Provider Central

Diagnostic imaging privileging changes

If you’re newly licensed as a different provider type, you will need a new contract. Submit the appropriate contracting application.

For changes related to your clinical profile in our provider directory, complete the clinical profile form.

Clinicians: Keep directory information current
We're required by law to keep our provider directories current and up-to-date, including whether you are accepting new patients. You are also obligated by your Blue Cross provider Agreement to do so. Your updates are critical, so members have the most accurate information. Even if your information is accurate today, please be sure to submit changes as they arise throughout the year.

For practice or contact information changes, such as changes to your address or phone number, use the Standardized Provider Information Change Form or the Sale of Dental Practice Form. Fax completed forms to 617-246-9397.

For changes related to

• New dentist joining your group
• New Tax ID Number (TIN)
• Joining a practice
• Opening a practice
• Adding another product or network to your contract
• Your new legal name

Email or call your Dental Network Manager. Refer to the chart below for your contact.

This page applies to MDs and DOs, but not psychiatrists, podiatrists, or chiropractors (see Behavioral Health or Ancillary professionals).

If you're not credentialed by us and you're joining or opening a new practice

Complete the:

1. HCAS Enrollment Form (see the Resource Documents section on hcasma.org)
2. Physician Group Application (Type 2 NPI required).
   

If you are becoming a concierge practice

Review our Concierge Practice fact sheet.

This page applies only to professional providers, such as dentists, doctors, ancillary specialists, and behavioral health professionals. If you are a hospital, facility, or lab, select the appropriate option on the left.

Changing your practice location or phone number?

• If you are a dental provider OR if you are reporting information for a medical group, submit the Provider Information Change Form. (Read these instructions before faxing us.) The Change Form is managed by the Mass Collaborative.
• Otherwise, update your CAQH Provider Data Portal (formerly ProView) data profile.

For non-demographic changes, please refer to the pages on the left.

We require all providers to maintain their data in our provider directories.

Faxing a Provider Information Change Form? Tell us how to use your data

Do you want members to call you at your new phone number/visit you at your new address? We will assume the answer is “yes” and add your changes to our provider directory unless you tell us not to.

If your changes are for our records and NOT for use by members, please write a note (where space allows) on the Provider Information Change Form before faxing us.

We require all providers to maintain their data in our provider directories

We use the information you enter in CAQH Provider Data Portal to update our provider directories, so it is important to validate your information on a quarterly basis. If you do not keep your data current, or if you do not regularly review and attest to its accuracy, you could be removed from our directory.

To validate the information on our website:

1. Go to Find a Doctor & Estimate Costs.
2. Fill in your name or your facility name and ZIP code.
3. Enter a network (example: HMO Blue) and click Search.
4. Review the information for all your site locations.*

*Only addresses where members can make appointments will display in the directory.

Questions?

• Medical providers, please email Providercredenroll@bcbsma.com with your inquiries regarding credentialing and provider enrollment. If you need to call us, you can reach us at 1-800-316-BLUE.
• Dental providers, call Dental Network Management at 1-800-882-1178, Option 4 or email us at DentalNetworkRequest@bcbsma.com.

This page applies to nurse practitioners (NPs), certified nurse midwives, certified registered nurse anesthetists, and physician assistants (PAs), except for those contracted with a behavioral health practice (see Behavioral Health Professionals on the left).

To be recognized as a primary care provider with a panel of patients, submit the appropriate contracting application (for PA-PCPs or NP-PCPs).

To discontinue being a primary care provider with a panel of patients, submit the appropriate Contract Update form.