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

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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
Education,continuedPhysician Assistants· Graduated from a physician assistant program approved by the AmericanMedical Association Committee on Allied Health Education and Accreditation,or its successor· Maintain certification issues by the National Commission on Certification ofPhysician AssistantsAdvance Practice Registered Nurses and Certified Nurse Midwives· Graduated from the advanced practice nursing education required to take thefirst national certification examination available from a board-approved nationalcertifying body appropriate to the specific field of advanced practice registerednursing· A current certificate issues by a board-approved national certifying bodyappropriate to the specific field of advanced practice registered nursingMental Health Providers· Completed Master’s level training or higherChiropractors· Graduated from a chiropractic program approved by the Council ofChiropractic EducationOptometrists· Graduated from a school approved by the board, including schools ofoptometry accredited the International Association of Boards of Examiners inOptometryPhysical and Occupational Therapists· Graduated from a physical or occupational therapy program approved by oneof the following organizations:· Committee on Accreditation in Physical Therapy Education· Accreditation Council for Occupational Therapy EducationRespiratory Therapists· Graduated from a respiratory therapy program approved by the Committee onAccreditation for Respiratory CareSpeech-Language Pathologists and Audiologists· Completed an academic, supervised clinical practicum and post-classroomsponsored employment requirements of the American Speech-Language andHearing AssociationCertified Surgical Assistants· Graduated from a National Surgical Assistant Association-approved programor surgical assisting
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Using this DirectoryIntroductionThi
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OnlineBenefits,Claims andEligibilit
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Personal Care Physicianswww.bcbsmt.
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Professional Providerswww.bcbsmt.co
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Specialty Care Providerswww.bcbsmt.
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Managed Care Provider Directory - Blue Cross and Blue Shield of ...

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