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New provider directory information required for health plans and providers
November 26, 2024

This article is for all providers caring for our members

As you know, federal and state regulations require health plans to collect directory information from providers and validate that information every 90 days. Massachusetts is now requiring additional information about your practice and facilities to ensure that members can access the most accurate information when searching for in-network care.

These new fields will capture additional information, such as:

  • ADA accessibility features
  • Age groups treated
  • Appointment availability
  • Demographics about patients you treat
  • Gender-specific treatment options
  • Languages spoken
  • Office locations and operating hours per location
  • Practice group affiliation
  • Telehealth availability

For all clinicians—including behavioral and mental health providers registered with CAQH, you’ll notice these new data fields in the CAQH Provider Data Portal starting this month. Save time by reviewing now or updating your information as it changes, including if you join or leave the Blue Cross network.

For facilities and health care providers who have not registered with CAQH, we’ll add these new data fields in the Blue Cross directory review surveys that we send to you, in 2025. We will share more information in the coming year.

Join us for an upcoming webinar

On Tuesday, January 28, 2025, from Noon - 1 p.m., we will join the Massachusetts Health & Hospital Association, the Massachusetts Medical Society, the Massachusetts Association of Health Plans, Healthcare Administrative Solutions (HCAS), CAQH and the Massachusetts Division of Insurance to host a training webinar to support this transition. The session will also be recorded.

We appreciate your collaboration

We understand these requirements may increase administrative work. We thank you for your collaboration and help in ensuring our members—your patients can find the care they need.

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