Be sure to keep your practice name updated in our Find a Doctor tool

To keep our Find a Doctor tool accurate and to meet our requirements as a health plan, we may remove providers who don’t maintain their information with us. This means you may be removed from Find a Doctor if your practice name doesn’t match the name you answer your phone with or if your other data, like locations or hours of operation, are not accurate.

For example, if you answer the phone as “ABC Family Medicine” your name in Find a Doctor should be “ABC Family Medicine.”

Why is this important?

With an accurate directory, we can:

  • Improve the quality of provider data in our directories to help our members—and prospective patients for you—find the care they need.
  • Ensure compliance with provider directory regulatory bodies — The Centers for Medicare and Medicaid Services (CMS) requires us to keep this information up to date.

How to update your practice name

To notify us of a name change, follow these steps 60 days or more before the change takes effect:

  1. Log in to your prism account.
  2. Click on Enrollments & Changes.
  3. Select either Change Individual Provider or Change Provider Organization.
  4. Follow the directions as indicated.
  5. For individual requests, submit a Provider Change Form. For multiple requests, submit a Provider Change Template.

The form must contain:

  • What's changing.
  • The effective date of the change.
  • Entity or tax ID number (EIN or TIN) W-9, as applicable. NPI number and taxonomy designation (specialty type) that you'll be using for billing.
  • If your request is to change the group information for a provider group, include the Type 1 NPIs of the impacted practitioners.

Check the status of your request

Once you submit your request, our team will receive an inquiry. You can check the status of your request and view comments from our team any time in prism by clicking on Enrollments & Changes and selecting the Inquiry ID. When your request is completed, you'll receive a comment from our team. When our team posts a comment, you'll receive an email notification.