Credentialing

Individual Credentialing

Credentialing Criteria
(As applicable by specialty)

• Current, Unrestricted Professional State License
• Current, Unrestricted Louisiana Controlled Dangerous Substance (CDS) License and Federal DEA Certificate
• Current 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
• Curriculum Vitae—explanation of past five years' work history (Past three years for recredentialing)
• No current Medicare/Medicaid Sanctions
• Completion of post graduate training (does not apply for recredentialing)

If the provider does not meet basic criteria, the application will be returned with an explanation and instructions for reapplying when applicable. Applications are reviewed based on specific standards as applicable.

Application and Supporting Documentation*
If you wish to become a participating provider in one of our networks, you should complete the Louisiana Standardized Credentialing Application. In order to prove you meet the criteria above, you must submit current copies of the following documents as applicable by specialty:

• Professional State Medical License
• Louisiana Controlled Dangerous Substance (CDS) License and Federal DEA Certificate
• Certificate(s) of Malpractice Insurance
• Certificate of Louisiana Patients Compensation Fund, as applicable
• History of malpractice claims paid (past 5 years)
• Employer Identification Number (EIN) Letter
• ECFMG Certificate, as applicable
• Curriculum Vitae (CV) (past 5 years' work history)
• Certification(s), including Board Certification, as applicable
• Health Plan Agreement, as applicable

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. The credentialing process can take 60—90 days; however, we average 40 days from receipt of the documentation.

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

Submission
You may fax or mail your application and supporting documents to BCBSLA using the information below.

Fax: 225.297.2750

Mail: Blue Cross and Blue Shield of Louisiana
Attn: Network Operations
P.O. Box 98029
Baton Rouge, LA 70898

Acceptance of the application is not a guarantee that the provider will be accepted in any network. The Credentialing Subcommittee must approve all providers. Providers may appeal subcommittee decisions using the guidelines on the Appeals and Terminations page.