Update Your Info

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Update Staff Contact Information

Want Timely Claim Payments and New Patient Growth?

Always keep your provider directory information up to date! We make it easy!

CMS requires us to regularly contact our network providers to confirm the accuracy of our directory information. Up-to-date directory information helps our members find new providers when they need care and ensures more timely and accurate claims processing.

There are two convenient, online tools you can use to keep your NPI-related practice/provider information accurate:

1. Provider DataPoint: Please use our web-based provider data management tool to submit real-time changes:

  • Change your practice information, including name, phone/fax, address, billing information, NPI, etc.
  • Add/delete a location to your already-contracted practice/group
  • Change provider information, including name, specialty, panel status, add a language, etc.
  • Add a provider who requires credentialing to your practice
  • Terminate a provider from your practice/group
  • Check the status of a previously submitted data change request

Call 1-800-348-9804 to add a new facility (hospital, skilled nursing facility, ambulatory surgical center, etc.). A new participation agreement and/or credentialing application may be required.
 
Fax: 1-207-828-7870
Mail: Martin’s Point Health Care, Network Management Department, PO Box 9746, Portland, ME 04104

 

2. National Plan and Provider Enumeration System (NPPES): CMS now allows providers to use the NPPES to certify their NPI data. Information and FAQs about using NPPES as a reliable source for provider directory data are available at https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/index. Please direct questions about the NPPES to Jeremy Willard at Jeremy.Willard@cms.hhs.gov

Tips for Practice Administrators

  • Create a monthly tickler reminder to check the accuracy of your provider/practice information in Provider DataPoint.
  • We no longer accept NPI-related updates/changes and credentialing applications via email or fax. They must be submitted online via Provider DataPoint.
  • Radiologists, anesthesiologists, and midlevel providers (NP, PA) who do not practice as PCPs do not require credentialing.
  • Please provide 30 days advance notice of changes to your provider/practice information when possible.

Changes that Require Notice

Practice, Group and Facility changes that require notice include, but are not limited to:

  • Practice name
  • Tax identification number*
  • Billing National Provider Indicator (NPI)
  • Address
  • Phone number, fax, or e-mail

Provider changes that require notice include, but are not limited to:

  • Provider information (name, degree, gender)
  • Spoken languages
  • Specialty **
  • Panel status (accepting new patients)
  • Hospital privileges
  • Adding a provider – provider joining practice/group**
  • Provider deletions – provider no longer participating with the practice/group

* Changes in tax ID numbers may require an amendment or new participation agreement depending on the reason for the change. Check with your provider representative for specific information.

** If adding a provider or a specialty, in most cases the provider must first be credentialed before rendering treatment to any plan member. Please see the Credentialing page for further detail.

Mental Health Providers: If you are interested in participating in the Martins Point network or need to make changes to your information, please contact the Behavioral Healthcare Program (BHCP) at 1-800-538-9698. Or, visit their website: https://www.bhcp.org/ProviderServices.aspx to download the BHCP Provider Change Form. 

Group Contact Information
In order to better communicate with your group, Martin’s Point is now collecting contact information for the following roles:

Provider Directory

By updating your information, you are ensuring the accuracy of our provider directory and creating a better experience for our members to search for and find the provider that is right for them. Please help us maintain an accurate provider directory by checking your provider listing for important information like address, phone number, and panel status.

Generations Advantage Directory

USFHP Directory

ROLE COMMUNICATION DESCRIPTION
Administrative Authorization and Referral Updates
Billing Claim and Payment Policy Updates
Clinical Medical Policy Updates
Contracting Contract Notices and Updates
Credentialing Credentialing and Delegation Updates
Executive Performance and Quality Updates
Financial Performance Updates
Population Health  Quality Updates
Practice Manager
General Notice Updates
Provider Data
Requests for Demographic Updates
Reporting
Report Delivery
By providing Martin’s Point with this information, your group will receive important updates and changes in a more timely and effective way.


Questions? Read more in the Provider Manual or Contact Us.