Join Healthy Blue -The Process
Participation in our networks is based on member access and need. The process for joining our network may include contracting, credentialing, and enrollment. The online provider enrollment application will route your request to all the needed steps:
- Contracting/negotiating: The process of the provider and Healthy Blue formally executing an agreement for the provider to deliver medical services that outlines reimbursement rates, scope of services, etc.
- Credentialing: The process of reviewing the qualifications and appropriateness of a provider to join the health plan's network. Credentialing requirements and processes will follow National Committee for Quality Assurance (NCQA) guidelines and company credentialing policy.
- Loading: The process of loading a contracted and credentialed provider to all Healthy Blue internal systems, loading for claims payment, and loading to the provider directory (if applicable).
Ready To Join — Next Steps
Professional providers — to become a contracted provider or add a provider to your existing group:
- Update your CAQH Proview®, ensure that your:
- Primary specialty is listed.
- Primary location is listed.
- Attestation is current.
- Ensure that you have an active Missouri Medicaid identification number,
for more information
- Complete the online provider enrollment application hosted on the Availity Portal*. The online application automatically accesses CAQH Proview®.
To learn more about or register for the
- Notification — you will be notified if:
- A new contract is needed.
- Your specialty is not needed/allowed.
- Any further credentialing information is required.
- Status updates: You will receive an application number upon successful completion of the provider enrollment application to assist with tracking your progress.
- Remember to obtain an approved
before seeing Healthy Blue members until you are participating
- Keep in mind, to be considered participating, you/your provider must be loaded. The process usually takes between 60 and 90 days
Facilities, Ancillary, and Health System Providers
To Join Healthy Blue, please send an email and W9.
Dental providers — Healthy Blue will contract for medical procedures, but routine dental benefits are managed by
Vision providers — Healthy Blue will contract for medical procedures, but routine vision benefits are managed by
* CAQH Proview® is an independent company proving online provider data-collection solution services on behalf of Healthy Blue.