This article is for all individual medical providers caring for our members. This does not apply to facilities or group practices.
Our provider directories supply Blue Cross members with valuable information about your practice. The Centers for Medicare & Medicaid Services require that provider directories include only locations where members can make an appointment with that provider at that location.
When providing location information, please be clear about the locations where appointments can be scheduled. You must be able to schedule and treat patients at each of the locations that are published in our directories.
Effective November 1, 2021
- We will include up to five practice locations per practitioner in our directories.
- If you have more than five locations, we will determine which locations to display based on provider data from any of the following: CAQH location detail information, claims, enrollment, or maintenance request forms.
Note: We will not limit the amount of practice locations you can request; this limitation only applies to the amount of practice locations we will display.
Remember, you are required to notify us of any practice location or limitation changes. If you need to correct, add, or remove a location, you can request the changes by completing the Provider Information Change form.
The information you provide in CAQH ProView is critical. Ensure that the practice location section of Proview is accurate for each location with specific attention to the ‘Practice details’ and ‘Provider at the location’ sections.
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