Changes to staff/address/phone

Reporting most provider changes

To notify Priority Health of changes in your address, staff, tax ID number, or if you are opening or closing to new patients, follow these steps: 60 days or more before the change takes effect, complete and print a change notification form.

Provider information form

It must contain:

  • What is 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 will be using for billing
  • If an NPI type 2 change is requested, you must also supply NPI type 1 information 

Our workflow for getting your questions answered

We work hard to process your requests in a timely manner. Existing provider requests inquiring about provider demographic changes without reimbursement changes will be processed within 18 calendar days. Demographic requests that include reimbursement changes will take 25 calendar days to process. 

  • We recognize that every request is unique, and not all workflow steps may be required to complete your request. Below is a diagram that was created to show you what step within the process your request is at in our workflow.

  • After a request is submitted, you’ll receive an initial email, letting you know we’ve received your request and indicating the workflow step your request is in. You’ll also get an inquiry number associated with the request. Keep the inquiry number in a safe place, because it will help us locate your request if you have questions.
  • Following this initial communication, you’ll receive updates from us at each step in the process, letting you know the status of your request, including any action items or additional information we need from you (if applicable).
  • Once your request is complete, you’ll receive a final communication from us.
  • We have created a new email for you to utilize in the event your request has gone over our processing time frames.  The email address is Be sure to include your inquiry number within your status update.

Reporting retirement/termination

At least 90 days prior to your retirement or termination of contract with Priority Health, notify us of the change by completing applicable information on our Provider Information form.