Skip Navigation

Manually Apply for Credentialing Offline

Becoming an in-network BCBSNC provider or facility is a two-part process. First, you'll need to have your credentials verified. For that, you'll need to fill out and send us the standard application with any other requested documents. Some specialties may also have additional requirements. The instructions for providers and facilities can be found below.

A few notes about the credentialing/recredentialing process

Once you've sent us your information, the Credentialing Committee will approve or deny your request. You won't be considered an in-network participating provider/facility or be able to file any BCBSNC member claims for direct payment until you've been contacted by the Network Management office and have a signed, active contract with an effective date.
If you've already sent us your credentialing application, you can go to Part 2.

We suggest you complete parts 1 and 2 at the same time to help speed up the process.

Part 1. Apply for Credentialing or Recredentialing

Providers

Providers must fill out a Uniform Application . As well as completing and sending us your application, you'll need to send documents specific to your specialty.

Avoid delays in processing your application

  • Be sure you fill out the entire application and enter N/A where appropriate. If you leave any fields blank, your application will be considered incomplete and won't be processed.
  • Include a copy of liability insurance.
  • If you have a single medical malpractice judgment case settled for $200,000.00 or multiple malpractice cases settled for any amount, you'll need to include two letters of recommendation from physician peers.
    Download Letter of Recommendation form.

Download Application


  • Provider must be Board Certified or Board Eligible by an ABMS member board (Residency/Fellowship Trained) in one of the following specialties:
    • Family Medicine
    • Internal Medicine
    • Otolaryngology
    • Pediatrics
    • Neurology
    • Psychiatry
    AND
    1. Sub-certified in Sleep medicine by one of the ABMS member boards listed above.
      OR
    2. Completed an ACGME accredited fellowship in Sleep Medicine

Facilities

For facility credentialing, you'll need to fill out and send us the BCBSNC Facilities Provider Application for Participation form. You'll also need to send us all required documents with your application at that time.

Avoid delays in processing your application

  • Be sure you fill out the entire form and enter N/A where appropriate. If you leave any fields blank, your application will be considered incomplete and won't be processed.
  • Send a completed application for each site and each organization that has a unique Federal Tax ID#.

Download Facility Application


Please include the following documents with your application:

  • All of the following services must be provided in order to meet contracting requirements:
    • Pharmacy
    • Nursing
    • Supplies
  • A copy of the Division of Health Service Regulation License and Board of Pharmacy Permit-Infusion Services is required for each site.
  • Home Infusion Agencies must be either accredited or certified by Centers for Medicare and Medicaid (CMS).
  • One of the following accreditation certificates is needed for each site (or letter attesting to all covered sites) if applicable:
    • Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
    • The Community Accreditation Program, Inc. (CHAP)
    • Accreditation Commission for Health Care (ACHC)
  • Medicare/Medicaid verification is needed for each site (or letter attesting to all covered sites) if applicable.
    Note: A current copy of the Medicare and Medicare Remittance Advice Summary (RA) from the facility will meet this requirement.
    Note: If applying for the Blue Medicare HMO and Blue Medicare PPO networks Medicare certification is required.  
  • A general liability malpractice insurance face sheet. It must include current coverage dates, provider name, address, and limits of coverage. Minimum coverage for all networks is $1 million occurrence/$3 million aggregate.
  • On the application form, if the facility isn't currently accredited and you've answered yes to any questions under section 1.G, an explanation is needed. The following information is required if question number C is answered yes:
    • Number of cases less than $200,000
    • If greater than $200,000 actual or anticipated, include the occurrence date, settlement date, and nature of case.

Send Us Your Application and Documents

Fill out the application, attach all appropriate documents and email, fax or mail them to us at:

Email
credentialing@bcbsnc.com

Fax
(919) 765-7016

Mail
Blue Cross and Blue Shield of North Carolina
Attn: Credentialing Department
P. O. Box 2291
Durham, NC 27702

Incomplete Applications

If your application is incomplete or if you have not submitted all of the required documents, we'll contact you within 15 days of receiving it requesting the missing information. Your incomplete application will be closed 60 days from when we receive it if the requested information isn't received.

Once Your Application is Complete

After you send the completed application and documents, you'll be presented to the Credentialing Committee for approval or denial. If denied, you'll be notified by certified mail. If approved, a Network Management associate will contact you to finalize the contracting process and assign your effective date.

Once You're Credentialed

Please don't send any claims until you've received an effective date for participation into the BCBSNC network. Claims aren't eligible for payment until a BCBSNC participation effective date has been decided.

Part 2: Register Your NPI Number

The next part is to enroll to register your NPI number. We recommend that you register your NPI number at the time you send in your credentialing application and supporting documents to help save you time.

You'll need to fill out and send an enrollment application and a tax ID form so BCBSNC can register your NPI. In addition to your registered NPI, you'll also need to have an active contract with BCBSNC. This will allow you to file claims for services provided to BCBSNC members.

Start NPI Registration Process