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Medical Policy and Clinical UM Guidelines

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Credentialing

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In order to participate in the Physicians Network of Blue Cross Blue Shield of Georgia, Inc. (BCBSGa) and/or Blue Cross Blue Shield Healthcare Plan of Georgia (BCBSHP), you will need to complete the credentialing application and receive the approval of the Credentials Committee of BCBSGa and BCBSHP. 
To assist you in moving through the process we have provided you with the following resources: 
Rights and Responsibilities
Rights and Responsibilities: A review of both the "Rights of Physicians" and "Responsibilities of Physicians" in our networks. 
Physician Office Standards
Please refer to the Physician Provider Manuals for the physician office review criteria for our providers. 
Medical Record Standards
Please refer to the Provider Manuals for the medical record review criteria for our providers. 
Medical Record Keeping Practice Standards
Please refer to the Provider Manuals for the physician office record keeping standards for our providers. 
 
Click Here for the CAQH Credentialing Website 
The following links contain information regarding submitting Credentialing information to BCBSGa/BCBSHP after 01/01/2008: 
New Requirement for Credentialing 
Frequently Asked Questions for CAQH Mandate 
CAQH Quick Reference Guide 
© 2009 BlueCross BlueShield of Georgia
Blue Cross Blue Shield of Georgia and Blue Cross Blue Shield Healthcare Plan of Georgia are Independent licensees of the
Blue Cross Blue Shield Association.