information is included with the submission of your application. Blue Cross uses the LSCA for both credentialing and recredentialing applications.

Professional Initial Credentialing Packet  

Some of the required Recredentialing Supporting Documentation for Professional Providers includes:

  • Complete the LSCA
  • Enclose a copy of state license
  • Enclose a copy of DEA registration and CDS license (as applicable)
  • Enclose a copy of Malpractice Liability Certificate (copy of policy declarations page)
  • Complete the LSCA Attachment A -Location Hours
  • Enclose a copy of the Collaborating Physician Agreement/Supervising Physician Agreement (NP/PA)

Network providers are recredentialed every three years from their last credentialing acceptance date. Blue Cross sends recredentialing packets directly to providers based on the correspondence information on file.

Need Help with DocuSign®?
Many of our applications and forms must be completed, signed and submitted digitally through DocuSign® only. This electronic method reduces the need to print and submit hardcopy documents. For details on completing DocuSign forms, view this guide.

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Update Your Information

Please note, providers are considered out of network until they receive the BCBSLA Welcome to the Network notification letter. The BCBSLA 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. BCBSLA 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.

Maintaining information within your provider record is a key piece to participating in Blue Cross and Blue Shield of Louisiana provider networks or obtaining a provider record. It is important that you keep us abreast of any changes to the information in your record. This allows us to keep our directories current, contact you when needed as well as disperse payments. These forms are in DocuSign® format, allowing you to easily submit them to Blue Cross electronically.

What change do you need to make?

Provider Update Request Form – to update information such as:

  • Demographic Information
    For updating 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 Practice Location 
    To add a practice location(s)
  • Remove Practice Location 
    To remove a practice location(s)
  • Tax Identification Number (TIN) Change 
    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 
  • EFT Term/Change Request
    To change your electronic funds transfer (EFT) information, or to cancel receiving payments via this method

Need Help with DocuSign®?
Many of our applications and forms must be completed, signed and submitted digitally through DocuSign® only. This electronic method reduces the need to print and submit hardcopy documents. For details on completing DocuSign forms, view this guide.

Frequently Asked Questions

Plus sign that becomes an "X" when the accordion collapses to show more content Credentialing Application and Process

What credentialing forms are available online?
Blue Cross offers both the Professional Initial Credentialing Packet and the Facility Initial Credentialing Packet online through DocuSign®. They can be found under the Network Enrollment >Join Our Networks section of this site.

As a professional provider, how do I apply for network participation?
You can apply for network participation by completing the Professional Initial Credentialing Packet through DocuSign.

What documents are included in the Professional Initial Credentialing Packet?
The packet includes the Louisiana Standardized Credentialing Application (LSCA), Credentialing Application Attachment A Location Hours, iLinkBlue Service Agreement, Business Associate Addendum Agreement, Electronic Funds Transfer (EFT) Enrollment Form and Administrative Representative Registration Form.

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 that the signing process is complete, and the form was 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 Blue Cross receives all required information.

Do I need to complete the entire credentialing packet?
Professional providers who are NOT credentialed with Blue Cross must complete and submit the full Professional Initial Credentialing Packet.

What credentialing criteria are required for my specific specialty type?
Our Provider Type Requirements document lists the criteria required for the different provider specialties to help you determine what criteria are needed for your specialty. It is available under Network Enrollment >Join Our Networks >Professional Providers then look under the “Credentialing Process” tab.

Can I get reimbursed at in-network rates during credentialing?
Professional providers who meet specific criteria may be eligible for reimbursement during the credentialing process. For full details view the Reimbursement During Credentialing guide.

How do I know if I have been granted reimbursement during credentialing?
A Record Assignment letter will be emailed to your provider group’s correspondence email address. If granted reimbursement during credentialing, the letter will state the effective date of your high-level benefits. If not granted, your Record Assignment letter will give the reason.

I am already credentialed with Blue Cross and am opening my own practice, what forms do I need to complete?
Credentialed providers in a provider group starting a new clinic (or solo providers creating a new provider group) must complete the Provider Update Request Form. Choose the “Existing Providers Joining a New Provider Group” option. Attach a W9, EIN letter and a copy of your malpractice liability insurance certificate and Louisiana Patients Compensation Fund (LPCF), if applicable. You must also complete the iLinkBlue Agreement Packet and include a voided check or bank letter.

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 inquiry 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 provider name, Tax ID, rendering provider NPI, group or clinic NPI, type of form submitted and the date it was emailed. Most emails are answered within 24-48 hours.

Note: For Blue Cross 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 I can sign a provider agreement?
Yes. Once your credentialing application is completed, accepted by Blue Cross and approved by our Credentialing Committee, you will then work with your Provider Contracting Representative to complete the provider agreement process.

Note: If you are joining an existing group and all necessary agreements are on file with Blue Cross, then your effective date will coincide with the date you are approved by our Credentialing Committee and no separate signing of a contract is required.

When will I become a PARTICIPATING provider?
Once you are approved by the Blue Cross Credentialing Committee and all necessary provider agreements are signed and executed with Blue Cross, 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.

I am an existing network provider. How do I complete my recredentialing?
Blue Cross and/or a delegate will contact you six (6) months prior to the expiration of your credentials. If you have not heard from Blue Cross, 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 Blue Cross record, must complete the Professional Initial Credentialing Application through DocuSign and follow the non-participating checklist on the Credentialing Checklist for Professional Providers.

I am currently an active hospital-based provider and am joining a practice/group that requires credentialing. How do I get credentialed if I only have a hospital-based record?
Get credentialed by completing the Professional Initial Credentialing Packet through DocuSign. The Professional Initial Credentialing packet contains the Louisiana Standardized Credentialing Application (LSCA), Attachment A Location Hours, LinkBlue Service Agreement, Business Associate Addendum Agreement, EFT Enrollment Form and Administrative Representative Registration Form.

Plus sign that becomes an "X" when the accordion collapses to show more content Updating Provider Information

How do I update the information that Blue Cross has on file about me?
Please complete the Provider Update Request Form to submit changes to the information Blue Cross 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 demographic information about the specific provider, such as NPI or specialty, then select applies to “Individual Provider.”
  • 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 applies to “Individual Provider” and complete an update on each individual provider for the group. For the Type of Change, select “Demographic Information.”

How do I change my specialty?
Complete the Demographic Information section of the Provider Update Request Form. There you can list your new specialty and select “yes” for change specialty. Please attach a copy of your professional license, insurance certificate and schooling showing that you completed the requirements for the newly reported specialty.

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” if this is for multiple providers in the group. If this is for a solo provider, choose “Individual Provider.” 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 Blue Cross.

As a credentialed provider with Blue Cross, how do I join an existing contracted provider group?
Complete the “Existing Provider Joining a New Group” section of the Provider Update Request Form. Choose “Individual Provider” for this type of request.

As a credentialed provider with Blue Cross, how do I setup a new provider group (new billing NPI)?
On the Provider Update Request Form, select “Individual Provider” then choose “Add Group Details” on the Group/Clinic Name field to enter the group name. Then complete the “Existing Providers Joining a New Provider Group” section of the form. For this change, all supplemental paperwork is required. This includes Malpractice Liability Insurance certificate with the provider’s name listed (or a roster from the insurance company), W-9, EIN letter, iLinkBlue Service Agreement, Business Associate Addendum Agreement, EFT Enrollment Form and Administrative Representative Registration Form.

As a credentialed provider with Blue Cross, how do I add a practice location to my practice/organization that is also set up with Blue Cross under an existing Tax ID number and billing NPI?
On the Provider Update Request Form, select “Individual Provider.” In the Current General Information, enter the Tax ID and the billing NPI for the existing group. For the type of change, select “Add New Practice Location (Existing Tax ID and Existing Billing NPI).”

As an existing provider group in the network with Blue Cross (actively billing with a group NPI), how do I remove one of my practice locations while staying active under that billing NPI.

On the Provider Update Request Form, select “Individual Provider.” In the Current General Information section, enter the Tax ID and the billing NPI for the existing location that the provider is requesting to be removed. For the type of change, select “Remove Practice Location (Existing Tax ID).”

On the Provider Update Request Form, if I select Terminate Network Participation, will that completely term me from every clinic I am associated with?
No. When completing the Provider Update Request Form, you must include a Tax ID and billing NPI. You will be terminated for that Tax ID only. It will not affect any of your other Tax ID locations.

How do I terminate my existing network participation with a group?
On the Provider Update Request form, select that the request applies to “Provider Group/Clinic” if there are multiple providers in the group. If this is a solo provider, then select “Individual Provider.” For type of change, select “Terminate Network Participation.” You must include a Tax ID and billing NPI. You will be terminated for that Tax ID only. It will not affect any of your other Tax ID locations.
Note: Provider can select different types of termination (partial or full). If you have multiple records with Blue Cross, then you must separately term each record, based on Tax ID and billing NPI.

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

When is a Tax ID change request needed?
When an entire group 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.

How do I update my Tax ID number?
On the Provider Update Request Form, select that the request applies to “Provider Group/Clinic” if there are multiple providers in the group. If this is a solo provider, then select “Individual Provider.” Then complete the “Change Tax ID Number” section of the form.

  • For a group, this request moves all providers from one Tax ID to another. A copy of each provider’s malpractice liability insurance certificate must be attached. You must also complete all necessary documents as listed in the section's checklist.
  • For a solo provider, all supplemental paperwork is required as noted in the section’s checklist.

How do I add a new practice location (new group billing NPI for existing Tax ID)?
On the Provider Update Request Form, select “Individual Provider” then choose “Add Group Details” on the Group/Clinic Name field to enter the group name. Then complete the “Existing Providers Joining a New Provider Group” section of the form. For this change, all supplemental paperwork is required. This includes Malpractice Liability Insurance certificate with the provider’s name listed (or a roster from the insurance company), W-9, EIN letter, iLinkBlue Service Agreement, Business Associate Addendum Agreement, EFT Enrollment Form and Administrative Representative Registration Form.

How do I change from a solo provider to a group?
To change from a solo provider to a group you will need to complete the Provider Update Request Form. At the top of the form, select that the request applies to “Individual Provider.” Under the Current General Information section, select “Add Group Details” to add the information about the new Group NPI. For type of change, select “Existing Providers Joining a New Provider Group.” In addition, all supplemental paperwork is required (iLinkBlue Service Agreement, Business Associate Addendum Agreement, EFT Enrollment Form, Administrative Representative Registration Form). Make sure to check the box on the “Existing Providers Joining a New Provider Group” under checklist to include the group paperwork when setting up a new billing NPI. You will also need to complete the iLinkBlue paperwork on the group service agreement.

How do I remove a practice location?

  • If you are linked to several locations under a billing NPI and want to remove a single location, complete the “Remove a Practice Location section” of the Provider Update Request Form.
  • If you are removing all locations under a billing NPI, please complete the “Request for Termination” section of the Provider Update Request Form for each location.

How will I know if Blue Cross 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 Blue Cross requesting additional information; or in case of a rejection, a rejection letter is sent.

As a credentialed provider, how do I get listed in the Blue Cross online directory?
To be listed in the directory, credentialed professional providers must be available to schedule patients’ appointments a minimum of 8 hours per week at the location listed. If you meet these requirements and need to be added to our online directory, complete the Provider Update Request Form. At the top of the form, select “Individual Provider,” then choose the “Existing Provider Joining a New Provider Group” option. Enter the office hours you work at that location. In addition, please attach a letter requesting the update to your directory status.

Plus sign that becomes an "X" when the accordion collapses to show more content Submitting Information Through DocuSign

I have never used DocuSign to submit forms. How do I know what to do?
Blue Cross’ 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 Blue Cross?
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 Blue Cross.

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 Blue Cross 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 Blue Cross. 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 Blue Cross?

  • 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 Blue Cross 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.

Plus sign that becomes an "X" when the accordion collapses to show more content Filing Claims

I received a notification that I now have an active provider record. Can I start submitting claims?
Yes. Once your record is set up, Blue Cross will send you a Record Assignment notification letting you know that you can now submit claims.

When can I start seeing Blue Cross members and filing claims?
The provider will not be in our network(s) until accepted by the Blue Cross Credentialing Committee and an active contract is in place. Blue Cross 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 Blue Cross 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.

The following forms can be found on our Provider page at www.bcbsla.com/providers, click on “Resources,”  and look under the “Forms” section.

  • iLinkBlue Agreement Packet
  • Provider Update Request Form
  • Professional Initial Credentialing Packet
  • Facility Credentialing Packet
Need Help with DocuSign®?
Many of our applications and forms must be completed, signed and submitted digitally through DocuSign® only. This electronic method reduces the need to print and submit hardcopy documents. For details on completing DocuSign forms, view this guide.