To Request Network Participation
Facilities at minimum must meet the criteria listed below:
If you wish to become a participating facility in one of our networks and you meet minimum criteria then you should submit a Health Delivery Organization (HDO) Information Form. If the provider does not meet basic criteria, the HDO form will be returned with an explanation and instructions for reapplying when applicable.
If you meet the above criteria, you must submit current copies of the following documents as applicable:
One of the following attachments is required based on the facility type:
All information submitted must be legible, current and without restriction. We will return all submitted information to the provider if the HDO Form is not signed and dated. Signature and date must be original. Signature stamps or date stamps are not acceptable.
* This information varies for recredentialing. View the Facility Recredentialing page to find out more.
The credentialing process can take 60-90 days from receipt of the HDO Form. Acceptance of the HDO Form is not a guarantee that the provider will be accepted in any network. Providers will remain non-participating in our networks until their HDO Form 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 HDO Forms 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.
BCBSLA reviews our contracted health delivery organizations as required by regulatory agencies. This policy applies to:
You may fax, e-mail or mail your HDO Form 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.
The BCBSLA Network Operations Department provides credentialing status updates only to the facility 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.
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