The Consolidated Appropriations Act Requires Provider Directory Information to Be Validated at Least Every 90 Days
As we previously communicated with you, the Consolidated Appropriations Act (CAA) outlines new requirements for maintaining and validating information to include provider directories (CAA Section 116).
The intent of these requirements is to help individuals make informed choices when selecting a provider.
What to Expect
To comply with these new CAA provisions, insurers must develop a process to verify provider directory accuracy. Effective Jan. 1, 2022, CAA requires that Blue Cross and Blue Shield of Kansas (BCBSKS) provide and regularly maintain an online provider directory to members. Providers must validate their information at least every 90 days through the provider portal. The directories must be available to participants, beneficiaries, and enrollees.
Directories should display at a minimum the following information about each provider:
- Name
- Address
- Specialty
- Phone number
- Digital contact information (email address and/or URL)
PLEASE NOTE: BCBSKS will use the URL of the provider website as the digital contact information. The URL on file will run through a routine validation process to ensure it is accessible by the public.
Should you fail to respond within the required time frame, the law requires insurers remove providers from the directory until your information is validated. While you will be removed from the directory, you will not be removed from the BCBSKS provider network(s).
- Last Attest Date – Date the provider attested last for any reason, i.e., QBRP, form submitted to change an address or office hours. Each time a form is submitted the Last Attest date will update.
- Attest Due Date – Date is calculated out 89 days form the Last Attest Date
Caution Flag – The caution flag will appear on the provider record indicating to the provider the attestation is due in 30 days.
If you have any questions regarding this newsletter, please contact your BCBSKS provider consultant.