Our Network Operations Department builds and manages provider networks that offer price, access and quality sufficient to support competitive premiums. Since 1996, we have been dedicated to fully credentialing providers who apply for participation in our networks. Our credentialing program is accredited by the American Accreditation HealthCare Commission, Inc. (URAC) for our HMO and Preferred Care PPO networks. All provider information in the credentialing process is considered highly confidential.
Criteria and Application Information
Individuals and facilities can be credentialed by us. All those interested in participating in our networks will be required to meet certain criteria. Every practitioner must practice in an acceptable professional location that ensures confidentiality of procedures and minimal risk to the members. An acceptable office location does not include a home of the provider or member. To find out more about credentialing requirements, use the links below. We delegate credentialing to Magellan Health Services* and Family Managed Care for our HMO network for behavioral health providers.
Individual Credentialing
Physicians and health care providers who meet the required criteria can view information on how to submit an application to us.
Recredentialing
Providers are recredentialed every three years. The recredentialing section shows what documents to submit in order to continue participation in our networks. The Credentialing Subcommittee reviews all recredentialing applications. Unless otherwise notified, providers should consider their recredentialing application approved for a three-year cycle.
Facility Credentialing
Health delivery organizations can become participating facilities in our networks. In this section, you can view the criteria and download the appropriate forms.
Receipt of an application or agreement does not guarantee acceptance into any network. The Credentialing Subcommittee must approve all providers. Providers may appeal subcommittee decisions using the guidelines on the Appeals and Terminations page.
For more information on network participation, call Network Operations at 1.800.716.2299, option 3.
The BCBSLA Network Operations Department only provides credentialing status updates to the physician in question. To check the status of an application or for additional information call 1.800.716.2299, option 3.
*Magellan Health Services, Inc. is an independent company that manages behavioral health services for Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc.
