June 27, 2016
Area(s) of Interest: Commercial Payors Payor Issues and Reimbursement
The California Medical Association (CMA) has received several inquiries over the past few weeks from practices concerned about the validity of requests for information from a company called BetterDoctor.
As you may know, a new law took effect July 1 that requires payors to ensure that their physician directories are accurate and up-to-date. BetterDoctor is a vendor working on behalf of a number of plans on a pilot project to ensure the accuracy of their physician directories as required under the new law. Practices are encouraged to respond to the information requests, as the law also requires physicians do their part to keep their information up-to-date.
Eight California plans have contracted with BetterDoctor to confirm provider directory information. The eight plans included in the pilot are Anthem Blue Cross, Blue Shield of California, Health Net of California, Humana, LA Care, Molina Healthcare, SCAN and Western Health Advantage. For more information on the pilot. There may also be other pilot programs taking place on behalf of other payors that utilize other vendors as well.
For more information about physicians’ obligations under SB 137, see CMA's new resource, “What Physicians Need to Know to Avoid Penalties Under the New Provider Directory Accuracy Law."