For Professional Providers

To Request Network Participation

Credentialing Criteria

(As applicable by specialty)

Providers at minimum must meet the criteria listed below:

  • Current, Unrestricted Professional State License
  • Current, Unrestricted Louisiana Controlled Dangerous Substance (CDS) License and Federal DEA Certificate
  • Current Professional Malpractice Liability Insurance with minimal coverage amounts of: $100,000/300,000 with Louisiana Patient's Compensation Fund (LPCF) OR $1,000,000/3,000,000 without LPCF and the Insurance carrier rating of at least an A by AM Best Company OR Self Insured through LPCF
  • Current Active, Admitting Unrestricted Hospital Privileges (at a participating hospital)
  • Curriculum Vitae—explanation of past five years' work history (Past three years for recredentialing)
  • No current Medicare/Medicaid Sanctions
  • Board Certification(s) or Board eligibility obtained by the American Board of Medical Specialties

Required Application

If you wish to become a participating provider in one of our networks and you meet minimum criteria then you should submit a Louisiana Standardized Credentialing Application.  If the provider does not meet basic criteria, the application will be returned with an explanation and instructions for reapplying when applicable. You must also complete our online interactive Network Interest Form.

Required Supporting Documentation*

If you meet the Credentialing Criteria listed at the top of this page, you must submit current copies of the following documents as applicable by specialty:

  • Professional State License
  • Louisiana Controlled Dangerous Substance (CDS) License and Federal DEA Certificate
  • Certificate(s) of Professional Malpractice Liability Insurance
  • Certificate of Louisiana Patients' Compensation Fund, as applicable
  • History of malpractice claims paid (past 5 years)
  • Employer Identification Number (EIN) Letter
  • Curriculum Vitae (CV) (past 5 years' work history)
  • If you are a Primary Care Physician (PCP) and you have a hospitalists group admitting patients for you, you must submit a letter stating the agreement between you and the hospitalist group that is signed and dated by both parties.
  • The following specialties do not require hospital privileges:  Hospital Based Anesthesiology, Hospital Based Pathology, Hospital Based Radiology, Podiatric Medicine, Dermatology, Allergy & Immunology, Psychiatry and Physical Medicine & Rehabilitation (Physiatry).  All pediatric subspecialties for the above specialties are included in the exception.  Infectious Disease providers require consulting privileges.
  • Certification(s), including Board Certification obtained by the American Board of Medical Specialties, as applicable
  • Electronic Funds Transfer (EFT) application and a copy of a preprinted voided check. See our EFT page.
  • iLinkBLUE and Business Associate Agreement 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 or your group does not have an agreement on file, please call Network Operations at 1.800.716.2299, option 3 to have the appropriate agreements sent to you.
  • W-9 Form

* This information varies for recredentialing. View the Professional Recredentialing page to find out more.

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. 

The credentialing process generally takes up to 90 days from receipt of the application. Acceptance of the application is not a guarantee that the provider will be accepted in any network.  Providers will remain non-participating in our networks until their application has been approved by the Credentialing Subcommittee.  We will not allow a provider to participate in any network until their credentials have been approved by the Credentialing Subcommittee.  We do not back date network participation prior to the approval date.  The credentialing approval date becomes the effective date of network participation unless a future date is requested.  All applications must not be older than 180 days at the time of the Credentialing Subcommittee meeting.

Providers may appeal subcommittee decisions using the guidelines on the Appeals and Terminations page.


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 only provides application status updates 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.

*When the credentialing department receives all required information and does not need to request clarifications and/or corrections.