It is critically important for us to have accurate and current information on file to ensure our members can locate you in our provider directories and contact you for timely access to care. It is also a requirement for compliance with the Centers for Medicare & Medicaid Services (CMS), the Affordable Care Act (ACA) and your agreement as a network provider for Asuris patients. View the CMS memo (PDF) regarding these requirements.
Providers whose contract status has lapsed more than 30 days will be required to resubmit an initial credentialing application. Not having an active practice location is considered a lapse.
We require that you verify the information about your practice and the networks you participate in at least every 30 days, following these steps:
- Visit Find a doctor from any page on our website.
- Type the provider's last name, first name in the search field.
- Verify demographic information for each location.
- Verify whether the provider is accepting new patients or offering telehealth services at each location. If you are a behavioral health provider, please verify your areas of focus.
- Confirm that patients may make appointments to be seen at each location listed for that provider.
Select the link for Networks Accepted to verify which networks apply for each provider at each location. You may need to review multiple types of networks (medical, dental or Medicare).
If your information is correct, you do not need to do anything else at this time.
Please let us know immediately if anything is incorrect or has changed (such as the provider networks you participate in, your phone number or address) by completing a Provider Information Update Form.
Contact your provider experience representative directly to let us know about any of the following changes:
- Closing a practice
- Changing organization ownership
Terminating a network affiliation for any reason
Submit the form for changes other than those listed above, including:
- Phone number
- Organization's address
- Accepting new patients
- Offering telehealth services
- eContracting email address
- Practice data validation email address
- National Provider Identifier (NPI) number
- Providers joining or leaving your clinic or practice
Changing your tax ID number (include a copy of your 147c letter from the IRS)
If your clinic or facility emails monthly provider rosters to us, please submit changes, corrections, additions or terminations immediately so that we can update the information that is displayed in our online directories as soon as possible. Your roster must be reviewed and validated in its entirety at least once per quarter and you must reply to any requests for roster review.
We routinely audit the information in our provider database. Please be sure to respond to any requests from us for validation of your provider directory information. Even if the information we have is accurate, we need your response for confirmation.
Regulatory agencies, CMS and other entities may also audit our provider directory accuracy by contacting your office. Please designate a staff member to respond to these requests. It is critical that the responder is informed and aware of what networks you participate in, and can confirm whether you are accepting new patients or not.
CMS can fine insurers up to $25,000 per beneficiary for errors in Medicare Advantage plan directories and up to $100 per member for errors in plans sold on federally run insurance exchanges.