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Regence provider recredentialing application form

Regence provider recredentialing application form 2025

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4.6 out of 5

40 votes

The document is a credentialing application form for organizational providers and facilities seeking to be credentialed or recredentialed by Regence BlueCross BlueShield of Utah. It includes sections for general information, demographic details, payment and billing information, licensure and certification requirements, liability insurance details, ownership and management information, attestation questions regarding legal and compliance issues, staffing credentialing processes, exclusion certifications, and a release of information authorization. The form aims to collect comprehensive data necessary for the evaluation of the facility's qualifications.

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Versions	Form popularity	Fillable & printable
2022	4.6 Satisfied (50 Votes)
2013	4.6 Satisfied (40 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the time limit for Regence filing?

To reach a Customer Care representative for questions regarding eligibility, claims status, or to request a replacement ID card, please call 1-866-738-3924 Monday - Friday 5:00 AM. to 6:00 PM PT or log in to your RGA account and submit an electronic request.

What is the phone number for Regence Blue Shield of Idaho provider relations?

When calling our Provider Contact Center at 1 (800) 253-0838, use the phone prompts below to access IVR: If your patient is a Regence member, press 1 and select: For questions regarding dental. For prescription pre-authorization questions.

How do I contact Regence Group Administrators?

How to contact Epic Support Go to the Epic Games Help page (Opens in a new tab). Type a description of the question or the issue you are facing in the search bar. If you find an article that answers your question or solves your problem, you are all set! Click the Contact Us button.

How do I file a complaint with Regence?

Phone: 1 (888) 384-3577. You can remain anonymous. In addition to the resources listed above, if you have a concern or a complaint about an accounting, internal controls or auditing matter, you can call the Audit and Compliance Committee Chair of the Board of Directors at (888) 655-5452 or send an email.

How do I contact Regence insurance?

Were here to help Whether youre a current Regence member or considering Medicare, you can reach out to a Regence Medicare plan advisor at 1-844-REGENCE (734-3623) (TTY: 711). Our hours are 9 a.m. to 5 p.m., Monday through Friday.

How do I file a complaint with Epic?

Regence is good insurance and will have broader coverage (youll be able to go to more institutions and see more doctors), but the cost will probably be higher.

What is the phone number for Regence credentialing?

If the information you need is not available in the Onboarding Tracker, call our Provider Contact Center at 1 (888) 349-6558. 6. View additional information about credentialing and contracting in our Self-Service Tool, on our provider website, regence.com.

Regence provider recredentialing application form 2025

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