Credentialing Information Review and contracting decision

Credentialing Information Review

Providers have the right to review and correct information submitted in support of their credentialing application and/or obtained from third party sources, excluding peer review and NPDB findings (if NPDB or HIPDB is applicable to the provider type). If corrections are needed, providers must submit corrected information by the date requested by BCBSF and, in all cases, no later than the completion of the credentialing process. Providers have the right to contact their local BCBSF office for a status of their credentialing application.

Contracting Decision

All applications are submitted, along with other required documentation, for review and evaluation. The Network Management Committee completes the credentialing review process and makes a final contracting decision. Applicants will be advised of the final decision regarding contracting status by letter. All such decisions are solely within the discretion of the Network Management Committee.