If you are an individual health care provider, medical practice group or facility that would like to join our network, you can find information related to our contract and credentialing processes here.
We contract with physicians, facilities and other health care professionals to form provider networks essential for the delivery of quality, accessible and affordable health care services to our members.
Excellus BlueCross BlueShield provides health insurance coverage to nearly 1.5 million individuals, and we welcome health care professionals to join our provider network to help the people in our communities live healthier and more secure lives through access to high quality, affordable care.
Our contract and credentialing process takes approximately 90 days to complete.
- You may require BOTH a contract and credentialing agreement to participate. View which provider types require credentialing and/or contractual agreements.
- • Please ensure that your enrollment application is complete before your return it to us, including required fields, Social Security number and taxonomy code. Your application must be signed and must include all required supporting documentation.
We do not exclude from participation in its network or otherwise discriminate against providers on the basis of race, color, national origin, sex, age or disability of individuals with whom the providers have a relationship.
Some states require that out-of-state providers enroll in their state's Medicaid program in order to be reimbursed. Some states may accept a provider's Medicaid enrollment in the state where they practice to fulfill this requirement.
- Complete an enrollment form.
- We will review your request and send the appropriate Participating Agreement.
- A request to participate in our network does not guarantee that you will receive a contract. All requests are reviewed for adequate member access to in-network care.
- Terminating a Licensed Physician: Any nurse practitioner (NP), physician assistant (PA), or certified behavioral analyst assistant who has a collaborating relationship with the terminated licensed physician must complete an Application for Non-Physician Health Care Practitioner to be reassigned.
- Where credentialing is required, providers can self-register on the Council for Affordable Quality Health Care (CAQH) website (www.caqh.org).
- Credentialing applications are usually processed within 90 days of receipt
The applicant has the right upon request to be informed of the status of their application for credentialing. They also have the right to review their submitted information for credentialing and correct erroneous information, upon request. The method of communication used by the applicant will determine the method of response (e.g. a phone inquiry will receive a phone response, a letter inquiry will receive a response by letter). The Plan will share current status, date of the next committee meeting, as well as identify the missing items necessary to complete the file for presentation to the Credentialing Committee.
We process claims and send information to you by using the information maintained in your provider record. This is also the information that appears in our print and online directories, two resources that our members use to find health care providers.
It’s very important that you inform us whenever any of your practice information changes. Please let us know immediately of any changes to your information using the Practitioner Demographic Changes form.