Skip to main content

Audience

  • Employers
    Employers
    • Small group health plans
      • Small Group Plans - Aware Network
      • Small Group Plans - High Value Network
      • Small group dental plans
      • Small group vision plans
    • Large Groups
      • Large Group Health Plans
      • Large Group Networks
      • Large group dental plans
      • Large group vision plans
    • Group Medicare
      • Group Medicare Advantage plans
      • Group Medicare Supplement plans
      • Group MedicareBlue Rx (PDP)
      • Group Platinum Blue (Cost) plans
    • Employer Insights and Updates
    • Behavioral health initiatives
    • Employer Documents & Forms
      • Employer reporting solution guide
  • Providers
    Providers
    • Medical Management
      • Medical & Behavioral Health Policies
      • Pharmacy Utilization Management
      • Prior Authorization
      • Prior Authorization Lookup Tool
    • Tools & Resources
      • Blueline phone self-service
      • Coordination of benefits and Medicare crossovers
      • Provider Toolkit
      • Reimbursement policies
    • Network Participation
      • Join Our Network
      • Provider Demographic Updates
    • Provider Documents & Forms
  • Agents
    Agents
    • Agent Resources
    • Agent Code of Conduct
    • Blue Cross Connect
  • Contact Us

Header utility menu

  • Contact Us

Members utility menu

  • Member Login
Home

Main Navigation

  • Our Plans
    Our Plans
    • Medicare Plans
      • Medicare Advantage Plans
      • Medicare Cost Plans
      • Medicare Supplement Plans
      • Medicare Prescription Drug Plans
      • SecureBlue (Minnesota Senior Health Options)
    • Individual & Family Health Plans
      • Blue Plus Metro MN health plan
      • Blue Plus Minnesota Value health plan
      • Blue Plus Southeast MN health plan
      • Individual & family plan resources
    • Medical Assistance (Medicaid)
      • Blue Advantage Families and Children
      • Blue Plus Minnesota Senior Care Plus (MSC+)
      • MinnesotaCare
      • SecureBlue (Minnesota Senior Health Options)
      • Medical Assistance Resources
    • Employer Provided Plans
    • Dental Plans
    • Vision Plans
    • International Health Plans
  • Understanding Health Insurance
    Understanding Health Insurance
    • Learn about Medicare
      • New to Medicare
      • Understanding Medicare
      • Eligibility & Enrollment
      • Meet with a Blue Cross Advisor
      • Attend a Medicare Workshop
    • Understanding healthcare costs
      • How You and Insurance Pay For Your Healthcare
      • Care Cost Estimator
      • Healthcare Cost Transparency
    • Prescription Drugs
    • Preventive care
    • Glossary
  • Find Care
    Find Care
    • Find a Doctor
    • Find a Dentist
    • Find an Eye Care Provider
    • Find a Pharmacy or Drug
    • Virtual Care Options
    • In-Home Care Options
    • Behavioral Health
    • About Networks
  • Member Resources
    Member Resources
    • Member FAQs
    • Member Forms & Documents
    • Member Login Help
    • ID Card
    • Manage Your Claims
    • Paying Your Premiums
    • Health Programs & Discounts
    • Caregiver Resources
    • Federal Employees & Retirees

Main navigation mobile

  • Home
  • Our Plans
    • Our Plans
    • Medicare Plans
      • Medicare Plans
      • Medicare Advantage Plans
        • Medicare Advantage Plans
        • Freedom Blue Medicare Advantage plan
      • Medicare Cost Plans
        • Medicare Cost Plans
        • Medicare Platinum Blue dental benefits overview
      • Medicare Supplement Plans
      • Medicare Prescription Drug Plans
      • SecureBlue (Minnesota Senior Health Options)
    • Individual & Family Health Plans
      • Individual & Family Health Plans
      • Blue Plus Metro MN health plan
      • Blue Plus Minnesota Value health plan
      • Blue Plus Southeast MN health plan
      • Individual & family plan resources
    • Medical Assistance (Medicaid)
      • Medical Assistance (Medicaid)
      • Blue Advantage Families and Children
      • Blue Plus Minnesota Senior Care Plus (MSC+)
      • MinnesotaCare
      • SecureBlue (Minnesota Senior Health Options)
      • Medical Assistance Resources
    • Employer Provided Plans
    • Dental Plans
    • Vision Plans
    • International Health Plans
  • Understanding Health Insurance
    • Understanding Health Insurance
    • Learn about Medicare
      • Learn about Medicare
      • New to Medicare
      • Understanding Medicare
        • Understanding Medicare
        • Understanding Original Medicare
        • Understanding Medicare Part C
        • Understanding Medicare Part D
        • Understanding Medicare Supplement
      • Eligibility & Enrollment
      • Meet with a Blue Cross Advisor
      • Attend a Medicare Workshop
    • Understanding healthcare costs
      • Understanding healthcare costs
      • How You and Insurance Pay For Your Healthcare
      • Care Cost Estimator
      • Healthcare Cost Transparency
    • Prescription Drugs
    • Preventive care
    • Glossary
  • Find Care
    • Find Care
    • Find a Doctor
    • Find a Dentist
    • Find an Eye Care Provider
    • Find a Pharmacy or Drug
    • Virtual Care Options
    • In-Home Care Options
    • Behavioral Health
    • About Networks
    • Jan K. Angell
  • Member Resources
    • Member Resources
    • Member FAQs
    • Member Forms & Documents
    • Member Login Help
    • ID Card
    • Manage Your Claims
    • Paying Your Premiums
    • Health Programs & Discounts
    • Caregiver Resources
    • Federal Employees & Retirees
  • Employers
    • Employers
    • Small group health plans
      • Small group health plans
      • Small Group Plans - Aware Network
      • Small Group Plans - High Value Network
      • Small group dental plans
      • Small group vision plans
    • Large Groups
      • Large Groups
      • Large Group Health Plans
      • Large Group Networks
      • Large group dental plans
      • Large group vision plans
    • Group Medicare
      • Group Medicare
      • Group Medicare Advantage plans
      • Group Medicare Supplement plans
      • Group MedicareBlue Rx (PDP)
      • Group Platinum Blue (Cost) plans
    • Employer Insights and Updates
    • Behavioral health initiatives
    • Employer Documents & Forms
      • Employer Documents & Forms
      • Employer reporting solution guide
  • Providers
    • Providers
    • Medical Management
      • Medical Management
      • Medical & Behavioral Health Policies
      • Pharmacy Utilization Management
      • Prior Authorization
      • Prior Authorization Lookup Tool
    • Tools & Resources
      • Tools & Resources
      • Blueline phone self-service
      • Coordination of benefits and Medicare crossovers
      • Provider Toolkit
      • Reimbursement policies
    • Network Participation
      • Network Participation
      • Join Our Network
      • Provider Demographic Updates
    • Provider Documents & Forms
  • Agents
    • Agents
    • Agent Resources
    • Agent Code of Conduct
    • Blue Cross Connect
  • Contact Us

Members utility menu

  • Member Login
Search

Members utility menu

  • Member Login
Toggle Hamburger
Close flyout
Type
Plan Type
Audience

BCBSMN Recredentialing Application for Practitioners
Forms and Publications
forms - credentialing
c05accbb-b16c-4153-888e-00789cfe5b9c
minnesota-uniform-reappointment-application.pdf

Footer Main Navigation

  • Our Plans
  • Understanding Health Insurance
  • Find Care
  • Member Resources

Footer Audience Navigation

  • Employers
  • Providers
  • Agents
  • Contact Us

Footer Utility

  • About Us
  • Newsroom
  • Blog
  • thrive. Magazine
  • Careers
Home

Footer Secondary

  • Help
  • Legal & Privacy
  • Nondiscrimination Practices

Social

  • Facebook
  • LinkedIn
  • Instagram
  • YouTube

 Third Party Website Icon: Please be aware when you are on the Blue Cross and Blue Shield of Minnesota (Blue Cross) website and see this Third Party Website icon, you will be connected to a third party site, whether via links provided by Blue Cross or otherwise, and you will be subject to the privacy policies of the third party sites. Blue Cross recommends careful consideration when using third party sites and to review the privacy policy of such sites prior to providing any personal information.

©2025 Blue Cross and Blue Shield of Minnesota. All rights reserved.
Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.