Contracting Enrollment & Credentialing for Vermont Health Providers
The group or individual must hold a contract with BCBSVT or a designated entity and the individual providers to be associated must be enrolled and credentialed.
You must complete a Provider Enrollment/Change Form (PECF) and submit:
- A copy of your state licensur* or certificate
- Proof of malpractice insurance
- Any applicable board certification or Drug Enforcement Agency license
- National Provider Identifier
Note: We are able to accept enrollment paperwork and begin the enrollment and credentialing process even if a provider is pending issuance of a State of Vermont Practitioner's license. Indicate on the Provider Enrollment/Change Form (PECF) "pending" for license # in Section 4, Provider Information.
Upon your receipt of the license, provide a copy by:
- Fax: (802) 371-3489
- Email: email@example.com
- U.S. Mail:
Attn: Network Management
P.O. Box 186 Montpelier, VT 05601-0186
Enrollment of Locum Tenen
You must complete a Provider Enrollment/Change Form (PECF) and indicate in Section 4, Locum Tenen, who the provider is covering for and how long they will be covering.
Locum Tenens who will be covering for another provider for a period of six months or less do NOT require credentialing.
You must complete a Council for Affordable Quality Healthcare (CAQH) Application for Credentialing and receive approval from one of the following credentialing committees:
- Blue Cross and Blue Shield of Vermont (BCBSVT) (888) 449-0443
- Dartmouth Hitchcock Alliance (hospital-owned Physicians only)
- Magellan (800) 866-4303
- Vermont Managed Care (VMC) (800) 639-3881
For BCBSVT credentialing, the first step is to complete or update a CAQH application . Read more about credentialing..