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CMS Audits to Validate Directory Information

As part of their efforts to drive industry improvement in directory accuracy, The Centers for Medicare & Medicaid Services (CMS) conducts audits of online directory information.

CMS audits consist of reviewers placing calls to provider offices to verify the accuracy of the information listed in our provider directory. If you’re practice is called, the reviewer will ask you the following questions, in the following order, to help them determine the accuracy of the information displayed in our directory.

  1. Does the provider see patients at this location?

  2. Does the provider accept the Medicare Advantage Prescription Drug (MA-PD) plan at this location?

  3. Does the provider accept (or not accept) new patients who have this MA-PD plan?
    (The provider directory is considered accurate if it correctly indicates if the provider is or is not accepting new patients)

  4. Is the provider a PCP, cardiologist, oncologist or ophthalmologist?

  5. Is the address correct (including the suite number, floor number and building number)?

  6. Is the phone number listed correct?
    (The numbers displayed should be the number a patient would call to schedule an appointment for the practitioners at this location)

  7. Is the provider’s name correct?

  8. Is the practice name correct?

Thank you for helping us ensure that the practitioner and practice information we display is current and accurate. Please review your information in our Doctor & Hospital Finder today and convey those demographic updates to us immediately.