The Consolidated Appropriations Act (CAA) requires provider directory information to be verified every 90 days. Providers and insurers have roles in fulfilling this requirement to maintain an accurate directory.
Under CAA, we’re required to remove providers from Provider Finder® if the information isn’t verified.
What to Verify
Verify your name, address, phone, specialty and digital contact information (website) every 90 days. It must be verified every 90 days even if your data hasn’t changed since you last verified it.
You must update your information when it changes, including if you join or leave a network. See our Verify and Update Your Information page for more information.
How to Verify Information
- Professional Providers: We recommend using the Availity® Essentials Provider Data Management (PDM) feature to quickly verify your information with us and other insurers every 90 days. See our PDM page and user guide for more details. If you’re unable to use Availity, use our Demographic Change Form. See our user guide on how to verify your data using the form.
If you haven’t verified your data, you may receive email reminders from us. These emails have a unique link to verify information.
- Professional Provider Groups can verify individual providers through the Availity PDM feature or our Demographic Change Form.
- ·Professional Provider Groups who submit changes by roster can verify all their providers’ information every 90 days with their roster. When a group submits a roster, all providers affiliated with this group and not listed with an update are verified as correct with no changes.
- Acute and Ancillary Facilities may only use the Demographic Change Form to verify information. See our user guide for more details.
How to Make Updates
If you need to change your data, follow the instructions below. Updating your data will count as your 90-day verification.
· All facilities and professional providers may continue to use the Demographic Change Form.
· Professional providers may update some data using Availity’s PDM feature.
See our Verify and Update Your Information page for details.
To enable us to meet the two-day directory update requirement defined by the CAA, we won’t accept demographic changes by email, phone or fax. Any demographic updates requested through these channels will be rejected and closed.
To apply to join our networks or add a provider to your current group, see How to Join.
More on the CAA and Transparency in Coverage Final Rule
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.