Blue Cross Blue Shield

How to Get Credentialed with Blue Cross and Blue Shield of North Carolina in North Carolina

Network: Open
60-60 Days CAQH Required

Quick Overview

Timeline

60 - 60 days

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

North Carolina-Specific Requirements

Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Uses CAQH ProView for credentialing. Typical processing timeline: 60-90 days from complete application. Requires active North Carolina medical license from the North Carolina Medical Board. DEA registration required. Board certification required for specialists. Blue Cross NC is the largest health insurer in the state and has been experiencing significant market growth. Delegated credentialing available through select medical groups and health systems. North Carolina has expanded Medicaid, which may affect commercial enrollment volumes. Re-credentialing every 3 years.

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for North Carolina.

2

Complete Your CAQH ProView Profile

Blue Cross and Blue Shield of North Carolina requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.

3

Submit Your Application

Submit your completed enrollment package to Blue Cross and Blue Shield of North Carolina.

4

Track & Follow Up

Credentialing typically takes 60-60 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

Board Certification

Conditional

Required if board certified; highly recommended

CV/Resume

5-year work history minimum; gaps > 6 months must be explained

DEA License

Conditional

Required if prescribing controlled substances

Malpractice Insurance

Medical Degree

Medical License

NPI Certificate

Professional Reference

3 peer references required

Enrollment Forms

CAQH ProView

Universal credentialing application used by most commercial and BCBS payers.

Required
Online Open →

BCBS-NC CAQH Submission Form

Required
Online Open →

Contact Information

Credentialing

National

800-777-1643

credentialing@bcbsnc.com

Quick Links

Blue Cross and Blue Shield of North Carolina Website Provider Portal

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Other Payers in North Carolina

Aetna UnitedHealthcare Cigna Healthcare Anthem / Elevance Health Humana Centene Corporation Molina Healthcare NC Medicaid UnitedHealthcare Community Plan Amerigroup (Anthem)
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