Providers now required to update practice demographic info every 90 days

Keeping up on state laws impacting providers, such as SB 137 helps to ensure that we have support to assist practices with compliance of the changing healthcare landscape.  What is SB 137, and how does it impact providers? Let's jump in:

SB 137 requires commercial health plans and insurers to comply with uniform standards and provide timely updates for their provider directories. SB 137 provides patients with more accurate and complete provider demographic information to help identify which providers are in which insurance networks.

Transparency for patients is key!

What is SB 137, and how does it impact providers? Let's jump in:

SB 137 requires commercial health plans and insurers to comply with uniform standards and provide timely updates for their provider directories. SB 137 provides patients with more accurate and complete provider demographic information to help identify which providers are in which insurance networks.

• Timely Communication with Insurers, and Accuracy of Demographic Information 
• Notify Whether a Provider is Accepting New Patients 
• Respond to Health Plan inquiries to validate the accuracy of your provider information. (Please be advised that Senate Bill 137 allows networks to impose the following penalties for non-compliance: removal from provider directory, delay of payment or reimbursement, or even termination of provider contract.
  

Even if you are located outside of California, you will see a greater emphasis in quarterly updates in Availity, CAQH attestations along with any provider portals with roster maintenance components. 

It goes without saying, you will not want to let any of the moving parts fall off the radar to potentially cause a disruption in network participation.  You can learn more about our credentialing maintenance services on our service page!