New Provider (Individual/Group) Credentialing and Enrollment Process Change Effective November 1, 2022

Effective November 1, 2022, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will begin utilizing the Council for Affordable Quality Healthcare (CAQH) ProView universal credentialing application. The upcoming changes to our processes will improve quality and timeliness in onboarding our new providers/practitioners to Blue Cross NC. Providers will be required to do the following:

• Utilize CAQH ProView for initial credentialing and recredentialing with Blue Cross NC.
• Complete the new online Individual Practitioner Enrollment Form for enrolling new practitioners
  or
• Complete the online Provider Group Enrollment Form for enrolling new groups
• Submit individual practitioner and group enrollment forms 60 days prior to the provider’s effective date; as it currently takes 60 days for a new enrollment to be processed.

This initial step of integrating automation and streamlining onboarding processes will improve turnaround times for credentialing and enrollment.

We appreciate your cooperation and look forward to partnering with you as we transition to a more automated and digitized workflow. Please see the FAQ which provides further guidance and instructions for utilizing these electronic processes.