Covered Providers as Recognized by Regence BlueShield of Idaho

Policy:  A provider is defined as a person or entity recognized as a covered Provider by Regence and duly licensed or certified under applicable state law to provide Covered Services as set forth in the member policy.

The following 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:

• Acupuncturist
• Advanced Certified Alcohol and Drug Counselor (ACADC),
• Advanced Practice Professional Nurse (APPN)
  • Nurse Practitioner (NP)
  • Certified Nurse Midwife (CNM)
  • Clinical Nurse Specialist (CNS)
  • Certified Registered Nurse Anesthetist (CRNA)
• Ambulatory Surgery Center (ASC)
• Audiologists (AuD)
• Certified Alcohol and Drug Counselor (CADC)
• Certified Nutritionalist (CN) (Washington counties only)
• Chiropractor (DC)
• Clinical Nurse Specialist
• Dentist (DDS/DMD)
• Dialysis Facility
• Dietitians (RD)
• Durable Medical Equipment (DME)
• Home Health
• Home Infusion Therapy
• Hospice
• Hospital
• Licensed Clinical Professional Counselor (LCPC)
• Licensed Clinical Social Worker (LCSW)
• Licensed Masters Social Worker – Independent Practice (LMSW-I)
• Licensed Marriage and Family Therapist (LMFT)
• Licensed Mental Health Counselors (LMHC) (Asotin County WA only)
• Licensed Professional Counselor (LPC)
• Occupational Therapist (OT)
• Optometrist (OD)
• Orthotics & Prosthetics
• Physician (MD/DO)
• Physician Assistant (PA)*
• Podiatrist (DPM)
• Psychologist (PhD)
• Physical Therapist (PT)
• Skilled Nursing Facility (SNF)
• Speech Therapist (SLP)

Unlicensed professionals are reimbursed for covered services only if recognized in Regence policies, as determined by Regence.

* Provider type requires supervision.

Rationale: To describe which provider types are recognized as covered provider types by Regence BlueShield of Idaho.

Disclaimer: Member policy determines what services are medically necessary.

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