Facility and professional provider maintenance tool

Quick reference guide

What are the provider maintenance tools?

Professional, facility, and ancillary providers can review and update information regarding their practice using our online provider maintenance tools. The tool can be used to update addresses and email, add or remove practitioners, change bank account information, update tax identification numbers, and much more.

Why is this important?

The Centers for Medicare & Medicaid Services’ (CMS) Medicare Managed Care Manual (Chapter 4, Section 110) states that we must be notified of changes in status regarding:

• ability to accept new patients.
• street address.
• telephone number.
• any other changes that affect availability to patients.

In turn, we are responsible for making updates to our provider directory within 30 days of the change to meet CMS requirements for timely information to members.

Where are the provider maintenance tools located?

Whenever providers experience a change, an online request should be submitted immediately using the following process:

1. Access our Payer Space (Availity).
2. Select either the facility (facilities and ancillary providers) or provider (professional providers) maintenance application.
3. Select the provider’s tax ID number.
4. Review the information listed and update as needed to maintain an accurate profile and meet CMS guidelines for timely information to members.
5. Click submit to complete your change request. Within five minutes, the system will return a confirmation email.