Updating Your Directory Information

CAQH

The easiest way to ensure that practitioner information is current, accurate and complete is to use CAQH ProView™.

Using CAQH ProView eliminates the need for you to share the same professional and practice information with all the health insurance plans with which you work. Simply create and maintain a single CAQH Proview profile – at no cost to you – and grant access to organizations you select for purposes of claims administration, credentialing and directory services.

  1. Review your current information in the Provider Directory Snapshot

  2. Make updates to your information and affiliations, as appropriate, paying specific attention to:
  • The office locations at which you practice
  • If you're currently accepting new patients
  • Degree(s) earned
  • Specialty
  • Email address
  • Gender
  • Hospital Affiliation(s)
  • Language(s) spoken
  • Phone number(s)
  • Fax number(s)
  • NPI information
  1. Re-attest that this information is current, accurate and complete and that it may be included in files and published in directories for the health plans you designate.

Thoroughly review the information within your CAQH Provider Directory Snapshot before you re-attest that your information is current, accurate and complete and that it may be included in files and published in directories for the health plans you designate.

Information omitted from your CAQH ProView profile might result in our making changes to your Horizon BCBSNJ provider file. For example, if you re-attest that your CAQH information is current, accurate and complete, but your CAQH ProView profile only includes three of the five locations at which you practice, Horizon BCBSNJ will remove your affiliations at those omitted locations.

If you do not have access to CAQH, you may also request changes to your provider file by:

  • Completing a copy of our Provider File Change Form, or
  • Explain your provider file change request on your practice letterhead

These file change requests may be submitted to us by email to EnterprisePDM@HorizonBlue.com or by mail to:

Horizon BCBSNJ
3 Penn Plaza East, PP-14C
Newark, NJ 07105-2200