Blue Cross Blue Shield

How to Get Credentialed with Independence Blue Cross in Pennsylvania

Network: Open
60-120 Days CAQH Required

Quick Overview

Timeline

60 - 120 days

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

Pennsylvania-Specific Requirements

Southeastern PA/Philadelphia. Primary practice address must be in PA or DE. SEPARATE enrollment from Highmark.

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 Pennsylvania.

2

Complete Your CAQH ProView Profile

Independence Blue Cross 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 Independence Blue Cross.

4

Track & Follow Up

Credentialing typically takes 60-120 days. Monitor your application status and respond promptly to requests for additional information.

Free Consultation

Need help enrolling with Independence Blue Cross?

Our specialists handle the entire Independence Blue Cross enrollment process: applications, follow-ups, and approvals in Pennsylvania.

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 →

Independence Blue Cross Credentialing

Required
Online Open →

Key Credentialing Terms

CAQH
The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
Credentialing
The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
Effective Date
The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
Fee Schedule
A complete listing of fees and reimbursement rates that an insurance payer will pay for specific medical services and pr...
HMO
A Health Maintenance Organization is a managed care plan that typically requires members to choose a primary care physic...
Network Status
A provider's participation status with a specific insurance payer, indicating whether they are in-network (contracted) o...
NPI
The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
PPO
A Preferred Provider Organization is a managed care plan that offers a network of contracted providers at lower costs to...

Credentialing Checklist

Make sure you have everything ready before applying to Independence Blue Cross.

View Physician Credentialing Checklist →

Contact Information

Provider Credentialing

National

1-800-275-2583

Mon-Fri 8am-5pm

Provider Services

National

1-800-275-2583

Claims & Billing

National

1-800-275-2583

Need Help?

Let PayerReady handle your Independence Blue Cross enrollment in Pennsylvania.

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Reviewed by the PayerReady Credentialing Team

Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.

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