Wrong Regence plan
A provider in Vancouver, Washington who applies to Regence of Oregon is rejected. The plans are separate legal entities with separate contracts.
Provider credentialing
Regence Credentialing Services
Regence holds the Blue Cross Blue Shield license in Washington, Oregon, Idaho and Utah. We file your application through Availity, keep CAQH current, and follow it through Regence's credentialing committee to a participation agreement.
7-14 daysto onboard your practice end to end
Weeklystatus report on every open application
50 statesMedicare, Medicaid and commercial panels
Regence at a glance
- Blue plans in WA, OR, ID and UT
- Separate legal entity per state
- Applications through Availity
- CAQH plus required attachments
- Typical timeline: 60 to 90 days plus contracting
The application path we run for this payer
- 1
Intake and gap review
Licenses, DEA, board certificates, malpractice, work history and NPI details are collected and compared against what each target payer asks for.
- 2
Profile setup
CAQH ProView, PECOS and payer portals are created or cleaned up, attested and linked to the correct Tax ID and locations.
- 3
Application submission
Every enrollment is filed in dependency order, with a tracking record for each payer, date and reference number.
- 4
Follow-up on a fixed cadence
Payers are contacted on a schedule. Requests for more information are answered the same business day.
- 5
Approval, contract and handoff
Effective dates, provider IDs and fee schedules are logged and loaded into your billing system.
Regence BlueShield in Washington, Regence BlueCross BlueShield of Oregon, Regence BlueShield of Idaho and Regence BlueCross BlueShield of Utah are separate plans under the Cambia Health umbrella. Each is one of the largest commercial payers in its state, and each credentials through its own application, though the process and portal are shared.
ClainetRCM knows the Regence process well from our work with Pacific Northwest practices, including the Washington market where Regence and Premera split most of the commercial membership.
Where this usually goes wrong
Availity attachment gaps
Regence requires specific attachments in Availity, including malpractice and license copies, even though it also pulls from CAQH. Missing one returns the application.
Committee timing
Regence credentialing committees meet on a schedule. An application submitted just after a meeting waits for the next cycle.
What ClainetRCM handles
One coordinator owns the file from intake to effective date.
- Correct Regence plan identification for each practice location
- Availity provider enrollment application with all required attachments
- CAQH ProView attestation with Regence authorized
- Committee cycle timing so applications do not miss a meeting
- Contracting follow-up and fee schedule review
- Provider ID and effective date loaded into billing
Regence plans by state
| Washington | Regence BlueShield. Shares the commercial market with Premera Blue Cross, which is a separate application. |
|---|---|
| Oregon | Regence BlueCross BlueShield of Oregon. |
| Idaho | Regence BlueShield of Idaho. Blue Cross of Idaho is a separate plan. |
| Utah | Regence BlueCross BlueShield of Utah. |
| Typical timeline | 60 to 90 days plus contracting when CAQH and attachments are complete. |
For Blue plans outside these states see Blue Cross Blue Shield credentialing.
Questions about Regence
Regence generally completes credentialing in 60 to 90 days from a complete Availity application, with contracting adding two to four weeks. Missing a committee cycle is the most common cause of a longer wait.
Yes. Regence pulls credentialing data from CAQH ProView and also requires certain attachments in the Availity application. We keep both in sync.
No. In Washington, Regence BlueShield and Premera Blue Cross are separate Blue plans with separate credentialing and contracts. Most Washington practices need both.
Regence offers Medicare Advantage products that are usually covered under the same credentialing file but a separate contract. We confirm product coverage before you sign. See Medicare Advantage credentialing.
Other payers and enrollment pages
Back to the provider credentialing overview, or continue with a related page.
Medicare Provider Enrollment Services
CMS-855 applications and PECOS filing
Medicaid Provider Enrollment Services
State Medicaid and MCO enrollment
PECOS Enrollment and Account Management
Medicare's online enrollment system
Medicare Revalidation Services
Cycle revalidation without deactivation
Washington medical billing
Apple Health, Regence and Premera
Private practices
Independent practices in the Northwest
Physical therapy billing
Common Regence-credentialed specialty
Free revenue audit
Find out what your practice is losing to denials.
Send us 90 days of remittance data and we will show you, line by line, which claims were underpaid, denied, or never worked, and what it would take to recover them. No cost, no obligation, and you keep the report either way.
No setup fee. No long-term contract. Pricing from 2.29% of monthly collections.