This article is for all providers caring for our members
To better serve our members and align with new state and federal regulations, we’re enhancing our provider directory. Beginning next month, we will display more detailed information about your practice in our Provider Directory, sourced directly from your CAQH provider profile or our Blue Cross directory validation survey.
As you know, federal and state regulations require health plans to collect directory information from providers and validate that information every 90 days. Massachusetts now requires additional information to ensure that members can access the most accurate information when searching for in-network care.
New information to be displayed
These new fields offer a fuller insight into your practice including:
- ADA accessibility features
- Age groups treated
- Appointment availability
- Demographics of patients treated
- Gender-specific treatment options
- Languages spoken
- Office locations and hours per location
- Practice group affiliation
- Telehealth availability
It is important to complete these fields accurately. If a field is left blank in your CAQH provider profile, it will display as “Information not available from provider” in our directory. See a sample of how information will display.
Action required: Keep your CAQH profile up to date
For all clinicians, including behavioral and mental health providers registered with CAQH, we encourage you to log in to your CAQH profile to review and update this information promptly even if you have no changes. Continue to review and attest to the accuracy of your information every 90 days to remain compliant and listed in the directory.
For dentists, facilities, group practices, labs, or ancillary institutional providers not part of CAQH’s validation process, we’ll continue to send you an email or letter each quarter to complete our quarterly directory survey to validate your information.
If your information is not up to date
You must review and attest to your information every 90 days. If your information is not attested to, you could potentially be suppressed from our directory. If you review your information and choose to leave an optional field blank, you must still complete the attestation for your entire profile. You will not be suppressed for leaving optional fields blank as long as you complete the CAQH attestation or our Blue Cross directory validation survey.
We appreciate your collaboration
Maintaining an updated profile—including any network changes—saves time and ensures the accuracy of the information displayed to our members. We recognize the administrative demands and appreciate your attention to this matter. Thank you for your efforts to help members find the care they need.
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