Become a Blue Cross Provider

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Join Our Medical Networks

Interested in joining Blue Cross Blue Shield of Massachusetts’ networks?

We offer HMO, PPO, Indemnity, and Medicare Advantage networks for medical providers.

To serve Blue Cross Blue Shield members, you must be contracted with the local Blue Cross Plan where your practice is located. Blue Cross Blue Shield of Massachusetts may contract with providers in certain contiguous counties that border Massachusetts to service local Massachusetts members.

For more information about the plans and products we offer, please see the Plans & Products section of our website.

HMO*	Managed care network
PPO or PPA*	Members can see in- or out-of-network providers for their care
Indemnity	Members can see any participating provider for their care; no referral is required
Medicare Advantage	For Medicare-eligible members Payment is based on the Medicare fee schedule Providers must already participate with Medicare
Medex	Medex is a Blue Cross Blue Shield of Massachusetts Indemnity supplemental plan secondary to Medicare Provider participation status depends on the member’s policy: group or non-group For Medex group policies (Member ID prefix XXG), members may see: An in-state provider who participates in our Indemnity network, or An out-of-state (OOS) provider who participates with Medicare (they do not have to participate with their state’s local Blue Cross Blue Shield plan) For Medex non-group policies (Member ID prefix XXM), members may see: Any provider who participates with Medicare

* Some of our HMO, PPO, and EPO members have a plan with a limited network of providers—a network that’s smaller than our traditional HMO and PPO networks.

How to join

Documents (including signed contracts) that were mailed to P. O. Box 55350 can now be emailed to Provider-Enrollment@bcbsma.com. When you use email, you’ll receive an automated confirmation from us.

Documents with fax instructions should continue to be faxed.

Step	Start the contracting application and credentials verification processes. Here's how: Check our credentialing guidelines to make sure you meet our requirements. Follow the credentialing steps we outline so we can review and approve your credentials as part of your enrollment with us. Note: Physicians and licensed practitioners use CAQH ProView^TM, the universal provider datasource for credentialing. We'll need you to authorize our access to your profile in CAQH ProView. Submit a contracting form. Be sure to select the right one for your provider type. The contracting application and credentialing verifying processes take place at the same time.
Step	Get a contract. Read, sign, and return one copy. You'll keep one copy for your records.
Step	Get your credentialing decision and welcome letter. Your welcome letter tells you: the effective date of your participation with us the products you are enrolled in how to up direct deposit with PaySpan, the vendor we use for electronic payments and remittances.
Step	Prepare to work with us electronically. We communicate contractual news, updates, and plan policies and procedures electronically. We also require providers to use our electronic technologies to answer questions before calling us. Please take these steps to work with us electronically: Complete the registration process for our Provider Central website and learn more We post contractual news and updates to this site, but you must be a registered user to get this important information. When we post a notice for your specialty that's contractually required, we send registered users an email and use a My Alerts inbox that you'll see on your homepage after you've logged in. Once registered, use the site to learn about our eTools. We offer several self-service technologies to help you check member eligibility and benefits, verify the status of your claims, and keep track of your payments from us. Navigate the site to find your fee schedule. Take action to submit claims electronically You can set up a direct connection with us or use a clearinghouse. To get started, contact our EDI support team at EDISupport@bcbsma.com We also offer Online Services for electronic claim submission (for CMS-1500 claims where a BCBS Plan is the primary payer and no supplemental documentation is required). You’ll need to register for this website and go to our eTools page to access this tool (there's no cost to use Online Services). Learn more about what our website offers

Participation benefits

Self-service tools

Technology overview. Learn more about the eTools we offer. Many of them are available at no additional cost to you.

Through our Provider Central website, we offer participating providers a variety of electronic self-service tools that automate your business processes and give you information you need 24/7. This includes:

Eligibility and benefits verification
Electronic claim submission options: Direct connection; Online Services, an option available at no cost to you through this website (requires log in); existing set-ups with multiple clearinghouses.
Direct deposit and online payments and remittances. We require providers to get paid by direct deposit using Payspan. Once registered for Payspan, you also get online Provider Payment and Provider Detail Advisories.

Learn more about what our website offers

Access to nearly three million members

Our members learn about you when they use our online and printed Find a Doctor & Estimate Costs directories to get information about you, such as your address, phone number, and quality and cost information. It's important that you keep this information up-to-date and notify us of any changes.

How we support providers

We’re here to support you in delivering high-quality health care to your patients.

As a participating provider, you should register for our website to:

Get your contractual notifications and other important news and updates
Access our self-service technologies that allow you to do business with us 24/7
Learn about plan procedures and policies

Enrollment questions

Please email ProviderApplicationStatus@bcbsma.com with your inquiries regarding credentialing and provider enrollment.

If you need to call us, you can find our phone numbers here.

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