Step 1: Provider Record ID Set up
You cannot complete credentialing and contracting process below until you have been assigned a provider record ID. Complete the Ancillary Provider Record Request Form and fax to the number on the form along with the supporting documents indicated on the form.
Step 2: Complete the Provider Questionnaire and Ancillary Checklist
Once you have an established provider record ID, complete the Credentialing/Recredentialing Ancillary/Hospital Provider Questionnaire.
You must include the appropriate information indicated on the Ancillary Credentialing Checklists section below. The Credentialing/Recredentialing Ancillary/Hospital Provider Questionnaire and any additional information required should be sent to the appropriate email address as indicated below by specialty.
Ancillary Credentialing Checklists:
- Durable Medical Equipment
- Free Standing Imaging
- Hearing Aid Supplier
- Independent Laboratories
- Orthotics and Prosthetics
Submit the following with the Provider Questionnaire to :
- Long Term Acute Care
- Radiation Therapy (Only Provider Questionnaire is required)
- Rehab Facilities - Inpatient Only
- Brain Injury (Post-Acute) Facilities
- Diabetes Management
- Disease Management (Only Provider Questionnaire is required)
- Home Dialysis
- Home Health
- Home Infusion Therapy
- Renal Dialysis
- Skilled Nursing Facilities
- Sleep Studies Center
- Ambulatory Surgery Centers
- Birthing Center
- Cardiac Catheter Lab
- Endoscopy Center
- Free Standing ER
- Psychiatric Day Treatment
- Psychiatric Hospital
- Substance Abuse Facility
When your information is received you will be assigned a case number. Cases are worked in the order they are received. This process can take up to 90 days to complete.
Step 3: Get Contracted
To participate in the BCBSTX network(s), once the provider receives confirmation that credentialing is approved, the provider should contact the Ancillary Contracting mailbox listed above by specialty to initiate the contracting process.