Jun 1, 2024

BCBSRI does not Credential Groups

As a reminder, BCBSRI does not credential groups (outside of ancillary). BCBSRI credentials individual providers within the group. When a new group is created, and the provider is not Credentialed with BCBSRI, an individual credentialing application should be filled out to tie the new provider to the new group. All other individual providers within that group, will follow the same process (if new to BCBSRI [if not new, they will need a PCF]). Group contracts should not be sent to Credentialing if you have individual professional providers rendering services.

Professional Claims should be submitted with the providers rendering NPI, and Type 2 billing NPI on all professional claims.