The process of recredentialing is identical to that for credentialing, and is consistent with NCQA and State of Texas requirements.

If you are not currently registered with CAQH, BCBSTX will add your name to its roster with CAQH. CAQH will then mail you access and registration instructions, along with your personal CAQH Provider ID, allowing you to obtain immediate access to the UPD via the Internet to complete and submit your application. This will help you to conform to the requirements of your provider contract/agreement to continue your participation with BCBSTX’s managed care networks.

If you are an existing user of CAQH, you are required to review and attest to your data once every four (4) months. At the time you are scheduled for recredentialing, BCBSTX will send your name to CAQH to determine if you have already completed the UPD credentialing process and authorized BCBSTX or selected “global authorization”. If so, BCBSTX will be able to obtain current information from the UPD database and complete the recredentialing process without having to contact you.

Note: If you are a physician or other professional provider that requires one of the following additional forms listed below, you must complete and forward by fax or mail to BCBSTX as indicated below.

•  Behavioral Health Form – required to be submitted to BCBSTX for all Behavioral Health Professionals with the exception of TRICARE (El Paso Only) Behavioral Health Professionals. Note: TRICARE (El Paso Only) Behavioral Health Professionals will need to complete and submit the form below.
• Behavioral Health Form/TRICARE (El Paso Only) – required to be submitted to BCBSTX for all TRICARE (El Paso Only) Behavioral Health Professionals.
• Hospital Referral Letter – required to be submitted to BCBSTX for those providers who do not have admitting privileges at a network hospital.
• Medical/Surgical Provider Areas (El Paso Only) – required to be submitted to BCBSTX for all TRICARE (El Paso Only) – Medical/Surgical Providers.

Forward applicable completed form(s) to BCBSTX:

Fax to: 972-996-8230 (preferred method)

or

Mail to:
Blue Cross and Blue Shield of Texas
Provider Administration
P.O. Box 650267
Dallas, TX 75265-0267

revised 06/2010