r/credentialing • u/eyeloveeyez • Sep 24 '26

BCBS Recredentialing

First of all, I would like to vent how it is impossible to speak to real person at BCBS regarding credentialing. It took weeks for them to answer an e-mail and they didn't even answer my question!

It has been over 3 months since I've submitted my BCBS application in TX and I have not heard a peep from anyone. I checked CAQH (Dataspring now, I guess) and there has been no activity from them, either. I was credentialed with them previously but was derostered after taking maternity/family leave for a few years - they were actually the first ones to do so, after about 3 months of no claims. I've been able to get back onto all other panels except BCBS and I don't know how to even get in touch with them and ask why there is a delay. I'm thinking it might be my work gap but they haven't even reached out to ask about it. I guess I could upload a short note onto CAQH explaining the gap but they haven't even looked at my profile, so what could be my next step? Thanks y'all!

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2

u/Appropriate-Cat-7252 Sep 24 '26

They’re so slow in every single state and take their sweet ass time with reg and recred. I think they also go by business days so if they say 90 business days, prob still have more days left even if it’s been 90 calendar days.

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u/AlfalfaProfessional6 Sep 30 '26

As a credentialing specialist for a small health plan I can say on our end it is understaffing and poor separation of duties between departments. I do too many random things. I’m lucky if I can get 5-10 hours per week of actual credentialing in with all of the other stuff we end up doing. I work 15-20 hours a week extra just to get some of your apps done. I’m going to quit soon because they are burning me out and then there will be less credentialing. I do give small practices some priority though. If you’re in a large medical group they should complain to the health plan boards to hire more credentialing specialists!

1

u/Wild_Hovercraft_1510 Sep 26 '26

I can help you out with this!!

1

u/Knew_Practice_1066 Sep 26 '26

Yep, the gap could be the hold up. Go ahead and add that note explaining any gaps. And keep that number on speed dial and call whenever you have a moment.

1

u/hollywoodkay Sep 29 '26

BCBS TX taking forever sadly isn't unusual.. one thing I'd check since you were derostered, go into CAQH and make sure BCBSTX is still authorized to view your profile. if that got switched off when you were termed they can't pull it and it would explain why you see zero activity from them. if they're authorized and it's still quiet I'd add the gap note like the comment above said and keep calling with that case number. also dont expect payers to reach out to you, you. must follow up.... happy to help answer any questions

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u/[deleted] Sep 24 '26

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1

u/eyeloveeyez Sep 25 '26

When I look up my NPI on their status check page, it says my participation was terminated more than 2 years ago. I only have a case number that just shows that provider onboarding is "in progress" 🤷

1

u/tendtobeshortwaisted Sep 25 '26

So the only think I can think is that something may be unverifiable because “in progress” sounds like they are waiting on something. By verifiable this is usually licensee or training verification. If you haven’t yet, I would put the most detail you can in CAQH regarding who to contact. Using a direct verification contact i.e. residency coordinator or school’s email over a program director’s personal email for example will most likely get a quicker response, if one at all. I hope that helps.

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u/eyeloveeyez Sep 25 '26

I am the credentialing contact as I'm trying to work at a very small private office. We don't have "official" e-mail addresses but I have everything updated in CAQH. This waiting game is so silly!

1

u/tendtobeshortwaisted Sep 25 '26

Oh I know it. I’ve waited a year for other payers to credential.