eNotification
2009 amendments and addendums to Regence
BlueShield of Idaho Participating and Preferred
provider agreements are currently being prepared.
We are are offering physicians, other health
care professionals and facilities in Nez Perce
and Asotin Counties the option to participate
in our eNotification pilot. Providers in other
counties will receive paper notification of
amendments and addendums.
eNotification provides electronic notification
when amendments or addendums are available
through the convenience of your personal email.
Once notified, you may access these documents
in a Health Insurance Portability and Accountability
Act (HIPAA)-secure environment by clicking
a personalized link in the email. You may also
save the documents for future reference.
Once enrolled in eNotification, delivery of contract documents will be done electronically. This process will ensure these important materials are delivered directly to you in a timely fashion. By using eNotification, you are now agreeing to accept updates, amendments, addendums, and any new agreements electronically. These eNotifications will replace and supersede any written notification requirements defined in your provider agreements.
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Provider Agreements
All practitioners requesting participation with us must
complete an application for participation, which has
been designed to provide the information necessary to
perform a comprehensive review of the practitioner’s
or organization's credentials.
Credentialing
Certain provider types are recognized as covered providers by Regence BlueShield of Idaho if they meet all of Regence requirements to be eligible as a covered provider.
All practitioners requesting participation with us must
complete an application for participation, which has
been designed to provide the information necessary to
perform a comprehensive review of the practitioner’s
or organization's credentials. After initial credentialing,
recredentialing occurs at a minimum of every three years
to verify that the practitioner continues to satisfy
all applicable criteria for participation.
| Hospital-Based
Practitioner Information Form |
Hospital-Based
Practitioner Information Form (PDF) |
Use this form when a provider is being added
to a hospital-based facility. Regence BlueShield
of Idaho defines Hospital Based Practitioners
as, “Practitioners who practice exclusively
within a hospital setting, meets our credentialing
and contracting criteria and provides care for
Regence BlueShield of Idaho members
only as a result of members being directed to the
hospital or other inpatient setting." |
Participating Effective Date Policy
All physicians and other health care professionals must be credentialed before they can participate in a Regence provider network.
- New provider agreements have an effective date of the first day of the month in which the provider was credentialed (e.g., if credentialing was approved on June 14, the agreement will be effective on June 1).
- If Regence does not receive a signed agreement in the same month as credentialing is completed, the agreement effective date will be the first of the month in which credentialing is approved or the signed agreement is received, whichever is later.
- A new provider joining a group or clinic agreement will have an effective date of the first day of the month in which he or she was credentialed (e.g., if credentialing was approved on June 14, the effective date of participation will be June 1).
- If a provider already participating with Regence adds an additional network, the effective date of the new network will be the first day of the month the signed agreement is received.
- Regence will no longer establish retroactive agreement effective dates.
- Claims submitted to Regence for dates of service prior to the provider’s effective date will be processed as out-of-network.
If you have any questions regarding this policy, please contact your provider consultant,
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