Information Change Request

Verify and Update Your Information

When seeking health care services, our members often rely upon the information in our online  Provider Finder^®. Beginning Jan. 1, 2022, the federal Consolidated Appropriations Act (CAA) of 2021 requires that certain provider directory information be verified every 90 days.

This means that starting Jan. 1, 2022, you must:

• Verify your name, specialty, address, phone and digital contact information (website) for our provider directory every 90 days, and
• Update your data when it changes, including when you join or leave a network

Under CAA, we’re required to remove providers from our Provider Finder whose data we’re unable to verify.

If you leave a network, you should continue to update your information immediately and according to your contract terms. If you are incorrectly identified as an in-network provider in Provider Finder, it may limit member cost-sharing to in-network levels. Learn more about the CAA.

How to Verify and Update

We recommend professional providers use the Availity^® Provider Data Management feature to quickly verify and update information. If you’re unable to use Availity, you may submit a Demographic Change Form .

Facilities may only use the Demographic Change Form to verify and update data.

We won’t accept demographic changes by email, phone or fax to enable us to meet the two-day directory update requirement defined by the CAA. Any demographic updates requested through these channels will be rejected and closed. Changes must be submitted electronically unless you have otherwise opted out of conducting business with us electronically; in that case, changes will be accepted by U.S. mail.

Changes professional providers can make in the Availity Provider Data Management feature include:

• Personal information and service locations
• Doing Business As (DBA) name
• Payment address change and contact information
• Group address change and contact information
• Hours of operation
• Business website URL

Changes providers and facilities can make with the Demographic Change Form  include:

• Legal Name
• NPI/Tax ID
• Directory information:
  • Office physical address
  • Telephone
  • Fax
  • Email
  • Hours of operation
• Billing contact information
• Credentialing contact information
• Administrative contact information
• Provider roster information (removing a provider from the group or location)

If you have completed a Demographic Change Form, you can check the status of your changes by entering the case number you received in your confirmation email in our Case Status Checker .

Tax ID Termination Request

Contracted providers or groups (excluding Par Agreement) requesting a Tax ID termination from a provider network, please contact the Network Services Department at (800) 567-8540.

Reminder

• You may specify more than one change within your request when all changes relate to the same billing (Type 2) NPI.

For the status of your professional contract application, or if you have questions, or need to make changes to an existing contract, please contact the Network Services Department at (800) 567-8540.