Our customer contact center is currently experiencing high call volumes. We thank you for your patience.
High call volume
Our customer contact center is currently experiencing high call volumes. We thank you for your patience.
Incomplete Credentialing or Recredentialing Applications Will Not Be Processed
Lapsed Recredentialing
Recredentialing occurs every three years. Three notifications are sent to request submission of recredentialing applications:
If recredentialing paperwork is not received by the three-year recredentialing due date, claims will deny, and providers will be liable for services rendered on or after that date. Claims will not be adjusted to accommodate a lapsed recredentialing timeframe.
A full credentialing application will be required to reinstate provider eligibility/participation as well as directory display capabilities.
Retroactive Providers
Providers have a responsibility to notify Blue Cross Blue Shield of North Dakota immediately when a new provider is joining a group/practice and when a provider is no longer on staff or taking appointments.
As of Jan. 1, 2022, BCBSND will not retroactively affiliate providers to a service location beyond 90 days. Credentialing/recredentialing must be current before any setup can occur. Services incurred more than 90 days prior to submission of any credentialing or affiliation request will be provider responsibility and adjustment requests will not be accommodated.
Directory Maintenance
This is a reminder that directory information must be reviewed and validated every 90 days starting Jan. 1, 2022, in accordance with the No Surprises Act. Our most recent provider demographic surveys have been timed to begin aligning with this new requirement.