July 10, 2025
Our members and other providers rely on our provider directory for accurate information about your practice. Contracted providers’ directory data must be verified at least every once 90 days, even if it hasn’t changed. This fulfills requirements of Illinois House Bill 5395 (Public Act 103-0650), also known as the Healthcare Protection Act, and the federal Consolidated Appropriations Act of 2021.
To verify your directory information:
- Commercial provider groups: Submit a complete roster every 90 days (at least once every quarter). We’ll call you if we don’t receive a roster.
- Commercial solo professional providers: We encourage you to submit a roster to meet the 90-day verification requirement. It’s the most efficient way to verify all directory information and will help reduce calls to your office for verification purposes.
- Commercial facility and ancillary providers, including labs and dental providers: Verify your directory information every 90 days using the Demographic Change Form.
- HMO Medical Groups or Independent Practice Associations: Continue with your normal process of submitting your complete, updated roster every month rather than every 90 days.
It’s important to complete verification via the roster, Demographic Change Form or by phone outreach to help ensure continued participation in our commercial networks.
When your information changes, update it with:
- Us, including when you join or leave a network
- The CAQH Provider Data Portal; learn more
- The National Provider Identifier Registry if you have an NPI; learn more from the Centers for Medicare & Medicaid Services National Plan and Provider Enumeration System
To help our members access your services, ensure your office staff members, including those at centralized offices:
- Have access to up-to-date information that aligns with information you’ve provided to us
- Can readily relay this information to our members or transfer them to the appropriate resource
Helpful directory information to regularly review includes your practice locations, phone number, specialty, appointment availability for new patients and in-network participation.
For more information: Refer to verify and update your information. If you have questions, contact your Provider Network Consultant.