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1 abr, 2019

If you verify it, they will come

Technology connects patients with the healthcare they need, which is why an online provider directory that displays accurate practice information is essential. For quite some

time, we have been engaging providers about the importance of verifying their practice information on our “Find a Doctor" tool. The reason is simple—inaccurate or missing provider data creates barriers to care for both our members and other providers. For example, if our members can’t find or contact you because they’re viewing missing or outdated information, they can’t access your services.

When a patient searches for an in-network provider on our Find a Doctor tool, they deserve an experience that leads them to reliable information. Yet patients in Rhode Island and across the country regularly encounter inaccurate information when searching online provider directories. In fact, a 2018 audit of Medicare Advantage plans conducted by the Centers for Medicare and Medicaid Services (CMS) found that about 49 percent of the provider directory locations listed had at least one inaccuracy! It’s important that patients have access to correct practice information, especially since accurate provider directories are a CMS requirement, not to mention a contractual agreement as a participating provider with BCBSRI.

Here are some important things you can do to ensure the accuracy of your provider data:

  • Make sure the primary address you have listed is the same address where a patient can make an appointment to see you.
  • Stay current on whether or not you are accepting new patients, and report your “open" or “closed" panels when that status changes.
  • List a primary phone number that is active and up-to-date.

Ensuring accurate practice information is critical, especially for providers who perform services at a number of different locations. For example, a specialist may have privileges at a hospital or facility where they offer certain procedures, but the primary address where their patients can make ap- pointments to see the provider should be listed in the online directory.

BCBSRI continues to offer providers opportunities to verify accurate practice information. Here are some of the options available to you:

  • Every quarter, we reach out directly to provider offices by fax, giving you the opportunity to verify your practice infor- mation as it appears on our Find a Doctor tool.
  • We send out periodic reminders in the BCBSRI Update section of this newsletter.
  • We are continuing our work on a self-service Provider Portal that will make submitting your practice updates even easier.
    To check if your information is accurate and up-to-date, please search for your practice in our Find a Doctor tool. I would also encourage you to reach out to our Provider Relations team at ProviderRelations@bcbsri.org for help updating your practice information. Thank you!

Gus  Manocchia,  M.D. Executive Vice President and Chief Medical Offi er