Credentialing and Recredentialing

Additional credentialing will not be required for those providers already credentialed in the Blue Choice® Blue Essentials, Blue Premier or Blue Advantage HMO networks and whose recredentialing is current

To join BCBSTX as a participating STAR, CHIP, or STAR Kids provider, you will need to request a Provider Record ID, sign agreements and complete the credentialing process. Refer to Network Participation – How to Join.

Informational notifications, provider presentations, facility applications and instructions, a webinar, and FAQs can be found on the on the Texas Health and Human Services website and CVO implementation updates

Facility Providers ONLY: Facilities can submit their credentialing application through AvailityTM. View the Availity portal demonstration for providers of the Provider Credentialing Application

Expediated Credentialing Process 

BCBSTX will provide an expedited credentialing process which allows for a "provisional network participation" status if the provider applicant has:

  • A valid BCBSTX Provider Record ID for claim payment
  • Submitted a current signed BCBSTX contract/agreement
  • Completes the CAQH ProView database online application with "global" or "plan specific" authorization to BCBSTX (or if applicable, submits a completed TDI application)**
  • A valid license in the state by, and in good standing with, the Texas Licensing Boards.

** Providers will be notified once the CAQH credentialing applications are reviewed for completeness. The review takes on average 8–10 calendar days.

If you have questions, please contact your local Network Management Office at TexasMedicaidNetworkDepartment@bcbstx.com.

Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly. Aperture is a trademark of Aperture Credentialing, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. "Aperture" provides administrative services to BCBSTX. If you have any questions about the products or services offered by such vendor, you should contact the vendor directly.