Prepare for the Consolidated Appropriations Act: Keep your provider directory information up to date
As we announced in the October edition of Provider News, Anthem Blue Cross and Blue Shield (Anthem) is working to comply with the requirements of the Consolidated Appropriations Act, or CAA.
Improving the accuracy of provider directory information
As part of the CAA, soon providers will be asked to verify their online provider directory information on a regular basis to help ensure Anthem members can locate the most current information for in-network providers and facilities. It is important that you keep your information up to date. Here’s what you can do now:
- Review your online provider directory information on a regular basis to ensure it is correct. You can check your directory listing on Anthem’s Find Care Consumers, members, brokers, and providers use the Find Care tool to identify in-network physicians and other healthcare providers supporting member health plans. To ensure we have your most current and accurate information, please take a moment to access Find Care. Go to anthem.com/provider, then under Provider Overview, choose Find Care.
- Submit updates and corrections to your directory information by using our online Provider Maintenance Form*. Online update options include:
- add/change an address location
- name change
- tax ID changes
- provider leaving a group or a single location
- phone/fax number changes
- closing a practice location
Once you submit the Provider Maintenance Form, you will receive an email acknowledging receipt of your request. Visit the Provider Maintenance Form landing page for complete instructions.
*Medicaid providers should use the Practice Profile Update Form to make changes.
Practice changes or to update demographics, or submit terminations
- Commercial/Medicare: Provider Maintenance Form
- Medicaid: Practice Profile Update Form
Consolidated Appropriations Act implementation
The Consolidated Appropriations Act does not preempt state law requirements. This means that the CAA applies in addition to any state law requirements of providers to update their provider directory information.
On August 20, 2021, the Tri-Agencies (Departments of Labor, Health and Human Services and the Treasury) announced that regulations to implement the provider directory requirements would be issued on or after January 1, 2022. Health plans are expected to implement the provider directory requirements based on a good faith, reasonable interpretation of the requirements by January 1, 2022, with a primary focus on ensuring that members who rely on provider directory information that inaccurately depicts a provider’s network status are only liable for in-network cost-sharing amounts. Anthem is moving forward with compliance of this good faith, reasonable interpretation of the requirements while awaiting additional regulatory guidance.
Watch for upcoming editions of Provider News in 2022 for updates on our ongoing efforts to comply with the CAA requirements.
December 2021 Anthem Provider News - Nevada