Provider directory accuracy matters.

Make sure to keep your provider/practice information up to date

CMS requires us to regularly contact network providers to confirm the accuracy of our directory information. To maintain appropriate continuity of care for our members, provide 30 days advance notice of any changes to your provider/practice information, including when providers leave your organization.

An accurate health plan provider directory is crucial for several reasons:

• Access to Care: It helps members easily find in-network providers who can best meet their needs, whether based on specialties, reviews, or proximity.
• Cost Management: It reduces the likelihood of paying unexpected out-of-network costs or paying out-of-pocket for uncovered services, controlling costs for the patient and the insurer.
• Legal and Regulatory Compliance: We are required by law to maintain and provide accurate directories or face penalties, fines, or loss of accreditation from regulatory bodies.

How to update your information

• Provider DataPoint: Use our web-based provider data management tool to submit real-time changes (practice info, provider info, add/terminate, credentialing, etc.).
• Visit: https://www.martinspoint.org/For-Providers/Tools/Update-Your-Info.

Tips for practice administrators

• Set a monthly tickler reminder to check info.
• All NPI-related updates and credentialing apps must be submitted online.
• Radiologists, anesthesiologists, and midlevel providers not practicing as PCPs do not require credentialing.
• For more information visit the Provider Demographic Updates section of our Provider Manual.