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Credentialing and Contracting

Regence BlueCross BlueShield of Utah evaluates all networks on a quarterly basis to ensure that members have access to an adequate number of providers. Based upon that review, an entire network or specific provider types may be ‘open’ (accepting applications for participation) or 'closed' to new provider applicants.

We contract with the following provider types. Unsolicited applications for credentialing or contracting from individuals or clinics not listed below will not be accepted.

  • 'Open' networks:
    Learn about our credentialing process.

  • 'Closed' networks:
    Complete the secure form to request a provider agreement should the network in your area open. We will contact you at that time with information about our contracting and credentialing process.
Covered Providers
Participating Dental Network
  Open Closed Exceptions
Dentist (DDS/DMD)    

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Physicians and other health care professionals

Covered Providers
Participating Network
Preferred ValueCare Network
Preferred BlueOption Network

Preferred FocalPoint Network

Regence MedAdvantage Network
  Open Closed Open Closed Open Closed
Invitation Only
Open Closed

Acupuncturist (LAC)/East Asian Medicine Practitioner (EAMP)

Exceptions: Acupuncturists may apply to participate with the Federal Employee Program

 

X   X   X
X
  Not eligible
Alcohol Treatment Facility      
X
 
Ambulatory Surgery Center (ASC)     X   X
X
 
Audiologist (AuD)      
X
 
Birthing Center   X   X   X
X
  X
Certified Nurse Midwife (CNM)
     
X
 
Certified Registered Nurse Anesthetist (CRNA)      
X
 

Chiropractic Physician (DC)

Exceptions: Preferred networks open for agreements effective October 1, 2010





     
X




 
Clinical Nurse Specialist (CNS)



 


 


 
X



 

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Covered Providers
Participating Network
Preferred ValueCare Network
Preferred BlueOption Network

Preferred FocalPoint Network

Regence MedAdvantage Network
  Open Closed Open Closed Open Closed

Invitation only

Open Closed
Dialysis Facility      
X
 
Dietitian (RD)   X   X   X
X
  X
Durable Medical Equipment (DME)   X   X   X
X
  X
Emergency Medical Services (EMS)      
X
 

Hearing Aids/Supplies

Exceptions: Hearing Aid/Supply providers may apply to be contracted with the Federal Employee Program

      X
X
  X
Home Health   X   X   X
X
  X
Home Infusion Therapy   X   X   X
X
  X
Hospice   X   X   X
X
  X

Hospital

Exceptions: Contracted on an individual basis.  Please contact Provider Network Development.

           
X
   

Imaging Centers

Exceptions: Panel closed except for case by case review

  X   X   X
X
  X
Laboratory (LAB)   X   X   X
X
  X
Licensed Clinical Social Worker (LSCW)      
X
 
Licensed Marriage and Family Therapist (LMFT)      
X
  Not eligible
Licensed Professional Counselor (LPC)      
X
  Not eligible
Long Term Acute Care Hospital (LTAC)      
X
 
Mental Health Facility   X   X   X
X
  X

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Covered Providers
Participating Network
Preferred ValueCare Network
Preferred BlueOption Network
Preferred FocalPoint Network
Regence MedAdvantage Network
  Open Closed Open Closed Open Closed
Invitation Only
Open Closed
Naturopathic Physician   X   X   X
X
  X
Nurse Practitioner (NP      
X
 
Occupational Therapist (OT)      
X
 
Optometrist (OD)      
X
 
Orthotics & Prosthetics     X   X
X
 
Physician (MD/DO)      
X
 

Physician Assistant (PA)

Exceptions: Regence BCBSU does not contract with PAs. Please submit claims for services rendered by PAs under the supervising physician's name (rather than the rendering PA's name) to ensure proper processing and payment of claims.

           
X
   
Podiatrist (DPM)      
X
 
Psychologist (PhD)      
X
 
Physical Therapist (PT)      
X
 
Residential Treatment Facility   X   X   X
X
  X
Skilled Nursing Facility (SNF)      
X
 
Speech Therapist (SLP)      
X
 
Urgent Care      
X
 

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