Joining our network is easy!
We’re glad to hear that you are interested in joining the Healthy Blue network.
We have a diverse network of exceptional healthcare professionals who ensure our members have uninterrupted access to the healthcare they need.
You make your patients’ lives better. We'll do the same for you.
Our prior authorization, referrals, claims, and payment processes are streamlined to help you focus on what you do best — caring for your patients.
We support you with:
- A coordinated approach to care with innovative patient outreach and education.
- Disease and case management resources.
- Patient-centered medical home transformation.
- Online self-service tools and live-agent support.
- Local Provider Relations staff committed to your success.
If you do not have access to the Provider Enrollment application under Payer Spaces, please contact your Availity administrator.
Join our network via email
LANetworkDevelopment@healthybluela.com
Write Request to join network in the subject line. Please include a copy of your W9 and your provider specialty in your request.
Credentialing with Healthy Blue
Credentialing is the process Healthy Blue uses to evaluate and select licensed independent practitioners to provide care to our members. Healthy Blue uses the Council for Affordable Quality Healthcare (CAQH) ProView application for credentialing. This secure and private website reduces the amount of paperwork you need to fill out to complete the credentialing process.
Why do we credential?
Credentials are evaluated according to criteria set forth in our policy to ensure the competency and conduct of the healthcare professionals serving members in our network.
Who do we credential?
We credential licensed healthcare professionals with whom the company intends to contract and market to our members. Our Program Summary includes a complete list of provider types we credential and those we do not.
Please note: Facilities (health delivery organizations) may also need to be credentialed before joining the network.
1. Register with CAQH (if you are not already registered). You may self-register by visiting proview.caqh.org. This is a secure and private website.
2. Authorize Healthy Blue so we can access your credentialing information. If you are already registered with CAQH, you will need to give us permission to review your information.
3. If you need assistance, please review the Provider Reference Guide or call the CAQH Provider help line at 888-599-1771.
4. Review and update your application. Please ensure all sections of the application are complete and accurate.
Credentialing application requirements
The credentialing process typically takes 45 days from the time the credentialing department receives your completed CAQH application.
Healthy Blue recredentials network providers every three years. If your CAQH application is current and complete at that time, no additional effort on your part may be required. If your CAQH has expired or has missing information, we will contact you to update the information.
Non-response to recredentialing request
If you do not update CAQH or supply the required information for recredentialing by the due date, your application will be considered incomplete and will result in an administrative termination from the network.
Providers have the right to:
- Review the information submitted to support their credentialing application.
- Correct erroneous information.
- Receive the status of their credentialing or recredentialing application upon request.
For a complete list of your credentialing rights as a provider, please review the Practitioner Credentialing Rights. To review your application or correct submitted information, please email our credentialing team at: credentialing@healthybluela.com.
Additional support services
Our network includes:
Office Support
We understand the demands programs like Medicaid can create for your staff. Our team of local and national professionals is here to help.
Our National Contact Center offers:
- A dedicated provider line for when you can’t access the internet.
- Live agents to assist you.
- A 24/7 NurseLine to help members get after-hours care.
Your local Provider Relations representative can help you with:
- Provider orientation.
- Health education material for your patients.
- Strategies for growing your practice.
- Tips to ease administrative burden for your staff.
Superior Vision
Providers who would like to contract for vision services only should contact Superior Vision for network participation.
Superior Vision Network Development
Phone
844-353-2900
DentaQuest
Providers who would like to contract for dental services only should contact DentaQuest for network participation.
DentaQuest Provider Assistance
Phone
800-508-6785
Superior Vision, offered by Versant Health, is an independent company providing routine and medical optometry services on behalf of Healthy Blue.
DentaQuest is an independent company providing dental benefit management services on behalf of Healthy Blue.
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Provider Manuals and Guides
- Referrals
- Forms
- Training Academy
- Pharmacy Information
- Electronic Data Interchange (EDI)