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Incomplete Provider Packets


Provider Administrative Policy

Section
Blue Cross of Idaho Information
Policy Date
August 2010
Status/Date
Revised/October 2013
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts


Policy

Incomplete Provider Packets

Blue Cross of Idaho works diligently on behalf of our members to develop contracting relationships with Idaho healthcare providers. Blue Cross of Idaho has specific criteria established for all provider specialties. The provider packet criterion is in place to assure that our contracting providers meet acceptable provider licensing, accreditation, and/or medical standards to provide the highest quality of care and services to our members.

Blue Cross of Idaho requires providers to submit a complete provider packet with all required documentation to finalize the implementation of the provider and applicable contract. Blue Cross of Idaho will void the entire provider packet originally received if there is incomplete or missing information. The packet will be voided 10 business days after attempting to obtain missing information. The provider will be required to resubmit the entire completed packet with all appropriate forms to begin the implementation process again.

Listed below are some of the most common reasons a provider packet is voided and a contract isn't implemented.

Missing Information 

  • Provider license (i.e., physician, lab, DME)
  • Accreditation certificate
  • Proof of liability/professional insurance
  • Medicare number
  • CLIA certificate
  • NPI provider ID
  • W-9 tax information
  • Surety bond for DMEPOS providers
  • Provider information sheet (PIS)

Please email or fax provider packet or contract information to: PR2PI@bcidaho.com or 208-387-6818.      


Policy History

Date Action Reason
October 2013 Revised Updated for new process
September 2011 Revised Changed timeframe incomplete contracts are kept.

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