Nov. 19, 2024
We require that all independent labs undergo credentialing and recredentialing for the following networks: PPO, Blue Choice PPOSM, Blue Cross Medicare Advantage (PPO)SM and Blue Cross Medicare Advantage (HMO)SM. These credentialing and recredentialing requirements help ensure compliance with professional standards.
The Join Our Network page on our provider website lists independent labs as a provider type that must complete the credentialing process and be recredentialed every three years. Accordingly, effective Dec. 1, 2024, the Credentialing Standards section of the provider manual for Blue Cross and Blue Shield of Illinois will be amended to reflect this requirement.
If you’re a contracted independent lab that’s not yet credentialed with us, we’ll be reaching out to you to start the process.
Supporting documentation: As part of the credentialing process and to ensure participation in the networks, independent labs must submit the following completed forms and other documents, which will be required upon request.
2. Independent Lab Questionnaire
3. Independent Lab Supplemental Form** [Coming in January 2025 to our website]
4. Insurance – Current Certificate of Insurance with Professional or General Liability including:
- Policy number; and
- Effective and termination dates; and
- Liability coverage of $1,000,000 per occurrence and $3,000,000 in the aggregate
5. Proof of Accreditation – One of the following current accreditations is required:
- Clinical Laboratory Improvement Act; or
- Centers for Medicare & Medicaid Services issued Commission on Clinical Laboratory Association; or
- The Joint Commission
6. Proof of Medicare Certification*** – One of the following is required:
- CMS certification letter; or
- Official document containing your Medicare Laboratory ID Number.
*Only for independent labs seeking to participate in any network
**Only for independent labs already participating in any network
***Only for independent labs seeking to participate or already participating in Blue Cross Medicare AdvantageSM