Recredentialing for our providers occurs every three years. When requested, submit the following application and required documents to our credentialing team.

Forms

Medical Recredentialing

South Carolina Uniform Managed Care Application

The following items must be included with the application:

• Copy of State license(s)
• Current copy of Drug Enforcement Administration (DEA) registration (if applicable)
• Current copy of malpractice insurance (Minimum of $1M/$3M)
• Copy of Board Certification (if applicable)
• Copy of Clinical Laboratory Improvement Amendment (CLIA) certification (if applicable)

Dental Recredentialing

Dental Provider Recredentialing Application

The following items must be included with the application:

• Copy of State Dental license(s)
• Current copy of Drug Enforcement Administration (DEA) registration (if applicable)
• Current copy of malpractice insurance (Minimum of $1M/$3M)
• Copy of Board Certification (if applicable)

Behavioral Health Recredentialing

Behavioral Health Provider Recredentialing Application

The following items must be included with the application:

• Copy of State license(s)
• Current copy of Drug Enforcement Administration (DEA) registration (if applicable)
• Current copy of malpractice insurance (Minimum of $1M/$3M)
• Copy of Board Certification (if applicable)
• Copy of protocols (Collaborative Agreement)
  • Only for nurse practitioners

How to Submit

Submit the application and required documents to our credentialing team using one of the following methods:

• Fax: 803-870-9997
• Email: Recred.App@bcbssc.com