Availity Essentials PDM application is now the intake channel for all provider demographic change requests, including roster uploads

As we communicated in October, November, and December 2023, Availity Essentials Provider Data Management (PDM) is now the intake application for care providers to submit demographic change requests, including submitting roster uploads. Availity Essentials PDM will replace all previous intake channels for demographic change requests and roster submissions as of January 1, 2024.

New group/professional contract requests and provider additions to an existing group/professional contract must be submitted through the Provider Enrollment application in Availity Essentials.

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. Note: You must log in to Availity Essentials first. Then, select the link:
• Learn about and attend one of our live webinars here.
• View the Availity Essentials PDM quick start guide here.

Roster Automation Template and Rules of Engagement specific training:

• If you missed one of our trainings throughout November and December 2023, register and listen to a recording here.

Benefits to our care providers using Availity Essentials PDM

The benefits of the Availity Essentials PDM application include the following:

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

Choice and flexibility to select the option that works best for you

Request data updates via either of the following options with 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.

Want to submit a roster using Availity Essentials PDM?

Now you can. Roster Automation is our 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.

How to access the Availity Essentials PDM application

Log on to 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 Provider Data Management by your Availity administrator. To find your Availity administrator, go to My Account Dashboard > My Account > Organization(s) > Administrator Information.

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 New to Availity? Get Started at the top of the home screen to access the registration page.

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

As a reminder, providers are responsible for the accuracy of the data they submit as well as submitting updates timely. If submitted updates or untimely updates result in claim denials or rejections, denials will stand.

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.
• Any specific state mandates or requirements for provider demographic updates

We are focused on reducing administrative burdens, so you can do what you do best – care for our members.

* If any record requires credentialing, that record will be rejected and must follow the Provider Enrollment application process.