BCBS of Kansas New Credentialing Requirements

BCBS of Kansas New Credentialing Requirements

by abilling, June 4, 2013

BCBS of Kansas has not historically required any provider be credentialed in order to be participating.  When adding a new provider to a group, we simply had to fax them a request to add the provider, and they would send us an application to fill out.  We would submit the application and BCBS would set the effective date we requested, including any back dating if necessary.

BCBS is now required to have their entire current provider network credentialed by August 1, 2013 (to include the following provider types:  MD, DO, DPM, PA, APRN, PhD, LSCSW, LCMFT, LCPC, LCP, LPT, DDS, OD, and DC – CRNAs are not currently required to be credentialed).  For any of the listed provider types requiring credentialing, it will be very important you notify ABI of new providers being added to your practice as soon as you become aware of the addition.  The credentialing process can take 90-120 days and BCBS will not back date any effective dates.  The effective date will be the date the credentialing process is complete.  If a provider is seeing BCBS patients and has not completed credentialing, those claims will be processed as out-of-network, creating a higher patient responsibility/out of pocket.  Please be advised, you will need to notify ABI as soon as you realize you will be adding new providers.



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Editor:  Philip Blann (pblann@anesthesiabilling.com).

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