Verify and Update Your Information

Verify your name, address, phone, specialty and digital contact information (website) every 90 days. It must be verified every 90 days even if your data hasn’t changed since you last verified it.

If you leave a network, 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. 

Professional providers: We recommend using the Availity^® Essentials Provider Data Management (PDM) feature to quickly verify your information with us and other insurers every 90 days. See our PDM page and user guide for more details.

If you’re unable to use Availity, use our Demographic Change Form. See our user guide  on how to verify your data using this form.

Professional provider groups can verify individual providers through the Availity PDM feature or our Demographic Change Form.

Professional provider groups who submit changes by roster can verify all their providers’ information every 90 days with their roster. When a group submits a roster, all providers affiliated with this group and not listed with an update are verified as correct with no changes.

Facilities may only use the Demographic Change Form to verify and update data. See our user guide on how to verify information using the form.

If you need to change your data, follow the instructions below. Updating your data will count as your 90-day verification. 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.

Note: To request to add an additional location or make a change(s) to a Roster Group, please use the Provider Onboarding Form.

Professional providers may update some data using the Availity PDM feature, including:

• Personal information
• Service location address change
• Payment address change and contact information
• Hours of operation
• Business website URL

Providers and facilities may continue to use the Demographic Change Form to update data, including:

• Legal name
• NPI/tax ID
  • Used for corrections only
  • Cannot be used for a new NPI/Tax ID 
    • New NPI/Tax ID numbers must use the Provider Onboarding Form
    • Exception for Tax ID updates – this form can be used if you are a solo provider changing from your SSN to TIN due to the Machine-Readable Files which is part of the CAA Final Rules.  This information must be noted on the tin change request.
• 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)

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

To receive the monthly Blue Review provider newsletter, include your email address when filling out the Demographic Change Form.

For the status of your professional contract application, questions, or if you need to make changes to an existing contract, please contact our Provider Network Representatives.