Jan. 12, 2022
In November, we told you about the Consolidated Appropriations Act (CAA) requirement that certain provider directory information be verified every 90 days. This requirement is effective as of Jan. 1, 2022.
What This Means for You
As of Jan. 1, you must:
- Verify your name, address, phone, specialty and digital contact information (website) for our Provider Finder® every 90 days
- Update your information when it changes, including if you come in or go out of a network
Under CAA, we are required to remove providers from Provider Finder whose data we are unable to verify. In addition, if you leave a network, you should 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.
How to Verify and Update
We recommend you use the Availity® Provider Data Management feature to quickly verify and update your information with us and other insurers every 90 days. If you are unable to use Availity, you may submit a Demographic Change Form.
Note: Facilities should only use the Demographic Change Form to verify and update their data.
We won’t accept demographic changes by email, phone or fax to enable us to meet the two-day update requirement defined by CAA. Any demographic updates requested through these channels will be rejected and closed.
To apply to join our networks or add a provider to your current group, see How to Join.
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 BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.