Managed Care Provider Directory - Blue Cross and Blue Shield of ...

EducationSource Of Information· Provider Credentialing Application· Professional School and Training Programs (highest level verified)· Certification BoardStandardTo be eligible to apply for network participation, the following providers must meet theminimum requirements:Physicians (MD, DO, DPM)To be eligible to apply for participation in the BCBSMT managed care, TriCare, andFederal Employee Program provider networks, at a minimum, a physician must have:· Obtained and maintained board certification by a recognized board in the areaof practice (American Board of Medical Specialties, American OsteopathicAssociation, American Podiatric Medical Association, Royal College ofPhysicians and Surgeons of Canada), or· A physician certified by the Royal College of Physicians and Surgeonsof Canada whose residency training was completed in an unrecognizedand/or non-accredited program is individually considered.· Completed residency training in the area of practice by a recognized programprior to June 30, 1991, or· Completed residency training in the area of practice on or after June 30, 1991,is within the time frame allotted by the specialty board to take the exam, andintends to take the exam.Physicians who completed their residency on or after June 30, 1991, are required tobecome board certified by a recognized board within five years of acceptance to thenetwork and must maintain board certification thereafter.To be eligible to apply for network participation in the BCBSMT traditionalparticipating provider network and Medicare Advantage, at a minimum, a physicianmust have:· Completed a medical degree or foreign equivalent· Completed one year of post-graduate training in General MedicineNote: A physician who only completes one year of post-graduate training can only beapproved as a General Practitioner. A physician must have completed a residencyprogram to be considered a specialist.Continued on next page