Provider Directory (Reminder)
Posted on April 26, 2024
Attention Providers and Practice Managers:
Accurate provider directories are critical to helping our members make educated decisions about their plan choices. Health New England offers an online directory for all products, and hard copies of each directory are available upon request.
In an effort to support the Centers for Medicare & Medicaid Services (CMS), MassHealth, and The National Committee for Quality Assurance (NCQA), and provisions of the Affordable Care Act (ACA), requirements stating that health plans engage providers in reviewing and maintaining up-to-date provider directory information, we reach out to our in-network providers on a quarterly basis to validate information.
To assist us in this endeavor, please review the information that Health New England has published for you in our provider search. We are asking for validation of at least the following information: address, phone number, office hours and availability to new patients. If any of the information that is published is inaccurate, please communicate any updates to us using one of the following ways:
- Visit our Forms library. Click on the ‘Provider’ tab, then ‘Most Used’ and choose the ‘Provider Information Change Form.’
- Email our Provider Enrollment team directly at penrollment@hne.com.
- Log into HNEDirect. Once logged in, click the last tab on the main page titled ‘Change Provider Info.’
In addition, earlier this year, Health New England began enrolling participating providers in a provider directory solution through CAQH ProView®, as part of a provider directory initiative that Health New England, along with other Massachusetts health plans, participates in through HealthCare Administrative Solutions Inc. (HCAS). Health New England is actively working to enroll providers in the CAQH provider directory program. Once enrolled, providers will receive email notifications from the CAQH and will be prompted to review their existing information in CAQH ProView and submit additional details about their practice. The directory program engages providers in reviewing and maintaining up-to-date provider directory information to help ensure Health New England members have access to accurate provider demographic information when seeking health care services.
Providers across all lines of business use CAQH ProView for credentialing with Health New England, and CAQH ProView will now include your provider directory information. Every three months, providers will be prompted to confirm their information, and attest that their data is accurate. If changes or updates are needed, providers may do so at any time and attest that their new data is accurate.
For more information about the provider directory initiative through CAQH, including a brief demonstration video by CAQH regarding how the system works, you may visit HCAS at https://www.hcasma.org/Directory.htm or CAQH at https://proview.caqh.org/Login/.