Federal guidelines require that insurance plans become accredited in order to be able to offer Affordable Care Act (ACA) compliant plans.
Blue Cross Blue Shield of Wyoming has received Health Plan with Health Insurance Marketplace Accreditation from URAC. URAC accreditation requires that all providers be fully credentialed if they participate in our network(s).
What You Need to Know about Credentialing
You will receive the credentialing application from BCBSWY via email. Please read the application thoroughly and complete all sections. The following tips will ensure that the application is complete and reduce delays in processing.
- Make sure work history is completed using month and year. Be sure to address any gaps in your work history.
- Any malpractice claims need to be disclosed and outcomes identified.
- If you have a DEA Certificate and Wyoming Controlled Substance Registration, include this information in the appropriate section of the application.
Any personal information gathered during this process (i.e. personal emails, addresses, telephone numbers, etc.) will be used solely for credentialing purposes.
If you are a new provider or adding a new provider to the BCBSWY network, participation with BCBSWY cannot be dated prior to approval of your credentialing application. If you plan to see BCBSWY members before notification of your credentialing approval, you may request to be added to our claims processing system as a non-participating provider.
Providers will need to communicate with members about their non-participating status at the time of service. Please note that there is no benefit for preventive services if a member sees a non-participating provider and the out-of-pocket costs are higher for covered services. Claims for non-participating providers will pay to the member and balances are the responsibility of the provider and the member.