Download and complete the Minnesota Uniform Initial Credentialing Application (PDF).
Fax to (651) 662-2905, or mail to:
Blue Cross and Blue Shield of Minnesota
Credentialing Department R315
P.O. Box 64560
St. Paul, MN 55164-0560
Blue Cross uses the credentialing process to evaluate each practitioner’s qualifications and performance. Upon receipt, the application will be reviewed for completeness and returned if incomplete. Providers may not schedule services with Blue Cross members until they have received written approval notification from Blue Cross and its affiliates.
Your credentialing application should be submitted correctly and completely for it to be processed without delays. An incomplete application will not meet eligibility criteria for participation. Practitioner and Provider Participation requirements state that practitioners and providers respond in a timely manner to our courtesy requests for missing information or additional credentialing information.
The most frequently omitted items are:
In some cases, a site visit will be required.
Blue Cross uses the recredentialing process to re-evaluate each practitioner’s qualifications and performance. Practitioners are recredentialed at least every three years, but may be asked to recredential more frequently. The recredentialing process is initiated by the Blue Cross credentialing department based on the last credentialing or recredentialing approval date. A recredentialing profile that is populated with previous credentialing information is sent four (4) months prior to the recredentialing due date. All practitioners are expected to respond to the requests in a timely manner. Lack of timely return of the completed recredentialing profile may result in network termination.
Recredentialing may occur whenever Blue Cross deems appropriate (e.g., when there are quality of care concerns or when reasonable information has been identified by Blue Cross that a member may be endangered by potentially unsafe or unethical care or treatment).
Credentialing applications are reviewed by the Medical Director and/or the Credentialing Committee on a regular basis. All credentialing decisions will be communicated in writing.
The credentialing criteria serve as the foundation for determining a provider’s eligibility and continued eligibility in all Blue Cross networks. Providers are expected to remain in compliance with credentialing criteria at all times. For more information on credentialing, please refer to the Credentialing Policy Manual (PDF).