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Contracted Providers are required to participate in the Credentialing program and must adhere to the same criteria and standards that were required during initial application to continue participation with Blue Cross and Blue Shield of Alabama network(s). Providers are recredentialed on a three year cycle. One-third of the networks are credentialed each year, spreading those throughout the year so that every provider is not recredentialed at the same time.
Blue Cross and Blue Shield of Alabama participates with the CAQH® Universal Provider Datasource® (UPD®) to streamline the credentialing process. The UPD will reduce the time required in the process and supports our administrative simplification and paper reduction efforts.
We encourage all providers to utilize UPD to experience firsthand how administrative burdens will be reduced.
Please visit https://upd.caqh.org/oas for more information.
Listed below are the documents and information necessary for the recredentialing process. These are items which can be loaded to the UPD and be accessible by Blue Cross. Supporting documentation must be legible and current.
Providers who do not participate with UPD will be required to complete the Recredentialing Form, see below, and provide all documentation back to Blue Cross by fax or mail as indicated on the Recredentialing Application. Failure to complete the recredentialing process may result in termination from the networks.
* CAQH, an unprecedented nonprofit alliance of health plans and trade associations, is a catalyst for industry collaboration on initiatives that simplify healthcare administration. CAQH solutions promote quality interactions between plans, providers and other stakeholders; reduce costs and frustrations associated with healthcare administration; facilitate administrative healthcare information exchange and encourage administrative and clinical data integration.
CAQH is solely responsible for its products and services, including the Universal Provider Datasource.