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New to Availity? Get Started
 * Solutions
   
    * For Payers
    * For Providers
    * For Vendors
   
    * Payer Solutions Overview
      
      Simplify complex processes and improve payer-provider collaboration.
   
    * Provider Engagement
      
      Streamline workflows and improve engagement.
   
    * Provider Directories
      
      Maintain compliance by capturing provider updates at the source.
   
    * Interoperability
      
      Transform data-sharing capabilities and reduce the cost of care.
   
    * End-to-End Authorizations
      
      Ease prior authorization burdens with AI-driven solutions.
   
    * Digital Correspondence
      
      Reduce print and postage costs and replace manual processes.
   
    * Payment Accuracy
      
      Lower admin costs and prevent revenue leakage.
   
    * Provider Solutions Overview
      
      Streamline workflows, reduce denials, and ensure accurate payments.
   
    * Revenue Cycle Management
      
      Automated solutions covering pre-service, post-service, and
      post-adjudication.
      
      * Eligibility & Coverage
      * Authorizations
      * Claim & Claim Status
      * Denial Prevention & Management
   
    * Vendor Solutions Overview
      
      Seamlessly deliver complete and accurate healthcare information.
   
    * Healthcare Connectivity
      
      Facilitate seamless data exchange via X12, REST, and FHIR APIs.

 * Products
   
    * Availity Essentials
      
      Streamline provider workflows and improve collaboration.
   
    * Availity Essentials Plus
      
      Reach more health plans while streamlining pre-service and billing.
   
    * Availity Essentials Pro
      
      Boost efficiency, prevent denials, expedite payments.
   
    * Availity Fusion
      
      Enhance clinical data quality for optimized downstream workflows.
   
    * Availity AuthAI
      
      Simplify the prior authorization review process.
   
    * EDI Clearinghouse
      
      Connect to health plans nationwide.
   
    * Intelligent Gateway
      
      Seamlessly connect and exchange administrative data.
   
    * API Marketplace
      
      REST and FHIR-based APIs for fast, secure connectivity.
   
    * Provider Data Management
      
      Maintain accurate provider directories.
   
    * Payer-to-Payer Hub
      
      Streamline data exchange to meet mandatory compliance.

 * Insights
   
    * Case Studies
      
      See success stories from our customers.
   
    * Blog
      
      Get the latest industry insights.

 * Resources
   
    * Essentials Registration & Support
      
      Get help registering or using Essentials.
   
    * Training & Education
      
      Learn about our training courses.
   
    * Essentials Payer List
    * Essentials Pro Payer List
    * Supported Systems
    * Preferred Vendors
    * Network Status

 * About
   
    * News & Press
    * Careers
    * Leadership
    * Availity Foundation
    * History
    * Availity India

 * Connect
   
    * Contact Sales
      
      Find the best way to get in touch.
   
    * Customer Support
      
      Get in touch with customer support.
   
    * Locations
      
      See where we're located.
   
    * Events
      
      Learn about upcoming industry events.

 * 
 * Essentials Login
 *  * Solutions
      
      Back
      
      SOLUTIONS
      
       * For Payers
         
         Simplify complex processes and improve payer-provider collaboration.
         
         Back
         
         FOR PAYERS
         
          * Payer Solutions Overview
            
            Simplify complex processes and improve payer-provider collaboration.
         
          * Provider Engagement
            
            Streamline workflows and improve engagement.
         
          * Provider Directories
            
            Maintain compliance by capturing provider updates at the source.
         
          * Interoperability
            
            Transform data-sharing capabilities and reduce the cost of care.
         
          * End-to-End Authorizations
            
            Ease prior authorization burdens with AI-driven solutions.
         
          * Digital Correspondence
            
            Reduce print and postage costs and replace manual processes.
         
          * Payment Accuracy
            
            Lower admin costs and prevent revenue leakage.
      
       * For Providers
         
         Streamline workflows, reduce denials, and ensure accurate payments.
         
         Back
         
         FOR PROVIDERS
         
          * Provider Solutions Overview
            
            Streamline workflows, reduce denials, and ensure accurate payments.
         
          * Revenue Cycle Management
            * Eligibility & Coverage
            * Authorizations
            * Claim & Claim Status
            * Denial Prevention & Management
      
       * For Vendors
         
         Seamlessly deliver complete and accurate healthcare information.
         
         Back
         
         FOR VENDORS
         
          * Vendor Solutions Overview
            
            Seamlessly deliver complete and accurate healthcare information.
         
          * Healthcare Connectivity
            
            Facilitate seamless data exchange via X12, REST, and FHIR APIs.
   
    * Products
      
      Back
      
      PRODUCTS
      
       * Availity Essentials
         
         Streamline provider workflows and improve collaboration.
      
       * Availity Essentials Plus
         
         Reach more health plans while streamlining pre-service and billing.
      
       * Availity Essentials Pro
         
         Boost efficiency, prevent denials, expedite payments.
      
       * Availity Fusion
         
         Enhance clinical data quality for optimized downstream workflows.
      
       * Availity AuthAI
         
         Simplify the prior authorization review process.
      
       * EDI Clearinghouse
         
         Connect to health plans nationwide.
      
       * Intelligent Gateway
         
         Seamlessly connect and exchange administrative data.
      
       * API Marketplace
         
         REST and FHIR-based APIs for fast, secure connectivity.
      
       * Provider Data Management
         
         Maintain accurate provider directories.
      
       * Payer-to-Payer Hub
         
         Streamline data exchange to meet mandatory compliance.
   
    * Insights
      
      Back
      
      INSIGHTS
      
       * Case Studies
         
         See success stories from our customers.
      
       * Blog
         
         Get the latest industry insights.
   
    * Resources
      
      Back
      
      RESOURCES
      
       * Essentials Registration & Support
         
         Get help registering or using Essentials.
      
       * Training & Education
         
         Learn about our training courses.
      
       * Essentials Payer List
       * Essentials Pro Payer List
       * Supported Systems
       * Preferred Vendors
       * Network Status
   
    * About
      
      Back
      
      ABOUT
      
       * News & Press
       * Careers
       * Leadership
       * Availity Foundation
       * History
       * Availity India
   
    * Connect
      
      Back
      
      CONNECT
      
       * Contact Sales
         
         Find the best way to get in touch.
      
       * Customer Support
         
         Get in touch with customer support.
      
       * Locations
         
         See where we're located.
      
       * Events
         
         Learn about upcoming industry events.
   
    * 
    * Essentials Login New to Availity?

Directory Information Verification for Providers
Jump to section
 * FAQs


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 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 automatically to every health plan you contract with that
participates with Availity Provider Data Management (PDM).

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.



New to Availity Essentials?

Register now to get started.

Already using the Availity Essentials?

Log in to verify your information.


FREQUENTLY ASKED QUESTIONS

What can I update in Availity PDM?

The new Provider Data Management tool lets you maintain the following
information:

 * Service locations and hours of operation
 * Providers who join your organization
 * Contact information for physicians and key staff
 * Whether you’re accepting new patients
 * Specialties
 * Languages spoken by physicians and staff
 * Other information that helps payers work with you

Why do I have to do this every 90 days if nothing has changed?

State and federal regulations require your payers to contact you every 90 days
to verify the information they are providing their members via provider
directories. The regulations also give the payer a limited amount of time to
update their directories when you inform them of a change.

Q: Why are provider directories getting so much attention?

Patients use provider directories—published by your payers—to find information
about your organization. An important part of reducing or eliminating surprise
billing for patients is ensuring those directories accurately reflect
specialties and network participation by providers. With the passage of the No
Surprises Act, if you don’t regularly verify your organization’s information, a
payer may choose to exclude it from their directories.

All payers are now required 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.

Q: Why is “Service Location” so important?

The CMS says inaccurate provider directories are a “significant barrier to
care.” Patients need to know where they can schedule appointments and see
doctors who are in-network for their insurance plans. Many people even decide
insurance company and specific network to sign up for based on physician
locations and office hours.

Q: Which phone number should I provide?

Patients need to know what number to call to make an appointment. That’s the
number that should appear first in your payers’ directories.

Availity Provider Data Management app in Availity Essentials also allows you to
enter billing, mailing, and business locations and phone numbers. That
information makes it easier for your payers to contact the right person in your
office when they need information to complete a claim, settle an overpayment, or
conduct other business with you.

Q: Can I share the updates I submit through Availity with other payers?

You can. After you’ve verified all the directory information is correct, you’ll
be able to download an electronic copy of your verified information. You can
email (or print and mail or fax) that information to all your payers who are
requesting verification.

Q: How do I get help if I’m stuck?

If you have technical problems, or need to know more about provider directory
updates, please call Availity Client Services at 1-800-242-4548 from 8:00am to
8:00pm Eastern time.

Q: What is QuickVerify and how am I eligible?

QuickVerify is a way for a provider to confirm that nothing has changed without
requiring them to move the entire verification process. Anyone that has attested
within the past two quarters is eligible for QuickVerify.

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 * Regulatory Compliance
 * Memberships
 * Responsible Disclosure
 * Supplier Code of Conduct
 * Essentials Login

 * © Copyright 2024 Availity, LLC. All rights reserved.
 * Privacy Policy
 * Terms of Use

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Availity is the place where healthcare finds the answers needed to shift focus
back to patient care. By solving the communication challenges between healthcare
stakeholders, Availity creates a richer, more transparent exchange of
information among health plans, providers, and technology partners. As the
nation’s largest health information network, Availity facilitates over 13
billion clinical, administrative, and financial transactions annually. The
company’s suite of dynamic products, built on a powerful, intelligent platform,
enables real-time collaboration for success in a competitive, value-based care
environment.

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