Credentialing Requirement For Non-Physician Practitioners

January 3, 2014

All providers listed in the provider directory and/or Provider Finder® must be credentialed. As a result, Blue Cross and Blue Shield of New Mexico (BCBSNM) has updated our credentialing policy to require the credentialing of non-physician practitioners, such as physician assistants and certified nurse midwives. The provider directory and Provider Finder are essential tools used by our members to locate providers. Adding non-physician practitioners to both of these tools will allow our members access to a more robust and comprehensive network of providers. The changes will be available on these tools starting January 2014.

The change in this policy will not interrupt your current payment process. This is just a courtesy notice to inform you of the changes. 

BCBSNM requires providers to use the Council for Affordable Quality Healthcare® (CAQH) for initial credentialing and recredentialing. The Universal Provider DatasourceTM (UPD) is a free online service that allows providers to fill out one application to meet the credentialing data needs of multiple organizations. For more information about the credentialing process, visit the Network Participation section.


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