You May Receive a Call from BCBSIL to Verify Directory Information
Illinois Chiropractic Society (ICS) members should be aware that Blue Cross and Blue Shield of Illinois (BCBSIL) has announced it will be conducting provider directory audits in the coming months, as required by the Illinois Health Care Access and Protection Act (IHCPA). You can view BCBSIL’s announcement here.
Why is This Happening?
The IHCPA (Public Act 102-0904) requires health insurers in Illinois to maintain accurate and up-to-date directories of healthcare providers. The law specifically requires the following: “At least once every 90 days, the issuer shall self-audit each network plan’s provider directories for accuracy, make any corrections necessary.”
Advertisement
As part of this process, BCBSIL (or a vendor working on their behalf) may call or otherwise contact your office to verify certain details about your practice.
What Information Will They Ask For?
According to BCBSIL, the information they may request for verification includes:
- Provider name
- Gender
- Phone number
- Practice locations
- Board certifications (if applicable)
- If you are accepting new patients
- Provider specialty
- Languages spoken other than English (if applicable)
- Website address
- Telehealth offerings (including modality and service options)
- Hospital, medical group, or facility affiliations (if applicable)
Other information that may potentially be requested according to the new law:
- Patient population served (i.e., pediatric, adult, elderly, or women), if applicable
- National Provider Identifier (NPI)
Reminder: While BCBSIL has not indicated they will be asking for your National Provider Identifier (NPI) during these calls, it is important to remember that your NPI is public information. NPIs are published by the federal government and widely available through the National Plan & Provider Enumeration System (NPPES).
ICS Understands Your Concerns
We understand that, given the current environment of phishing attempts and scam phone calls, it can feel risky to provide information over the phone to an unsolicited caller.
We share your concern and encourage all members to use caution. However, the information BCBSIL has indicated they will request is limited to public or directory-type information — details that are commonly available to patients and the public.
If anyone calling claims to be from BCBSIL (or a vendor working for them) and asks for any of the following information, STOP the communication immediately and notify ICS so we are aware of requests for:
- Social Security Numbers
- Bank account or credit card information
- Login credentials or passwords
- Private patient information
- Any other personally identifiable information not included in the “What Information Will They Ask For?” section above
Other Networks and Insurance Companies
Directory audits like these are now required by Illinois law, and health plans are obligated to conduct them. Failure to verify your information could result in removal from an insurer’s directory, which could impact patient access and referrals.
Lastly, since the requirement applies to all health plans, we anticipate other insurers will perform similar audits of their network directories. Ultimately, the law will benefit patients and physicians alike by ensuring directory information is accurate and up-to-date.
