PAYER READY CREDENTIALING & COMPLIANCE
Blue Cross Blue Shield

How to Get Credentialed with BlueCross BlueShield of Tennessee in Tennessee

Network: Open
60-120 Days CAQH Required

Quick Overview

Timeline

60 - 120 days

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

How BlueCross BlueShield of Tennessee Credentialing Actually Works

Verified July 2026

Apply Through

CAQH plus Availity

Timeline

Tennessee law requires a decision on a clean CAQH application within 90 days (Tenn. Code 56-7-1001)

Recredentialing

Not published by the payer

Enter your information in CAQH ProView, register with Availity, and complete the enrollment application there. Provider service line: (800) 924-7141.

Behavioral health routing: Behavioral health reads in house: the plan's own behavioral team works with providers, and BlueCare (TennCare) behavioral is integrated in the plan.

The stall to avoid: If your application is clean and 90 days pass without a decision, cite the Tennessee statute: it is a real lever.

From PayerReady's payer enrollment research, built from the payer's own provider manuals and enrollment pages. Payer processes change; when a fact is not published by the payer, we say so rather than guess.

Tennessee-Specific Requirements

BlueCross BlueShield of Tennessee. Uses CAQH ProView for credentialing. Typical processing timeline: 60-90 days. Requires active Tennessee medical license from the Tennessee Board of Medical Examiners. DEA registration and Tennessee Controlled Substance Registration required. Board certification required for specialists. BlueCross BlueShield of Tennessee is the largest health insurer in the state, covering approximately 3.4 million members. Delegated credentialing available through larger medical groups and health systems. 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 Tennessee.

2

Complete Your CAQH ProView Profile

BlueCross BlueShield of Tennessee 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 Tennessee.

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 BlueCross BlueShield of Tennessee?

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

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 Tennessee.

View Physician Credentialing Checklist →

Contact Information

Provider Credentialing

National

1-800-924-7141

Mon-Fri 8am-5pm

Provider Services

National

1-800-924-7141

Claims & Billing

National

1-800-924-7141

Need Help?

Let PayerReady handle your BlueCross BlueShield of Tennessee enrollment in Tennessee.

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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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