Join Our Network(s)

All providers must be enrolled and credentialed by Blue Cross and Blue Shield of Alabama. Visit our webpage for new providers for details about joining our network(s).

Update Provider Data

Visit the Provider Maintenance webpage to find forms to add locations and make changes to Tax ID and/or demographic information for providers who have been active for three months or more.

Use these real-time practice-level reports to help answer questions about provider data. To access these reports, select Profiles & Reports then click on the report name under Provider Data Management.

• Active Provider Locations: This report shows participating providers who have active locations and/or locations that have been temporarily suspended due to no claims activity for more than three months under a specific tax identification number. This report can also be used to check a provider’s network participation status and effective dates. Note: If the provider is not listed, he or she is not participating in a Blue Cross network.
• HPN and EPO Providers: This report lists providers who participate in the Blue High Performance Network^® (BlueHPN^®) for Exclusive Provider Organization (EPO) plans. The report also shows active provider locations and those that have been temporarily suspended for no claims activity. 
• Preferred Physician Laboratory: This report lists providers with an Preferred Physician Laboratory. The report also shows active provider locations and those that have been temporarily suspended for no claims activity. 
• Preferred Radiology Program Providers: This report shows active Preferred Radiology Program (PRP) providers with certification(s) due to expire within six months. The report also shows active provider locations and those that have been temporarily suspended for no claims activity under a specific PRP-flagged group.
• Select Network Program Providers: This report lists providers who participate in a Select Program. The report also shows active provider locations and those that have been temporarily suspended for no claims activity. 
• Urgent Care Providers: This report lists providers designated as urgent care under a specific tax identification number. The report also shows active provider locations and those that have been temporarily suspended for no claims activity. 

Note: To re-activate a provider's location due to no claims activity for more than three months, a provider can submit a claim for a service provided at that site and our system automatically re-activates the location.

Recredential a Provider

Contracted providers must be recredentialed with Blue Cross every three years to continue participation in our provider network(s). Review the Recredentialing webpage for details.

Use this real-time practice-level report to help answer questions about recredentialing timelines:

• Providers Due for Recredentialing: This report lists providers who are due for recredentialing under a specific tax identification number. Providers must be recredentialed every three years. This report helps groups identify which providers are approaching their recredentialing deadline. New providers can be added to this report monthly.

Provider Data and Credentialing Mandates and Processes

Review mandates regarding provider data and credentialing: 

• Requirements for Updating Provider Directory Information: Read about your responsibilities to verify and update your provider directory information under the Consolidated Appropriations Act (CAA).
• 2024 CMS Final Rule: Read about mandates regarding provider terminations beginning in 2024.
• 2025 CMS Final Rule: Read about wait time requirements for routine primary care, behavioral health, and non-urgent specialty care. 

Webcast:
Provider Data and Credentialing Mandates and Processes