11/06/2023
As a reminder, the Consolidated Appropriations Act (CAA) of 2021 requires that certain directory information be verified every 90 days. It must be verified every 90 days even if your data hasn’t changed since you last verified it.
Under the CAA, we’re required to remove providers from Provider Finder® if the information isn’t verified.
Medicaid Providers
In addition, Medicaid Provider are required by Texas Health and Human Services Commission (HHSC) to update their information through Provider Enrollment and Management System (PEMS). To learn more, see PEMS Portal website.
What to Verify
Verify your name, address, phone, specialty, and digital contact information (website) every 90 days. You also 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 details on:
- How to Verify - Professional Providers
- How to Verify – Professional Provider Groups
- How to Verify – Professional Provider Groups Who Submit Change by Roster
- Note: Medical groups who update their provider information by roster can verify all their providers’ information every 90 days with their roster. When you submit a roster, all providers affiliated with this group and not listed with an update are verified as correct with no changes.
- How to Verify – Acute and Ancillary Facilities
- How to Update Your Information – All Facilities and Professional·
- If you need to change your data, you may continue to use the Demographic Change Form. Professional providers may update some data through Availity Provider Data Management. See our Verify and Update Your Information page for details. Updating your data will count as your 90-day verification.
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.
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.