What is REcredentialing and CLIA certification

Recredentialing

After a provider has completed the initial credentialing process, he/she will undergo recredentialing at least every three years thereafter from the date of the last approval. The recredentialing process is conducted in the same manner as outlined in the Credentialing section above
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The provider is considered to be approved by the Credentialing Committee and recredentialed for another three-year cycle unless otherwise notified.

If a provider’s network participation has been terminated, that provider may be required to reapply and complete the initial credentialing process above before being reinstated as a participating provider in our networks. Important Note: All providers, regardless of network participation, must include their NPI(s) on their application.

Status Changes

A provider is required to report changes to credentialing criteria to Blue Cross within 30 days from the date of occurrence. Failure to do so may result in immediate termination.

CLIA Certification Required

If you perform laboratory testing procedures in your office, we require a copy of your Clinical Laboratory Improvement Act (CLIA) certification to be mailed or faxed with your LSCA when applying for credentialing or recredentialing:

BCBSLA - Network Operations
P.O. Box 98029
Baton Rouge, LA 70898-9029
Fax: 225-297-2750 • Attn: Network Operations


Credentialing Process and Network Provider Directory

As a network provider, you may only participate in the Blue Cross networks and be listed in the network provider directory as the specialty you actually practice. For example, providers may not participate in our networks as one of the following specilties of general practice, family practice, internal medicine or pediatrics unless they practice in a full primary care provider (PCP) capacity. For more information on our

credentialing process, visit www.bcbsla.com/providers >Credentialing.