Blue Cross Blue Shield

How to Get Credentialed with Blue Cross & Blue Shield of Rhode Island in Rhode Island

Network: Open
60-120 Days CAQH Required

Quick Overview

Timeline

60 - 120 days

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

Rhode Island-Specific Requirements

Blue Cross and Blue Shield of Rhode Island (BCBSRI). Uses CAQH ProView for credentialing. Typical processing timeline: 60-90 days. Requires active Rhode Island medical license from the Rhode Island Department of Health, Board of Medical Licensure and Discipline. DEA registration and Rhode Island controlled substance registration required. Board certification required for specialists. BCBSRI is the largest health insurer in Rhode Island. Delegated credentialing available through select health systems. Rhode Island has specific prompt-credentialing regulations. 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 Rhode Island.

2

Complete Your CAQH ProView Profile

Blue Cross & Blue Shield of Rhode Island 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 & Blue Shield of Rhode Island.

4

Track & Follow Up

Credentialing typically takes 60-120 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 →

Contact Information

Credentialing

National

(401) 274-4848

Database.Credentialing@bcbsri.org

Quick Links

Blue Cross & Blue Shield of Rhode Island Website Provider Portal

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Other Payers in Rhode Island

Aetna UnitedHealthcare Cigna Healthcare Anthem / Elevance Health Humana Centene Corporation Molina Healthcare Rhode Island Medicaid UnitedHealthcare Community Plan TRICARE
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