Directory Information Verification for Providers

Keep your directory information up to date with all your payers


Patients use provider directories—published by your payers—to find information about your organization. For Medicare, Medicaid, and exchange patients, it’s especially important that these directories be accurate and up to date. With the passage of the No Surprises Act, payers must have processes in place to suppress unverified providers from their directories.

The Centers for Medicare and Medicaid Services (CMS) and the department of Health and Human Services (HHS) now require all payers, including commercial health plans, to check with their providers quarterly to make sure their directory information is correct. Every 90 days, each of your payers will ask you to verify your information they have on file,. That means a lot of repetitive work for you.

Until now.

Availity’s Directory Verification app in Availity Essentials lets you update your directory information online, using forms pre-populated with most of your information. You simply verify the information that’s correct, fix what’s wrong, and click the Submit button. Availity automatically sends your updates to payers who are working with us on their directories.

Instead of filling out multiple forms and faxing or emailing them to each health plan, you can make electronic updates right from your daily workflow and then send the edits to every health plan you contract with.

You can also download a report with all your verified information to send to other payers you work with when they ask for your updates.

Keeping your business and physician information current also helps you minimize costly and repetitive work caused by misdirected patient claims, payments, or general calls searching for specific roles within your business. This saves you money and time, and it frees up staff resources to focus on patient care.

The healthcare industry is changing quickly, and providers and health plans need better ways to work together. Availity Provider Data Management is one way we can help ensure providers and health plans get the right information at the right time in the care cycle.


Frequently Asked Questions

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