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Providers

Credentialing

As part of an ongoing commitment to both our subscribers and our network practitioners, BCBSNE has developed a credentialing program that must be completed prior to participation. Credentialing policies and procedures have been established in compliance with Nebraska law, and modeled after URAC and NCQA standards.

To streamline the credentialing application process, we work with CAQH. Fill out one online application for use with over 650 of the nation's leading health plans, hospitals and practitioner groups, saving you time and paperwork. Providers must be licensed in order to be credentialed (some exceptions may apply).

Apply for Credentialing »

After completing the online application, email CredentialingRequests@NebraskaBlue.com with the following:

  • Provider's full name (first name, middle initial, last name)
  • Provider's date of birth and gender
  • The provider's nine-digit Social Security number
  • Provider NPI
  • CAQH Provider ID Number
  • Address of the office where the provider is requesting to be credentialed (facility name, address, city, state, ZIP and office phone number)
  • Office location start date
  • Tax ID number of the office where the provider is requesting to be credentialed
  • The provider's specialty type (e.g. MD - Family Practice, PA, PT, etc.)
    • Is the provider Medication Assisted Treatment (MAT) certified?
    • Does the provider offer Telehealth Services?
  • Contact information of the representative submitting the credentialing information

Note: You must receive confirmation from CAQH that your application is completed in order for BCBSNE to start the credentialing process. The information provided to BCBSNE will be used to obtain information from the CAQH database. The information will be pulled and processed in the date order received. Please refrain from submitting the request to BCBSNE more than 60 days from the start date of the provider.

If you are a provisional provider or Registered Behavioral Technician (RBT), please complete the Provisional Provider Form.

If you are part of a Physician-Hospital Organization, contact your PHO representative directly.

If are credentialing on behalf of a facility, please email BCBSNE directly at CredentialingRequests@nebraskablue.com.

 

Send an email to HealthNetworkRequests@NebraskaBlue.com with the following information:

  • Provider Name (of the provider and/or practice) terming
  • Provider NPI
  • Tax ID
  • Address
  • Term date (month/day/year)

Please ALSO include the following (if applicable):

  • No longer participating with BCBSNE
  • Transferring your contract to another group
    • Indicate which group you are working with so that we can coordinate efforts

Termination request without a transfer notice, BCBSNE will process termination, notification letters sent out to all members that have seen the provider within the last 18 months.

Termination request with transfer notice, BCBSNE will sync with both parties and transfer accordingly, termination letters will not be sent out.

We've reviewed the provider community's most-asked questions and created this online resource library to offer you easily-accessible information and process transparency. These guides should always be the first stop to verify or clarify any portion of the credentialing process.

Log into CAQH to check application status »

You can also make a manual request for status updates. Please allow additional time to process manual status updates as these require in-depth research by our credentialing staff.
How to Manually Request Status.

Additionally, see  Top Causes of Credentialing Delays.