Confirm your provider directory information in CAQH ProView

It’s important that your contact information in the Blue Cross Blue Shield of Michigan and Blue Care Network health care provider directory is accurate, current and complete. Patients and referring physicians use this information to search for a health care practice that meets their needs.

New federal and state regulations require regularly updated, accurate information in provider directories. There are new rules by the Centers for Medicare & Medicaid Services for Medicare Advantage plans and Medicare and Medicaid insurance plans, requirements for qualified health care plans participating in the federally facilitated Marketplace and provider directory requirements in 26 states.

In the May 2016 Record, we informed you that Atlas Systems will help gather information for our provider directory.

Working with CAQH
Within in the next couple of months, Blue Cross and BCN will work with CAQH**, a nonprofit alliance, to ensure that the information in our provider directory is accurate and up to date. Our goal is to help you avoid frequent outreach for the same information by multiple health care plans, which could create a significant burden on your staff’s time and resources.

For many years, we’ve been a participant in CAQH ProView, which streamlined the credentialing process. Now we’re working together to use that same information to simplify the process of updating provider directories. We’ll be using CAQH ProView for our quarterly directory attestation.

Blue Cross and BCN worked with CAQH to begin a multi-plan initiative to encourage physicians and other health care professionals with existing CAQH ProView^®** profiles to:

• Review their current information in a new “Provider Directory Snapshot” as part of their regular re-attestation process
• Make updates to their information and affiliations, as appropriate
• Re-attest that this information is current, accurate and complete and may be published in the provider directories for the participating health care plans that they designate

After Blue Cross and BCN receive this information, we’ll incorporate it into our provider files. To meet CMS and other requirements, CAQH will reach out to you once each quarter to review and update your directory information. We also encourage other health care plans you contract with to participate in this initiative as well.

If you have questions about your provider file information or about CAQH ProView**, contact your provider consultant. To learn more about the CAQH Provider Directory initiative**, go to caqh.org**.

**Blue Cross Blue Shield of Michigan doesn't own or control the content of this website.