Credentialing Requirement for Facility-Based Providers

As we told you in March, the Consolidated Appropriations Act (CAA) of 2021 requires that we list all contracted providers in our online directory, Provider Finder®. To be listed, contracted providers must be credentialed with Blue Cross and Blue Shield of New Mexico (BCBSNM), including providers based at facilities who haven’t previously been credentialed.  

To Become Credentialed
You must be registered with the Council for Affordable Quality Healthcare® (CAQH) and complete a free credentialing application online.

  • If you’re a first-time CAQH user: Register on CAQH ProView and complete your online credentialing application. If you’ve already registered with CAQH but haven’t received an email or letter with your CAQH provider ID and application instructions, email us at CAQHCommunications@bcbstx.com.
  • If you’re already registered and applied with CAQH through another health plan: Log in to CAQH ProView and add BCBSNM as a health plan authorized to access your information.

Learn more on our Network Participation page.

Verify Your Directory Information Every 90 Days
CAA requires that your directory information be verified every 90 days. Use the Availity® Essentials Provider Data Management feature to quickly verify your data for all health plans, or our Demographic Change Form. Facilities may only use the Demographic Change Form to verify information. Learn more on our Verify and Update Your Information page.

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 BCBSNM. BCBSNM makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.

The Council for Affordable Quality Healthcare, Inc. (CAQH) is a not-for-profit collaborative alliance of the nation's leading health plans and networks. The mission of CAQH is to improve health care access and quality for patients and reduce administrative requirements for physicians and other health care providers and their office staffs. CAQH is solely responsible for its products and services, including ProView.