Blue Cross Blue Shield

How to Get Credentialed with BlueCross BlueShield of South Carolina in South Carolina

Network: Open
60-120 Days CAQH Required

Quick Overview

Timeline

60 - 120 days

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

South Carolina-Specific Requirements

BlueCross BlueShield of South Carolina. Uses CAQH ProView for credentialing. Typical processing timeline: 60-90 days. Requires active South Carolina medical license from the South Carolina Board of Medical Examiners. DEA registration and South Carolina DHEC controlled substance registration required. Board certification required for specialists. BlueCross BlueShield of South Carolina is the largest health insurer in the state. The parent company also operates Companion Plans (BCBS federal employee program). Delegated credentialing available through select 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 South Carolina.

2

Complete Your CAQH ProView Profile

BlueCross BlueShield of South 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 BlueCross BlueShield of South Carolina.

4

Track & Follow Up

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

Free Consultation

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Our specialists handle the entire BlueCross BlueShield of South Carolina enrollment process: applications, follow-ups, and approvals in South Carolina.

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 →

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 BlueCross BlueShield of South Carolina.

View Physician Credentialing Checklist →

Contact Information

Provider Credentialing

National

800-868-2510

Mon-Fri 8am-5pm

Provider Services

National

800-868-2510

Claims & Billing

National

800-868-2510

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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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