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I need My Information Online!

Here's how to get your provider information online

As a provider, having your information listed on an insurance company's website can increase your chances of patients coming to your clinic. Patients search for providers in their area that carry the insurance they have. So, how does a provider's information end up on the website in the first place?

Getting your provider listed on an insurance website involves two main steps: contracting with the insurance company and updating their provider directory. Here's a breakdown of the process:

1. Credential and contract with the insurance company:

2. Update the provider directory:

  • Once your contract is finalized, the insurance company will update its provider directory to include your information. This typically can take anywhere from 14-60 days.

  • Some insurance companies allow you to update your profile information directly online. Check the insurance company's website for instructions on how to do this.

  • Consider joining multiple networks. Being in-network with multiple insurance companies can help you attract more patients.

  • Maintain your insurance provider profile. Make sure to update your information with the insurance company regularly, especially if you change your address, phone number, or accepted insurance plans. This might require a demographic update application to be submitted. 

The importance of maintaining a provider's information

Maintain your NPICAQHUHC, and Availity Profiles. Commercial insurance companies look to your CAQH, NPI, and Availity accounts to keep their profiles up to date. If you have outdated information on those accounts, it can affect the information that's listed with the insurance. UHC has its own provider portal that it uses in addition to NPI, CAQH, and Availity. These sites must be confirmed or attested every 30-180 days, depending on the site.

Even though the insurance companies use multiple sites to keep their records current, providers might still need to submit a demographic update application. Each insurance has its own standards and requirements for maintaining provider information. Each state can also vary on what is needed and how to update information.

If a provider's information is not attested within the specific site limits (each insurance has its own requirements), the site will stop sending the provider's information to the insurance company. If the insurance company doesn't receive a provider's information after a period of time, then the insurance company can potentially end that provider's contract, and thus, the provider will be out of network.

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