Established Providers - Recredentialing


Is it time for you to go through the recredentialing process? Download and complete the credentialing update form, then fax along with required documentation to 803-870-9997 or email to

Required Items

Additional Documentation for Healthy BlueSM Recredentialing
Disclosure of Ownership Form — The form should be completed based on the entity/practice and included with the individual’s application. A separate form is required for each location where the provider renders services.