ExchangeAdministrativeMedium impact
Update and Verify Your Information in Provider Directory Pilot for Qualified Health Plans
BCBS Oklahoma·OK·General
Effective date
Nov 1, 2026
We identified it
Sep 25, 2026
Summary
Beginning November 1, 2026, Blue Cross Blue Shield of Oklahoma will automatically sync provider directory information from the CMS Qualified Health Plan (QHP) directory for marketplace plans. Providers no longer need to separately update their information through Availity, roster submissions, or demographic change forms if they maintain their QHP directory record with 90-day verification cycles and 30-day update protocols.
Action Required
By November 1, 2026: Providers participating in Blue Advantage PPO and MyBlue HMO must ensure they have completed initial validation in the CMS QHP Directory Pilot and establish a maintenance routine. Billing/administrative team should: (1) Log into the QHP Directory Pilot to validate prepopulated information if not yet completed, (2) Update directory information within 30 days of any practice changes (address, phone, credentials, etc.), (3) Verify all directory information every 90 days regardless of changes. Once this routine is established, STOP submitting demographic updates through Availity Essentials, roster submissions, or the Demographic Change Form, as BCBS OK will auto-sync from CMS QHP directory. Failure to maintain QHP directory accuracy may result in outdated provider information across all marketplace plans and potential claim routing issues. Contact CMS Provider Directory Pilot team with questions.