Covered California removes provider directory, again February 12, 2014 Managed Care Covered California 0 Following numerous complaints from both enrollees and providers, Covered California has removed its provider directory from the exchange website until further notice. "While the combined provider directory was a useful service for many consumers, some enrollees located physicians thought to be in their plan, and subsequently discovered they were not,” exchange staff wrote in a statement, noting that enrollees who relied upon information present in the provider directory should contact their health insurance plan to verify the provider is in the exchange network. CMA is also encouraging patients to contact their physician directly to verify participation in an exchange product. “If enrollees find the resolution unsatisfactory, they can contact Covered California’s Service Center to cancel enrollment in their plan, and enroll in a different plan before the end of open enrollment period, March 31,” exchange staff wrote. The exchange’s provider directory has been a subject of criticism since it was unveiled late last year. After weeks of delays, the online provider directory was launched in early October, only to be removed from the site two days later due to inaccuracies and slow loading times. The directory was relaunched, but then pulled a second time before the end of October. During the directory’s initial debut, the California Medical Association was instrumental in notifying Covered California of multiple errors present within the database. Even in its more recent directories, however, CMA identified more than 300 providers located in states other than California, and as far away as Winnipeg, Canada. With the directory now offline indefinitely, Covered California is asking potential enrollees to locate providers using links to each health insurance plan’s respective provider directories, which are available on the exchange’s website. Meanwhile, California physicians are able to identify which exchange plans are listing them as a participating provider using CMA’s members-only physician participation lookup took. The tool, which is available at www.cmanet.org/exchange-lookup, allows physicians to quickly identify which exchange plans list them as participating physicians. Practices, however, should also take the extra step of verifying participation status with the health plans themselves, as they will have the most updated information. For further information on verifying participation status with the health plans, please refer to CMA’s “Surviving the Second Month of Covered California,” which is available at CMA’s exchange resource center, www.cmanet.org/exchange. Contact: CMA's reimbursement helpline, (888) 401-5911 or economicservices@cmanet.org. Comments are closed.
