Resources

PA Resources Portlet

Resources

CODING & DOCUMENTATION

EDUCATION & EVENTS

ENROLLMENT & CREDENTIALING

FORMS & MANUALS

HEALTHCARE INFORMATION & TECHNOLOGY

PATIENT HEALTH

PHARMACY

POLICIES & GUIDELINES

PRE-SERVICE REVIEW

PROGRAMS & INITIATIVES

PROVIDER NETWORKS & SPECIALTIES

PA Dynamic Rendering

ENROLLMENT & CREDENTIALING

Enrollment and Credentialing

Pick the option that best describes what you need to do today:

Recredential, Maintenance, Join Network

Recredentialing - An existing provider needing to be recredentialed within a 36 month timeframe
Maintenance to make changes - A credentialed provider needing to make changes to Tax ID or demographic information
Joining a network - A new or existing provider interested in joining a Blue Cross and Blue Shield of Alabama provider network

Note: According to the Blue Cross and Blue Shield Association, plans are not allowed to contract directly with out-of-area providers residing outside of their service area. Providers living outside of the Blue Cross and Blue Shield of Alabama service areas are not allowed to work remotely.

Out-of-service area providers can provide telemedicine to patients located in Alabama, but they need to contract and submit claims to the Blue Plan where the provider is located. We cannot contract with providers located in another Blue Plan’s service area.

Provider Data and Credentialing Mandates and Processes

Find out the latest credentialing mandates regarding provider data and updates to the credentialing processes.

Requirements for Updating Provider Directory Information - Read about the responsibilities you have under the Consolidated Appropriations Act (CAA) to verify and update your provider directory information.
2024 CMS Final Rule - Read about mandates regarding provider terminations beginning in 2024.

Webcast:

Provider Data and Credentialing Mandates and Processes - November 2023

Practitioner Rights