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Insurer guide for therapists

BCBS Credentialing: How Therapists Join Blue Cross Blue Shield and Anthem

Blue Cross Blue Shield is not one insurer: it is an association of 33 independent companies, each licensed for its own area, and each runs its own credentialing. To join, find the Blue plan where you practice and apply through that plan; most read your CAQH profile, now run by DataSpring. Stated times differ by plan: Anthem says typically 45 days from a complete CAQH application, Blue Shield of California 45 to 60 days, and Horizon up to 90 days. Most of these plans ask for a license to practice independently.

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By Nasar Haq, Founder and CEO, Medtransic. Last reviewed 2026-11-11.

Six Blue plans, six ways in

Illustrative
  1. 01

    Anthem

    Begin application, then CAQH

  2. 02

    Blue Shield of California

    BH application by email or fax

  3. 03

    BCBS of Michigan

    enrollment tool, CAQH in 14 days

  4. 04

    Highmark

    CAQH ID, then the CertifyOS portal

  5. 05

    BCBS of Texas

    record ID, then credentialing

  6. 06

    Florida Blue

    behavioral health through Lucet

How each plan below takes a therapist's application, from its own site, read 2026-11-11.
Blue companies
33
independent, one per area
Anthem
45 days
typically, from a complete CAQH file
Recredentialing
Every 3 years
at the plans covered here
If we do it
$150
per application, per provider

Where Blue Cross Applications Go Wrong

Most problems come from treating Blue Cross Blue Shield as one company.

Applying to the wrong Blue plan

Some states have more than one: California has Anthem Blue Cross and Blue Shield of California, and Pennsylvania and New York list four each. Each credentials separately.

Assuming medical and behavioral are the same network

Florida Blue delegates behavioral health to Lucet, and its own provider agreements exclude LCSWs, LMFTs, LMHCs and psychologists unless explicitly included.

Letting the CAQH clock run out

BCBS of Michigan closes an enrollment request if CAQH is incomplete or the attestation is expired after 14 calendar days. Anthem needs a status of Initial Application Complete or Reattestation.

Seeing members too early

Michigan, Highmark and Blue Shield of California all say to wait for confirmation. Blue Shield of California and BCBS of Texas process earlier claims as out-of-network.

Applying with an associate license

BCBS of Michigan lists limited licenses such as LLMSW and LLPC as not eligible. Highmark handles some associate licenses through enumeration under a group, not credentialing.

01Credentialed by Anthem (Elevance Health)

Anthem Blue Cross and Blue Shield

Behavioral health clinicians start from Anthem's own Begin application button, the same one as medical providers, then register with CAQH and authorize Anthem. Anthem says credentialing typically takes 45 days from the time it receives your completed CAQH application. A complete file needs five years of work history in month and year format and current liability insurance.

Stated time
45 days
typically, from complete CAQH
Recredentialing
Every 3 years
Questions
Email
credentialing@anthem.com

Who Anthem's criteria cover (its 12-state criteria document)

  • LCSWs with a master's or doctoral degree in social work and a license to practice independently
  • LPCs, MFTs and LMHCs with a qualifying master's or doctoral degree; divinity and biblical counseling degrees do not qualify
  • Psychologists with a state clinical psychologist license and a doctoral degree
  • Psychiatric nurse practitioners with a psychiatric nursing master's and ANCC or Pediatric Nursing Certification Board certification

Watch forIf you do not update CAQH by your recredentialing due date, Anthem treats the application as incomplete and ends your participation. Carelon Behavioral Health, Elevance's behavioral health company, runs its own network through Availity; Anthem's pages send therapists to Anthem's own application.

02Credentialed by Blue Shield's behavioral health network team

Blue Shield of California

Blue Shield of California has a separate behavioral health application for MDs, NPs, psychologists, LMFTs, LCSWs and LPCCs. Credentialing begins once it has a completed application, a signed contract and rates. Applications must be dated no more than 30 days before you send them, by email or fax.

Stated time
45 to 60 days
for completed applications
Malpractice
$1M / $3M
per occurrence / aggregate
CAQH
Required
attestation current

Watch forFor direct contract providers, credentialing approval alone does not make you participating. Services before your effective date process as out-of-network.

03Credentialed by BCBSM enrollment

Blue Cross Blue Shield of Michigan and Blue Care Network

You must complete the CAQH application within 14 calendar days of applying, or the request is closed and you reapply. BCBSM says review can take up to 90 days, and Blue Care Network takes extra time. For Blue Care Network, LMSWs, LPCs and LMFTs enroll as individuals first, then add themselves to a group.

CAQH
14 days
or the request closes
Review
Up to 90 days
for BCBSM participation
Status
1-800-822-2761

Watch forOnly see members after the confirmation letter arrives. Limited licenses such as LLMSW, LLPC and LLMFT are not eligible in any BCBSM network.

04Credentialed by Highmark, through the CertifyOS Provider Portal

Highmark (Pennsylvania, Delaware, West Virginia, New York)

Get a CAQH provider ID and select Highmark to receive your information, then complete the initial credentialing application in the CertifyOS Provider Portal. Before billing, you must be affiliated with a billing practice. Behavioral health clinicians need a license at the highest level in their state, for independent practice where that applies.

CAQH
Required
for all network providers
Portal
CertifyOS
step two
Recredentialing
At least every 3 years

Watch forLicensed social workers in Delaware and Pennsylvania cannot be credentialed; they follow Highmark's enumeration process. Do not see members or submit claims until Highmark notifies you of acceptance.

05Credentialed by BCBSTX, with Verisys verifying

Blue Cross and Blue Shield of Texas

First get a provider record ID for each tax ID you bill under, through the Provider Onboarding Form. A record ID does not enroll you in any network: until you are contracted, approved and activated, claims are processed as out-of-network. Your CAQH data supports credentialing, and Verisys may contact you to re-attest or fill gaps.

Record ID
Per tax ID
before credentialing
Corrections
30 days
for conflicting information
Recredentialing
Every 3 years

Watch forA record ID with no claims for 24 consecutive months may be canceled automatically. Check credentialing status with your NPI or license number in BCBSTX's Credentialing Status Checker.

06Behavioral health run by Lucet Behavioral Health

Florida Blue and Lucet

Florida Blue delegates behavioral health management to Lucet, and its own participating agreements exclude LCSWs, LMFTs, LMHCs and psychologists unless explicitly included. Lucet's own site lists master's-level social workers, counselors and therapists and psychologists among those eligible, with criteria such as at least 15 practice hours a week.

Behavioral health
Lucet
per Florida Blue's manual
Florida Blue decision
30 business days
written response
Networks
Some closed
or open in limited areas

Watch forFlorida Blue says some of its networks may be closed or open only in limited areas. Lucet's criteria come from Lucet's own site, not Florida Blue's.

What we handle, and what stays with you

Medtransic runs

  • Finding the right Blue plan and path, and filing the application
  • Your CAQH profile, set up and kept current at no extra cost
  • Credentialing at $150 per application, per provider, with no charge if we find the panel closed

Your practice keeps

  • Your license, malpractice cover and signatures
  • Which insurers you join
  • Your clinical work

How to Apply to a Blue Plan, Step by Step

The order is the same everywhere. The details belong to the plan.

  1. 1

    Find the Blue plan where you practice

    bcbs.com finds the local company by ZIP code or by the first three letters of a member ID. Where a state has two or more Blue plans, you may want each.

  2. 2

    Find who credentials behavioral health

    Most plans here credential therapists themselves. Florida Blue hands behavioral health to Lucet, so you apply there.

  3. 3

    Get CAQH ready and authorize the plan

    Most plans here use CAQH. Complete it, attest, and authorize the plan before you apply, because Michigan gives you only 14 days.

  4. 4

    Apply through the plan's own path

    Anthem's Begin application, Blue Shield of California's behavioral health application, Highmark's CertifyOS portal or BCBSTX's onboarding form.

  5. 5

    Answer correction requests fast

    Anthem gives at least 14 days to send more information; BCBSTX gives 30 calendar days to correct conflicting information. A missed deadline can close the file.

  6. 6

    Wait for the letter before seeing members

    Your participation starts on the effective date the plan gives you. Michigan, Highmark and Blue Shield of California all say not to see members before then.

In our experience credentialing usually takes 60 to 90 days with each payer. Plans that state a time measure from a complete file, so the clock starts only when nothing is missing.

Other Blue Plans and Related Companies

Horizon BCBSNJ

Horizon has handled behavioral health credentialing itself since October 2019. It says credentialing can take up to 90 days from the date it has everything; its behavioral health provider line is 1-800-682-9091.

CareFirst

CareFirst uses CAQH as its credentialing verification organization, then asks for a CareFirst Questionnaire. Its directory attestation is separate from CAQH and due at least every 90 days.

Independence Blue Cross

Apply with the Practitioner Participation Form and CAQH. The contract comes by DocuSign, and you have 30 calendar days to sign it.

Carelon Behavioral Health

Elevance's behavioral health company runs its own network. New enrollment goes through the Carelon payer space in Availity, and recredentialing is every three years.

Highmark associates

Licensed associate MFTs and counselors appear in Highmark's enumeration table for Pennsylvania and Delaware commercial plans. Enumerated providers need a group contract and are not listed in the directory.

Recredentialing

Anthem, Blue Shield of California, BCBSM, BCBSTX, Florida Blue and Carelon all recredential every three years; Highmark at least every three years.

Your client portal, included

Your EHR shows what you billed. Your portal shows what we are doing about it.

Your EHR or practice management system runs your practice, but it does not show you our work. The Medtransic HIPAA Compliant Portal does: every claim and its current stage, the denials we are working, your A/R by age, each payer application and its in-network date, and the documents we still need from you. It is the same record our team works from, and it comes with every client account.

Did that claim get paid?
Every claim with its stage and amount, the denials we're working, and your receivables by age.
Where is my application with Aetna?
Each payer application shows its stage, its history, and the date you can start seeing that payer's patients.
What do you still need from me?
One list of the documents we're waiting on. Upload once, and it reaches every payer that asked for it.
See the client portal →
The billing screen in the Medtransic client portal: totals billed, paid, adjusted and outstanding, a twelve-month chart and A/R by age.
The billing screen. Shown with sample data. It works in any browser, on your desk or your phone. iPhone and Android apps are coming soon.

When a Blue Plan Can Wait

  • If you hold an associate or limited license, most Blue plans here will not credential you in your own name. Apply once you are fully licensed.
  • If the Blue plan in your area is closed to your license type, a single case agreement or a superbill can cover a client in the meantime.

Questions about BCBS and Anthem credentialing

Is BCBS credentialing the same in every state?

No. Blue Cross Blue Shield is an association of 33 independent companies, each licensed for its own area. Each runs its own credentialing, with its own forms, rules and timelines.

How long does Blue Cross Blue Shield credentialing take?

It depends on the plan. Anthem says typically 45 days from a complete CAQH application, Blue Shield of California 45 to 60 days, Horizon up to 90 days, and BCBS of Michigan up to 90 days for review. In our experience it usually takes 60 to 90 days with each payer.

Does Anthem use CAQH?

Yes. Anthem says it uses the CAQH application for credentialing: register with CAQH, authorize Anthem, and keep the application complete. A complete file needs a CAQH status of Initial Application Complete or Reattestation.

Is Anthem the same as Blue Cross Blue Shield?

Anthem is one of the Blue companies, owned by Elevance Health, licensed in its own states. In California, Anthem Blue Cross and Blue Shield of California are separate companies that credential separately.

Does Carelon credential therapists for Anthem?

Anthem's own pages do not say so: they send behavioral health clinicians to Anthem's application. Carelon, Elevance's behavioral health company, runs its own network with its own enrollment through Availity.

How do I check my BCBS credentialing status?

With the plan you applied to. Anthem takes questions at credentialing@anthem.com, BCBS of Michigan at 1-800-822-2761, and BCBS of Texas through its Credentialing Status Checker by NPI or license number.

Can a pre-licensed associate get credentialed with BCBS?

Usually not in their own name. BCBS of Michigan does not accept limited licenses, and Highmark handles some associate licenses through enumeration under a group contract instead of credentialing.

Can you credential me with Blue Cross Blue Shield?

Yes. We find the right Blue plan, file the application and keep your CAQH profile current for $150 per application, per provider, with no charge if we find the panel closed.

Keep reading

+ Sources: 21 checked 2026-11-11

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