Provider Maintenance Form (PMF) enhancement

In an effort to improve the process for submitting a demographic change request for multiple providers such as change of address/termination etc., we have enhanced the PMF to allow for the usage of an excel spreadsheet. Please submit one PMF with an excel spreadsheet indicating all provider names and demographic information including a comments column noting the action(s) needed for each provider along with the appropriate effective date. Reminder, please notify us at least 30 days prior of any provider demographic and/or practice changes. For notices of termination from our network, refer to the termination clause in your Agreement for specific notification requirements.