Credentialing and Provider Enrollment
Streamlined Credentialing and Provider Enrollment processes
BMC HealthNet Plan’s membership in HealthCare Administrative Solutions, Inc (HCAS) helps streamline the credentialing process for providers. Several Massachusetts health plans founded the non-profit entity to collaborate on administrative simplification. The credentialing process, which is nearly seamless to providers, offers a single point-of-entry to submit information used to determine a provider’s qualifications to treat patients and participate in health plan networks.
Initial applicants to the Plan will be credentialed through HCAS, which has an arrangement with Aperture, a national credentialing verification organization, to centralize and streamline the credentialing process. Aperture partners with CAQH to obtain updated data from providers requesting to join the network. For more information, go to the HCAS Web site.
BMC HealthNet Plan also has a centralized process for enrolling providers into the network. Here are the steps to become credentialed and enrolled at BMC HealthNet Plan:
- Complete an HCAS Enrollment Form, available here
- Complete a BMC HealthNet Plan Provider Data Form, available in Section 15 of our online Provider Manual.
- Once the forms are completed, submit the information in one of the following ways:
- Email, via secure email, the documents to BMCHP.email@example.com
- If more convenient, a fax may be sent to 1-617-897-0818. Please note that we will receive this fax through the emaill address above.
- Postal-mail the documents to:
BMC HealthNet Plan Provider Processing Center Two Copley Place, Suite 600 Boston, MA 02116
Once we receive your forms, we will begin the credentialing process through Aperture, whose representatives may contact you to verify information.
Participating providers must complete the BMC HealthNet Plan Change Form and fax it back as indicated when correcting or changing provider information. Please Note: You can fill out in the information before printing the form.
Non-participating providers must complete the Non-Participating Provider Action Form.
Please note: This credentialing process does not change how you interact with our Provider Relations team. You should still call your Provider Relations representative with administrative questions, or you can call our provider line at 888-566-0008.