Covered California Health Plan Network Directory Accuracy August 12, 2015 Covered California Anthem Blue Cross, Blue Shield, Covered California, DMHC, managed care, provider network 0 Last November, the California Department of Managed Health Care (DMHC) released the results of an audit of the Anthem Blue Cross and Blue Shield Covered California networks. Among other things, the audit found that 12.8% of the physicians listed on Anthem’s network were not accepting Covered California patients, while 12.5% were not in practice at the location listed in Anthem’s directory. The audit also found only 56.7% of the physicians listed in Blue Shield's Covered California directory could be verified as accepting Covered California patients. DMHC will be conducting a follow-up of its audit this fall to determine whether the health plans have resolved their inaccurate network directories. SFMS physicians who are misidentified as participating in a network by Anthem or Blue Shield when in fact they are not, or whose information in a network directory is inaccurate, are urged to contact CMA’s Center for Economic Services at (888) 401-5911 or economicservices@cmanet.org. Comments are closed.
