Join our network
Details on contracting, credentialing and recredentialing
Contracting eligibility
Step 1: Determine if a contract request will be accepted for your specialty
Blue Cross continually assesses its network of providers to ensure that it is sufficient to meet the access and availability needs of its members throughout the service area in accordance with Minnesota Statute 62K.10. Provider networks that meet these needs are "managed."
Managed networks = Contract requests are not being accepted at this time.
|
Providers that are eligible for a provider contract but are not required to have a contract are limited. Limited networks are accepting contract requests.
|
Step 2: Confirm you are in the contracting area
The Blue Cross provider contracting area includes Minnesota and the border counties of North Dakota, South Dakota, Iowa and Wisconsin. Lab, DME and pharmacy providers are an exception to this contracting area. If you are not in one of these counties and are not a lab, DME or pharmacy provider and you need to submit a claim, contact your local Blue Cross plan.
| Iowa | North Dakota | South Dakota | Wisconsin | Minnesota |
|---|---|---|---|---|
| Allamakee | Cass | Brookings | Buffalo | All counties |
| Allamakee | Cass | Brookings | Buffalo | |
| Dickinson | Grand Forks | Deuel | Burnett | |
| Emmet | Pembina | Grant | Douglas | |
| Howard | Richland | Minnehaha | La Crosse | |
| Kossuth | Trail | Moody | Pepin | |
| Lyon | Walsh | Roberts | Pierce | |
| Mitchell | Polk | |||
| Osceola | Saint Croix | |||
| Winnebago | Trempealeau | |||
| Winneshiek | Vernon | |||
| Worth | Vernon |
Step 3: Mandatory enrollment with Minnesota Health Care Programs
Before a request for a contract can be considered, providers must enroll with Minnesota Health Care Programs (MHCP). MHCP is administered by the Minnesota Department of Human Services (DHS).
The following must be enrolled: All clinic or facility NPIs; every clinic or facility location (if one NPI is affiliated with multiple locations); and all affiliated practitioners. Enrolling with MHCP does not mean that providers must contract with MHCP, though providers may do this if they wish. Instructions for enrolling with MHCP can be found on the DHS website (select “Enrollment process for Managed Care Organization (MCO) network providers”).
Do not submit a contract request form until you receive a MHCP Enrollment or Welcome Letter/Notification.
Provider contact information
Mailing addresses, phone and fax numbers.
Contracts
Step 4: Complete a contract request application for your provider type
Do not see our members until you receive an executed contract or amendment. Any claims submitted prior to that time will either be denied or processed as out of network.
A request for a contract is not a guarantee that you will receive one. The process for approved contract requests typically takes 60-90 days to complete. The timing is dependent on whether facility or practitioner credentialing by Blue Cross is needed. The Blue Cross Credentialing team will notify you if credentialing is required.
Contracting information for all provider types
Respond to credentialing request (if applicable)
Some specialties require credentialing. Contracted providers are expected to always remain in compliance with credentialing criteria. The credentialing team will notify you if credentialing is required.