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.

Why an Accurate Directory Matters

1. Access to Care: It helps members easily find in-network providers who can best meet their needs.
2. Cost Management: It reduces the likelihood of unexpected out-of-network costs for members.
3. Legal and Regulatory Compliance: We are required by law to maintain accurate directories.

How to Update Your Information

Provider DataPoint: Use our web-based provider data management tool to submit real-time changes:

• Change practice information, including name, phone, fax, address, and billing details.
• Add/delete a location for your already-contracted practice/group.
• Update provider information such as specialty, languages spoken, and panel status.
• Add a provider who needs credentialing or terminate a provider from your practice.
• Check the status of a previously submitted data change request.

Visit: Update Your Info. If you have questions, see the instructions on our website or speak to a Provider Representative.

Tips for Practice Administrators

• Set a monthly reminder to check provider/practice information in Provider DataPoint.
• All NPI-related updates and credentialing applications must be submitted online.
• Radiologists, anesthesiologists, and midlevel providers who do not practice as PCPs do not require credentialing.
• For more information, visit the Provider Demographic Updates section of our Provider Manual.