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All providers (as defined by the provider specialties listed below) must be enrolled and credentialed by Blue Cross and Blue Shield of Alabama and practice in an acceptable professional location that ensures confidentiality of procedures and minimal risk to the members. Please follow the steps below.
There are several required documents that you must submit for enrollment. Print this handy checklist to track your progress throughout enrollment and ensure that all necessary documents/forms are submitted. Some of the required forms are provided in step 3. .
All providers eligible for an NPI are required to obtain one. Visit the National Plan and Provider Enumeration System (NPPES) website.
Click on the appropriate specialty from the list below to view and print the application and list of supporting documents necessary for enrollment. By utilizing the proper application and returning the correct supporting documents, you can significantly speed up the enrollment process. Submit all current supporting documentation in a legible format.
An application and supporting documents from this section are also needed for a provider who:
Applications/Supporting Documentation Requirements
Complete the Network Interest Form that is included with the application for your specialty. It is required for all new applications and expresses your interest in network participation. Please note: Enrollment is not the same as joining a Blue Cross Provider Network. After the enrollment and credentialing process is complete, a provider will be reviewed and invited to participate in a network if all criteria are met.
Important - Enrollment and expressed interest in network participation are not a guarantee of acceptance as a participant in a network.
Register Online for Direct Deposit/EFT or complete the EFT Authorization Agreement that is included with your application. EFT provides an easy and efficient way to ensure your Blue Cross and Blue Shield of Alabama payments are deposited directly into your bank account. It's secure, confidential and convenient, and there is no charge to you for this service.
View our CAQH Frequently Asked Questions/Answers.
Missing a Form or Document?
Click here for quick access to miscellaneous forms, such as the Network Interest Form, Hospital Data Form, Request for Taxpayer Identification Number or EFT Authorization Agreement. The Application Document Package includes all forms that are required for new and existing providers.
If you are adding a location or making other changes, go to Provider Maintenance for instructions and forms.