Provider Directory Demographic Data

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Provider Directory Demographic Data

Sunday, March 5, 2017

Accurate provider directories are important for patients and referring physicians to know which physicians are taking new patients. They also provide information on how to contact the physician’s practice, location, and primary specialty.

Effective January 1, 2016, the Centers for Medicare & Medicaid Services (CMS) mandated that Medicare Advantage (MA) Plans provide complete and accurate information regarding physicians who are available to new patients/enrollees in their online and printed directories. MA plans must communicate at least quarterly to verify the physician location and availability information.

Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) have created a Provider Directory Compliance Plan. This plan addresses the physician demographic data collection process, as well as penalties for non-compliance.

For more information on what Blue Cross and Blue Care Network are doing for providers to attest their demographic data >>