Blue Cross Blue Shield

How to Get Credentialed with Anthem Blue Cross and Blue Shield of Ohio in Ohio

Network: Open
45-60 Days CAQH Required Delegated Credentialing

Quick Overview

Timeline

45 - 60 days

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

Yes

Ohio-Specific Requirements

Multiple BCBS licensees operate in Ohio: Anthem Blue Cross and Blue Shield of Ohio (Elevance Health subsidiary) and Medical Mutual of Ohio. Providers may need to enroll with each separately. Anthem Ohio uses CAQH ProView with standard Anthem credentialing process. Medical Mutual also uses CAQH ProView. Typical processing timeline: 45-60 days for Anthem; 60-90 days for Medical Mutual. Requires active Ohio medical license from the State Medical Board of Ohio. DEA registration and Ohio Terminal Distributor of Dangerous Drugs (TDDD) license required if dispensing. Board certification required for specialists. Delegated credentialing available through larger health systems and medical groups. 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 Ohio.

2

Complete Your CAQH ProView Profile

Anthem Blue Cross and Blue Shield of Ohio 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 Anthem Blue Cross and Blue Shield of Ohio.

4

Track & Follow Up

Credentialing typically takes 45-60 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
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