You can join the BCBSMT provider network in the following easy steps:
Step 1 — Get Set Up
Before you join our networks or send claims electronically as an out-of-network provider, please request a Provider Record ID. Professional providers and groups please fill out the online Provider Onboarding Form. Facility and Ancillary providers please fill out the Facility/Ancillary Participation Form.
These forms are necessary to perform an initial assessment to confirm your eligibility for participation. If you do not meet eligibility requirements, you will receive a notification letter from BCBSMT.
Step 2 — Complete the Contract
After you have been set up with a BCBSMT Provider Record, BCBSMT will forward you all eligible contracts. Sign, date and return the contracts with which you wish to participate. Forward completed contracts to BCBSMT at:
- Email: MTContracting@bcbsmt.com (preferred method) or
- Mail to:
Blue Cross and Blue Shield of Montana
Network Management Dept.
3645 Alice Street
Helena, MT 59601-8656
Step 3 — Complete Credentialing
Once a Provider Record has been created, you will need to be credentialed.
- Credentialing Process for Physicians and other Professional Providers, register online and complete the CAQH Proview credentialing application, or if already, registered with CAQH, log in and update any outdated information.
- The online CAQH application can be completed at any time.
- The BCBSMT credentialing process does not begin until after the Provider Record is created and you have submitted a complete CAQH application, including a signed contract and required documents.
- The BCBSMT credentialing process takes an average of 45 days to complete.
- Credentialing Process for Hospitals and other Ancillary Providers
Note: Credentialing is one step of the Join Our Network onboarding process. A current, complete credentialing application through CAQH is a requirement to begin the credentialing portion of onboarding. A missing, incomplete, or outdated CAQH profile, or failure to release the profile to BCBSMT, will result in the discontinuation of the onboarding process if not completed or released within 45 days. If your request is discontinued for this reason, you will be required to re-start the Join Our Network onboarding process.
A hard copy application will be sent to you with your contracts. Complete and return the application, along with the signed contract and requested documents to BCBSMT.
Provisional Credentialing
Effective July 15, 2023, BCBSMT will provide a provisional credentialing process which allows for a provisional network participation status if the provider applicant has:
A valid BCBSMT Provider Record ID for claim payment.
Completed the Council for Affordable Quality Healthcare (CAQH) ProView database online application with "global" or "plan specific" authorization to BCBSMT.
A valid license to practice in Montana
Tips:
Ensure Your Montana Practice Address is provided and marked as the Primary Address
Ensure the malpractice Certificate of Insurance includes the individual provider's name
Ensure you have returned the signed contract
Step 4 — For participation in the BCBSMT Healthy Montana Kids (HMK) network, an additional provider enrollment and screening process is required. HMK Screening Form.
Step 5 — Review Process
After we review your Provider Onboarding application, your signed contract and you complete the credentialing process, we will let you know if you are accepted into our networks. If you are accepted, you will receive a welcome letter with your enrolled network(s) and their effective date(s).
Step 6 — Get Connected
Participation in all electronic options available to BCBSMT providers is strongly encouraged.
- Availity® Essentials – To register with Availity or learn more about services available to BCBSMT providers, visit the Availity website at availity.com, or call Availity Client Services at 800-AVAILITY (282-4548). Learn more about Availity.
- Electronic Funds Transfer (EFT)
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.