Reminder: Start using PDM capability available on Symphony Provider Directory and Availity Essentials prior to retirement of previous intake channels

As we communicated in October, Availity Essentials Provider Data Management (PDM) and Symphony file-based data exchange are now the two options for care providers to submit demographic change requests, including submitting roster uploads. Availity Essentials PDM and Symphony will replace all current intake channels for demographic change requests and roster submissions as of January 1, 2024. Read the previously published article here.

While there are two options available, providers only need to use one or the other. The Availity Essentials PDM application option is available at no cost to providers, and the Symphony option is a premium service available for an additional cost if providers choose to sign up for it.

If preferred, providers may continue to use the Provider Enrollment application in Availity Essentials to submit requests to add new practitioners under existing groups.

Take action now

Don’t wait until January to start using one of these options. Start using it today to take advantage of the benefits of these options and familiarize yourself with the process before the legacy intake channels retire.

Option one: Availity Essentials PDM application via Availity Essentials (available at no cost to care providers)

The Availity Essentials PDM application allows you the flexibility to request data updates via either one of the following options within Availity Essentials PDM:

• Multi-payer platform option: Allows providers to make updates once and have that information sent to all participating health plans, submitting each change separately.
• Roster upload option: Allows providers to submit multiple updates within one spreadsheet via the Upload Rosters feature:
  • The Upload Roster feature is currently only available, and shared with, Anthem.

Benefits to our care providers using Availity Essentials PDM

The Availity Essentials PDM application will ensure the following:

• Attest and manage current provider demographic information
• Consistently updated data
• Decreased turnaround time for updates
• Compliance with federal and/or state mandates
• Improved data quality through standardization
• Increased provider directory accuracy

Option two: Symphony file-based data exchange (premium service available to care providers for a fee)

As we communicated in February, Anthem is participating with Symphony, California’s centralized platform for provider directory data, led by the nonprofit organization, Integrated Healthcare Association. Providers can choose to work directly with Symphony for file-based data exchange and for multi-plan data submission, attestation, and reporting. Symphony benefits medical groups by reducing administrative burden, improving data quality, and supporting compliance. Contact the Symphony team here if you are interested in learning more.

Benefits to our care providers using Symphony:

• Submit and attest to data for many health plans at one time with 17 health plans currently participating.
• Improve data quality through standardization and reports that highlight data discrepancies.
• Comply with federal and/or state mandates as well as with health plan requirements.
• Partner with Symphony Client Success team members who advocate for each Symphony participant’s unique needs.

Want to submit a roster using Availity Essentials PDM?

Now you can. Roster Automation is the new technology solution designed to streamline and automate provider data additions, changes, and terminations that are submitted using a standardized Microsoft Excel submission. Any provider, whether an individual provider/practitioner, group, or facility, can use Roster Automation today:*

1. Use the Roster Automation Standard Template:
   • For your convenience, there is a standard roster Excel document. Find it online here.
2. Follow the Roster Automation Rules of Engagement:
   • This reference document is available to ensure error-free submissions, driving accurate and more timely updates through automation. Find it online here.
   • More detailed instructions on formatting and submission requirements can also be found on the first tab of the Roster Automation Standard Template (User Reference Guide).
3. Upload your completed roster via the Availity Essentials PDM application.

What about the previous methods by which I have been submitting information?

While we are in the process of sunsetting our legacy intake channels, we will continue to process submissions received through current intake channels until December 31, 2023. Effective January 1, 2024, all PDM requests, including rosters, must be submitted via Availity Essentials PDM or Symphony. As of this date, all provider demographic change requests, including rosters, will be rejected if submitted through any format/channel other than Availity Essentials PDM or Symphony. Again, if preferred, providers may continue to use the Provider Enrollment application in Availity Essentials to submit requests to add new practitioners under existing groups.

How to access the Availity Essentials PDM application

Log onto Availity.com and select My Providers > Provider Data Management to begin the attestation process. If submitting a roster, find the TIN/business name for which you want to verify and update information. Before you select the TIN/business name, select the three-bar menu option on the right side of the window, and select Upload Rosters (see screen shot below) and follow the prompts.

Availity administrators will automatically be granted access to PDM. Additional staff may be given access to PDM by you Availity administrator. To find your Availity administrator, go to My Account Dashboard > My Account > Organization(s) > Administrator Information.

Training is available:

• Availity Essentials PDM application specific training:
  • An Availity Essentials account is required for accessing these training options. If not registered yet, see information below for registration details:
    • Learn about and attend one of our live webinars by visiting here.
    • Note: You must log in to Availity Essentials first. Then, select the link.
    • View the Availity Essentials PDM quick start guide by visiting here.
      Note: You must log in to Availity Essentials first. Then, select the link.

• Roster Automation Template and Rules of Engagement specific training:
  • Thursday, November 16, 4-5pm ET — Register November 16, 2023.
  • Wednesday, November 29, 4-5pm ET — Register November 29, 2023.
  • Wednesday, December 6, 4-5pm ET — Register December 6, 2023.
  • Tuesday, December 12, 11-12pm ET — Register December 12, 2023.
  • Monday, December 18, 4-5pm — Register December 18, 2023.

Space is limited — Register today!

Not registered for Availity yet?

If you aren’t registered to use Availity Essentials, signing up is easy and 100% secure. There is no cost for your providers to register or to use any of our digital applications. Start by logging into Availity.com and selecting the Register icon at the top of the home screen, or you can use this link to access the registration page.

If you have questions regarding registration, reach out to Availity Client Services at 800‑AVAILITY (800-282-4548).

Start using Availity Essentials PDM today to improve your PDM experience.

Exclusions

Behavioral health providers assigned to Carelon Behavioral Health, Inc. will continue to follow the process for demographic requests and/or roster submissions, as outlined by Carelon Behavioral Health.

* If any roster data updates require credentialing, your submission will be routed appropriately for further action.