Effective January 1, 2014, IBC began providing the option for Certified
Registered Nurse Practitioners (CRNPs), practicing independently within a
participating primary care physician practice, to be recognized as a
participating provider. To elect this
option, a CRNP must complete the
credentialing and contracting process. Once completed, CRNPs may bill directly
for their services as the performing provider using their newly assigned
provider number. Reimbursement for CRNP services shall be made in accordance
with IBC medical and claim payment policies and, where applicable, the
contracted CRNP fee schedule. In the event a CRNP fee schedule is not included
in the contract, reimbursement shall be based on 85 percent of the applicable
contracted professional fee schedule.
Reimbursement for covered vaccines shall be based on 100 percent of the
applicable contracted professional fee schedule. If your PCP practice is
interested in credentialing a CRNP as a PCP to participate in our network,
please complete the
Council for Affordable
Quality Healthcare (CAQH) credentialing form. Once the form is completed,
providers should notify our Contracting Provider Network Contract
Administration Department at
Application_Requests@ibx.com. Please include
the following information in your email:
CRNP's name
CRNP's mailing address
CRNP's office address
CRNP's CAQH ID number
CRNP's NPI (
Note: A group NPI for the CRNPs in your office will need to
be provided.)
contact person?s name, telephone number, and email address.
If you have any questions regarding this process, please contact Customer
Service at
1-800-ASK-BLUE.