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
- 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.