For Hospital-Based Providers

Hospital-Based Providers who DO NOT wish to be listed in our provider directories

A hospital-based provider is defined as a provider that only sees patients as a result of their being admitted or directed to the hospital.  A provider IS NOT considered hospital-based if you have patients referred directly to you from another physician or organization.  The classification as a hospital-based provider applies for the hospital location only and not for any other practice locations outside the hospital.

In general, hospital-based providers are not required to be credentialed to participate in our networks.  Hospital-based providers wishing to be placed in our provider directories are required to have their credentials approved by the Credentialing Subcommittee prior to network participation.

Note: Hospital-Based Providers who DO wish to be listed in our provider directories should instead follow the guidelines on Network Participation for Professional Providers page.

Required Application

If you wish to become a participating hospital-based provider in one of our networks, then you should submit a Louisiana Standardized Credentialing Application (LSCA) (only select sections as identified below).  If the provider does not meet basic criteria, the application will be returned with an explanation and instructions for reapplying when applicable.

  • General Information (page 1)
  • Primary/Secondary Location (pages 1-3); Complete as many sections up to Fourth Practice Location as needed.
  • Specialty (page 5)
  • Professional Licenses (page 8)
  • General Questions (page 9)
  • Provider Statement to Release Information (page 10)

Required Supporting Documentation

  • Current, Unrestricted, Professional State License
  • Employer Identification Number (EIN) Letter
  • Electronic Funds Transfer (EFT) application and a copy of a preprinted voided check.  See our EFT page.
  • iLinkBLUE and Business Associate Agreements appropriate for your practice.  See our iLinkBLUE page.
  • Provider Network Agreements, as applicable. If you are interested in network participation and you did not receive agreements, you may call Network Operations at 1.800.716.2299, option 3 to have the appropriate agreements sent to you.

All information submitted must be legible, current and without restriction.  We will return all submitted information to the provider if the application is not signed and dated.  Signature and date must be original.  Signature stamps or date stamps are not acceptable.


You may fax, e-mail or mail your application and supporting documents to BCBSLA using the following information.  Please use the mail option only when including agreements, as they are too large to send through the fax/e-mail option.

  • Fax: 225.297.2750
  • E-mail:
  • Mail: Blue Cross Blue Shield of Louisiana
    Attn: Network Administration
    P.O. Box 98029
    Baton Rouge, LA  70898

The BCBSLA Network Operations Department provides credentialing status updates only to the provider in question.  To check the status of an application, questions regarding network participation or for any other additional information call 1.800.716.2299, option 3.