Provider Demographic & Status Update (Insurance)

Outdated provider information can lead to claim delays, denials, and compliance issues with insurance companies.

This service updates a provider’s demographic or status information with insurance payers to ensure records are accurate, current, and aligned with payer requirements.

What’s included

• One provider
• One update type (name, address, contact information, or provider status)
• Submission to one insurance payer
• Confirmation once the update request has been submitted

Insurance payers may include

Medicare, Medicaid, Blue Cross Blue Shield (BCBS), Aetna, Cigna, Carelon Behavioral Health, WellSense Health Plan, Tufts Health Plan, UniCare/Wellpoint, and others.

If updates are required with multiple insurance payers, this service must be purchased separately for each payer.

Important notes

• This service is for demographic and provider status updates only
• It does not include new credentialing, contract negotiations, fee schedule changes, or terminations
• Processing timelines are determined by each insurance company

Medicare disclosure

Medicare requires providers to submit or certify updates through the PECOS system unless online access has been granted. If access has not been granted, this service includes preparation and guidance, and the provider will complete the final submission directly.

A completed Provider Information Update Form and any required documentation (such as a W-9) are required before processing begins.