Apply for Credentialing

Credentialing Instructions

Credentialing Instructions and Forms to aid you in completing the credentialing process.

Providers

• Advanced Practice Nurse
• Board Certified Medical Doctor/Doctor of Osteopathy/Doctor of Dental Science or Doctor of Dental Surgery/Doctor of Medical Dentistry/Doctor of Podiatry
• Licensed Certified Social Worker/Certified Substance Abuse Counselor/Licensed Clinical Addiction Specialist/Licensed Pastoral Counselors/Licensed Marriage and Family Therapist and Licensed Psychological Associate / Psychiatric Nurses (RN), and Certified Nurse Specialists (CNS)
  Our mental health network may be closed in some counties. Please contact BCBSNC Network Management to confirm network status prior to submitting an application.
• Doctor of Optometry/Psychologist/Physical Therapist/Occupational Therapist/Speech Pathologist/Audiologist/Chiropractors or Respiratory Therapists
• Licensed Dietician Nutritionist
• Licensed Professional Counselor
• NON Board Certified Medical Doctor/Doctor of Osteopathy/Doctor of Dental Science or Doctor of Dental Surgery/Doctor of Medical Dentistry/Doctor of Podiatry
• Pharmacist
• Physician Assistant

Facilities

• Ambulance (PARTNERS only)
• Ambulatory Surgical Centers
• Birthing Centers (BCBSNC Only)
• Cardiac Event Monitoring (PARTNERS Only)
• Cardiac Event Monitoring (PARTNERS Only) (Equipment Only)
• Independent Diagnostic Testing Facility (PARTNERS Only)
• Dialysis Facilities
• Durable Medical Equipment (Diabetic Supplies Only) The DME provider network for BCBSNC closed to new providers effective 6/1/07.  The DME provider network for PARTNERS closed to new providers effective 8/10/07.
• Free Standing Radiology (PARTNERS Only)
• Home Durable Medical Equipment The DME provider network for BCBSNC closed to new providers effective 6/1/07.  The DME provider network for PARTNERS closed to new providers effective 8/10/07
• Home Durable Medical Equipment (Equipment Only) The DME provider network for BCBSNC closed to new providers effective 6/1/07.  The DME provider network for PARTNERS closed to new providers effective 8/10/07
• Home Health Agencies
• Home Infusion Therapy
• Hospice Agencies (BCBSNC Only)
• Hospitals
• Intensive Outpatient Facilities (BCBSNC Only)
• Mobile X-ray (PARTNERS Only)
• Orthotics and Prosthetics The O&P provider network for BCBSNC closed to new providers effective 6/1/07.  The O&P provider network for PARTNERS closed to new providers effective 8/10/07
• Orthotics and Prosthetics (Breast Prosthetics Only) The O&P provider network for BCBSNC closed to new providers effective 6/1/07.  The O&P provider network for PARTNERS closed to new providers effective 8/10/07
• Private Duty Nursing (BCBSNC Only)
• Reference Laboratories (PARTNERS Only)
• Residential Treatment Facilities (BCBSNC Only)
• Skilled Nursing Facilities (PARTNERS Only)
• Sleep Centers (PARTNERS Only)

Submission information

Complete the required information, attach all appropriate forms, and mail or fax them directly to us at: