Provider Directory Information Verification

Nov. 17, 2021

Requirement of the Consolidated Appropriations Act (plan years on or after Jan. 1, 2022)

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.

What this means for you: Starting Jan. 1, 2022, you must:

  • Verify your directory information every 90 days
  • Update your information when it changes, including if you come in or go out of a network

You can submit your changes via the Demographic Change Form or, if you are adding additional networks, use the Provider Onboarding Form. Also, watch for information coming soon in our News and Updates or Blue Review newsletter regarding the Provider Data Management tool that will provide easy access to update your information via Availity®. We won’t accept changes by email, phone, or fax. Updates will be reflected in our Provider Finder®.

Under CAA, we are required to remove providers from our directory whose data we are unable to verify within 90 days. If you don't verify your details every 90 days, we will reach out to you by email and ask that you quickly respond by following the unique link in the email. It will take you to a secure landing page where you can update your information.

If you leave a network, please update your directory information immediately. If you are incorrectly identified as an in-network provider, it may limit member cost-sharing to in-network levels.

More on the CAA and Transparency in Coverage Final Rule .


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