May 2024
Has your information changed? Let us know!
When seeking health care services, our members often rely upon the information in our online Provider Finder®. Prospective patients can use this online tool to confirm if your practice is a contracted in-network provider for their health care benefit plan. Other providers may use the Provider Finder when referring their patients to your practice.
We encourage you to check your information as it appears in our Provider Finder on a monthly basis.
- Verify your information (name, specialty, address, phone and website URL) for our provider directory every 90 days. This is required by federal law.
- Update your data when it changes, including when you join or leave a network.
- If you leave a network, update your information immediately and according to your contract terms.
See below for reminders and instructions on how to update your data. Updating your data will count as your 90-day verification.
How To Make Demographic Changes
Online options are available for most changes you may need to request.
- Professional Providers – We recommend using the Availity® Essentials Provider Data Management feature to request changes to existing demographic information, such as service location, payment address, business website URL, hours of operation and languages spoken. See our PDM page and user guide for more details. If you’re unable to use Availity, use our Demographic Change Form. You may specify more than one change within your request as long as all changes relate to the same billing (Type 2) National Provider Identifier. As a participating provider, your NPI(s) should already be on file with BCBSIL. If needed, you can request deactivation of an existing NPI.
- Professional Provider Groups – Groups can verify individual providers using the Availity PDM feature or our Demographic Change Form.
- Acute and Ancillary Facilities – Facilities and ancillary providers may use only the Demographic Change Form to verify and update data. See our user guide for more details.
To enable us to meet the two-day directory update requirement defined by the CAA, we won’t accept demographic changes by email, phone or fax. Any demographic updates requested through these channels will be rejected and closed.
For more information, refer to our Verify and Update Your Information page.
Request Addition of Provider to Group
If you need to add a provider to your current contracted group, complete the Provider Onboarding Form. Due to the credentialing requirements, changes aren’t immediate upon submission of this form. The provider being added to the group won’t be considered in-network until they’re appointed into the network.
Other Information Changes
The following types of changes are more complex and require special handling.
- Legal Name Change for Existing Contract – If you’re an existing provider that needs to report a legal name change, complete a new contract application to initiate the update process.*
- Medical Group Change for Multiple Providers – If you’re a group (Billing NPI Type 2) and have more than five changes, please email our Illinois Provider Roster Requests team for a current copy of your roster to initiate your multiple-change request. (Verification reminder: Medical groups who update their provider information by roster can verify all their providers’ information every 90 days by submitting a roster. When you submit a roster, all providers affiliated with this group and not listed with an update are verified as correct with no changes.)
*For status of your professional contract application, application, use the Case Status Checker.
If you have any questions, contact your assigned Provider Network Consultant.
