Join Our Network - Become a Participating Provider
Thank you for your interest in becoming a participating provider with Excellus BlueCross BlueShield.
Excellus BlueCross BlueShield is part of The Lifetime Healthcare Companies, a family of companies that now provides health insurance coverage to nearly 1.5 million people across 39 counties of New York state. We welcome health care professionals to join our provider network to help people in our communities live healthier and more secure lives through access to high quality, affordable care.
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.
- Complete the Application for Provider Enrollment FormOpen a PDF
(View all application for enrollment forms)
- Ensure all fields on the Enrollment Form are completed in full
(Incomplete applications will delay the process time)
- Include all required supporting documents along with your Enrollment Form. You’ll find a checklist is on cover page of Enrollment Form.
- A contract is required for all provider enrollments, unless you are a nurse practitioner (NP), physician assistant (PA), licensed master social worker (LMSW), or licensed creative arts therapist (LCAT) with a sponsoring physician. Please refer to the Application for Non-Physician Health Care PractitionerOpen a PDF
You may be required to be credentialed. Please see credentialing requirements and policies below.
Complete the Application for Provider Enrollment Form and submit the form to the Enrollment mailbox at ProviderEnrollment@Excellus.com.
A request to participate in our network does not guarantee that you will receive a contract.
Terminating a Licensed Physician:
Any nurse practitioner, physician assistant, 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.
Updating Practice Information:
Contracted providers can make updates to practice information using the Demographics Change form.
Provider Relations will review your enrollment request and will send the appropriate Participating Agreement for your review and signature.
We cannot begin to process your enrollment application until we have your signed and dated contract returned back to us. Once your enrollment has been finalized, you may request a copy of the fully executed contract.
You may not provide services to Excellus BlueCross BlueShield members until you are credentialed, and your contract is fully executed.
Credentialing applications are usually processed within 60 days of receipt.
See credentialing and recredentialing requirements for all specialties.
Keep your practice information up to date by submitting Demographic Changes form.
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.