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.
The Credentialing Process
Blue Cross and Blue Shield of Nebraska has partnered with CAQH to streamline the credentialing process; allowing you to fill-out a single online app for use with over 650 of the nation's leading health plans, hospitals, and practitioner groups... saving you time and paperwork!
Are you ready to credential with BCBSNE? Initiate the credentialing process by registering online at CAQH.
Once you have completed CAQH's registration process and have received a confirmation from them, email BCBSNE with the following, required information for the provider being credentialed:
- 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
- CAQH Provider ID Number
- Location of the office where the provider is requesting to be credentialed
• Provide the complete office address (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.)
- 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.
- Providers must be licensed in order to be credentialed (some exceptions may apply).
• If you are a provisional provider, 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.
How It All Fits Together
We've reviewed our 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 a "first stop" to verify or clarify any portion of the Credentialing Process.
* Please allow additional time to process manual status updates as these require in-depth research by our Credentialing staff. We recommend utilizing the Online system when possible.