Provider FAQs

CAQH Provider Portal

Below you'll find answers to the questions we get asked the most.

Providers will need to refer to NebraskaBlue.com/Providers/Credentialing for credentialing requirements. The initial credentialing and re-credentialing processes have not changed.

We do not currently utilize CAQH for other entities – just professionals/practitioners.

No. Providers still need to complete our Credentialing Requirements listed under our Credentialing Section.

Credentialing Information for Providers

Access is in CAQH under “Authorize”.

Effective dates are honored the date the request was received and or the date requested on the update.

We will not backdate.

Updates requested for future dates will go by the requested date.

Updates can be made by updating your CAQH Provider Profile and clicking "Review & Attest".

If there are no changes to be made, you will need to notify quarterly by confirming your practice locations and clicking "Review & Attest".

  • Name
  • Address
  • Office Locations
  • Phone and Fax Number for your specific practice
  • Location
  • Accepting New Patients
  • Email Address
  • Languages Spoken
  • NPI
  • Specialties

For example, a provider with Select Choice joins a TIN who does not yet have that contract. Are they still in network with Select? We rely on those approval letters to be certain. 

When a provider extends to a new practice and that TIN is already is participating with Blue Cross and Blue Shield of Nebraska (BCBSNE), the practitioner will get added to that TIN and receive the networks that are already established under that TIN.

When a provider extends to a new practice and that TIN is not participating with BCBSNE, the provider data specialists will still handle the contracting the same as it today, by reaching out and getting the necessary agreements needed.

NaviNet® Quarterly rosters are posted every 90 days and is the data that is currently in BCBSNE’s provider data system. If the provider terms in CAQH due to retiring or moving locations, the CAQH data will update our provider data system, and then when the next quarterly roster comes out on NaviNet, that provider should no longer be showing at that TIN if they termed.

Yes. Providers can archive a location. If you are archiving a location be sure to add your new or current location at the same time. Do not do this in separate requests.

Please ensure you are clicking "Review & Attest" after each update is made.

Provider Data Portal Review & Test

Updated every 90 days and is available to download via NaviNet